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Case Reports in Cardiology

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https://www.readbyqxmd.com/read/28638664/torsade-de-pointes-induced-by-hypokalemia-from-imipenem-and-piperacillin
#1
Varun Kumar, Sandeep Khosla, Monica Stancu
Imipenem-cilastatin and piperacillin-tazobactam are two antibiotics with broad antimicrobial coverage. Besides the many well established adverse effects of these drugs, there have been few case reports of hypokalemia. Here we present an interesting case of resistant hypokalemia caused by these drugs leading to Torsades de Pointes which has never been reported in the past. Hypokalemia resolved with discontinuation of piperacillin.
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/28634555/a-rare-case-of-pneumopericardium-in-the-setting-of-tuberculous-constrictive-pericarditis
#2
Lauro L Abrahan Iv, Stephanie Martha O Obillos, Jaime Alfonso M Aherrera, Jose Donato A Magno, Celia Catherine C Uy-Agbayani, Ulysses King G Gopez, Jobelle Joyce Anne R Baldonado
A 28-year-old Filipino male was admitted due to high-grade fevers and dyspnea on a background of chronic cough and weight loss. Due to clinical and echocardiographic signs of cardiac tamponade, emergency pericardiocentesis was performed on his first hospital day. Five days after, chest radiographs showed new pockets of radiolucency within the cardiac shadow, indicative of pneumopericardium. On repeat echo, air microbubbles admixed with loculated effusion were visualized in the anterior pericardial space. Constrictive physiology was also supported by a thickened pericardium, septal bounce, exaggerated respiratory variation in AV valve inflow, and IVC plethora...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/28634554/false-positive-transit-time-flowmetry-graft-failure-in-multivessel-coronary-spasm-following-off-pump-coronary-artery-bypass-grafting
#3
George Kassimis, George Krasopoulos
Intraoperative Transit Time Flowmetry is currently recommended to assess graft patency during coronary artery bypass grafting (CABG), especially in presence of haemodynamic instability or inability to wean the patient from cardiopulmonary bypass, new regional wall motion abnormalities, or significant ventricular arrhythmias. The VeriQ™ system is one of the currently available systems, which detects imperfections that may be corrected by graft revision. In this case report, multivessel coronary spasm (CS) post-CABG interferes with these intraoperative parameters misleading initially into false results...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/28634553/acute-lymphoblastic-leukemia-with-infective-endocarditis-presented-with-unusual-intracardiac-mass
#4
Ali Sadeghpour Tabaei, Leili Koochakzadeh, Mohammadrafie Khorgami, Sepehr Sadeghpour Tabaei
Acute lymphoblastic leukemia (ALL) is a systemic disease that is presented with different symptoms and signs. Cardiac manifestation is rare in ALL, but it is very important and needs appropriate management. It usually presents as leukemic myocardial infiltration and in the presence of cardiac mass comprehensive evaluation for other etiologies is mandatory. We reported on a 6-year-old boy in remission phase of ALL and large cardiac mass in the right atrium with obscure early symptoms and signs, in whom infective endocarditis (IE) was diagnosed and appropriate medical treatment was performed...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/28620551/mitochondrial-cardiomyopathy-presenting-as-dilated-phase-of-hypertrophic-cardiomyopathy-diagnosed-with-histological-and-genetic-analyses
#5
Toshiki Kuno, Syohei Imaeda, Yohei Asakawa, Hiroshi Nakamura, Genzou Takemura, Daisuke Asahara, Akira Kanamori, Tomoyuki Kabutoya, Yohei Numasawa
We report a case with 46-year-old man diagnosed with mitochondrial cardiomyopathy in the dilated phase of hypertrophic cardiomyopathy. Since cardiac magnetic resonance imaging, beta-methyl-p-(123)I-iodophenyl-pentadecanoic myocardial scintigraphy, and positron emission tomography/computed tomography revealed no remarkable findings, we performed electron microscopic examination, which aided in diagnosing mitochondrial cardiomyopathy. Muscle biopsy was also compatible with mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes and DNA analysis also concluded it...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/28611926/aneurysm-of-the-pulmonary-artery-in-fallot-s-tetralogy
#6
Kawtar Afrikh, Loua Hattach, Nadia Fellat, Mustapha El Bakkali, Halima Benjelloun
INTRODUCTION: Pulmonary artery aneurysms are a rare entity. Etiologies of these findings are multiple, but they are exceptionally associated with Fallot's Tetralogy. In this study, we present an unusual case of an important aneurysm of the left pulmonary artery associated with Fallot's Tetralogy disease. CASE PRESENTATION: A 30-year-old woman has been admitted for dyspnea and cyanosis. The data which had been obtained from echocardiography, cardiac catheterization, and angio-magnetic resonance imaging (MRI) suggested the existence of an important aneurysm of the left pulmonary artery associated with a regular Fallot's disease with a pulmonic stenosis...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/28607778/saphenovenous-graft-aneurysm-a-rare-complication-of-cabg
#7
James Thomas Connell
Saphenovenous graft aneurysm is a rare complication of coronary artery bypass grafts that is likely underdiagnosed. It is typically asymptomatic, slow growing, and often diagnosed incidentally on angiography or following catastrophic rupture. There is no consensus on best management but PCI and surgery appear to have more favourable mortality outcomes relative to conservative management. We present the case of a 48-year-old male with a cardiovascular risk profile hallmarked by diabetes mellitus, end stage renal failure, recalcitrant hyperlipidaemia, and IHD previously treated with CABG...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/28607777/type-a-quadricuspid-aortic-valve-infective-endocarditis-complicated-by-multiple-aortocardiac-fistulae-case-report-and-brief-literature-review
#8
Amine Ghalem, Mohammed Bachrif, Anass Hbali, Mostapha Beghi, Nabila Ismaili, Noha El Ouafi
Aortocardiac fistulae (ACF) are exceptionally due to infective endocarditis; they are usually congenital, posttraumatic, or complicate aortic dissection. In infective endocarditis setting, their presence should prompt urgent surgery as patients can deteriorate rapidly. We report the case of a 78-year-old female patient with the first ever reported quadricuspid aortic valve infective endocarditis complicated by multiple aortocardiac fistulae. Additionally, we provide a brief review of ACF, in infective endocarditis and quadricuspid aortic valve...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/28589043/anomalous-papillary-muscle-insertion-causing-dynamic-left-ventricular-outflow-tract-obstruction-without-hypertrophic-obstructive-cardiomyopathy
#9
Ravi Korabathina, Katherine Chiu, Hugh M van Gelder, Arthur Labovitz
Anomalous papillary muscle insertion directly into the surface of the mitral valve leaflet is rare, especially in a subject without apparent evidence of hypertrophic cardiomyopathy. We present a case of this isolated congenital malformation producing two hemodynamic sequelae of dynamic left ventricular outflow tract obstruction and severe mitral regurgitation.
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/28589042/pyridostigmine-induced-prolonged-asystole-in-a-patient-with-myasthenia-gravis-successfully-treated-with-hyoscyamine
#10
Mohammad Saud Khan, Abhinav Tiwari, Zubair Khan, Himani Sharma, Mohammad Taleb, Jeffrey Hammersley
Reversible acetylcholinesterase inhibitors are used as first-line treatment for myasthenia gravis. They improve symptoms by increasing concentration of acetylcholine at the neuromuscular junction and stimulating nicotinic receptors. Serious bradyarrhythmias can occur from muscarinic stimulation in heart, which in rare cases may progress to asystole. These patients can initially be managed with hyoscyamine, a muscarinic antagonist. Persistence of bradyarrhythmias even after hyoscyamine treatment may warrant pacemaker placement...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/28567311/retrieval-of-embolized-amplatzer-patent-foramen-ovale-occlusion-device-issues-related-to-late-recognition
#11
Allan J Davies, Nicholas Collins, Nicole Organ
Embolization of a percutaneous patent foramen ovale (PFO) closure device is a rare but serious complication. While early, periprocedural device embolization can normally be managed with snare and percutaneous retrieval, late embolization requires a different management strategy due to inability of the device to deform to allow passage into a large caliber sheath. We present a case of asymptomatic device embolization recognized six months following implantation and discuss the challenges encountered in successfully retrieving the device...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/28567310/absence-of-left-circumflex-artery-a-rare-congenital-disorder-of-coronary-arteries
#12
Saad Ullah, Muzammil Khan, Noman Ahmed Jang Khan, Hassan Zeb, Roshan Patel
Congenital absence of left circumflex artery is a rare occurrence and very few cases have been reported in literature. It is a benign incidental finding; however some patients present with sudden onset chest pain mimicking acute coronary syndrome often resulting in detection of this rare anatomy on coronary angiography. Coronary computed tomography angiography is a relatively new noninvasive imaging modality which can be used to confirm this suspicion and diagnose this unique morphology reliably.
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/28567309/left-atrial-myxoma-in-pregnancy-management-strategy-using-minimally-invasive-surgical-approach
#13
Noppon Taksaudom, Kuntharee Traisrisilp, Rungsrit Kanjanavanit
This case report concerns a young woman who, during her pregnancy, suffered severe mitral regurgitation. It was discovered at the same time that she had a left atrial myxoma. During the early postpartum period she successfully underwent an anterior minithoracotomy to remove the left atrial myxoma in conjunction with repair of the mitral valve. The thoracotomy approach in this specific patient was chosen as it would give a better chance of successful mother-child bonding because the patient would be able to avoid the precautions which would have been necessary following a sternotomy, especially the limitation of her ability to hold her child during the first 4-6 weeks postoperatively...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/28540089/failed-tavi-in-tavi-implantation-tavi-dislocation-followed-by-ensuing-surgical-graft-resection
#14
Róbert Novotný, Jaroslav Hlubocký, Tomáš Kovárník, Petr Mitáš, Zuzana Hlubocka, Jan Rulíšek, Sevim Ismihan Gulmez, Shubjiwan Kaur Ghotra, Jaroslav Lindner
We are presenting a case report of failed valve-in-valve treatment of severe aortic stenosis. A control ultrasonography after TAVI implantation revealed a severe aortic regurgitation of the graft which was subsequently unresolved with postimplantation dilatation. Second TAVI was implanted with cranial dislocation to the aortic root. Patient underwent a CT examination to clarify the TAVI in TAVI position. Patient underwent a surgical resection of TAVI with implantation of biological aortic valve prosthesis. In situations where TAVI treatment fails or is complicated beyond the possibility of endovascular repair, surgical intervention despite its higher risks is the preferred choice...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/28536660/sorafenib-associated-heart-failure-complicated-by-cardiogenic-shock-after-treatment-of-advanced-stage-hepatocellular-carcinoma-a-clinical-case-discussion
#15
Candace Wu, Kamal Shemisa
Background. Sorafenib, an oral tyrosine kinase inhibitor (TKI), targets multiple tyrosine kinase receptors (TKRs) involved in angiogenesis and tumor growth. Studies suggest that inhibition of TKR impacts cardiomyocyte survival. Inhibition of VEGF signaling interrupts angiogenesis and is associated with the development of hypertension and compensatory hypertrophy. Compensated hypertrophy ultimately leads to heart failure. Case Description. A 76-year-old man with a past medical history of systolic heart failure due to ischemic cardiomyopathy and stage IIIC hepatocellular carcinoma (HCC) presented with symptoms of decompensated heart failure...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/28529807/a-novel-modified-reverse-controlled-antegrade-and-retrograde-subintimal-tracking-technique-for-bypassing-the-calcified-proximal-cap-of-coronary-total-occlusions
#16
Tsuyoshi Isawa, Masahiko Ochiai, Masato Munehisa, Tatsushi Ootomo
Antegrade crossing is the most common approach to chronic total occlusions (CTOs). However, it is sometimes difficult to penetrate the proximal hard cap with guidewires, especially in the case of CTOs of anomalous coronary arteries because of a lack of support. Herein, we describe a novel, modified reverse controlled antegrade and retrograde subintimal tracking (CART) technique in which the dissection reentry was intentionally created in the proximal segment of the vessel, not within the occluded segment, using retrograde guidewire and the aid of an antegrade balloon...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/28512586/cryoablation-for-ventricular-tachycardia-originating-from-anterior-papillary-muscle-of-left-ventricle-guided-by-intracardiac-echocardiography
#17
Ibrahim Marai, Nizar Andria, Osnat Gurevitz
Papillary muscles (PMs) were reported to be origin of ventricular arrhythmia (VA). Radiofrequency (RF) ablation was reported to be acutely effective in eliminating VA. However, the recurrence rate is high. Recently, cryoablation guided by intracardiac echocardiography, 3-dimensional mapping system, and image integration was introduced as alternative strategy for this challenging ablation. We present a case of ventricular tachycardia originating from anterior PM of left ventricle treated by cryoablation guided only by intracardiac echocardiography...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/28487777/severe-dilatation-of-coronary-artery-ostium-complicating-sinus-of-valsalva-aneurysm-differential-diagnosis-and-review-of-the-literature
#18
Paul Bamford, Nicholas Collins
Coronary artery dilatation may be due to various aetiologies including congenital anomalies, atherosclerotic coronary disease, and Kawasakis disease. We describe a case characterised by apparent severe dilatation of the right coronary artery ostium in an asymptomatic male. Subsequent imaging and surgical intervention documented the presence of a sinus of Valsalva aneurysm extending into the ostium of the right coronary artery. This represents an unusual manifestation of a sinus of Valsalva aneurysm. The underlying pathophysiology, differential diagnosis, role of surgical management, and outcomes are discussed...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/28487776/reversible-myocardial-injury-and-intraventricular-thrombus-associated-with-aluminium-phosphide-poisoning
#19
Abdelkader Jalil El Hangouche, Hala Fennich, Oumaima Alaika, Taoufiq Dakka, Zaineb Raissouni, Latifa Oukerraj, Nawal Doghmi, Mohamed Cherti
Aluminium phosphide (ALP) is widely used as a fumigant pesticide. In case of ALP poisoning, it is responsible for myocardial dysfunction, related to toxic myocarditis, and hemodynamic disorders. We report a case of a 28-year-old female who had intentionally ingested ALP and was admitted with cardiogenic shock. The transthoracic echocardiography (TTE) at the time of admission showed severe global myocardial hypokinesia with the presence of a giant left ventricular thrombus. Cardiovascular magnetic resonance (CMR) revealed extensive toxic myocarditis with a left ventricular systolic dysfunction...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/28484651/surgical-repair-of-subacute-right-ventricular-perforation-after-pacemaker-implantation
#20
Takeshi Oda, Takanori Kono, Keiichi Akaiwa, Yasushi Takahara, Chie Yasuoka, Katsuhiko Nakamura
We report an 84-year-old woman who presented with right ventricular perforation 4 days after pacemaker implantation for syncope due to sick sinus syndrome. Median sternotomy revealed no pericardial effusion, but the pacing lead had penetrated the right ventricle and pericardium. When the pleura was opened, the tip of the lead was seen in the visceral pleura. The lead was cut in the pericardial cavity and extracted from the left subclavian wound together with the generator. The right ventricular perforation was sutured and a temporary pacing lead was placed on the right ventricular wall intraoperatively...
2017: Case Reports in Cardiology
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