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https://www.readbyqxmd.com/read/28325788/decompression-illness-with-hypovolemic-shock-and-neurological-failure-symptoms-after-two-risky-dives-a-case-report
#1
Sebastian Klapa, Johannes Meyne, Wataru Kähler, Frauke Tillmans, Henning Werr, Andreas Binder, Andreas Koch
Hypovolemia is known to be a predisposing factor of decompression illness (DCI) while diving. The typical clinically impressive neurological symptoms of DCI may distract from other symptoms such as an incipient hypovolemic shock. We report the case of a 61-year-old male Caucasian, who presented with an increasing central and peripheral neural failure syndrome and massive hypovolemia after two risky dives. Computed tomography (CT) scans of the chest and Magnetic resonance imaging scans of the head revealed multiple cerebral and pulmonary thromboembolisms...
March 2017: Physiological Reports
https://www.readbyqxmd.com/read/28325571/frequency-of-development-of-aortic-valve-disease-in-unrepaired-perimembranous-ventricular-septal-defects
#2
Asif Padiyath, Elizabeth S Makil, Katherine T Braley, Elijah H Bolin, Xinyu Tang, Jeffery M Gossett, R Thomas Collins
We sought to determine the natural history of aortic valve disease in patients with unrepaired perimembranous ventricular septal defects (pVSDs) and to identify echocardiographic parameters predictive of increased risk of surgical repair of pVSD because of aortic valve disease. We retrospectively analyzed all echocardiograms of patients with a diagnosis of pVSD at our institution from January 1999 to January 2015. All available echocardiographic data were collected. Patients were excluded if there was another structural cardiac anomaly other than bicuspid aortic valve, small patent foramen ovale, or ductus arteriosus...
February 28, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28320890/a-biophysical-vascular-bubble-model-for-devising-decompression-procedures
#3
Ran Arieli, Abraham Marmur
Vascular bubble models, which present a realistic biophysical approach, hold great promise for devising suitable diver decompression procedures. Nanobubbles were found to nucleate on a flat hydrophobic surface, expanding to form bubbles after decompression. Such active hydrophobic spots (AHS) were formed from lung surfactants on the luminal aspect of ovine blood vessels. Many of the phenomena observed in these bubbling vessels correlated with those known to occur in diving. On the basis of our previous studies, which proposed a new model for the formation of arterial bubbles, we now suggest the biophysical model presented herein...
March 2017: Physiological Reports
https://www.readbyqxmd.com/read/28320124/the-p-wave-terminal-force-in-embolic-strokes-of-undetermined-source
#4
Simona Lattanzi, Claudia Cagnetti, Alessandra Pulcini, Marco Morelli, Simone Maffei, Leandro Provinciali, Mauro Silvestrini
BACKGROUND: The Embolic Stroke of Undetermined Source (ESUS) is a recently developed clinical construct which describes stroke patients for whom the embolic source remains undetermined despite recommended investigations. The aim of the study was to characterize the ESUS population according to the abnormality in the P-wave terminal force in lead V1 (PTFV1). METHODS: We retrospectively identified consecutive patients hospitalized for acute ischemic stroke who met the ESUS diagnostic criteria...
April 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28317214/characterization-of-blood-flow-through-intrapulmonary-arteriovenous-anastomoses-and-patent-foramen-ovale-at-rest-and-during-exercise-in-stroke-and-transient-ischemic-attack-patients
#5
Rinaldo Romac, Otto Barak, Duska Glavas, Zora Susilovic Grabovac, Petar Lozo, Igor Roje, Kresimir Caljkusic, Irena Drmic-Hofman, James T Davis, Zeljko Dujic, Andrew T Lovering
OBJECTIVES: We determined whether stroke and/or TIA subjects have exercise-induced blood flow through intrapulmonary arteriovenous anastomoses (QIPAVA ) and/or patent foramen ovale (QPFO ) and a genetic predisposition for ischemic stroke. METHODS: Twenty-eight stroke and/or TIA subjects (33-63 years old) underwent transthoracic saline contrast echocardiography concomitant with transcranial Doppler to detect QIPAVA and QPFO at rest and during supine exercise with and without breathing 100% O2 ...
March 19, 2017: Echocardiography
https://www.readbyqxmd.com/read/28299822/when-to-use-femoral-vein-injection-for-diagnosis-of-patent-foramen-ovale-effect-of-a-persistent-eustachian-valve-on-right-atrial-flow-patterns-during-contrast-transesophageal-echocardiography
#6
Tat W Koh
Contrast echocardiography using agitated saline injected into the antecubital vein is the most common method used for the diagnosis of patent foramen ovale. We describe a case whereby the presence of a persistent eustachian valve and a "negative contrast sign" during contrast transesophageal echocardiography raised suspicion of a false-negative result. Femoral vein injection of contrast successfully demonstrated a patent foramen ovale. Femoral vein injection should be considered if this scenario is recognized because the eustachian valve directs blood preferentially from the inferior vena cava toward the interatrial septum and this route may prove to be more reliable...
March 16, 2017: Echocardiography
https://www.readbyqxmd.com/read/28296023/closure-of-patent-forman-ovale-defects-using-gore%C3%A2-cardioform-septal-occluder
#7
Stefan E Hardt, Andreas Eicken, Felix Berger, Stephan Schubert, Mario Carminati, Gianfranco Butera, Jochen Grohmann, Rene Höhn, Jens Erik Nielsen-Kudsk, David Hildick-Smith, Magnus Settergren, John D Thomson, Nicolas Geis, Lars Søndergaard
AIMS: The GORE® CARDIOFORM Septal Occluder (GSO) is a novel device designed for rapid and effective closure of patent foramen ovale (PFO) which has distinctive features making it suitable for a broad spectrum of anatomical variations. We report the procedural and 6 months follow-up results of the first prospective, multicenter study using GSO. METHODS AND RESULTS: This single-arm study included 150 subjects undergoing closure of PFO in 10 European centers. In 149 out of 150 patients implantation of a GSO device was successful...
March 15, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28295858/non-obstructive-carotid-atherosclerosis-and-patent-foramen-ovale-in-young-adults-with-cryptogenic-stroke
#8
A Jaffre, B Guidolin, J-B Ruidavets, N Nasr, V Larrue
BACKGROUND AND PURPOSE: Up to 50% of ischaemic strokes in young adults are classified as cryptogenic despite extensive work-up. We sought to evaluate the prevalence of non-obstructive carotid atherosclerosis (NOCA) and its association with patent foramen ovale (PFO) in young adults with cryptogenic stroke (CS). METHODS: Patients aged 18-54 years, consecutively treated for first-ever CS in an academic stroke service, were included. NOCA was assessed using carotid ultrasound examination and was defined as carotid plaque with <50% stenosis...
March 15, 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/28295809/a-new-method-to-predict-the-need-for-a-rashkind-procedure-in-fetuses-with-dextro-transposition-of-the-great-arteries
#9
Maciej Słodki, Roland Axt-Fliedner, Katarzyna Zych-Krekora, Aline Wolter, Andreea Kawecki, Christian Enzensberge, Ewa Gulczyńska, Maria Respondek-Liberska
OBJECTIVE: Prenatal congenital heart disease classification system specify critical d-TGA with restriction of the foramen ovale (which requires Rashkind procedure) and planned d-TGA. However, current prenatal diagnostic criteria for post-delivery foramen ovale (FO) restriction in d-TGA are inadequate, resulting in a high false negative rate. We aim to find an echocardiographic features to predict the need for Rashkind procedure. METHODS: 98 patients from 2 European centers diagnosed prenatally with fetal d-TGA from 2006 to 2013 were analyzed and two groups were compared: 1) those in which the Rashkind procedure was performed within the first 24 hours of life; and 2) those who did not undergo a Rashkind procedure before cardiac surgery...
March 14, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28295572/dyspnea-following-thoracostomy-closure-after-right-pneumonectomy-an-uncommon-echocardiographic-diagnosis-and-therapeutic-approach
#10
Matteo Pernigo, Barbara Canneto, Davide Betta, Gionata Molinari, Flavio Ribichini, Guido Zannini, Corrado Vassanelli, Andrea Rossi
Dyspnea and hypoxemia are common postoperative problems after pneumonectomy. One of the rarer causes of respiratory distress after right pneumonectomy is the development of a significant right-to-left shunt across a patent foramen ovale (PFO), which can evolve at a variable interval of time after the operation. We report here our experience with a patient who underwent right pneumonectomy, followed by several complications, and who presented severe dyspnea 7 months later, after the closure of a right thoracostomy...
March 14, 2017: Echocardiography
https://www.readbyqxmd.com/read/28286853/paradoxical-embolism-due-to-persistent-foramen-ovale-a-case-report
#11
Dormar David Barrios, Jonathan Roncancio, Albert Alejandro Avila, Jaime Andrés Alvarado, Ana Cristina Montenegro
The mean percentage of cryptogenic strokes among ischemic strokes is 31%, of which one-third may be associated with patent foramen ovale. The foramen ovale is required for blood flow through the fetal atrial septum. It is formed as of the fourth week of gestation, and this leads to right-left interatrial shunt that allows the passage of oxygenated blood to systemic circulation. In 75% of cases, its closure is complete by 2 years of age, but it may persist in 25% of patients. We present the case of a patient with paradoxical embolism in the lower extremities and ischemic stroke in the clinical context of a patent foramen ovale...
2017: Emergency (Tehran, Iran)
https://www.readbyqxmd.com/read/28283958/pfo-and-migraine-is-there-a-role-for-closure
#12
REVIEW
Melissa Rayhill, Rebecca Burch
Observational studies suggest that closure of a patent foramen ovale for other indications may reduce or even eliminate migraine attacks, particularly migraine with aura. The first randomized clinical trial of patent foramen ovale (PFO) closure for prevention of migraine, the MIST trial, showed negative results. The results of the other two completed studies in this area have recently been published in the last year. PRIMA and PREMIUM were also both negative for their primary endpoints. The PREMIUM trial did show a reduction in headache days in the migraine with aura subgroup but the final results of this subset analysis have not been published...
March 2017: Current Neurology and Neuroscience Reports
https://www.readbyqxmd.com/read/28283957/migraine-and-stroke-what-s-the-link-what-to-do
#13
REVIEW
Anna Gryglas, Robert Smigiel
Migraine and stroke are common, disabling neurologic disorders, with a high socioeconomic burden. A link between them has been proposed years ago, and various theories have been proposed to explain this bidirectional relation. However, the precise causes remain unclear. We briefly summarize existing hypotheses of this correlation seeking for recommendations for stroke prevention in migraineurs, if any exist. Among the strongest suggested theories of migraine-stroke association are cortical spreading depression, endovascular dysfunction, vasoconstriction, neurogenic inflammation, hypercoagulability, increased prevalence of vascular risk factors, shared genetic defects, cervical artery dissection, and patent foramen ovale...
March 2017: Current Neurology and Neuroscience Reports
https://www.readbyqxmd.com/read/28283176/usefulness-of-the-prenatal-echocardiogram-in-fetuses-with-isolated-transposition-of-the-great-arteries-to-predict-the-need-for-balloon-atrial-septostomy
#14
Trisha V Vigneswaran, Vita Zidere, Owen I Miller, John M Simpson, Gurleen K Sharland
The outcome of the arterial switch operation for transposition of the great arteries (TGA) is excellent, but there is still associated preoperative mortality. Hypoxemia due to inadequate mixing of the pulmonary and systemic circulations may be implicated. Prediction of early hypoxemia by prenatal echocardiographic criteria has proved difficult. We aimed to identify prenatal echocardiographic features that may predict the need for emergency balloon atrial septostomy (BAS) in isolated TGA. Third trimester fetal echocardiograms of the last 40 cases of isolated TGA were reviewed without knowledge of the postnatal outcome...
February 9, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28282389/4d-flow-mri-assessment-of-right-atrial-flow-patterns-in-the-normal-heart-influence-of-caval-vein-arrangement-and-implications-for-the-patent-foramen-ovale
#15
Jehill D Parikh, Jayant Kakarla, Bernard Keavney, John J O'Sullivan, Gary A Ford, Andrew M Blamire, Kieren G Hollingsworth, Louise Coats
AIM: To investigate atrial flow patterns in the normal adult heart, to explore whether caval vein arrangement and patency of the foramen ovale (PFO) may be associated with flow pattern. MATERIALS AND METHODS: Time-resolved, three-dimensional velocity encoded magnetic resonance imaging (4D flow) was employed to assess atrial flow patterns in thirteen healthy subjects (6 male, 40 years, range 25-50) and thirteen subjects (6 male, 40 years, range 21-50) with cryptogenic stroke and patent foramen ovale (CS-PFO)...
2017: PloS One
https://www.readbyqxmd.com/read/28279512/intracranial-video-eeg-monitoring-in-presurgical-evaluation-of-patients-with-refractory-epilepsy
#16
Marlena Hupalo, Rafal Wojcik, Dariusz J Jaskolski
OBJECTIVE: Reviewing our experience in intracranial video-EEG monitoring in the presurgical evaluation of patients with refractory epilepsy. METHODS: We report on 62 out of 202 (31%) patients with refractory epilepsy, who underwent a long term video-EEG monitoring (LTM). The epileptogenic zone (EZ) was localised either based on the results of LTM or after intracranial EEG recordings from depth, subdural or foramen ovale electrodes. The decision on the location of the electrodes was based upon semiology of the seizures, EEG findings and the lesions visualised in MRI brain scan...
March 2, 2017: Neurologia i Neurochirurgia Polska
https://www.readbyqxmd.com/read/28275422/concomitant-left-atrial-myxoma-and-patent-foramen-ovale-is-it-an-evolutional-synergy-for-a-cerebrovascular-event
#17
Glenmore Lasam, Roberto Ramirez
We report a case of a 48-year-old female who presented initially with an abrupt onset of left facial and hand numbness after her routine yoga with no associated syncope, palpitation, chest pain or dyspnea. She consulted her primary care physician and recommended hospital care for possible stroke. On the day of admission, she complained of left facial and hand hemiparesthesia. Cranial imaging and angiography were unremarkable but echocardiography and cardiac computed tomography revealed left atrial mass. She underwent resection of the left atrial mass with an incidental finding of patent foramen ovale intraoperatively...
February 2017: Cardiology Research
https://www.readbyqxmd.com/read/28266661/influence-of-the-valsalva-maneuver-on-cardiac-hemodynamics-and-right-to-left-shunt-in-patients-with-patent-foramen-ovale
#18
Enfa Zhao, Yafei Zhang, Chunmiao Kang, Hua Niu, Jing Zhao, Lei Sun, Baomin Liu
The purpose of this study was to investigate the influence of the Valsalva maneuver (VM) on cardiac hemodynamics in patients with patent foramen ovale (PFO). Sixty-five patients who were highly suspected to have PFO were included. The changes in E, A, E/A ratio of mitral valve blood flow, E, A, E/A ratio of tricuspid valve blood flow, left ventricular end-diastolic volume, area and right atrial area during the resting state and the strain phase of the Valsalva maneuver were observed by transthoracic echocardiography (TTE)...
March 7, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28262410/-platypnea-orthodeoxia%C3%A2-a-report-of-two-cases
#19
V Mercier, G Tragas, P Compère, P Lefebvre, A Van Meerhaeghe
The plathypnea orthodeoxia syndrome is a rare condition that is characterized by dyspnea and hypoxia that occurs in the upright position and improves with recumbency. The diagnostic is often made tardively and requires the combination of two components: a mechanical one (for example a patent foramen ovale) and a kinetic one (for example COPD). This combination contributes to the blood flow through the communication. The treatment consists of closing the veno-arterial communication (in the case of a patent foramen ovale, the closing of the inter-atrial septum) (Knapper et al, 2014)...
March 2, 2017: Revue de Pneumologie Clinique
https://www.readbyqxmd.com/read/28251616/migraine-with-neurological-features-in-a-scuba-diver-with-a-patent-foramen-ovale
#20
Ashhar Ali, A David Rothner
Neurologic complications of decompression sickness have been observed for over half of a century. Little is known, however, about the risk of diving in patients that suffer from migraine with aura (MWA). We report the case of a pediatric patient with a history of migraine with aura, who was later found to have a PFO, who developed headache with neurological symptoms during a scuba diving lesson.
March 2, 2017: Headache
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