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https://www.readbyqxmd.com/read/28429696/polymorphic-ventricular-tachycardia-due-to-variant-angina-diagnosed-on-holter-monitoring-and-confirmed-with-cold-pressor-test
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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...
March 31, 2017: Resuscitation
https://www.readbyqxmd.com/read/28363949/incidental-finding-of-anomalous-circumflex-coronary-artery-from-right-coronary-sinus-prior-to-aortic-valve-surgery
#7
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
#8
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)...
March 9, 2017: Clinical Chemistry
https://www.readbyqxmd.com/read/28255467/type-1-kounis-syndrome-in-patient-with-idiopathic-anaphylaxis
#9
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
https://www.readbyqxmd.com/read/28169140/influence-of-cardiovascular-risk-factors-on-the-prevalence-of-coronary-atherosclerosis-in-patients-with-angiographically-normal-coronary-arteries
#10
Daniel O Bittner, Lutz Klinghammer, Mohamed Marwan, Jasmin Schmid, Christian Layritz, Udo Hoffmann, Stephan Achenbach, Tobias Pflederer
RATIONALE AND OBJECTIVES: Cardiovascular (CV) disease is predominately influenced by CV risk factors and coronary computed tomography angiography (CTA) is capable of detecting early-stage coronary artery disease. We sought to determine the influence of CV risk factors on the prevalence of nonobstructive atherosclerosis in patients with normal-appearing coronary arteries in invasive coronary angiography (ICA). MATERIALS AND METHODS: In this retrospective analysis, we included 60 consecutive symptomatic patients, having undergone ICA and coronary CTA...
February 3, 2017: Academic Radiology
https://www.readbyqxmd.com/read/28142134/coronary-spasm-after-an-injection-of-vincristine
#11
Rosine Gros, Vincent Hugon, Jean-Marc Thouret, Vincent Peigne
Cardiotoxicity, including heart failure, thromboembolic events, and myocardial ischemia, is a concern for cardiologists and oncologists. The most frequently involved drugs are anthracyclines. We report an episode of coronary spasm due to vincristine, a vinca alkaloid, in a 49-year-old man treated for a diffuse undifferentiated carcinoma. The patient suffered recurrent episodes of typical chest pain with ST-elevation in the inferior area. Coronary spasm was confirmed by an angiogram, which showed normal coronary arteries...
2017: Chemotherapy
https://www.readbyqxmd.com/read/28133551/large-left-ventricular-thrombus-in-a-patient-with-systemic-and-venous-thromboembolism-secondary-to-protein-c-and-s-deficiency
#12
Mohit Pahuja, Bujji Ainapurapu, Aiden Abidov
58-year-old Hispanic female presented with an altered mental status. A CT scan of the head demonstrated multiple scattered infarcts and a large right temporal lobe infarct. We also diagnosed the patient with right popliteal and femoral vein thrombosis, bilateral pulmonary embolism, and a transient right radial artery occlusion. Her 12-lead EKG showed lateral ST elevation. Emergent coronary angiogram revealed normal coronaries. Echocardiogram demonstrated a large mobile mass attached to the anterolateral free wall with overall normal contractility of the left ventricle...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/28063138/are-biventricular-systolic-functions-impaired-in-patient-with-coronoray-slow-flow-a-prospective-study-with-three-dimensional-speckle-tracking
#13
Tuğba Kemaloğlu Öz, Mehmet Eren, Işıl Atasoy, Tayfun Gürol, Özer Soylu, Bahadır Dağdeviren
The newly developed three dimensional speckle-tracking echocardiography (3D-STE) technology provides quick and comprehensive quantitative assessment of biventricular myocardial dynamics. The impact of coronary slow flow phenomenon (CSFP) on biventricular functions has not been comprehensively evaluated using this new technology. Therefore, the aim of this study was to evaluate the effects of CSFP on biventricular systolic functions using 3D-STE. Forty patients with CSFP and otherwise normal coronary arteries (NCAs) and 40 age- and sex-matched controls with normal coronary angiograms (CAGs) were prospectively enrolled...
January 6, 2017: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/28047848/tu-h-campus-iep2-02-four-dimensional-coronary-artery-visualization-based-on-image-propagation
#14
B Liu, B Liang, X Xu, B Guo, R Wei, S Xu, F Zhou, Q Wu
PURPOSE: 4D visualization of coronary artery using X-ray angiograms rotationally acquired on C-arm has many valuable applications, like dynamic roadmapping. In this work we propose and validate a method to visualize 4D artery based on 3D coronary image propagation. METHODS: After sorting the angiograms into different cardiac phases using nearest-neighbor ECG gating, a high quality 3D coronary image was reconstructed at one phase using a motion-compensated iterative reconstruction method...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28000218/supra-hisian-conduction-block-as-an-unusual-presenting-feature-of-takotsubo-cardiomyopathy
#15
Mukund Aravind Prabhu, Praveen Gopalakrishna Pai, Anjith Vupputuri, Saritha Shekhar, Madhavankutty Santhakumari Harikrishnan, Natarajan Umayammal Kumaraswamy
BACKGROUND: Atrioventricular (AV) block is rare in Takotsubo cardiomyopathy (TC). CASE REPORT: A 66-year-old female presented with fatigue. Her electrocardiogram revealed 3:2 Mobitz Type II AV block, confirmed to be supra-Hisian by electrophysiological study. Echocardiogram and left ventricular angiogram showed moderate left ventricular dysfunction and apical ballooning, whereas coronary angiogram revealed mildly ectatic coronaries. At 2 weeks AV block persisted, needing permanent pacemaker implantation...
December 21, 2016: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/27993910/a-38-year-old-man-with-progressive-dyspnoea-and-ventricular-tachycardia
#16
Alphonsus C Liew, Claire E Raphael, Raad Mohiaddin
CLINICAL INTRODUCTION: A previously healthy 38-year-old man presented with a 3-month history of progressive dyspnoea and ventricular tachycardia (VT). He suffered a viral illness 4 months earlier. There was no family history of cardiac disease or sudden cardiac death (SCD). ECG showed left bundle branch block (LBBB). Echocardiography revealed a dilated left ventricle with severely impaired systolic function. Coronary angiogram showed angiographically normal coronary arteries. He was diagnosed as having dilated cardiomyopathy and was referred for further assessment with cardiovascular magnetic resonance (CMR) (figure 1) and subsequently CT thorax...
December 19, 2016: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/27957255/pulmonary-vein-thrombosis-in-a-patient-with-polycythemia-vera
#17
Bhaskar Bhardwaj, Dany Jacob, Amit Sharma, Mouhanna Abu Ghanimeh, Paramdeep Baweja
Pulmonary vein thrombosis (PVT) is a rarely encountered disease entity with varied clinical presentations. It is usually associated with lung carcinoma, lung surgeries and as a complication of the radiofrequency catheter ablation procedure for atrial fibrillation. Its clinical manifestations can vary from mild hemoptysis to lung infarction with hemodynamic compromise. A 76-year-old male presented with a 2-d history of pleuritic left sided chest pain. His past medical history included polycythemia vera, atrial fibrillation, coronary artery disease, pulmonary embolism and pulmonary hypertension...
November 26, 2016: World Journal of Cardiology
https://www.readbyqxmd.com/read/27934810/effect-of-hypertension-at-presentation-on-prognosis-in-patients-with-dilated-cardiomyopathy-presenting-with-normal-renal-angiogram
#18
Swetha Balije, Ashutosh Kumar, Goru Bhawani, Kasturi S N Murthy, Neera Kumari
BACKGROUND & OBJECTIVES: Dilated cardiomyopathy (DCM) is a progressive disease of heart with systolic and diastolic dysfunction carrying a poor long-term prognosis. The prognostic index and predictors of mortality are considered to be useful in guiding the treatment. This study was undertaken to evaluate the effects of hypertension at presentation on prognosis in patients with DCM presenting with normal renal and coronary angiogram. METHODS: An observational, analytical, non-interventional and a combination of retrospective and prospective study was conducted in patients between 15 and 75 yr of age with DCM having on and off symptoms while receiving treatment in a cardiology outpatient department for more than a year...
August 2016: Indian Journal of Medical Research
https://www.readbyqxmd.com/read/27933639/assessment-of-left-atrial-volume-and-function-by-real-time-three-dimensional-echocardiography-in-obese-patients
#19
Julide Yagmur, Mehmet Cansel, Ertugrul Kurtoglu, Siho Hidayet, Nusret Acıkgoz, Necip Ermis, Fatma Ozyalin
OBJECTIVE: To evaluate left atrial (LA) volume and functions in obese subjects using real time three-dimensional echocardiography (RT3DE) and also the relationship between LA mechanical functions and N-terminal pro-atrial natriuretic peptide (NT-proANP). METHODS: This study included 40 obese (26 females and 14 males, mean age 51.9 years) and 40 normal weight subjects (23 females and 16 males, mean age 53.5 years) with normal coronary angiograms. All the study participants underwent RT3DE to assess LA volume and mechanical function...
December 9, 2016: Echocardiography
https://www.readbyqxmd.com/read/27915215/cha2ds2-vasc-hsf-score-new-predictor-of-severity-of-coronary-artery-disease-in-2976-patients
#20
Ranjan Modi, S V Patted, P C Halkati, Sanjay Porwal, Sameer Ambar, Prasad Mr, Vijay Metgudmath, Ameet Sattur
BACKGROUND: CHADS2 and CHA2DS2-VASc scores have been used for assessing prognostic risk of thromboembolism in non valvular atrial fibrillation patients. They include similar risk factors for the development of CAD To increase the likelihood of determining CAD severity, the CHA2DS2-VASc-HS and CHA2DS2-VASc-HSF score comprising of hyperlipidemia, smoking and family history respectively in addition to the components of the CHA2DS2-VASc score and male instead of female gender. The aim was to investigate whether these risk scores can be used to predict CAD severity...
February 1, 2017: International Journal of Cardiology
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