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https://www.readbyqxmd.com/read/28606950/pathophysiology-of-takotsubo-syndrome
#1
REVIEW
Francesco Pelliccia, Juan Carlos Kaski, Filippo Crea, Paolo G Camici
Originally described by Japanese authors in the 1990s, Takotsubo syndrome (TTS) generally presents as an acute myocardial infarction characterized by severe left ventricular dysfunction. TTS, however, differs from an acute coronary syndrome because patients have generally a normal coronary angiogram and left ventricular dysfunction, which extends beyond the territory subtended by a single coronary artery and recovers within days or weeks. The prognosis was initially thought to be benign, but subsequent studies have demonstrated that both short-term mortality and long-term mortality are higher than previously recognized...
June 13, 2017: Circulation
https://www.readbyqxmd.com/read/28597772/right-ventricular-st-elevation-myocardial-infarction-as-a-cause-of-death-in-idiopathic-pulmonary-arterial-hypertension
#2
Yang Zhan, Barry Burstein, Ali O Abualsaud, Mohamed Nosair, Andrew M Hirsch, Lyda Lesenko, David Langleben
A 32-year-old woman with advanced idiopathic pulmonary arterial hypertension (PAH), treated with oral tadalafil and intravenous epoprostenol, presented with typical angina pectoris of one day's duration. Her electrocardiogram, previously typical of pulmonary hypertension, revealed an acute ST-elevation myocardial infarction in the anterior precordial leads. She had a prior coronary angiogram, in preparation for lung transplantation, that revealed normal coronary arteries. Urgent coronary angiography showed acute occlusion of several acute marginal coronary branches that feed the right ventricle (RV)...
April 2017: Pulmonary Circulation
https://www.readbyqxmd.com/read/28578664/macrophage-migration-inhibitory-factor-promoter-polymorphisms-794-catt5-8-relationship-with-soluble-mif-levels-in-coronary-atherosclerotic-disease-subjects
#3
Lu Qian, Xiao-Yan Wang, Saroj Thapa, Lu-Yuan Tao, Shao-Ze Wu, Gao-Jiang Luo, Lu-Ping Wang, Jiao-Ni Wang, Jie Wang, Ji Li, Ji-Fei Tang, Kang-Ting Ji
BACKGROUND: We analyzed the relationship of -794 CATT5-8 MIF polymorphisms with soluble MIF in Coronary Atherosclerotic Disease (CAD) patients. METHODS: A total of 256 patients selected, on which 186 normal-coronary and 70 Coronary artery disease subjects, were recruited in the study (Retrospectively registered). Genotyping of -794 CATT5-8 polymorphisms were performed by PCR and DNA sequencing. Serum MIF levels were measured using an ELISA kit. Patients were classified by coronary angiogram, and CAD based on Gensini's integral degree (angiographic scoring system)...
June 2, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28567361/unexpected-evolution-of-a-non-stenotic-lesion-in-the-left-main-coronary-artery-of-a-patient-with-non-st-segment-elevation-myocardial-infarction
#4
Alexandru Florin Ispas, Lionel Mangin, Alexandru Paziuc, Loic Belle
A 72-year-old man was referred to our catheterization laboratory 48 hours after a non-ST-segment elevation myocardial infarction. His medical history included coronary artery disease (CAD) (percutaneous coronary intervention of the right coronary artery and chronic total occlusion of the circumflex artery), atrial fibrillation (AF), and chronic kidney disease. An electrocardiogram showed a pre-existent left bundle-branch block and the patient's maximum cardiac troponin concentration was 8.64 µg/L (upper limit of normal: 0...
June 2017: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/28552098/cardiopulmonary-exercise-testing-in-aortic-stenosis
#5
Van Doan Tuyet Le
Patients with moderate to severe aortic stenosis (AVA <1.3 cm(2)) who were judged, by a referring cardiologist, as asymptomatic or equivocal symptomatic from the aortic stenosis were included in the study. Patients with left ventricular ejection fraction <50% were not included. Twenty-nine percent of the referred patients were judged asymptomatic and 71% equivocal symptomatic from their valve disease. The mean age was 72 years and 90% of the patients had an AVA-index <0.6 cm(2)/m(2). By clinical evaluation in the outpatient clinic, 48% were judged as having functional limitation corresponding to NYHA≥II...
May 2017: Danish Medical Journal
https://www.readbyqxmd.com/read/28551719/t-wave-changes-in-patients-with-wellens-syndrome-are-associated-with-increased-myocardial-mechanical-and-electrical-dispersion
#6
Ivan Stankovic, Srdjan Kafedzic, Aleksandra Janicijevic, Radosava Cvjetan, Tijana Vulovic, Milica Jankovic, Ivan Ilic, Biljana Putnikovic, Aleksandar N Neskovic
Some patients with unstable angina and critical stenosis of the left anterior descending coronary artery (LAD) present with Wellens syndrome (WS), i.e., inverted or biphasic T-waves in the anterior precordial leads. We assessed clinical, angiographic, electro- and echocardiographic characteristic of patients with WS. In this retrospective study, clinical, angiographic, electro- and echocardiographic characteristic of 35 patients with WS were compared to 57 patients with critical LAD stenosis and normal resting electrocardiogram (ECG), and 45 subjects with normal coronary angiogram...
May 27, 2017: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/28515826/successful-restoration-of-complete-heart-block-to-normal-sinus-rhythm-by-primary-angioplasty-of-dual-left-anterior-descending-artery
#7
Santosh Kumar Sinha, Vikas Mishra, Mukesh Jitendra Jha, Mahmadula Razi, Nasar Abdali, Anupam Mahrotra, Mohammad Asif, Lokendra Rekwal, Vikas Chaturvedi, Shravan Singh, Vinay Krishna
Dual left anterior descending (LAD) artery is a rare coronary anomaly. We present a patient with a rare case of dual LAD, smaller one arising from the left main coronary stem and larger one from right coronary artery who presented with acute anterior wall myocardial infarction with complete heart block (CHB). Temporary pacemaker was implanted and coronary angiogram revealed critical occlusion of proximal LAD which was subsequently revascularized by primary angioplasty using drug-eluting stent (Xience prime, 2...
April 2017: Cardiology Research
https://www.readbyqxmd.com/read/28515825/late-presentation-of-aortic-aneurysm-and-dissection-following-cardiac-catheterization
#8
Abimbola Shofu, G Mustafa Awan, Bassam Omar, Ghazanfar Qureshi
We report a 63-year-old female with hypertension, hyperlipidemia, and prior pacemaker insertion for atrial fibrillation with symptomatic bradycardia, who was admitted with substernal chest pressure and diaphoresis. Her electrocardiogram revealed atrial fibrillation with demand ventricular pacing and her cardiac biomarkers were negative for acute coronary syndrome. Echocardiogram revealed normal left ventricular systolic function and normal aortic root diameter. Coronary angiography revealed 60-70% obtuse marginal lesion, otherwise mild disease...
April 2017: Cardiology Research
https://www.readbyqxmd.com/read/28515822/primary-percutaneous-coronary-intervention-angioplasty-of-occluded-twin-circumflex-coronary-artery-in-a-patient-of-acute-inferior-wall-myocardial-infarction-a-rare-anomaly
#9
Santosh Kumar Sinha, Vikas Mishra, Nasar Abdali, Mukesh Jitendra Jha, Mahmadula Razi, Shravan Singh, Lokendra Rekwal, Vikas Chaturvedi, Chandra Mohan Varma, Ramesh Thakur
Anomalies of the coronary arteries are reported in 1-2% of patients among diagnostic angiogram. Dual origin of a circumflex from both sinuses is extremely rare among them. We report a case of a patient who underwent primary percutaneous coronary intervention for acute inferior wall myocardial infarction where left coronary injection demonstrated normal obtuse marginal and right coronary injection demonstrated normal right coronary artery (RCA). On further probing, an anomalous left circumflex (LCx) artery was seen arising from RCA ostium which was subsequently cannulated and revascularized by deployment of 2...
April 2017: Cardiology Research
https://www.readbyqxmd.com/read/28465992/stress-induced-worsening-of-left-ventricular-diastolic-function-as-a-marker-of-myocardial-ischemia
#10
Mohamad Jihad Mansour, Wael Aljaroudi, Ali Mroueh, Omar Hamoui, Walid Honeine, Nada Khoury, Jinane Abi Nassif, Elie Chammas
BACKGROUND: Echocardiography has been the subject of interest in diagnosing diastolic dysfunction and estimating left ventricular filling pressures (LVFPs). The present study is set to estimate the correlation between the worsening of diastolic parameters and the evidence of inducible ischemia during an exercise stress echocardiography (SE) in comparison with the results of coronary computed tomographic angiogram (CCTA). METHODS: A total of 191 consecutive patients from the executive screening program who underwent exercise SE followed by CCTA were evaluated...
April 2017: Journal of Cardiovascular Echography
https://www.readbyqxmd.com/read/28465287/prevalence-of-subclinical-coronary-artery-disease-in-masters-endurance-athletes-with-a-low-atherosclerotic-risk-profile
#11
Ahmed Merghani, Viviana Maestrini, Stefania Rosmini, Andrew T Cox, Harshil Dhutia, Rachel Bastiaenen, Sarojini David, Tee Joo Yeo, Rajay Narain, Aneil Malhotra, Michael Papadakis, Mathew G Wilson, Maite Tome, Khaled AlFakih, James C Moon, Sanjay Sharma
Background -Studies in middle aged and older (masters) athletes with atherosclerotic risk factors for coronary artery disease (CAD) report higher coronary artery calcium (CAC) scores compared with sedentary individuals. Few studies have assessed the prevalence of CAD in masters athletes with a low atherosclerotic risk profile. Methods -We assessed 152 masters athletes aged 54.4±8.5 years (70% male) and 92 controls of similar age, sex and low Framingham 10 year CAD risk scores with an echocardiogram, exercise stress test, CT coronary angiogram, and cardiovascular magnetic resonance imaging (CMRI) with late gadolinium enhancement (LGE) and a 24-hour Holter...
May 2, 2017: Circulation
https://www.readbyqxmd.com/read/28429696/polymorphic-ventricular-tachycardia-due-to-variant-angina-diagnosed-on-holter-monitoring-and-confirmed-with-cold-pressor-test
#12
Semi Öztürk, Tuğba Aktemur, Muhsin Kalyoncuoğlu, Gündüz Durmuş, Mehmet Can
A 52-year-old man complaining of persistent recurring chest pain at night underwent coronary angiogram at another institution. Normal coronaries were observed and he was discharged with muscle spasmolytic prescription. Since symptoms had continued, 24-hour Holter monitoring was ordered at our facility and results revealed huge ST elevation and polymorphic ventricular tachycardia. Cold pressor test performed in catheterization laboratory also resulted in ventricular tachycardia. Nifedipine was prescribed and follow-up Holter monitoring revealed no further vasospastic episodes...
April 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/28414663/not-another-acs-rule-out
#13
S Preston, R Nelson, M Watts, D Smith, T Dewenter, D Spruill
CASE: A 50 year old African-American woman with diabetes, hypertension, and hyperlipidemia presented with progressively worsening retro-sternal chest pain, exacerbated by activity and relieved by rest. She also endorsed a thirty-pound unintentional weight loss, and dysphagia. She was dysarthric with left-sided Bell's Palsy and a palpable left axillary lymph node. She had been evaluated at several hospitals in the previous months for similar typical chest pain. Her troponin values were normal, and an EKG showed T-wave inversions in leads I and aVL...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28377824/takotsubo-cardiomyopathy-in-a-patient-with-undiscovered-sigmoid-colon-cancer
#14
Huang Po-Yen, Ku Po-Ming
Takotsubo cardiomyopathy (TTC) is a stress-related cardiomyopathy that is characterized by reversible left systolic dysfunction, which appears to be precipitated by sudden emotional or physical stress in the absence of myocardial infarction. Here we present a rare case that clinically presented with intermittent abdominal pain, initially impressed as non-ST elevation myocardial infarction and congestive heart failure but with a normal coronary angiogram. Her symptoms relieved spontaneously without returning...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/28376710/electrocardiographic-changes-mimicking-acute-coronary-syndrome-in-a-large-intracranial-tumour-a-diagnostic-dilemma
#15
Nilukshana Yogendranathan, H M M T B Herath, S P Pahalagamage, Aruna Kulatunga
BACKGROUND: ST elevation Myocardial infarction is a medical emergency. A variety of noncardiac conditions had been known to mimic the ECG changes that are seen in acute coronary syndrome. Although the common ECG changes that are documented with raised intracranial pressure are T inversions, prolongation of QT interval and sinus bradycardia, ST elevation or depression, arrhythmias and prominent U waves have also been recognized. However, ST elevations in association with primary intracranial tumours are rarely reported...
April 4, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28374328/epicardial-and-microvascular-coronary-vasomotor-dysfunction-and-its-relation-to-myocardial-ischemic-burden-in-patients-with-non-obstructive-coronary-artery-disease
#16
Edoardo Verna, Sergio Ghiringhelli, Stefano Provasoli, Simone Scotti, Jorge Salerno-Uriarte
AIM: To assess the relative contribution of epicardial endothelium-dependent (EDD) and microvascular endothelium-independent (EIMVD) coronary vasomotor dysfunction to the extent of myocardial ischemia in patients with normal angiograms or non-obstructive coronary artery disease (NOCAD). METHODS: Coronary vasomotion was evaluated by quantitative angiography and blood flow (CBF) measurements during intracoronary acetylcholine, nitroglycerine, and adenosine in 101 patients...
April 3, 2017: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
https://www.readbyqxmd.com/read/28373095/out-of-hospital-cardiac-arrest-survivors-with-inconclusive-coronary-angiogram-impact-of-cardiovascular-magnetic-resonance-on-clinical-management-and-decision-making
#17
A Baritussio, A Zorzi, A Ghosh Dastidar, A Susana, G Mattesi, J C L Rodrigues, G Biglino, A Scatteia, E De Garate, J Strange, L Cacciavillani, S Iliceto, A Nisbet, G D Angelini, D Corrado, M Perazzolo Marra, C Bucciarelli-Ducci
BACKGROUND: Non-traumatic out of hospital cardiac arrest (OHCA) is the leading cause of death worldwide, mainly due to acute coronary syndromes. Urgent coronary angiography with view to revascularisation is recommended in patients with suspected acute coronary syndrome. Diagnosis and management of patients with inconclusive coronary angiogram (unobstructed coronaries or unidentified culprit lesion) is challenging. We sought to assess the role of Cardiovascular Magnetic Resonance (CMR) in the diagnosis and management of OHCA survivors with an inconclusive coronary angiogram...
July 2017: Resuscitation
https://www.readbyqxmd.com/read/28363949/incidental-finding-of-anomalous-circumflex-coronary-artery-from-right-coronary-sinus-prior-to-aortic-valve-surgery
#18
Amer Harky, Alexander Hof, Mohammad U Ahmad, Rakesh Uppal
Anomalous origin of the left circumflex (Cx) artery is a common and mostly benign coronary artery anomaly. We report the case of a man aged 52 years who presented to his local hospital with progressive breathlessness on exertion and syncopal episodes. His admission transthoracic echocardiography (TTE) showed bicuspid aortic valve, severe aortic stenosis with a valve area of 0.5 cm(2) and his left ventricular ejection fraction (LVEF) was 27%. His coronary angiogram showed normal coronary arteries but anomalous origin of the Cx artery from the right coronary...
March 31, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28280053/copeptin-associates-with-cause-specific-mortality-in-patients-with-impaired-renal-function-results-from-the-luric-and-the-4d-study
#19
Vera Krane, Bernd Genser, Marcus E Kleber, Christiane Drechsler, Winfried März, Graciela Delgado, Bruno Allolio, Christoph Wanner, Wiebke Fenske
BACKGROUND: In chronic kidney disease (CKD) arginine vasopressin (AVP) cannot efficiently act via renal V2-receptors. AVP is upregulated leading to augmented activation of V1a- and V1b-receptors, which might contribute to the increase in cardiovascular and infectious complications in CKD. Here, we evaluate copeptin, a surrogate of AVP, and its association with cause specific mortality among patients within the whole spectrum of renal function. METHODS: Copeptin was measured in baseline samples from the LURIC (n = 3131 patients with coronary angiograms) and the 4D-Study (n = 1241 type 2 diabetic hemodialysis patients)...
May 2017: Clinical Chemistry
https://www.readbyqxmd.com/read/28255467/type-1-kounis-syndrome-in-patient-with-idiopathic-anaphylaxis
#20
Tajda Keber, Jana Makuc, Gregor Sekavčnik
Kounis syndrome represents the concurrence of acute coronary syndromes or anginal pain with allergic, hypersensitivity, and anaphylactic reactions. It can be associated with normal coronary angiogram or preexistent coronary pathology. Idiopathic anaphylaxis is defined as anaphylaxis without any identifiable precipitating agent or event. We present a case of male who experienced attacks of dyspnoea, hypoxemia, hypotension, purple-red skin, and chest pain over several years. He was diagnosed with idiopathic anaphylaxis...
2017: Case Reports in Cardiology
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