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Acute Cardiac Care

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https://www.readbyqxmd.com/read/27869561/successful-drug-coated-balloon-angioplasty-and-single-anti-platelet-therapy-to-treat-an-ischaemic-stroke-patient-with-haemorrhage-and-acute-coronary-syndrome
#1
Hee Hwa Ho, Kwang How Mok
A 55-year-old male presented with two challenging problems, i.e. acute coronary syndrome (ACS) and a major bleeding episode. He first presented with ischaemic stroke and was treated with thrombolysis. However this was complicated by haemorrhagic transformation. He subsequently developed ACS with urgent coronary angiography demonstrating a critical stenosis in the proximal left anterior descending artery. Percutaneous coronary intervention (PCI) was deemed necessary but we were mindful of causing bleeding complications from the use of anti-thrombotic therapy...
November 21, 2016: Acute Cardiac Care
https://www.readbyqxmd.com/read/27869560/syncope-seizure-or-both
#2
Paraskevi Koutrolou-Sotiropoulou, Abhijeet Singh, Mason Leeman-Markowski, Eric J Rashba
Ictal asystole (IA) is a rare phenomenon in patients with seizures with an incidence of 0.27-0.4% and has been proposed as a possible mechanism of sudden unexpected death in epilepsy patients (SUDEP). We present a case of a 53-year-old woman who initially presented with episodes of expressive aphasia and was treated with antiepileptic drugs (AEDs). While on therapy she experienced episodes of syncope. During her hospitalization for tapering of AEDs and 24-hour EEG monitoring, the patient developed a seizure followed by sinus bradycardia and an 18-second sinus pause, resulting in loss of consciousness and slowing of cerebral activity...
November 21, 2016: Acute Cardiac Care
https://www.readbyqxmd.com/read/27786543/assessment-of-safety-of-performing-percutaneous-coronary-intervention-after-a-recent-episode-of-gastrointestinal-bleeding
#3
Saima Karim, Sweetheart T Ador-Dionisio, Munira Karim, Mohammad Karim, Sadaf S Khan, Ashish Atreja, Stephen Ellis
BACKGROUND: Little literature exists on the risk of performing coronary intervention (PCI) on patients who have had recent gastrointestinal bleeding (GIB), although bleeding after PCI has been identified as a risk factor for long-term mortality. METHODS: Patients within the Cleveland Clinic PCI database who had acute GIB within 30 days preceding PCI during the same hospitalization (n = 79) were retrospectively compared to those who had PCI without recent GIB (n = 10 979) for mortality and need for revascularization...
October 27, 2016: Acute Cardiac Care
https://www.readbyqxmd.com/read/27759433/emergency-physician-accuracy-in-interpreting-electrocardiograms-with-potential-st-segment-elevation-myocardial-infarction-is-it-enough
#4
Giacomo Veronese, Federico Germini, Stella Ingrassia, Ombretta Cutuli, Valeria Donati, Luca Bonacchini, Maura Marcucci, Andrea Fabbri
BACKGROUND: Electrocardiogram (ECG) interpretation is widely performed by emergency physicians. We aimed to determine the accuracy of interpretation of potential ST-segment elevation myocardial infarction (STEMI) ECGs by emergency physicians. METHODS: Thirty-six ECGs resulted in putative STEMI diagnoses were selected. Participants were asked to focus on whether or not the ECG in question met the diagnostic criteria for an acutely blocked coronary artery causing a STEMI...
October 19, 2016: Acute Cardiac Care
https://www.readbyqxmd.com/read/27754742/coronary-artery-spasm-is-st-elevation-key-for-diagnosis
#5
Pedro A Villablanca, David F Briceno, Anand D Jagannath, Martin Cohen, Robert Pyo
Coronary vasospasm is uncommon during pregnancy and the postpartum period. We present a very rare case of an acute coronary vasospasm in a 36-year-old woman who was two weeks postpartum. The coronary arteriograms showed a coronary vasospasm in the distal left anterior descending and circumflex coronary arteries. Electrocardiogram (ECG) presentation was atypical, with T-wave inversions in leads I, aVL, and V2 to V6. To our knowledge, this is the first case with a well-documented coronary artery vasospasm in a postpartum woman without the classic ST elevation on ECG...
October 18, 2016: Acute Cardiac Care
https://www.readbyqxmd.com/read/27754710/extrinsic-compression-of-left-main-coronary-artery-due-to-dilated-pulmonary-trunk-resulting-in-ischaemic-symptoms
#6
Rohit Bhoil, Shikha Sood, Sabina Bhoil, Anshul Chamail, R G Sood
Left coronary artery compression syndrome is an uncommon entity and characterized by compression of the LMCA in-between the aorta and an enlarged main pulmonary arterial trunk. It is usually associated with a congenital cardiac defect. Cardiac 64-slice MDCT provides a non-invasive and an accurate method for assessing the degree of dynamic LMCA compression throughout the cardiac cycle, its angulation relative to the left sinus of Valsalva and depiction of pulmonary pathology, making it a valuable tool in the workup of patients suspected of left coronary artery compression...
October 18, 2016: Acute Cardiac Care
https://www.readbyqxmd.com/read/27754701/left-ventricular-non-compaction-cardiomyopathy-incidental-diagnosis-after-st-elevation-myocardial-infarction
#7
Jackson J Liang, Eric R Fenstad, Christopher D Janish, Lawrence J Sinak
Left ventricular non-compaction cardiomyopathy is a rare congenital cardiomyopathy, which usually presents early in life but may also manifest into adulthood. We present the case of an elderly woman with left ventricular non-compaction cardiomyopathy, which was discovered incidentally following an ST-elevation myocardial infarction.
October 18, 2016: Acute Cardiac Care
https://www.readbyqxmd.com/read/27736197/spinal-cord-infarction-post-cardiac-arrest-in-stemi-a-potential-complication-of-intra-aortic-balloon-pump-use
#8
Matthew Harris, Grigoris V Karamasis, Shayna Chotai, Kare H Tang, Gerald J Clesham, Paul A Kelly
Intra-aortic balloon pump (IABP) is commonly used as a cardiac assist device in various clinical situations: cardiogenic shock, mechanical complications of acute myocardial infarction, high risk percutaneous coronary interventions, coronary artery bypass graft surgery and refractory unstable angina and ventricular arrhythmias as bridge to therapy. Although current data support its safety, there is limited or no support for its efficacy. We present the case of spinal cord infarction after IABP use in a patient who presented with ST elevation myocardial infarction and cardiac arrest and we discuss the potential mechanism of such a devastating complication...
October 13, 2016: Acute Cardiac Care
https://www.readbyqxmd.com/read/27736160/red-thrombus-like-appearance-of-protruding-calcification-into-the-lumen-of-the-coronary-artery-by-optical-coherence-tomography
#9
Mitsuyasu Terashima, Hideaki Kaneda, Tetsuo Matsubara, Takahiko Suzuki
No abstract text is available yet for this article.
October 13, 2016: Acute Cardiac Care
https://www.readbyqxmd.com/read/27682809/intrathecal-baclofen-withdrawal-a-rare-cause-of-reversible-cardiomyopathy
#10
Stephen O Awuor, Paul M Kitei, Yassir Nawaz, Amy M Ahnert
Baclofen is commonly used to treat spasticity of central etiology. Unfortunately, a potentially lethal withdrawal syndrome can complicate its use. This is especially true when the drug is administered intrathecally. There are very few cases of baclofen withdrawal leading to reversible cardiomyopathy described in the literature. The authors present a patient with a history of chronic intrathecal baclofen use who, in the setting of acute baclofen withdrawal, develops laboratory, electrocardiogram, and echocardiogram abnormalities consistent with cardiomyopathy...
September 28, 2016: Acute Cardiac Care
https://www.readbyqxmd.com/read/27283143/iatrogenic-left-main-coronary-artery-dissection-due-to-pin-hole-balloon-rupture-not-to-be-panicked%C3%A2
#11
Balakumaran Jeyakumaran, Ajay Raj, Bhagya Narayan Pandit, Tarun Kumar, Surender Deora
Iatrogenic left main coronary artery (LMCA) dissection is a rare complication and may have devastating consequences if not immediately intervened. The management includes urgent revascularization mostly with percutaneous coronary intervention (PCI) with bail-out stenting and rarely requires coronary artery bypass graft (CABG) surgery. In clinically and hemodynamically stable patients, a conservative approach may be preferred. Here, we present a rare case of iatrogenic retrograde LMCA dissection due to pin-hole rupture of angioplasty balloon that was managed conservatively...
June 9, 2016: Acute Cardiac Care
https://www.readbyqxmd.com/read/27712143/mayo-registry-for-telemetry-efficacy-in-arrest-mr-tea-study-an-assessment-of-the-effect-of-admission-diagnosis-on-outcomes-from-in-hospital-cardiopulmonary-arrest
#12
David Snipelisky, Jordan Ray, Gautam Matcha, Archana Roy, Brooke Clark, Adrian Dumitrascu, Veronica Bosworth, Anastasia Whitman, Patricia Lewis, Tyler Vadeboncoeur, Fred Kusumoto, M Caroline Burton
INTRODUCTION: Little data exists evaluating how different risk factors influence outcomes following in-hospital arrests. METHODS: A retrospective review of patients that suffered a cardiopulmonary arrest between 1 May 2008 and 30 June 2014 was performed. Patients were stratified into subsets based on cardiac versus non-cardiac reasons for admission. RESULTS: 199 patients met inclusion criteria, of which 138 (69.3%) had a non-cardiac reason for admission and 61 (30...
December 2015: Acute Cardiac Care
https://www.readbyqxmd.com/read/27712142/chronic-obstructive-airway-disease-among-patients-hospitalized-with-acute-heart-failure-clinical-characteristics-precipitating-factors-management-and-outcome-observational-report-from-the-middle-east
#13
Hadi A R Khafaji, Kadhim Sulaiman, Rajvir Singh, Khalid F Alhabib, Nidal Asaad, Alawi Alsheikh-Ali, Mohammed Al-Jarallah, Bassam Bulbanat, Wael Almahmeed, Mustafa Ridha, Nooshin Bazargani, Haitham Amin, Ahmed Al-Motarreb, Husam Al Faleh, Abdelfatah Elasfar, Prashanth Panduranga, Jassim Al Suwaidi
BACKGROUND: The purpose of this study was to report the prevalence, clinical characteristics, contributing factors, management and outcome of patients with chronic obstructive pulmonary disease (COPD) among patients hospitalized with heart failure (HF). METHODS: Data were derived from Gulf Care (Gulf acute heart failure registry), a prospective multicenter study of 5005 consecutive patients hospitalized with acute heart failure during February to November 2012 in seven Middle Eastern countries...
December 2015: Acute Cardiac Care
https://www.readbyqxmd.com/read/27494366/the-potential-of-cystatin-c-to-evaluate-the-prognosis-of-acute-heart-failure-a-comparative-study
#14
Tae-Hun Kim, Hyungseop Kim, In-Cheol Kim
BACKGROUND: The prognosis of acute heart failure (HF) can be determined by cardio-renal function which is assessed by cystatin-C (Cys-C). We evaluated whether Cys-C could be a more useful prognostic indicator in acute HF, compared with uric acid (UA) and N-terminal pro-B-type natriuretic peptide (NT-proBNP). METHODS: Two hundred thirty-two HF patients in the emergency room were studied using measurements of Cys-C, UA, and NT-proBNP. During the follow-up, cardiac events, defined as the composites of recurrent HF or cardiac death, were determined...
December 2015: Acute Cardiac Care
https://www.readbyqxmd.com/read/27494267/a-shift-in-coronary-care-unit-patient-population-ten-year-experience-from-an-urban-tertiary-care-center
#15
Joseph M Krepp, Shrinivas Hebsur, Julio A Panza, Howard A Cooper, Federico M Asch
The need for cardiovascular expertise in the treatment of advanced heart failure (AHF), malignant arrhythmias, and structural heart disease has shifted the role of the CCU to a more diverse and medically complex patient population. This study's purpose was to analyze the temporal trends in the principal diagnosis leading to admission to the CCU in a tertiary referral hospital. Over the last 15 years, the CCU has evolved from a medical unit strictly focusing on the care of patients with ACS to an advanced cardiac intensive care unit...
December 2015: Acute Cardiac Care
https://www.readbyqxmd.com/read/27283388/a-local-network-for-extracorporeal-membrane-oxygenation-in-refractory-cardiogenic-shock
#16
Carlotta Sorini Dini, Chiara Lazzeri, Marco Chiostri, Gian Franco Gensini, Serafina Valente
BACKGROUND: Veno-arterial extracorporeal membrane oxygenation (VA ECMO) represents a therapeutic option in patients with refractory cardiogenic shock (RCS). This strategy is limited to a restricted number of centres with capabilities for implanting VA ECMO and management patients on this support. We report on the initial experience of our ECMO referral centre for patients with RCS. METHODS: We retrospectively analysed our ECMO data registry for RCS of 14 patients treated with VA ECMO, consecutively admitted to our intensive cardiac care unit (ICCU), which is an ECMO referral centre...
December 2015: Acute Cardiac Care
https://www.readbyqxmd.com/read/27283269/pulmonary-artery-rupture-with-pseudoaneurysm-formation-secondary-to-swan-ganz-catheter-balloon-inflation
#17
Auras R Atreya, Sonali Arora, Gregory Valania
Pulmonary artery catheters have been extensively used for hemodynamic assessment over the past several decades. We present a case that highlights the management of a known, but rare and catastrophic complication of pulmonary artery catheter based therapy. An elderly lady with acute decompensated heart failure, severe pulmonary hypertension, and atrial fibrillation on anticoagulation had a pulmonary artery catheter inserted for hemodynamic monitoring. Subsequently, the patient developed acute hemoptysis and damped pulmonary artery pressure waveforms during inflation of the catheter tip balloon...
December 2015: Acute Cardiac Care
https://www.readbyqxmd.com/read/25806974/differences-in-undergoing-cardiac-procedures-within-three-months-after-first-myocardial-infarction-by-country-of-birth-in-women-and-men-a-swedish-national-cohort-study
#18
Dong Yang, Stefan James, Ulf De Faire, Lars Alfredsson, Tomas Jernberg, Tahereh Moradi
OBJECTIVE: To examine the relationship between country of birth and the utilization of coronary angiography, percutaneous coronary intervention (PCI) and coronary artery bypass graft (CABG) after a first-time myocardial infarction (MI). DESIGN, SETTING AND PATIENTS: 117,494 MI patients of all ages who were admitted to coronary care units between 2001 and 2009 in Sweden were followed-up for three months after admission. MAIN OUTCOME MEASURES: Undergoing coronary angiography, PCI or CABG after first-time MI...
March 2015: Acute Cardiac Care
https://www.readbyqxmd.com/read/25806830/effects-of-levosimendan-on-heart-failure-in-normotensive-patients-does-loading-dose-matter
#19
Elisabetta Palmerini, Stefan Söderberg, Sergio Mondillo, Roberto Favilli, Stefano Lunghetti
BACKGROUND: Levosimendan is a calcium sensitizer and K(+)-ATP channel opener with inotropic and vasodilatatory effects irrespective of myocardial oxygen consumption, used for treatment of heart failure (HF). A loading dose is usually given by infusion for 12 h; however, profound lowering of blood pressure often disrupts or prolongs the infusion. The aim of this study was to assess clinical, biochemical and myocardial differences between different regimes of levosimendan therapy, with or without loading dose, and compared to standard therapy in heart failure...
March 2015: Acute Cardiac Care
https://www.readbyqxmd.com/read/25738399/spontaneous-pneumomediastinum-pneumopericardium-and-epidural-pneumatosis-insights-on-clinical-management
#20
Casey J Allen, Laura F Teisch, Kenneth D Stahl
Spontaneous pneumomediastinum is a benign condition that has been reported, however the association with epidural pneumatosis is much less common. A 27-year-old male presented with concomitant air in the epidural space, mediastinum and pericardium after illicit drug use and engagement in sexual activity. The patient was hemodynamically stable. Non-invasive tests ruled out aerodigestive injury. The patient was discharged after a short observation without intervention. Invasive and potentially risky diagnostic tests may be safely avoided in patients who remain asymptomatic with this unique presentation...
March 2015: Acute Cardiac Care
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