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Case Reports in Cardiology

S Serge Barold, Scott Upton
This report describes the occurrence of asymptomatic hyperkalemia induced by the sequential administration of metoprolol and carvedilol in an 81-year-old man with type II diabetes and stable stage III renal insufficiency. The potassium level rose to 5.6-5.7 mEq/L with metoprolol and normalized when the agent was discontinued. However, the potassium level rose again to 5.6 mEq/L after the administration of carvedilol but the level normalized by halving the dose. The observations of hyperkalemia induced by two different β -blocker drugs in the same patient confirm that this side effect is common to all β -blocker drugs...
2018: Case Reports in Cardiology
Sebhat Erqou, Robert L Kormos, Norman C Wang, Dennis M McNamara, Raveen Bazaz
There is an increasing prevalence of patients with concomitant implantable cardioverter-defibrillators (ICDs) and left ventricular devices (LVADs). The potential for negative interactions between these continually evolving technologies is a valid concern. Previously reported interactions include inappropriate ICD therapy and interference with ICD telemetry function. Understanding the nature of such interactions and developing a comprehensive strategy to approach such situations are important. In this report, we describe a case of electromagnetic interference from LVAD inhibiting the pacing function of an ICD that was corrected by reprograming the device...
2018: Case Reports in Cardiology
Daria Yunina, Dikshya Sharma, Richard Fazio, Hossam Amin, Yuriy Tsirlin, Vijay Shetty
Congestive heart failure (CHF) is a chronic disease process affecting multiple organ systems and is associated with significant morbidity and mortality. We report a case of a 43-year-old male with a history of unspecified cardiomyopathy who presented to the hospital with abdominal pain, distention, and nausea for 4 months. He was diagnosed with left ventricular noncompaction and gastroparesis. While symptoms of dyspnea, orthopnea, or increasing peripheral edema are the first that come to mind when thinking of a CHF exacerbation, we must broaden our scope to include such things as nausea, vomiting, abdominal pain, and bloating which can also indicate worsening cardiac function...
2018: Case Reports in Cardiology
Wadie David, Narmeen Rehman, Robby Singh, Shukri David
Primary cardiac tumors are extremely rare and are difficult to diagnose. Although usually benign in nature, myxomas require surgical resection due to their increased risk of embolic and cardiac complications, with the timing of resection dependent on the presentation and size of the tumor. However, if diagnosed early, patients with primary benign cardiac tumors have excellent prognosis following surgery. Therefore, a high index of suspicion and a wide differential diagnosis are very important in detecting rare conditions that can affect otherwise healthy individuals...
2018: Case Reports in Cardiology
Khurram Butt, Ranjeet Kumar, Jason D'Souza, Joseph Limback, Rajesh Shah, Jeremy Burt
Fungal infection of prosthetic heart valves is rare and can lead to severe complications including death. Dematiaceous mold, also known as "black fungi," are an extremely rare cause of endocarditis that usually affect immunocompromised hosts. The infection is usually chronic and can lead to heart failure and embolic complications. These fungi have limited antifungal treatment modalities. We present a rare case of prosthetic aortic valve, root, and graft infection in an immunocompetent host that revealed itself through renal, mesenteric, and cerebral embolic phenomenon...
2018: Case Reports in Cardiology
Pradyumna Agasthi, Hemalatha Narayanasamy, Dan Sorajja, James Slack, Farouk Mookadam
Decitabine is a pyrimidine analogue of nucleoside cytidine, used for the treatment of myelodysplastic syndromes, chronic myelogenous leukemia, and acute myelogenous leukemia. We present a case of cardiomyopathy associated with decitabine used for secondary acute myelogenous leukemia. The patient presented with new heart failure symptoms and an ejection fraction decline.
2018: Case Reports in Cardiology
Sijan Basnet, Priya Rajagopalan, Rashmi Dhital, Biswaraj Tharu
Takotsubo cardiomyopathy is characterized by transient apical ballooning with preserved basal ventricular function triggered by physical or emotional stressors. We present a case of a 75-year-old man referred to our facility for the management of acute myocardial infarction later diagnosed as takotsubo cardiomyopathy. We believe platelet-mediated adrenaline release from massive thrombocytosis might have been the precipitating factor for the pathogenesis of takotsubo cardiomyopathy.
2018: Case Reports in Cardiology
Michelle T Lee, Naddi Marah
About 350,000 cases of out-of-hospital cardiac arrest (OHCA) occur yearly in the United States. Unfortunately, even with treatment from emergency medical service (EMS) staff and hospitalization, only 12% survive past discharge for multiple reasons. Classically, Brugada syndrome (BrS) initially presents as a new syncopal episode in young males without obstructive coronary artery disease (CAD). However, in this case report, a patient who emergently presented with a ST-elevation myocardial infarction (STEMI) challenges the stereotypical presentation...
2018: Case Reports in Cardiology
Masahito Munakata, Yohei Numasawa, Shiro Ishikawa, Takashi Koyama
Percutaneous coronary intervention for left main trifurcation disease is challenging. Although side branch protection techniques such as the jailed balloon technique and jailed Corsair technique are the established methods for treatment of coronary bifurcation lesions, little is known regarding the application and feasibility of these techniques for left main trifurcation disease. We herein describe a 72-year-old man with angina pectoris who was successfully treated with percutaneous coronary stent implantation for a left main trifurcation lesion...
2018: Case Reports in Cardiology
Stephen Tomlinson, John Atherton, Sandhir Prasad
A 24-year-old female with a diagnosis of primary carnitine deficiency, a rare inherited metabolic disorder predominantly described in the paediatric literature that causes cardiomyopathy, presented for evaluation after three months of nonadherence with prescribed carnitine therapy. Initial echocardiography demonstrated severe left ventricular dilation (104 ml/m2 ) (normal < 76 ml/m2 ) with moderate systolic dysfunction (ejection fraction 40%) and severe right ventricular dilation with mild systolic dysfunction...
2018: Case Reports in Cardiology
Anju Adhikari, Adam Hafeez, Alexandra Halalau
Cardiac sarcomas have a high infiltrative and metastatic potential and are often associated with poor prognosis. These tumors are often identified incidentally by thoracic and cardiac imaging. However, when symptomatic, their presentation can differ based on the localized structural effects on the endocardium, myocardium, pericardium, and valves as well as on dynamic effects on the cardiac function. We report a case of a 61-year-old female who presented to the emergency room with recurrent chest pain, fatigue, and chronic anemia...
2018: Case Reports in Cardiology
Gregor Leibundgut, Christian Degen, Florian Riede
This case report describes a quick and safe method to successfully retrieve an undeflatable angioplasty balloon via the transradial access site. The article also presents potential mechanisms of contrast media entrapment and bench tests of guidewire-assisted balloon puncture. After successful stent implantation in the proximal right coronary artery in a 74-year-old female patient referred for acute coronary syndrome, the balloon catheter became undeflatable for an unknown reason. Several attempts to burst the balloon in the guide catheter and the aorta failed...
2018: Case Reports in Cardiology
Amy Mertens, Pratik Dalal, Michael Ashbrook, Ivan Hanson
Traumatic vessel perforation is a potential complication of chronic total occlusion (CTO) percutaneous coronary artery intervention (PCI). A rare consequence of this complication is a coronary-cameral fistula. The management of this condition is not well elucidated. Herein, we present such a case of symptomatic left anterior descending to the right ventricle (LAD-RV) fistula which was treated with coil embolization.
2018: Case Reports in Cardiology
Peter J Kennel, Melvin Parasram, Daniel Lu, Diane Zisa, Samuel Chung, Samuel Freedman, Katherine Knorr, Timothy Donahoe, Steven M Markowitz, Hadi Halazun
We report a case of a 20-year-old man who presented to our institution with a new arrhythmia on a routine EKG. Serial EKG tracings revealed various abnormal rhythms such as episodes of atrial fibrillation, profound first degree AV block, and type I second degree AV block. He was found to have positive serologies for Borrelia burgdorferi . After initiation of antibiotic therapy, the atrial arrhythmias and AV block resolved. Here, we present a case of Lyme carditis presenting with atrial fibrillation, a highly unusual presentation of Lyme carditis...
2018: Case Reports in Cardiology
Kareem Genena, Mir Ali, Donald Christmas, Henry Siu
While acute coronary syndromes most commonly occur secondary to unstable atherosclerotic plaque, coronary aneurysms, also known as coronary artery ectasia (CAE), represent a less common etiology. Whereas coronary atherosclerosis accounts for about 50% of CAE, the remaining 50% are either congenital or secondary to a host of inflammatory and connective tissue disorders, with Kawasaki disease being a well-known association. Patients with CAE have worse outcomes than the general population regardless of the presence of associated atherosclerotic coronary artery disease...
2018: Case Reports in Cardiology
Oreoluwa Oladiran, Salik Nazir
Left ventricular dysfunction is a rare side effect of bevacizumab occurring in 2-4% of cases. We report the case of a 68-year-old woman who presented to the emergency department (ED) with sudden onset of shortness of breath, orthopnea, and paroxysmal nocturnal dyspnea. She was tachypneic and in respiratory distress. Physical examination revealed jugular venous distention, diffuse expiratory wheeze, and bipedal edema. She had been started on bevacizumab for the treatment of hereditary hemorrhagic telangiectasia 1 month prior to presentation...
2018: Case Reports in Cardiology
Yu Yamada, Tomoko Ishizu, Hidekazu Tsuneoka, Yutaka Eki, Hitoshi Horigome
The prognosis of tetralogy of Fallot (TOF) treated only with Blalock-Taussig shunt (BTS) operation is unclear. A woman with TOF underwent classic BTS operation at 10 years of age. Despite no medication, she delivered two children and worked without apparent heart failure. At 72 years of age, she complained of dyspnea on exertion and leg edema. The cardiac angiogram revealed a well-patent BTS and severely stenotic right ventricular outflow tract. Right heart catheterization showed adequately maintained pulmonary blood flow with slight pulmonary arterial hypertension...
2018: Case Reports in Cardiology
Jonathan Sen, Michael Mok, Mark Perrin
Transcatheter aortic valve implantation (TAVI) is an effective intervention for severe aortic stenosis in patients at intermediate or high surgical risk, but damage to the native conduction system such as left bundle branch block (LBBB) may offset its benefits. New onset LBBB is associated with a higher risk of cardiovascular morbidity and mortality. His-bundle pacing (HBP) may be useful to treat TAVI-induced LBBB but has yet to be reported. We present the case of a 76-year-old man with severe symptomatic aortic stenosis treated with TAVI...
2018: Case Reports in Cardiology
Ahmed S Yassin, Ahmed Subahi, Hossam Abubakar, Ahmed Rashed, Mohamed Shokr
Background . Takotsubo cardiomyopathy is associated with increased risk of ventricular arrhythmias, atrial fibrillation, and bradyarrhythmias. However, sinus node dysfunction is relatively infrequent in the setting of takotsubo cardiomyopathy. Case Report . We are reporting a case of a 73-year-old woman with a history of asymptomatic sinus bradycardia who developed sick sinus syndrome complicated by takotsubo cardiomyopathy. Conclusion . Acute symptomatic sick sinus syndrome in patients with preexisting silent sinus node dysfunction can trigger takotsubo cardiomyopathy...
2018: Case Reports in Cardiology
E Fry, J Urbanczyk, J Price, R Digiovanni, M Jepson, D Gantt
Purulent pericarditis is a rare disease in the era of antibiotics, with Streptococcus pyogenes being a possible, though uncommon etiology. Even more uncommon are mycotic aneurysms secondary to group A strep purulent pericarditis and bacteremia. We report a case of an 18-year-old female with a history of strep pharyngitis develop Streptococcus pyogenes purulent pericarditis with subsequent ventricular fibrillation (VF). Following initial stabilization, she ultimately developed a 4.8 cm mycotic aneurysm of the ascending aorta, with resultant compression of the pulmonary trunk and right pulmonary arteries...
2018: Case Reports in Cardiology
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