2.1 = | 1.751 Cit. to date |
842 Docs. to date |
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Abra Guo, Hooman Bakhshi, James O'Hara, Leonard Genovese, Adam Fein, Alireza Maghsoudi, Chirag Sandesara
2021-08-02
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Hypoplastic coronary artery disease is a rare congenital anomaly that may present with ischaemic heart disease, heart failure or sudden cardiac death (SCD). We describe a case of cardiac arrest in a healthy young man. Work-up revealed a hypoplastic left anterior descending artery. The patient underwent cardioverter-defibrillator implantation for secondary prevention.
Amr Abdin
2014-11-11
Views: 922
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PDF: 328
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Final revision: 0
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A 74-year-old man presented to our Emergency Department with acute dyspnoea. His electrocardiogram showed atrial flutter with 2:1 block and a rate of 150 bpm. Initial investigations revealed a D-dimer level of 6.01 mg/dl. Based on the patient’s complaints and the high D-dimer level, computed tomography pulmonary angiography was immediately performed. This showed no evidence of pulmonary embolism, but there were pneumatic changes in the right upper lung lobe. Antibiotics treatment was started with pipracillin/tazobactam, after which the patient’s condition improved. However, on the third day after admission he developed acute dyspnoea, diaphoresis and cardiopulmonary instability immediately after defecation. To promptly confirm our clinical suspicion of pulmonary embolism, a transthoracic echocardiography was carried out. This demonstrated a worm-like, mobile mass in the right heart. The right ventricle was enlarged, and paradoxical septal motion was present, indicating right ventricular pressure overload. The systolic tricuspid valvular gradient was 56 mmHg. The patient was treated with thrombolysis. His condition was greatly clinically improved after 3 hours. After 10 days of hospitalization, the patient was discharged.
Jason Kuniyoshi, Maggie Kwock, Krixie Silangcruz, Witina Techasatian, Yoshito Nishimura
2023-03-18
Views: 351
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Introduction: While T-wave inversions (TWI) are associated with various pathologies, they are rarely associated with cardiac memory, termed the Chatterjee phenomenon.
Case: A 76-year-old man with sick sinus syndrome with a pacemaker presented with chest tightness and new onset TWI in his precordial leads. On admission, he tested positive for COVID-19, but remained stable and only required minimal supplemental oxygen. His troponin was only slightly elevated, and EKG showed TWI throughout his precordial leads. A previous EKG had shown normal sinus rhythm without a paced rhythm or ST wave abnormalities. Interrogation of his pacemaker revealed an AV-paced rhythm. Given his chest tightness without dynamic changes in his troponin or EKG, the symptoms were considered more likely related to his COVID-19 infection, and he was discharged home.
Discussion: Aberrancies in normal cardiac conduction can result in altered electrical activation, especially for those with AV pacemakers, leading some patients to develop cardiac memory, manifesting as TWI.
Conclusion: AV-paced rhythm and narrow QRS complexes with TWI localized to precordial leads without evidence of active cardiac ischaemia may suggest cardiac memory, termed the Chatterjee phenomenon, requiring no invasive interventions.
Camila Marchi Blatt, Rafaela Vianna Magalhães, João Vitor Soares Cruz, Larissa Nunes, Gibran Avelino Frandoloso, Gabriel Savogin Andraus, Rebecca Saray Marchesini Stival
2022-09-06
Views: 445
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Takotsubo syndrome is known for its association with psychological stress factors. Rarely, it is associated with invasive procedures. We present a case of Takotsubo induced by bronchoscopy, a procedure with a low rate of complications.
Christopher Balfe, Cormac O'Connor, Gerard Giblin, Kevin Walsh, Ivan Casserly, David Moore, Vincent Maher
2020-11-04
Views: 758
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This case report describes a young female Caucasian patient with newly presenting severe mitral stenosis at the peak of the coronavirus pandemic in the Republic of Ireland.
The initial presumptive diagnosis was of severe coronavirus illness. This case report highlights the importance of keeping an open mind to alternative diagnoses and examines some of the challenges in the diagnosis and management of a rare condition in the pandemic environment.
This patient gained 10 kg of weight within 6 weeks of percutaneous balloon mitral valvuloplasty, highlighting the contribution of cardiac cachexia to her low body weight and demonstrating the exceptional benefit that this treatment can offer to patients.
Muhammad Umer Riaz Gondal, John Lemoine, Jared Segal, Zainab Kiyani, Muhammad Ibraiz Bilal, Fawwad Ansari, Brian McCauley
2024-03-21
Views: 224
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Introduction: Combination-based adjuvant chemotherapy utilising capecitabine and oxaliplatin is widely used in gastric cancer treatment. Rare but severe cardiac events such as prolonged QT, cardiac arrest and cardiogenic shock can result from their use.
Case description: A 45-year-old female with gastric adenocarcinoma was started on capecitabine-oxaliplatin chemotherapy one week before presenting to the emergency department with weakness. Blood pressure was 78/56 mmHg, heart rate 140 bpm and oxygen saturation 85%. She became unresponsive with pulseless ventricular fibrillation; CPR was initiated with immediate intubation. She received two shocks with a return of spontaneous circulation. Laboratory tests revealed serum potassium (3.1 mmol/l), magnesium (1.1 mg/dl) and troponin (0.46 ng/ml). An EKG revealed sinus tachycardia with a prolonged QT interval (556 ms). The combined effects of capecitabine, oxaliplatin and electrolyte abnormalities likely contributed to the QT prolongation. An echocardiogram demonstrated an ejection fraction of 10%–15%. An emergent right-heart catheterisation showed right atrial pressure of 10 mmHg and pulmonary artery pressure of 30/18 mmHg; cardiac output and index were not recorded. An intra-aortic balloon pump was placed, and she was admitted to the ICU for cardiogenic shock requiring norepinephrine, vasopressin and dobutamine. A repeat echocardiogram showed a significantly improved ejection fraction of 65%, and she was discharged.
Discussion: Capecitabine and oxaliplatin cardiotoxicity is an exceedingly rare occurrence, with both drugs reported to cause QT prolongation.
Conclusion: Healthcare providers must recognise the QT prolongation effects of capecitabine and oxaliplatin, leading to life-threatening cardiac arrhythmias.
Abbie Evans, Juthipong Benjanuwattra , Barbara Mora, Mahmoud Abdelnabi
2023-02-28
Views: 1085
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Acute myocarditis is a well-recognized condition attributable to a variety of viral illnesses. Common viral aetiologies include enteroviruses including coxsackie, adenovirus, influenza, echovirus, parvovirus B19 and herpesvirus. A high index of suspicion, early diagnosis, and prompt management with supportive anti-failure measures, and in selected cases immunosuppressive therapies including high-dose steroids, might be considered for better outcomes. The authors report a case of sudden onset of acute heart failure complicated by cardiogenic shock caused by viral myocarditis in a patient who initially presented with norovirus gastroenteritis. She had no previous cardiac history or significant cardiovascular risk factors. Prompt medical management for cardiogenic shock for norovirus-induced myocarditis was started, her symptoms gradually improved, and she was discharged safely on regular follow-up.
Nouraldeen Manasrah, Chandima J Herath, Ali Al Sbihi, Sarah Alqasem, Andrew S Kao, Ahmed J Chaudhary, Rana Ismail
2022-03-28
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Obesity has become a major public health problem with increased prevalence. It is associated with cardiovascular mortality. Phentermine is approved for short-term obesity treatment in conjunction with lifestyle modifications. Palpitation is a well-documented side effect of phentermine. However atrial fibrillation (AF) is rarely reported. We present a case of new-onset AF in a healthy woman who was recently started on phentermine for weight loss.
Catarina Lameiras, Ana Corte-Real, Ana Órfão, Marta Mendes Lopes, Maria do Céu Dória
2021-02-08
Views: 815
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Kounis syndrome (KS) is defined as acute coronary syndrome (ACS) triggered by mast cell and platelet activation in the setting of allergic or anaphylactic insults. KS is a unique and complex cause of ACS and many cases may be missed due to its highly variable clinical manifestations. In this report, we present a case of KS type I triggered by metamizole in the absence of a previous history of allergy to this drug. Following the administration of metamizole, the patient developed generalized acute urticaria, chest pain and diaphoresis. Electrocardiography (ECG) showed ST-segment elevation suggestive of myocardial infarction complicated by ventricular tachycardia. No coronary disease was observed on coronary angiography. The cardiac manifestations of KS may be life-threatening, and so it is important to appropriately recognize and treat this condition.
Napohn Chongprasertpon, Santhosh David
2020-06-29
Views: 826
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We describe a case of coronary artery embolism leading to an out-of-hospital cardiac arrest (OHCA) in which the diagnosis was achieved with utilisation of cardiac magnetic resonance imaging. The patient was otherwise well prior to this episode. Emergency diagnostic coronary angiography revealed patent arteries with TIMI 3 flow. Subsequent cardiac magnetic resonance imaging demonstrated myocardial infarction and focal microvascular obstruction in the infarcted territory. This report describes an uncommon case presentation, highlights areas for improvement in diagnostic criteria, and briefly discusses the currently available data regarding coronary artery embolism.
2.1 = | 1.751 Cit. to date |
842 Docs. to date |
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