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Cardiac shortness of breath

Choukri Mekkaoui, Timothy G Reese, Marcel P Jackowski, Stephen F Cauley, Kawin Setsompop, Himanshu Bhat, David E Sosnovik
Purpose To develop a clinically feasible whole-heart free-breathing diffusion-tensor (DT) magnetic resonance (MR) imaging approach with an imaging time of approximately 15 minutes to enable three-dimensional (3D) tractography. Materials and Methods The study was compliant with HIPAA and the institutional review board and required written consent from the participants. DT imaging was performed in seven healthy volunteers and three patients with pulmonary hypertension by using a stimulated echo sequence. Twelve contiguous short-axis sections and six four-chamber sections that covered the entire left ventricle were acquired by using simultaneous multisection (SMS) excitation with a blipped-controlled aliasing in parallel imaging readout...
September 28, 2016: Radiology
Robert C Hsu, Joshua Burak, Sumit Tiwari, Chayan Chakraborti, Gary E Sander
BACKGROUND: Chagas disease (CD), caused by Trypanosoma cruzi, affects 6-7 million people worldwide annually, primarily in Central and South America, and >300,000 people in the United States. CD consists of acute and chronic stages. Hallmarks of acute CD include fever, myalgia, diaphoresis, hepatosplenomegaly, and myocarditis. Symptoms of chronic CD include pathologic involvement of the heart, esophagus, and colon. Myocardial involvement is identifiable by electrocardiogram and cardiac magnetic resonance imaging showing inflammation and left ventricular wall functional abnormalities...
2016: Ochsner Journal
Anne Maree Kelly, Anna Holdgate, Gerben Keijzers, Sharon Klim, Colin A Graham, Simon Craig, Win Sen Kuan, Peter Jones, Charles Lawoko, Said Laribi
BACKGROUND: This study aimed to determine epidemiology and outcome for patients presenting to emergency departments (ED) with shortness of breath who were transported by ambulance. METHODS: This was a planned sub-study of a prospective, interrupted time series cohort study conducted at three time points in 2014 and which included consecutive adult patients presenting to the ED with dyspnoea as a main symptom. For this sub-study, additional inclusion criteria were presentation to an ED in Australia or New Zealand and transport by ambulance...
September 22, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Fahad Almehmadi, Mark Chandy, Kim A Connelly, Jeremy Edwards
Delayed cardiac tamponade after a penetrating chest injury is a rare complication. The clinical diagnosis of tamponade is facilitated with imaging. We present a case report of a 23-year-old male who was brought to emergency after multiple stab wounds to the chest. After resuscitation and repair of laceration of right internal mammary artery and right ventricle, he was discharged but later returned with shortness of breath. Echocardiography revealed a rare case of delayed pericardial tamponade causing left ventricular collapse...
2016: Case Reports in Cardiology
Selçuk Yazıcı, Tuncay Kırış, Ufuk S Ceylan, Şükrü Akyüz, Ahmet O Uzun, Recep Hacı, Sait Terzi, Abdullah Doğan, Ayşe Emre, Kemal Yeşilçimen
BACKGROUND: Cardiac troponins and red cell distribution width (RDW) are associated with increased mortality in acute pulmonary embolism (PE). In this study, we aimed to investigate the accuracy of the combined use of troponin and RDW in predicting short-term mortality in acute PE patients. METHODS: The data of 201 patients with the diagnosis of acute PE were retrospectively analyzed. We obtained troponin-RDW scores (TR scores) using a combination of troponin and RDW values, and then evaluated this score's accuracy in predicting mortality in patients with acute PE...
September 19, 2016: Wiener Klinische Wochenschrift
Tejinder Kataria, Shyam Singh Bisht, Deepak Gupta, Ashu Abhishek, Trinanjan Basu, Kushal Narang, Shikha Goyal, Pragya Shukla, Manish Bansal, Hardeep Grewal, Kulbeer Ahlawat, Susovan Banarjee, Manoj Tayal
BACKGROUND: Radiotherapy for carcinoma of breast and thoracic structures involves inadvertent radiation to heart and coronary arteries (CA). Coronary artery stenosis in high radiation dose segments has been documented. Cardiac and respiratory motion induced displacement of CA and internal risk volume (IRV) margin remains inadequately quantified. MATERIAL AND METHODS: Twenty cases of carcinoma breast, lung and lung metastasis were enrolled in this study. ECG gated intravenous contrast enhanced computed tomography (CECT) scans were performed in inspiratory breath hold (IBH) and expiratory breath hold (EBH)...
September 15, 2016: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
Wenyan Wang, Huaicong Long, Zhiying Zhao
Cardiac lymphoma is extremely rare. An intracardiac mass has rarely been reported to be the cardiac involvement of extranodal lymphoma. It is difficult to establish a final diagnosis via routine examinations. The ability of an echocardiogram to characterize tissue is limited; systemic (18)F-FDG PET/CT scans provide important information for both staging and response assessment in patients with lymphoma. A 68-year-old Chinese male with a second patent foramen ovale (PFO) and an interventricular septal defect presented at our institute with persistent fever, shortness of breath, repeated paroxysmal supraventricular tachycardia (PSVT) attack, and rapidly progressing superior vena cava syndrome...
2016: Case Reports in Cardiology
Ingela Wiklund, Milena Anatchkova, Hafiz Oko-Osi, Robyn von Maltzahn, Dina Chau, Fady I Malik, Donald L Patrick, John Spertus, John R Teerlink
BACKGROUND: Patient-reported outcome (PRO) measures can be used to support label claims if they adhere to US Food & Drug Administration guidance. The process of developing a new PRO measure is expensive and time-consuming. We report the results of qualitative studies to develop new PRO measures for use in clinical trials of omecamtiv mecarbil (a selective, small molecule activator of cardiac myosin) for patients with heart failure (HF), as well as the lessons learned from the development process...
2016: Health and Quality of Life Outcomes
T G Wilson, P Jenkins, A Hoschtitzky, M McCabe
To date, there have been less than a 100 confirmed case reports of primary cardiac malignant fibrous histiocytomas, a rare form of sarcoma. In this report, we discuss the case of a 15-year-old girl who initially presented with a histiocytic cerebral sarcoma that was treated with aggressive resection and chemotherapy. Three years later, the same patient developed increasing shortness of breath and was found to have a high-grade pleomorphic undifferentiated cardiac sarcoma that likely represents the primary tumour from which the cerebral lesion metastasised...
2016: Ecancermedicalscience
Ding-Kuo Chien, Ming-Yuan Huang, Chien-Hsuan Huang, Shou-Chuan Shih, Wen-Han Chang
OBJECTIVE: Acute myocardial infarction (AMI) is a medical emergency; a missed or delayed diagnosis of this disease may contribute to a poor outcome and even death. Several studies have found elderly patients with AMI have atypical presentations for diagnosis, therefore we undertook this study to determine the risks among the elderly population, especially in female patients. MATERIALS AND METHODS: In this one-year retrospective study, we reviewed the cases of AMI patients who had visited the emergency department at Mackay Memorial Hospital, Taiwan, and who had either been discharged or had died following a diagnosis of AMI (ICD code 410)...
August 2016: Taiwanese Journal of Obstetrics & Gynecology
Tomoyuki Kido, Teruhito Kido, Masashi Nakamura, Kouki Watanabe, Michaela Schmidt, Christoph Forman, Teruhito Mochizuki
BACKGROUND: Cardiovascular cine magnetic resonance (CMR) accelerated by compressed sensing (CS) is used to assess left ventricular (LV) function. However, it is difficult for prospective CS cine CMR to capture the complete end-diastolic phase, which can lead to underestimation of the end-diastolic volume (EDV), stroke volume (SV), and ejection fraction (EF), compared to retrospective standard cine CMR. This prospective study aimed to evaluate the diagnostic quality and accuracy of single-breath-hold full cardiac cycle CS cine CMR, acquired over two heart beats, to quantify LV volume in comparison to multi-breath-hold standard cine CMR...
2016: Journal of Cardiovascular Magnetic Resonance
Heewon Chung, Hoon Ko, Tharoeun Thap, Changwon Jeong, Se-Eung Noh, Kwon-Ha Yoon, Jinseok Lee
We introduce a cardiac rehabilitation program (CRP) that utilizes only a smartphone, with no external devices. As an efficient guide for cardiac rehabilitation exercise, we developed an application to automatically indicate the exercise intensity by comparing the estimated heart rate (HR) with the target heart rate zone (THZ). The HR is estimated using video images of a fingertip taken by the smartphone's built-in camera. The introduced CRP app includes pre-exercise, exercise with intensity guidance, and post-exercise...
2016: PloS One
Fuad M Al-Azzam, Sameh M Said, Hartzell V Schaff
Malignant cardiac tumors are very rare. They carry a high risk of morbidity and death. We present a case of malignant intimal sarcoma that originated from the pulmonary valve leaflet in a 72-year-old woman. The clinical presentation was gradual onset of shortness of breath and fatigue.We successfully removed the tumor, with pulmonary valve preservation.
September 2016: Annals of Thoracic Surgery
Antonio F Saad, Luis Monsivais, Luis D Pacheco
BACKGROUND: Despite its seldom occurrence, fetal tachycardia can lead to poor fetal outcomes including hydrops and fetal death. Management can be challenging and result in maternal adverse effects secondary to high serum drug levels required to achieve effective transplacental antiarrhythmic drug therapy. CASE: A 33-year-old woman at 33 weeks of gestation with a diagnosis of a fetal sustained superior ventricular tachycardia developed chest pain, shortness of breath, and bigeminy on electrocardiogram secondary to digoxin toxicity despite subtherapeutic serum drug levels...
July 2016: American Journal of Perinatology Reports
C W Bircher, S Farrakh, R Gada
Arrhythmias are one of the most common forms of cardiac disease presenting in pregnancy. Women with underlying arrhythmias may only present to health care professionals when they are pregnant. The most common type of sustained arrhythmia presenting in pregnancy is a supraventricular tachycardia (SVT). This can be difficult to diagnose, as symptoms such as palpitations, dizziness and shortness of breath are also common symptoms of pregnancy. We present the management of a woman who developed intrapartum SVT...
June 2016: Obstetric Medicine
Nicla A Varnier, Sarah Chwah, Trent Miller, Franziska Pettit, Mark Brown, David Rees, Amanda Henry
BACKGROUND: Shortness of breath is a common physiological pregnancy presentation, secondary to both hormonal and mechanical effects. Its pathological causes are common (asthma exacerbation or infection); new-onset cardiac pathology is rarely considered. CASE: JC, a 39-year old G4P2T1, presented at 34 weeks' gestation with shortness of breath unrelieved by salbutamol. History included asthma, poly-drug abuse and smoking. Initial presentation was consistent with asthma exacerbation and she was treated as such...
September 2015: Obstetric Medicine
Amanda M Perak, Alexander R Opotowsky, Brian K Walsh, Jesse J Esch, James A DiNardo, Barry D Kussman, Diego Porras, Jonathan Rhodes
OBJECTIVE: To assess the feasibility and accuracy of inert gas rebreathing (IGR) pulmonary blood flow (Qp) estimation in mechanically ventilated pediatric patients, potentially providing real-time noninvasive estimates of cardiac output. STUDY DESIGN: In mechanically ventilated patients in the pediatric catheterization laboratory, we compared IGR Qp with Qp estimates based upon the Fick equation using measured oxygen consumption (VO2) (FickTrue); for context, we compared FickTrue with a standard clinical short-cut, replacing measured with assumed VO2 in the Fick equation (FickLaFarge, FickLundell, FickSeckeler)...
October 2016: Journal of Pediatrics
Kevin Martell, Roderick Simpson, David Skarsgard
We present the case of a 62-year-old male originally diagnosed with squamous cell carcinoma (SCC) of the right retromolar trigone, Stage cT2N2bM0. He was treated radically with a pharyngotomy and segmental mandibular resection, right selective neck nodal dissection, and then reconstruction with a free fibular flap. The pathologic stage was T4aN1. He then received adjuvant chemoradiation therapy with a radiation dose of 6,000 cGy in 30 fractions, along with cisplatin, 100 mg/m(2) every three weeks. Good local control was repeatedly documented for two years...
2016: Curēus
Michelle A Hieger, Michael P Emswiler, Kevin F Maskell, John T Sentz, Kristin B Miller, Carl E Wolf, Kirk L Cumpston, Brandon K Wills
BACKGROUND: Adulteration of drugs of abuse may be done to increase profits. Some adulterants are relatively innocuous and others result in significant toxicity. Clenbuterol is a β2-adrenergic agonist with veterinary uses that has not been approved by the U.S. Food and Drug Administration for human use. It is an infrequently reported heroin adulterant. We describe a cluster of hospitalized patients with laboratory-confirmed clenbuterol exposure resulting in serious clinical effects. CASE SERIES: Ten patients presented with unexpected symptoms shortly after heroin use...
September 2016: Journal of Emergency Medicine
Börge Arndt, Timo Gaiser, Alexander Marx, Christina Rieger
A 43-year-old man was admitted to this hospital because of shortness of breath and chest pain. The patient had a history of cardiac surgery at the age of seven (due to a congenital heart defect), and of intracerebral bleeding which had occurred at the age of 23. There was no history of autoimmune disorders. Computed tomography revealed a well-circumscribed anterior mediastinal mass, measuring 4 × 3 × 3 cm with calcification and cystic components. Therefore a malignant tumor was suspected for which a thymectomy was performed...
July 2016: Deutsche Medizinische Wochenschrift
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