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https://www.readbyqxmd.com/read/29455773/takotsubo-syndrome
#1
REVIEW
Sanjiv Gupta, Madan Mohan Gupta
Takotsubo syndrome is a reversible acute heart failure frequently precipitated by an emotional or physical stress. The clinical presentation resembles acute coronary syndrome. Pathogenesis is complex and may involve brain-heart axis and neuro-hormonal stunning of the myocardium. Coronary angiography reveals normal epicardial arteries with no obstruction or spasm. NT-ProBNP maybe remarkably elevated. Regional wall motion akinesia (RWMA) of left ventricle extends beyond the territory of one coronary artery. Reduced left ventricle ejection fraction (LVEF) and RWMA recover in 6-12 weeks...
January 2018: Indian Heart Journal
https://www.readbyqxmd.com/read/29455180/takotsubo-syndrome-in-a-premenopausal-patient
#2
Maria Menezes, Daniela Marto, Isabel Marcão, Catarina Salvado
Takotsubo syndrome is a rare clinical condition, with a pathophysiology that is not fully understood. Characterised by an acute and usually reversible heart failure, the condition is often preceded by a stressful event. For the diagnosis of Takotsubo syndrome to be possible, the absence of coronary artery disease as a cause is required. We report a case of Takotsubo syndrome in a 47-year-old woman of fertile age. Electrical and echocardiographic presentations were classical in the patient. However, abnormally elevated cardiac biomarkers were registered...
February 17, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29455059/the-impact-of-infection-on-mortality-in-octogenarians-who-were-admitted-due-to-acute-coronary-syndrome
#3
Kudret Keskin, Gökhan Çetinkal, Serhat Sığırcı, Süleyman Sezai Yıldız, Şükrü Çetin, Ahmet Gürdal, Betül Balaban Kocaş, Kadriye Orta Kılıçkesmez
BACKGROUND: The prevalence of coronary artery disease is on the rise as the life expectancy of the population increases. However, treatment of acute coronary syndrome in the elderly patients has its own problems that have not been thoroughly addressed in the clinical trials. Since these patients are generally fragile and have multiple co-morbidities, the course of acute coronary syndrome can frequently be complicated. Infection, which co-exists either at the initial presentation or is acquired during the hospital stay, is a condition about which there is little published data...
February 10, 2018: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/29452690/utility-of-physician-selection-of-cardiac-tests-in-a-chest-pain-unit-to-exclude-acute-coronary-syndrome-among-patients-without-a-history-of-coronary-artery-disease
#4
Stacey J Howell, Jonathan Bui, Balasingam Thevakumar, Ezra A Amsterdam
There are few data on the utility of physician selection of cardiac tests, including no-test, in a chest pain unit (CPU) to rule out acute coronary syndrome in low-risk patients without a history of coronary artery disease. We analyzed consecutive low-risk patients admitted to our CPU between 2012 and 2014 and determined the proportion of patients selected for testing, the type of initial cardiac test selected, and the incidence of major adverse cardiac events (MACEs) at 30 days and 6 months. The study group comprised 619 patients: mean age 57 years (27 to 92), 332 women (54%), and 360 (58%) with multiple cardiac risk factors...
January 10, 2018: American Journal of Cardiology
https://www.readbyqxmd.com/read/29451512/-antegrade-and-retrograde-approach-through-the-venous-graft-for-treating-a-chronic-total-occlusion-in-a-patient-with-acute-coronary-syndrome-complicated-by-pulmonary-edema
#5
Francesco Gallo, Matteo Tebaldi, Carlo Tumscitz
Percutaneous treatment of chronic total occlusions (CTO) is one of the major challenges in contemporary interventional cardiology. These lesions are identified in 15% to 30% of all patients referred for coronary angiography. Percutaneous coronary intervention (PCI) of CTOs is technically challenging and requires familiarity with advanced interventional techniques as well as specialty equipment. The choice of strategy and materials is based on clinical features and coronary anatomy; the correct choice is essential to improve the success probability...
January 2018: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/29447784/design-of-disco-direct-or-subacute-coronary-angiography-in-out-of-hospital-cardiac-arrest-study
#6
Rickard Lagedal, Ludvig Elfwén, Stefan James, Jonas Oldgren, David Erlinge, Ollie Östlund, Ewa Wallin, Ing-Marie Larsson, Gisela Lilja, Tobias Cronberg, Sten Rubertsson, Per Nordberg
BACKGROUND: Acute coronary syndrome is a common cause of out-of-hospital cardiac arrest (OHCA). In patients with OHCA presenting with ST elevation, immediate coronary angiography and potential percutaneous coronary intervention (PCI) after return of spontaneous circulation are recommended. However, the evidence for this invasive strategy in patients without ST elevation is limited. Observational studies have shown a culprit coronary artery occlusion in about 30% of these patients, indicating the electrocardiogram's (ECG's) limited sensitivity...
March 2018: American Heart Journal
https://www.readbyqxmd.com/read/29434120/ventricular-septal-perforation-a-rare-but-life-threatening-complication-associated-with-takotsubo-syndrome
#7
Masaki Tsuji, Toshiaki Isogai, Yuta Okabe, Yoshihiro Nishimura, Shingo Itagaki, Kazuaki Enatsu, Motoyuki Hisagi, Takahiro Nonaka, Mikio Ninomiya, Toshiya Otsuka, Hiroyuki Tanaka, Tamotsu Tejima
A 71-year-old woman was admitted with dyspnea. An electrocardiogram revealed ST-segment elevation, and echocardiography showed akinesis in the left ventricular apex with hyperkinesis of the base. Coronary angiography revealed no stenosis, and left ventriculography indicated ballooning of the left ventricular apex and apical ventricular septal perforation. We diagnosed the patient with Takotsubo syndrome complicated by ventricular septal perforation, which was surgically repaired. Although ventricular septal perforation is recognized as a life-threatening complication after acute myocardial infarction, it can also occur after Takotsubo syndrome...
February 9, 2018: Internal Medicine
https://www.readbyqxmd.com/read/29425541/-spontaneous-coronary-artery-dissection-an-exceptional-cause-of-acute-coronary-syndrome
#8
H Yao, A Ekou, J J N'Djessan, A Zoumenou, I Angoran, R N'Guetta
Spontaneous coronary artery dissection (SCAD) is an uncommon cause of acute coronary syndrome (ACS) or sudden death, which typically affects young women. We reported two cases of black Africans patients, aged 56 and 52 years old, who presented to Abidjan Heart Institute for ACS. Coronary angiography showed spontaneous dissection of the right coronary artery in the first case, and dissection of the distal left anterior descending artery in the second. A conservative approach was preferred. Both patients received antiplatelet agents, beta-blockers, angiotensin converting enzyme inhibitors and statins, with a favorable in-hospital course...
February 2018: Journal de Médecine Vasculaire
https://www.readbyqxmd.com/read/29421012/clinical-features-and-outcomes-of-patients-with-type-2-myocardial-infarction-insights-from-the-thrombin-receptor-antagonist-for-clinical-event-reduction-in-acute-coronary-syndrome-tracer-trial
#9
Patrícia O Guimarães, Sergio Leonardi, Zhen Huang, Lars Wallentin, Frans Van de Werf, Philip E Aylward, Claes Held, Robert A Harrington, David J Moliterno, Paul W Armstrong, Harvey D White, Karen P Alexander, Renato D Lopes, Kenneth W Mahaffey, Pierluigi Tricoci
BACKGROUND: Type 2 myocardial infarction (MI) is characterized by an imbalance between myocardial blood supply and demand, leading to myocardial ischemia without coronary plaque rupture, but its diagnosis is challenging. METHODS: In the TRACER trial, patients with non-ST-segment elevation acute coronary syndromes were included. We aimed to describe provoking factors, cardiac biomarker profiles, treatment patterns, and clinical outcomes of patients with type 2 MIs...
February 2018: American Heart Journal
https://www.readbyqxmd.com/read/29410284/coronary-angiographic-findings-and-outcomes-in-patients-with-sudden-cardiac-arrest-without-st-elevation-myocardial-infarction-a-swedeheart-study
#10
Axel Wester, Moman A Mohammad, Pontus Andell, Rebecca Rylance, Josef Dankiewicz, Hans Friberg, Stefan James, Elmir Omerovic, David Erlinge, Sasha Koul
BACKGROUND/AIM: Sudden cardiac arrest (SCA) has a substantial mortality rate and the acute coronary syndrome constitutes the major cause. Post-resuscitation electrocardiogram ST-elevation SCA (STE-SCA) is a strong indication for emergency coronary angiography, but the role of early angiography and PCI in patients without ST-elevation (NSTE-SCA) remains to be established. This paper aimed to describe this patient group and evaluate the prognostic effect of early PCI in a large nationwide cohort of NSTE-SCA patients undergoing coronary angiography...
February 1, 2018: Resuscitation
https://www.readbyqxmd.com/read/29407892/the-impact-of-myocardial-bridge-on-coronary-artery-spasm-and-long-term-clinical-outcomes-in-patients-without-significant-atherosclerotic-stenosis
#11
Purumeh Nam, Byoung Geol Choi, Se Yeon Choi, Jae Kyeong Byun, Ahmed Mashaly, Yoonjee Park, Won Young Jang, Woohyeun Kim, Jah Yeon Choi, Eun Jin Park, Jin Oh Na, Cheol Ung Choi, Hong Euy Lim, Eung Ju Kim, Chang Gyu Park, Hong Seog Seo, Dong Joo Oh, Seung-Woon Rha
BACKGROUND AND AIMS: Myocardial bridge (MB) and coronary artery spasm (CAS) can induce a sustained chest pain, acute coronary syndrome (ACS) and even sudden cardiac death. The aim of this study is to evaluate the relationship between MB and CAS and its impact on long-term clinical outcomes. METHODS: A total of 812 patients with MB without significant coronary artery disease (CAD), who underwent acetylcholine (ACH) provocation test, were enrolled. Significant CAS was defined as ≥70% temporary narrowing by ACH test, and MB was defined as the characteristic phasic systolic compression of the coronary artery with a decrease of more than 30% in diameter on the angiogram after intracoronary nitroglycerin infusion...
February 2, 2018: Atherosclerosis
https://www.readbyqxmd.com/read/29406426/history-of-vasomotor-symptoms-extent-of-coronary-artery-disease-and-clinical-outcomes-after-acute-coronary-syndrome-in-postmenopausal-women
#12
Luca A Ferri, Nuccia Morici, Giorgio Bassanelli, Nicoletta Franco, Leonardo Misuraca, Laura Lenatti, Emilia Lo Jacono, Chiara Leuzzi, Elena Corrada, Tiziana C Aranzulla, Delia Colombo, Angelo Cagnacci, Francesco Prati, Stefano Savonitto
OBJECTIVE: Vasomotor symptoms (VMS) during menopausal transition have been linked to a higher burden of cardiovascular risk factors, subclinical vascular disease, and subsequent vascular events. We aim to investigate the association of VMS with the extent of coronary disease and their prognostic role after an acute coronary syndrome. METHODS: The Ladies Acute Coronary Syndrome study enrolled consecutive women with an acute coronary syndrome undergoing coronary angiography...
February 5, 2018: Menopause: the Journal of the North American Menopause Society
https://www.readbyqxmd.com/read/29401041/perivascular-epicardial-fat-stranding-at-coronary-ct-angiography-a-marker-of-acute-plaque-rupture-and-spontaneous-coronary-artery-dissection
#13
Sandeep Hedgire, Vinit Baliyan, Evan J Zucker, Daniel O Bittner, Pedro Staziaki, Richard A P Takx, Jan-Erik Scholtz, Nandini Meyersohn, Udo Hoffmann, Brian Ghoshhajra
Purpose To evaluate the frequency and implications of perivascular fat stranding on coronary computed tomography (CT) angiograms obtained for suspected acute coronary syndrome (ACS). Materials and Methods This retrospective registry study was approved by the institutional review board. The authors reviewed the medical records and images of 1403 consecutive patients (796 men, 607 women; mean age, 52.8 years) who underwent coronary CT angiography at the emergency department from February 2012 to March 2016. Fat attenuation, length and number of circumferential quadrants of the affected segment, and attenuation values in the unaffected epicardial and subcutaneous fat were measured...
February 5, 2018: Radiology
https://www.readbyqxmd.com/read/29398567/quantification-of-coronary-low-attenuation-plaque-volume-for-long-term-prediction-of-cardiac-events-and-reclassification-of-patients
#14
S Deseive, R Straub, M Kupke, A Broersen, P H Kitslaar, S Massberg, M Hadamitzky, J Hausleiter
BACKGROUND: To investigate the incremental prognostic value of low-attenuation plaque volume (LAPV) from coronary CT angiography datasets. METHODS: Quantification of LAPV was performed using dedicated software equipped with an adaptive plaque tissue algorithm in 1577 patients with suspected CAD. A combination of death and acute coronary syndrome was defined as primary endpoint. To assess the incremental prognostic value of LAPV, parameters were added to a baseline model including clinical risk and obstructive coronary artery disease (CAD), a baseline model including clinical risk and calcium scoring (CACS) and a baseline model including clinical risk and segment involvement score (SIS)...
January 6, 2018: Journal of Cardiovascular Computed Tomography
https://www.readbyqxmd.com/read/29397881/incidence-predictors-and-impact-on-six-month-mortality-of-three-different-definitions-of-contrast-induced-acute-kidney-injury-after-coronary-angiography
#15
Benoit Guillon, Fiona Ecarnot, Charles Marcucci, Didier Ducloux, Marion Chatot, Marc Badoz, Benjamin Bonnet, Romain Chopard, Pierre Frey, Nicolas Meneveau, François Schiele
We assessed incidence, predictors, and impact on 6-month mortality of contrast-induced acute kidney injury (CI-AKI) after coronary angiography with or without percutaneous coronary intervention in patients with acute coronary syndrome (ACS), according to 3 different CI-AKI definitions. Serum creatinine (sCr) was assessed at baseline and 48 to 72 hours after procedure to classify patients into 3 CI-AKI groups: Group 1: increase in sCR ≥25% over baseline but absolute increase <0.5 mg/dl; Group 2: absolute increase ≥0...
January 9, 2018: American Journal of Cardiology
https://www.readbyqxmd.com/read/29395365/prognostic-impact-of-interleukin-1-receptor-antagonist-in-patients-with-documented-coronary-artery-disease
#16
Niklas Schofer, Sebastian Ludwig, Nicole Rübsamen, Renate Schnabel, Karl J Lackner, Hans J Ruprecht, Christoph Bickel, Ulf Landmesser, Stefan Blankenberg, Tanja Zeller
BACKGROUND: IL-1β-mediated inflammation contributes to development and progression of coronary artery disease (CAD). We aimed to assess the prognostic impact of the inflammatory marker Interleukin-1 receptor antagonist (IL1-Ra), reflecting high IL-1β activity, in patients with documented CAD. METHODS: IL-1Ra levels were determined in 1337 subjects of the AtheroGene study, a prospective cardiovascular registry comprising patients with CAD as detected by coronary angiography presenting with acute coronary syndrome (ACS) or stable angina...
January 29, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29384900/a-case-report-of-acute-inferior-myocardial-infarction-in-a-patient-with-severe-hemophilia-a-after-recombinant-factor-viii-infusion
#17
Silva Zupančić-Šalek, Marijo Vodanović, Dražen Pulanić, Boško Skorić, Irina Matytsina, Jolanta Klovaite
RATIONALE: The extent of protective effects of hemophilia against thrombotic events such as myocardial infarction (MI) and other acute coronary syndromes remains to be determined, as major risk factors for cardiovascular disease exist despite factor VIII (FVIII) deficiency. We present a case report of a 41-year-old male with severe hemophilia A and several cardiovascular risk factors. PATIENT CONCERNS: This morbidly obese patient developed chest pressure, followed by chest pain and difficulty in breathing shortly after receiving on-demand treatment with intravenous recombinant FVIII (rFVIII) (turoctocog alfa) dosed per body weight...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29381986/st-segment-elevation-associated-with-hydrochloric-acid-ingestion-a-case-report
#18
I-Jeng Yeh, Kuan-Ting Liu
RATIONALE: Electrocardiography (ECG) was used to diagnose acute coronary syndrome, but many other diseases may also result in ST segment change. We report one case of ingested hydrochloric acid present with ST segment elevation in the ECG. However, subsequent coronary angiography did not reveal significant coronary occlusion. PATIENT CONCERNS: An 83-year-old female was transferred to our emergency department (ED) from the branch hospital due to ingestion of toilet bowl cleaner containing 9...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29376398/spontaneous-coronary-artery-dissection-acute-findings-on-coronary-computed-tomography-angiography
#19
Marysia S Tweet, Nila J Akhtar, Sharonne N Hayes, Patricia Jm Best, Rajiv Gulati, Philip A Araoz
BACKGROUND: The coronary computed tomography angiography features of acute spontaneous coronary artery dissection, an important cause of acute coronary syndrome in young women, have not been assessed. METHODS: The "Virtual" Multicenter Mayo Clinic Spontaneous Coronary Artery Dissection Registry was established in 2010 and includes retrospective and prospective patient data. Retrospective assessment of acute coronary computed tomography angiography images was performed for 14 patients (16 vessels) who had images performed within two days of invasive coronary angiography diagnosis of acute spontaneous coronary artery dissection...
January 1, 2018: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/29374937/-optical-coherence-tomographic-analysis-of-in-stent-neoatherosclerosis-in-lesions-with-restenosis-after-drug-eluting-stent-implantation
#20
Z J Liu, B Shi, C C Deng, G X Xu, R Z Zhao, C Y Shen, Z L Wang, H L Liu
Objective: To explore the imaging characteristics and related influencing factors of in-stent neoatherosclerosis (ISNA) in patients with restenosis after drug-eluting stent(DES) implantation with optical coherence tomography(OCT). Methods: A total of 25 cases of coronary heart disease patients(DES placement time ≥8 months) with coronary artery angiography showing DES in-stent restenosis (ISR) in Zunyi medical college affiliated hospital from July 2013 to December 2015 were included in this study and patient's data were retrospectively analyzed...
January 24, 2018: Zhonghua Xin Xue Guan Bing za Zhi
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