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https://www.readbyqxmd.com/read/28529306/normalization-of-diffuse-st-depression-with-avr-elevation-after-rehydration-in-a-patient-with-severe-aortic-stenosis
#1
Sachin R Patel, Vikas J Patel, Brittany Clark, George Rust
BACKGROUND Isolated ST elevation in lead aVR in combination with global ST depression with normalization after rehydration is a unique electrocardiographic pattern that is associated with a broad range of diagnoses. Its association with left main coronary artery disease and other acute coronary syndromes suggest the need for early and aggressive cardiac evaluation. CASE REPORT A 53-year-old man presented with altered mental status and loss of consciousness. He was unresponsive, hypotensive, tachycardiac, and diaphoretic...
May 22, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28516757/gastric-perforation-caused-by-an-intragastric-balloon-endoscopic-findings
#2
In Kyung Yoo, Hoon Jai Chun, Yoon Tae Jeen
Intragastric balloon (IGB) insertion has been most frequently used in the West as an effective endoscopic treatment for morbid obesity, in practice. Recently, there is a growing number of cases requiring IGB deployment for obesity treatment in Korea. One of the reported complications of IGB use is gastric perforation. A 47-year-old woman was admitted to the hospital with mild symptoms, 7 weeks after having an IGB placed. Esophagogastroduodenoscopy was performed and gastric ulcer perforation was observed in the ulcer base, where food particles were impacted...
May 18, 2017: Clinical Endoscopy
https://www.readbyqxmd.com/read/28514261/doppler-ultrasound-evaluation-of-circulatory-support-devices
#3
Zachary Nuffer, Andrey Rupasov, Shweta Bhatt
In the setting of mechanical circulatory support devices, including ventricular assist devices, extracorporeal membrane oxygenation, intraaortic balloon pumps, and the total artificial heart, the spectral Doppler waveform is significantly altered, reflecting systemic hemodynamic changes. As the prevalence of these devices increases, a better understanding of both the devices themselves and their associated Doppler ultrasound findings is necessary for accurate image interpretation. This article reviews the clinical indications, pathophysiology, and sonographic findings of these devices, with emphasis on the variation in arterial Doppler waveforms that can be seen with normal function, as well as the major complications...
May 16, 2017: Ultrasound Quarterly
https://www.readbyqxmd.com/read/28512440/clinical-depression-and-punishment-sensitivity-on-the-bart
#4
David Hevey, Kevin Thomas, Sofia Laureano-Schelten, Karen Looney, Richard Booth
Depression is associated with altered sensitivity to reward and punishment, which can influence complex decision-making. We examined punishment sensitivity in the performance of participants with major depressive disorder (MDD) with that of a comparison group on the automatic Balloon Analogue Risk Task (BART), which is a direct measure of risk taking. The present study examined the BART performance of 30 individuals with MDD and 30 matched comparison individuals. The comparison group (M = 63.25) entered a significantly (p < 0...
2017: Frontiers in Psychology
https://www.readbyqxmd.com/read/28505298/early-health-outcome-and-10-year-survival-in-patients-undergoing-redo-coronary-surgery-with-or-without-cardiopulmonary-bypass-a-propensity-score-matched-analysis
#5
Vito D Bruno, Mustafa Zakkar, Filippo Rapetto, Asif Rathore, Roberto Marsico, Pierpaolo Chivasso, Raimondo Ascione
OBJECTIVES: To investigate the in-hospital health outcome and 10-year survival in patients undergoing redo coronary surgery with (redo-CABG) or without (redo-OPCAB) cardiopulmonary bypass. METHODS: A total of 349 redo coronary surgery patients were identified from our registry. Of these, 143 redo-OPCAB patients (40.97%) were compared with 206 redo-CABG patients. To minimize the bias, we also conducted propensity score matching. In Matched Analysis A, 111 redo-OPCAB patients with any type of primary cardiac operation were compared with 111 redo-CABG cases...
May 15, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28501864/first-line-support-by-intra-aortic-balloon-pump-in-non-ischaemic-cardiogenic-shock-in-the-era-of-modern-ventricular-assist-devices
#6
Corstiaan A den Uil, Giorgia Galli, Lucia S Jewbali, Kadir Caliskan, Olivier C Manintveld, Jasper J Brugts, Nicolas M van Mieghem, Mattie J Lenzen, Eric Boersma, Alina A Constantinescu
OBJECTIVES: Little is known about circulatory support in cardiogenic shock (CS) from other causes than the acute coronary syndrome or after cardiotomy. We evaluated the effects of first-line intra-aortic balloon pump (IABP) support in this subpopulation of CS patients. METHODS: A retrospective study was performed in 27 patients with CS from end-stage cardiomyopathy supported firstly by IABP in the years 2011-2016. RESULTS: At 24 h, lactate decreased from 3...
May 13, 2017: Cardiology
https://www.readbyqxmd.com/read/28500136/percutaneous-mechanical-circulatory-support-devices-in-cardiogenic-shock
#7
REVIEW
Aditya Mandawat, Sunil V Rao
Despite a high rate of early revascularization and use of intra-aortic balloon pump counterpulsation therapy, the prognosis of patients with cardiogenic shock has remained poor. In the hopes of improving outcomes, clinicians are increasingly turning to percutaneous left and right mechanical circulatory support devices. Until recently, the evidence base for these devices had consisted only of observational data, meta-analyses, and small feasibility trials. In this article, we describe the contemporary outcomes of patients with cardiogenic shock, the hemodynamics of cardiogenic shock, and hemodynamic effects of percutaneous mechanical circulatory support devices...
May 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28498865/when-do-traumatic-experiences-alter-risk-taking-behavior-a-machine-learning-analysis-of-reports-from-refugees
#8
Mareike Augsburger, Thomas Elbert
Exposure to traumatic stressors and subsequent trauma-related mental changes may alter a person's risk-taking behavior. It is unclear whether this relationship depends on the specific types of traumatic experiences. Moreover, the association has never been tested in displaced individuals with substantial levels of traumatic experiences. The present study assessed risk-taking behavior in 56 displaced individuals by means of the balloon analogue risk task (BART). Exposure to traumatic events, symptoms of posttraumatic stress disorder and depression were assessed by means of semi-structured interviews...
2017: PloS One
https://www.readbyqxmd.com/read/28496024/a-survival-case-of-fulminant-right-side-dominant-eosinophilic-myocarditis
#9
Keishi Moriwaki, Kaoru Dohi, Taku Omori, Muneyoshi Tanimura, Emiyo Sugiura, Shiro Nakamori, Toshiki Sawai, Kyoko Imanaka-Yoshida, Norikazu Yamada, Masaaki Ito
A 59-year-old Japanese woman was admitted to a nearby hospital with dyspnea and general malaise. Transthoracic echocardiography revealed right ventricular (RV) dilatation with severely reduced systolic function and leftward shift of the intraventricular septum. She was initially diagnosed with acute right heart failure, and fell into cardiogenic shock requiring an intra-aortic balloon pump and inotropic agents. An endomyocardial biopsy (EMB) demonstrated extensive interstitial edema, infiltration of inflammatory cells including numerous eosinophils, and myocytolysis with eosinophil degranulation...
May 12, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28490683/-concomitant-surgery-for-symptomatic-severe-carotid-artery-stenosis-and-aortic-valve-stenosis-with-contralateral-internal-carotid-artery-occlusion-a-case-report
#10
Tomonori Takeshita, Kohei Ishihara, Yuu Murakami, Hiroshi Munakata, Katsuhito Mabuni, Tadao Kugai, Tomoaki Nagamine
We report a case of concomitant carotid endarterectomy(CEA)and aortic valve replacement(AVR)for symptomatic severe carotid artery and aortic valve stenosis(AS). A 77-year-old man, presented to our hospital with AS complicated by right internal carotid artery(ICA)stenosis and left ICA occlusion, seeking treatment for AS. He suffered from left hemiparesis, and diffusion-weighted magnetic resonance imaging(MRI)showed multiple ischemic lesions in the right cerebral hemisphere. He was admitted to our neurosurgical department and received treatment for acute cerebral infarction caused by severe right ICA stenosis...
May 2017: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/28489254/use-of-intra-aortic-counterpulsation-in-cardiogenic-shock-post-liver-transplantation
#11
Arun P Palanisamy, Satish N Nadig, Gabriel R Chedister, Jacob E Dowden, David G Koch, William D Stoll, John W McGillicuddy, Kenneth D Chavin
Left ventricular dysfunction resulting in cardiogenic shock occurs infrequently following organ reperfusion in liver transplantation. The etiology of the cardiogenic shock is often multifactorial and difficult to manage due to the complex nature of the procedure and the patient's baseline physiology. Traditionally, this hemodynamic instability is managed medically using inotropic agents and vasopressor support. If medical treatment is insufficient, the use of an intra-aortic balloon pump for counterpulsation may be employed to improve the hemodynamics and stabilize the patient...
May 10, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28489217/intra-aortic-balloon-pump-in-cardiogenic-shock-state-of-the-art
#12
Petronio Generoso Thomaz, Leonel Adelino Moura, Giovana Muramoto, Renato Samy Assad
The clinical definition of cardiogenic shock is that of a low cardiac output and evidence of tissue hypoxia in the presence of adequate blood volume. Cardiogenic shock is the main cause of death related to acute myocardial infarction (AMI), with a mortality rate of 45-70% in the absence of aggressive and highly specialized technical care. The intra-aortic balloon pump (IABP) is one of the most widely used mechanical assisting devices. During the last two decades, about 42% of patients with AMI who evolved with cardiogenic shock received mechanical circulatory assistance with IABP...
January 2017: Revista do Colégio Brasileiro de Cirurgiões
https://www.readbyqxmd.com/read/28472406/short-term-mechanical-circulatory-support-as-a-bridge-to-durable-left-ventricular-assist-device-implantation-in-refractory-cardiogenic-shock-a-systematic-review-and-meta-analysis
#13
Corstiaan A den Uil, Sakir Akin, Lucia S Jewbali, Dinis Dos Reis Miranda, Jasper J Brugts, Alina A Constantinescu, Arie Pieter Kappetein, Kadir Caliskan
Short-term mechanical circulatory support (MCS) is increasingly used as a bridge to decision in patients with refractory cardiogenic shock. Subsequently, these patients might be bridged to durable MCS either as a bridge to candidacy/transplantation, or as destination therapy. The aim of this study was to review support duration and clinical outcome of short-term MCS in cardiogenic shock, and to analyse application of this technology as a bridge to long-term cardiac support (left ventricular assist device, LVAD) from 2006 till June 2016...
May 3, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28471899/angioinvasive-aspergillus-associated-stroke-in-an-immunocompetent-host-following-cardiac-surgery-and-ecmo
#14
Tapan Kavi, Nikhil Madan, Tamara Majic, Axel Rosengart, Marcel Maya, Serguei Bannykh, Shouri Lahiri
INTRODUCTION: Invasive cerebral aspergillosis is an uncommon cause of stroke among immunocompetent patients and has not been reported in association with cardiac surgery or extracorporeal membrane oxygenation (ECMO). We report the case of an immunocompetent host who developed aspergillus-associated stroke following coronary artery bypass graft (CABG) and ECMO. CASE REPORT: A 59-year-old woman developed cardiogenic shock after 3-vessel-CABG requiring intra-aortic balloon pump placement and subsequent veno-arterial ECMO...
May 2017: Neurologist
https://www.readbyqxmd.com/read/28471885/extracorporeal-membrane-oxygenation-for-acute-decompensated-heart-failure
#15
Laurence Dangers, Nicholas Bréchot, Matthieu Schmidt, Guillaume Lebreton, Guillaume Hékimian, Ania Nieszkowska, Sébastien Besset, Jean-Louis Trouillet, Jean Chastre, Pascal Leprince, Alain Combes, Charles-Edouard Luyt
OBJECTIVE: Long-term outcomes of patients treated with venoarterial-extracorporeal membrane oxygenation for acute decompensated heart failure (i.e., cardiogenic shock complicating chronic cardiomyopathy) have not yet been reported. This study was undertaken to describe their outcomes and determine mortality-associated factors. DESIGN: Retrospective analysis of data prospectively collected. SETTING: Twenty-six-bed tertiary hospital ICU. PATIENTS: One hundred five patients implanted with venoarterial-extracorporeal membrane oxygenation for acute decompensated heart failure...
May 3, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28470925/modalities-and-effects-of-left-ventricle-unloading-on-extracorporeal-life-support-a-review-of-the-current-literature
#16
Paolo Meani, Sandro Gelsomino, Eshan Natour, Daniel M Johnson, Hans-Peter Brunner La Rocca, Federico Pappalardo, Elham Bidar, Maged Makhoul, Giuseppe Raffa, Samuel Heuts, Pieter Lozekoot, Suzanne Kats, Niels Sluijpers, Rick Schreurs, Thijs Delnoij, Alice Montalti, Jan Willem Sels, Marcel van de Poll, Paul Roekaerts, Thomas Poels, Eric Korver, Zaheer Babar, Jos Maessen, Roberto Lorusso
INTRODUCTION/AIM: Veno-arterial extracorporeal membrane oxygenation (V-A ECMO) support is increasingly used in refractory cardiogenic shock and cardiac arrest, but is characterized by a rise in afterload of the left ventricle (LV) which may ultimately either further impair or delay cardiac contractility improvement. The aim of this study was to provide a comprehensive overview regarding the different LV venting techniques and results currently available in the literature. METHODS: A systematic literature search was performed in the PubMed database: 207 articles published between 1993 and 2016 were included...
May 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/28461800/bioprosthetic-aortic-valve-replacement-in-a-donor-heart-before-orthotopic-heart-transplantation
#17
Manish Patel, Khashayar K Vahdat, Sriram Nathan, Marija Petrovic, Pranav Loyalka, Biswajit Kar, Igor D Gregoric
Current criteria for donor hearts limit the number of hearts available for transplantation, despite an increasing number of recipients on waiting lists. We report the case of a patient with ischemic cardiomyopathy and refractory ventricular tachycardia who underwent successful orthotopic heart transplantation and concurrent aortic valve replacement with a donor heart that had displayed moderate aortic valve regurgitation. The patient was a 71-year-old man with a history of advanced heart failure, 5-vessel coronary artery bypass grafting, and paroxysmal ventricular tachycardia...
April 2017: Texas Heart Institute Journal
https://www.readbyqxmd.com/read/28458558/impact-of-around-the-clock-in-house-cardiology-fellow-coverage-on-door-to-balloon-time-in-an-academic-medical-center
#18
Luke C Kohan, Vijaiganesh Nagarajan, Michael A Millard, Michael J Loguidice, Nancy M Fauber, Ellen C Keeley
OBJECTIVES: To assess if a change in our cardiology fellowship program impacted our ST elevation myocardial infarction (STEMI) program. BACKGROUND: Fellows covering the cardiac care unit were spending excessive hours in the hospital while on call, resulting in increased duty hours violations. A night float fellow system was started on July 1, 2012, allowing the cardiac care unit fellow to sign out to a night float fellow at 5:30 pm. The night float fellow remained in-house until the morning...
2017: Vascular Health and Risk Management
https://www.readbyqxmd.com/read/28457738/acromegalic-cardiomyopathy-with-malignant-arrhythmogenic-pattern-successfully-treated-with-mechanical-circulatory-support-and-heart-transplantation
#19
Sara Doimo, Daniela Miani, Nicoletta Finato, Mauro Driussi, Gianfranco Sinagra, Ugolino Livi, Alessandro Proclemer
Cardiovascular involvement is common in acromegaly and can lead to development of acromegalic cardiomyopathy, characterized by concentric biventricular hypertrophy with a progressive impairment of diastolic and systolic function. The onset of heart failure and arrhythmias are related to poor prognosis. We report on a case of a 48-year-old man with acromegalic cardiomyopathy caused by pituitary adenoma. Despite the successful trans-sphenoidal resection of the tumour, the patient was rehospitalized for ventricular arrhythmic storms that led to cardiogenic shock, which required mechanical hemodynamic support with intra-aortic balloon pump, venoarterial extracorporeal membrane oxygenation, and urgent heart transplantation...
February 21, 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28450765/effect-of-body-mass-index-on-postoperative-complications-in-beating-coronary-artery-surgery
#20
Feridoun Sabzi, Reza Faraji
BACKGROUND: Body Mass Index (BMI) is considered as an important risk factor in cardiovascular surgery. We designed a historical cohort study for the evaluation of perioperative complications related to BMI in patients who underwent off-pump coronary artery bypass grafting (OPCAB). METHODS: We studied 1120 consecutive patients who underwent OPCAB between January 2008 and December 2011 in Imam Ali Hospital, Kermanshah, Iran. Patients were divided into four groups according to BMI: underweight/low BMI (< 18...
November 2016: Ethiopian Journal of Health Sciences
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