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Cardiogeneic Shock

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https://www.readbyqxmd.com/read/28806755/acquired-von-willebrand-syndrome-in-cardiogenic-shock-patients-on-mechanical-circulatory-microaxial-pump-support
#1
Ulrike Flierl, Jörn Tongers, Dominik Berliner, Jan-Thorben Sieweke, Florian Zauner, Christoph Wingert, Christian Riehle, Johann Bauersachs, Andreas Schäfer
Early use of mechanical circulatory support, e.g. veno-arterial extracorporeal membrane oxygenation (ECMO) or left ventricular unloading by microaxial pump in refractory cardiogenic shock is recommended in current guidelines. Development of acquired von Willebrand Syndrome (AVWS) in patients with left ventricular assist devices (LVADs) and ECMO has been reported. There is an increasing number of patients treated with the Impella® CP microaxial pump for left ventricular unloading. However, the prevalence of AVWS in these high risk patients is unknown and needs to be determined...
2017: PloS One
https://www.readbyqxmd.com/read/28802656/rethinking-papillary-muscle-resection-for-refractory-ventricular-tachycardia-in-the-lvad-era-a-case-report
#2
Zachary J Il'Giovine, Adam D DeVore, Chetan B Patel, Jason Koontz, Jacob Schroder
We report the case of a 57-year-old man with a history of ischemic cardiomyopathy who presented to the hospital with recurrent episodes of ventricular tachycardia refractory to antiarrhythmic medications. Mapping identified a deep premature ventricular contraction focus in the anterolateral papillary muscle, an area that has been previously identified as difficult to treat with radiofrequency catheter ablation. The hospital course was complicated by cardiogenic shock and VT-storm, and the patient ultimately underwent surgical resection of the anterolateral papillary muscle with left ventricular assist device placement as a successful bridge to cardiac transplantation...
July 12, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/28801325/aluminium-phosphide-poisoning-with-severe-cardiac-dysfunction-and-the-role-of-digoxin
#3
Khalid Hamid Changal, Muzamil Latief, Manzoor Parry, Farhat Abbas
Aluminium phosphide (ALP) is a common cause of suicidal poisoning in India where it is easily available and commonly known as 'rice tablet'. In rural areas of India, it is still used to protect rice and stored grains from rodents and pests. (1) There is no specific antidote for phosphide poisoning and treatment involves meticulous supportive care. Ingestion can lead to severe cardiac suppression and cardiogenic shock. For patients poisoned with ALP who continue to have refractory shock with persistent myocardial suppression despite the use of adrenergic inotropic agents, the addition of digoxin may be beneficial...
August 11, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28800178/outcomes-of-catheter-ablation-of-ventricular-tachycardia-with-mechanical-hemodynamic-support-an-analysis-of-the-medicare-database
#4
Arash Aryana, André d'Avila, Christina L Cool, Marc A Miller, Fermin C Garcia, Gregory E Supple, Srinivas R Dukkipati, Dhanunjaya Lakkireddy, T Jared Bunch, Mark R Bowers, Padraig Gearoid O'Neill, Vivek Y Reddy, Francis E Marchlinski
INTRODUCTION: There is a paucity of data in favor of mechanical support during catheter ablation of ventricular tachycardia (VT). This study investigated the outcomes of VT ablation associated with mechanical support using percutaneous ventricular assist device (PVAD) versus intra-aortic balloon pump (IABP). METHODS AND RESULTS: We retrospectively examined the outcomes of patients who underwent VT ablation associated with PVAD versus IABP from 2010-2013, captured by the Medicare Inpatient Standard Analytic File database...
August 11, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28798015/morbidity-and-mortality-conference-for-percutaneous-coronary-intervention
#5
Jacob A Doll, Robert Overton, Manesh R Patel, Sunil V Rao, Michael H Sketch, J Kevin Harrison, James E Tcheng
BACKGROUND: Morbidity and mortality conference is a common educational and quality improvement activity performed in cardiac catheterization laboratories, but best practices for case selection and for maximizing the effectiveness of peer review have not been determined. METHODS AND RESULTS: We reviewed the 10-year percutaneous coronary intervention morbidity and mortality conference experience of an academic medical center. Cases were triggered for review by the occurrence of prespecified procedural events...
August 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28780576/mechanical-and-surgical-bioprosthetic-valve-thrombosis
#6
REVIEW
Wei Yao Lim, Guy Lloyd, Sanjeev Bhattacharyya
Valve thrombosis can occur in mechanical prosthetic valves and is increasingly recognised in transcatheter and surgically implanted bioprosthetic valves. The risk of thrombosis of mechanical valves is higher in the mitral position compared with aortic position and in older generation valves (ball and cage valves). There is a wide spectrum of presentation from the asymptomatic patient to those with embolic complications or cardiogenic shock. A combination of transthoracic and transesophageal echocardiography is required to assess the haemodynamic effect of thrombosis (valve gradients and area), leaflet motion and thrombus size...
August 5, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28779859/double-right-coronary-artery-in-primary-pci-finding-the-hidden-treasure%C3%A2
#7
Luciano Candilio, Roberto Nerla, Jonathan Byrne
Double Right Coronary Artery (RCA) is one of the rarest congenital coronary anomalies. Although it can be regarded as a benign condition in the vast majority of cases, it has been associated with acute and life-threatening presentations, including inferior ST-segment elevation myocardial infarction (STEMI), cardiogenic shock and complete heart block, tachyarrhythmias, or even sudden death. However, the role of a double RCA in these conditions is yet to be clarified as more recent data prove no statistically significant association between prevalence of significant atherosclerosis in anomalous coronary arteries in comparison to normal coronary arteries...
July 5, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28776066/-management-of-an-elderly-patient-in-the-emergency-room-at-the-end-of-life-a%C3%A2-medical-ethics-challenge
#8
G Michels, R Nies, S Ortmann, R Pfister, F Salomon
A 94-year-old patient with cardiogenic shock due to myocardial infarction was admitted via the emergency room. A coronary angiography and intensive care were requested. The need for care due to dementia was known. After case discussion in the interdisciplinary and multiprofessional treatment team, the decision for a palliative care concept in the form of symptom control was made in the emergency room, taking into account the patient's medical history, the current situation, and the presumed patient consent...
August 3, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28770279/-treatment-of-an-uncommon-case-of-a-cardiogenic-shock-simultaneous-use-of-a-va-ecmo-and-an-impella-cp%C3%A2
#9
H Haake, K Grün-Himmelmann, U Kania, F Trudzinski, P M Lepper, J Vom Dahl
We report the case of a 48-year old woman where probably the intramuscular administration of glucocorticoids by an orthopedist induced a pheochromocytoma crisis. The development of a cardiogenic shock with a cardiac arrest made the use of a venoarterial extra corporeal membrane oxygenation (VA-ECMO, Cardiohelp®, Maquet, Rastatt) necessary. To treat a pulmonary edema under VA-ECMO an Impella-CP® (Abiomed, Aachen) was implanted. A coronary angiography, endomyocardial biopsies and a computer tomography were performed...
August 2, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28765018/takotsubo-cardiomyopathy-triggered-by-venous-air-embolism-during-craniotomy-in-sitting-position-a-case-report
#10
Florian Raimann, Christian Senft, Jörg Honold, Kai Zacharowski, Volker Seifert, Jan Mersmann
BACKGROUND: Here we present a case of a stress induced cardiomyopathy (TakoTsubo cardiomyopathy) caused by a venous air embolism during a craniotomy in sitting position. CASE DESCRIPTION: A 69-year old female patient was admitted to the neurosurgical department and scheduled for elective resection of a cerebellar metastasis in sitting position. After craniotomy and opening of the posterior fossa a venous air embolism was detected via transesophageal echocardiography...
July 29, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28764639/antithrombotic-treatment-during-coronary-angioplasty-after-failed-thrombolysis-strategies-and-prognostic-implications-results-of-the-respire-registry
#11
José M De la Torre Hernández, Mario Sadaba Sagredo, Miren Telleria Arrieta, Federico Gimeno de Carlos, Elena Sanchez Lacuesta, Juan A Bullones Ramírez, Javier Pineda Rocamora, Victoria Martin Yuste, Tamara Garcia Camarero, Mariano Larman, Jose R Rumoroso
BACKGROUND: Thrombolysis is still used when primary angioplasty is delayed for a long time, but 25%-30% of patients require rescue angioplasty (RA). There are no established recommendations for antithrombotic management in RA. This registry analyzes regimens for antithrombotic management. METHODS: A retrospective, multicenter, observational registry of consecutive patients treated with RA at 8 hospitals. All variables were collected and follow-up took place at 6 months...
August 1, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28762172/mechanical-circulatory-support-for-decompensated-heart-failure
#12
REVIEW
Tarique Al Musa, Colin Dominic Chue, Hoong Sern Lim
PURPOSE OF REVIEW: Cardiogenic shock from decompensated heart failure is associated with significant morbidity and mortality. Mechanical circulatory support (MCS) improves haemodynamics and reverses organ dysfunction in critically ill patients with cardiogenic shock. This paper summarises the main modalities of mechanical support and their physiological impact, practical considerations, advantages and disadvantages to facilitate a holistic approach in managing a potentially lethal pathology...
July 31, 2017: Current Heart Failure Reports
https://www.readbyqxmd.com/read/28758605/rescue-extracorporeal-membrane-oxygenation-therapy-in-methamphetamine-toxicity
#13
Laura K Morrison, J Kromm, J Gaudet, D Zuege, B Button, F Warshawski, S N Lucyk
Complications related to methamphetamine use and abuse are common presentations seen in the emergency department. Standard management focuses on addressing the central nervous system and cardiovascular effects with the use of sedation and hemodynamic support. We describe a case report of a patient with methamphetamine toxicity and subsequent severe cardiomyopathy refractory to conventional management that responded to cardiovascular support with extracorporeal membrane oxygenation therapy (ECMO). A 22-year-old female was admitted in severe cardiogenic shock following intravenous administration of methamphetamine and oral fentanyl use...
July 31, 2017: CJEM
https://www.readbyqxmd.com/read/28758066/subsequent-safe-pregnancy-with-cesarean-delivery-in-a-patient-with-a-history-of-peripartum-takotsubo-syndrome-complicated-by-cardiogenic-shock
#14
Rodolfo Citro, Michele Bellino, Flora Minichino, Davide Di Vece, Donatella Ferraioli, Raffaele Petta
Takotsubo syndrome (TTS) is an acute and reversible heart failure syndrome, usually occurring in females but rarely in the peripartum period. In women with a history of peripartum TTS, it is unclear how to manage subsequent pregnancies. A 39-year-old female with a history of peripartum TTS complicated by cardiogenic shock became pregnant again. She underwent close cardiological follow-up for monitoring left ventricular systolic function and hemodynamic conditions. Epidural anesthesia was preferred to avoid catecholamine surge during cesarean delivery...
July 2017: Journal of Cardiovascular Echography
https://www.readbyqxmd.com/read/28753141/atrial-esophageal-fistula-secondary-to-ablation-for-atrial-fibrillation-a-case-series-and-review-of-the-literature
#15
Lily K Fatula, William D Bolton, Allyson L Hale, Barry R Davis, James E Stephenson, Sharon Ben-Or
This article describes 2 patients who presented to our institution with left atrial esophageal fistula after atrial fibrillation ablation; it also compares our experience with other atrial esophageal fistula cases reported in the literature. We performed a retrospective review of 2 patients who presented to our hospital between July 2015 and September 2015 with atrial esophageal fistula. Patient A, a 57-year-old man, presented 31 days postablation with a fever and right-sided weakness. A chest computed tomography showed gas in the left atrium and esophagus; an echocardiogram confirmed the diagnosis of atrial esophageal fistula...
July 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28744986/complete-recovery-of-fulminant-peripartum-cardiomyopathy-on-mechanical-circulatory-support-combined-with-high-dose-bromocriptine-therapy
#16
Patrick Horn, Diyar Saeed, Payam Akhyari, Denise Hilfiker-Kleiner, Malte Kelm, Ralf Westenfeld
Peripartum cardiomyopathy (PPCM) is an idiopathic cardiomyopathy presenting with heart failure due to left ventricular systolic dysfunction towards the end of pregnancy or in the months following delivery, where no other cause of heart failure is found. We report a case of a woman with PPCM who developed a critical cardiogenic shock with repeated cardiopulmonary resuscitation. We show for the first time that mechanical circulatory support combined with high-dose bromocriptine therapy to suppress systemic prolactin levels may serve as an effective therapeutic option in patients with fulminant PPCM and cardiogenic shock...
July 25, 2017: ESC Heart Failure
https://www.readbyqxmd.com/read/28743786/outcomes-of-patients-presenting-with-clinical-indices-of-spontaneous-reperfusion-in-st-elevation-acute-coronary-syndrome-undergoing-deferred-angiography
#17
Paul Fefer, Roy Beigel, Shaul Atar, Doron Aronson, Arthur Pollak, Doron Zahger, Elad Asher, Zaza Iakobishvili, Nir Shlomo, Ronny Alcalai, Michal Einhorn-Cohen, Amit Segev, Ilan Goldenberg, Shlomi Matetzky
BACKGROUND: Few data are available regarding the optimal management of ST-elevation myocardial infarction patients with clinically defined spontaneous reperfusion (SR). We report on the characteristics and outcomes of patients with SR in the primary percutaneous coronary intervention era, and assess whether immediate reperfusion can be deferred. METHODS AND RESULTS: Data were drawn from a prospective nationwide survey, ACSIS (Acute Coronary Syndrome Israeli Survey)...
July 25, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28743481/prevalence-and-prognostic-relevance-of-atrial-fibrillation-in-patients-with-takotsubo-syndrome
#18
Thomas Stiermaier, Francesco Santoro, Charlotte Eitel, Tobias Graf, Christian Möller, Nicola Tarantino, Francesca Guastafierro, Matteo Di Biase, Holger Thiele, Natale D Brunetti, Ingo Eitel
BACKGROUND: Takotsubo syndrome (TTS) is associated with a considerable risk of complications during the acute phase and substantial long-term mortality rates. Concomitant atrial fibrillation may have an impact on outcome in these patients. Aim of this study was to assess the prevalence and prognostic relevance of atrial fibrillation in TTS. METHODS: We performed an international, multicenter study including 387 TTS patients consecutively enrolled at 3 centers. Atrial fibrillation was defined as known history before admission or documented episodes during hospital stay...
July 18, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28743479/integrating-heart-rate-variability-vital-signs-electrocardiogram-and-troponin-to-triage-chest-pain-patients-in-the-ed
#19
Jeffrey Tadashi Sakamoto, Nan Liu, Zhi Xiong Koh, Dagang Guo, Micah Liam Arthur Heldeweg, Janson Cheng Ji Ng, Marcus Eng Hock Ong
BACKGROUND: Current triage methods for chest pain patients typically utilize symptoms, electrocardiogram (ECG), and vital sign data, requiring interpretation by dedicated triage clinicians. In contrast, we aimed to create a quickly obtainable model integrating the objective parameters of heart rate variability (HRV), troponin, ECG, and vital signs to improve accuracy and efficiency of triage for chest pain patients in the emergency department (ED). METHODS: Adult patients presenting to the ED with chest pain from September 2010 to July 2015 were conveniently recruited...
July 17, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28741848/pharmacologic-considerations-in-the-management-of-patients-receiving-left-ventricular-percutaneous-mechanical-circulatory-support
#20
J Erin Allender, Brent N Reed, Jenna L Foster, Jeremy D Moretz, Carrie S Oliphant, Douglas L Jennings, Robert J DiDomenico, James C Coons
Percutaneous mechanical circulatory support (MCS) devices, including the intra-aortic balloon pump, Impella, and TandemHeart, are often used for hemodynamic support in the setting of refractory cardiogenic shock. The thrombotic and bleeding complications associated with these devices is well recognized, and the Impella and TandemHeart devices have unique anticoagulation considerations that may influence patient outcomes. Both devices typically require use of a heparinized purge solution in combination with intravenous unfractionated heparin, thereby providing multiple sources of heparin exposure...
July 25, 2017: Pharmacotherapy
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