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https://www.readbyqxmd.com/read/27890301/thrombolytic-therapy-associated-acute-myocardial-infarction-in-patients-with-acute-ischemic-stroke-a-treatment-dilemma
#1
Chih-Jen Yang, Po-Chuan Chen, Chin-Sheng Lin, Chia-Lin Tsai, Shih-Hung Tsai
Acute myocardial infarction (AMI) is uncommon in the acute phase of acute ischemic stroke (AIS) and occurs in approximately 1% of the population. Here, we report a paradoxical case of AMI during tissue plasminogen activator (t-PA) infusion for AIS. We review and analyze the previously reported cases. We found that only patients with AMI which occurred after thrombolytic therapy for AIS who received an adequate combination of anticoagulation plus percutaneous coronary intervention survived their events. Several mechanisms have been proposed for the development of AMI after thrombolytic therapy...
November 22, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27760527/outcome-of-cardiac-surgery-in-patients-with-low-preoperative-ejection-fraction
#2
Marina Pieri, Alessandro Belletti, Fabrizio Monaco, Antonio Pisano, Mario Musu, Veronica Dalessandro, Giacomo Monti, Gabriele Finco, Alberto Zangrillo, Giovanni Landoni
BACKGROUND: In patients undergoing cardiac surgery, a reduced preoperative left ventricular ejection fraction (LVEF) is common and is associated with a worse outcome. Available outcome data for these patients address specific surgical procedures, mainly coronary artery bypass graft (CABG). Aim of our study was to investigate perioperative outcome of surgery on patients with low pre-operative LVEF undergoing a broad range of cardiac surgical procedures. METHODS: Data from patients with pre-operative LVEF ≤40 % undergoing cardiac surgery at a university hospital were reviewed and analyzed...
October 18, 2016: BMC Anesthesiology
https://www.readbyqxmd.com/read/27749762/infectious-complications-and-immune-inflammatory-response-in-cardiogenic-shock-patients-a-prospective-observational-study
#3
Jiri Parenica, Jiri Jarkovsky, Jan Malaska, Alexandre Mebazaa, Jana Gottwaldova, Katerina Helanova, Jiri Litzman, Milan Dastych, Josef Tomandl, Jindrich Spinar, Ludmila Dostalova, Petr Lokaj, Marie Tomandlova, Monika Goldergova Pavkova, Pavel Sevcik, Matthieu Legrand
INTRODUCTION: Cardiogenic shock (CS) patients are at a high risk of developing infectious complications; however, their early detection is difficult, mainly due to a frequently occurring non-infectious inflammatory response, which accompanies an extensive myocardial infarction or a post-cardiac arrest syndrome. The goal of our prospective study was to describe infectious complications in CS and the immune/inflammatory response based on a serial measurement of several blood-based inflammatory biomarkers...
September 29, 2016: Shock
https://www.readbyqxmd.com/read/27736197/spinal-cord-infarction-post-cardiac-arrest-in-stemi-a-potential-complication-of-intra-aortic-balloon-pump-use
#4
Matthew Harris, Grigoris V Karamasis, Shayna Chotai, Kare H Tang, Gerald J Clesham, Paul A Kelly
Intra-aortic balloon pump (IABP) is commonly used as a cardiac assist device in various clinical situations: cardiogenic shock, mechanical complications of acute myocardial infarction, high risk percutaneous coronary interventions, coronary artery bypass graft surgery and refractory unstable angina and ventricular arrhythmias as bridge to therapy. Although current data support its safety, there is limited or no support for its efficacy. We present the case of spinal cord infarction after IABP use in a patient who presented with ST elevation myocardial infarction and cardiac arrest and we discuss the potential mechanism of such a devastating complication...
October 13, 2016: Acute Cardiac Care
https://www.readbyqxmd.com/read/27648039/early-outcomes-of-on-pump-versus-off-pump-coronary-artery-bypass-grafting
#5
Ghulam Hussain, Hammad Azam, Mirza Ahmad Raza Baig, Naseem Ahmad
OBJECTIVES: To see the early post-operative outcomes of off-pump versus on-pump coronary artery bypass graft surgery. METHODS: This retrospective analytical study was conducted at Ch. Pervaiz Elahi Institute of Cardiology Multan, Pakistan. Our Primary outcome variables were; necessity of inotropic support, nonfatal myocardial infarction, ICU stay, nonfatal stroke, new renal failure requiring dialysis and death within 30 days after operation. There were two groups of patients; Group-I (On-pump group) and Group-II (Off-pump Group)...
July 2016: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/27443107/a-case-of-post-myocardial-infarction-papillary-muscle-rupture
#6
Amornpol Anuwatworn, Christopher Milnes, Vishesh Kumar, Amol Raizada, Verlyn Nykamp, Adam Stys
Papillary muscle rupture is a rare, life-threatening post myocardial infarction mechanical complication. Without surgical intervention, prognosis is very poor. Clinicians need to recognize this complication early, as prompt therapy is crucial. We present a case of inferior ST elevation myocardial infarction complicated by posteromedial papillary muscle rupture resulting in severe acute mitral regurgitation (flail anterior mitral leaflet), acute pulmonary edema and cardiogenic shock. In our patient, a new mitral regurgitation murmur suggested this mechanical complication...
June 2016: South Dakota Medicine: the Journal of the South Dakota State Medical Association
https://www.readbyqxmd.com/read/27342873/twinkle-overexpression-prevents-cardiac-rupture-after-myocardial-infarction-by-alleviating-impaired-mitochondrial-biogenesis
#7
Takahiro Inoue, Masataka Ikeda, Tomomi Ide, Takeo Fujino, Yuka Matsuo, Shinobu Arai, Keita Saku, Kenji Sunagawa
Cardiac rupture is a fatal complication after myocardial infarction (MI). However, the detailed mechanism underlying cardiac rupture after MI remains to be fully elucidated. In this study, we investigated the role of mitochondrial DNA (mtDNA) and mitochondria in the pathophysiology of cardiac rupture by analyzing Twinkle helicase overexpression mice (TW mice). Twinkle overexpression increased mtDNA copy number approximately twofold and ameliorated ischemic cardiomyopathy at day 28 after MI. Notably, Twinkle overexpression markedly prevented cardiac rupture and improved post-MI survival, accompanied by the suppression of MMP-2 and MMP-9 in the MI border area at day 5 after MI when cardiac rupture frequently occurs...
September 1, 2016: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/27258225/permanent-continuous-flow-left-ventricular-assist-devices-use-after-acute-stabilization-for-cardiogenic-shock-in-acute-myocardial-infarction
#8
Josephine Chou, Christian Bermudez, Robert Kormos, Jeffrey Teuteberg
Cardiogenic shock complicating acute myocardial infarctions (CS-AMI) carries high mortality rates. Early use of durable continuous flow left ventricular assist devices (CF-LVAD) in these patients has traditionally been discouraged. Therefore we sought to assess the efficacy and complications of CF-LVAD use in CS-AMI after stabilization with temporary mechanical support. From January 2006 to November 2014, 9 patients underwent CF-LVAD implant after CS-AMI (Heartmate II, six; HVAD, three). All patients required temporary mechanical circulatory support prior to CF-LVAD implant and were INTERMACS profile 1; average time from MI to CF-LVAD implant was 20 days...
June 1, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/27251920/st-elevation-myocardial-infarction
#9
Tawfiq Choudhury, Nick Ej West, Magdi El-Omar
ST segment elevation myocardial infarction remains a significant contributor to morbidity and mortality worldwide, despite a declining incidence and better survival rates. It usually results from thrombotic occlusion of a coronary artery at the site of a ruptured or eroded plaque. Diagnosis is based on characteristic symptoms and electrocardiogram changes, and confirmed subsequently by raised cardiac enzymes. Prognosis is dependent on the size of the infarct, presence of collaterals and speed with which the occluded artery is reopened...
June 2016: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/27229327/women-with-cardiogenic-shock-derive-greater-benefit-from-early-mechanical-circulatory-support-an-update-from-the-cvad-registry
#10
Susan M Joseph, Meredith A Brisco, Monica Colvin, Kathleen L Grady, Mary Norine Walsh, Jennifer L Cook
OBJECTIVES: The aim of this analysis was to assess survival differences between men and women supported with Impella 2.5 (Abiomed Inc., Danvers) in the setting of acute myocardial infarction (AMI) complicated by cardiogenic shock (CS). BACKGROUND: Data on sex differences in outcomes of CS with mechanical circulatory support are sparse. METHODS: Patients enrolled in the cVAD Registry who underwent percutaneous coronary intervention (PCI) and Impella 2...
June 2016: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/27118140/influence-of-body-mass-index-on-outcomes-after-minimal-access-aortic-valve-replacement-through-a-j-shaped-partial-upper-sternotomy
#11
Metesh Acharya, Leanne Harling, Marco Moscarelli, Hutan Ashrafian, Thanos Athanasiou, Roberto Casula
BACKGROUND: Minimal-access aortic valve replacement (MAAVR) may reduce post-operative blood loss and transfusion requirements, decrease post-operative pain, shorten length stay and enhance cosmesis. This may be particularly advantageous in overweight/obese patients, who are at increased risk of post-operative complications. Obese patients are however often denied MAAVR due to the perceived technical procedural difficulty. This retrospective analysis sought to determine the effect of BMI on post-operative outcomes in patients undergoing MAAVR...
2016: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/27102502/ventricular-assist-device-in-acute%C3%A2-myocardial-infarction
#12
MULTICENTER STUDY
Deepak Acharya, Renzo Y Loyaga-Rendon, Salpy V Pamboukian, José A Tallaj, William L Holman, Ryan S Cantor, David C Naftel, James K Kirklin
BACKGROUND: Patients with acute myocardial infarction (AMI) complicated by acute heart failure or cardiogenic shock have high mortality with conventional management. OBJECTIVES: This study evaluated outcomes of patients with AMI who received durable ventricular assist devices (VAD). METHODS: Patients in the INTERMACS (Interagency Registry for Mechanically Assisted Circulatory Support) registry who underwent VAD placement in the setting of AMI were included and compared with patients who received VAD for non-AMI indications...
April 26, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27073732/ventricular-septal-rupture-complicating-acute-myocardial-infarction-in-the-modern-era-with-mechanical-circulatory-support-a-single-center-observational-study
#13
Jared J Liebelt, Yuanquan Yang, Joseph J DeRose, Cynthia C Taub
Ventricular septal rupture (VSR) is a rare but devastating complication after acute myocardial infarction (AMI). While the incidence has decreased, the mortality rate from VSR has remained extremely high. The use of mechanical circulatory support with intra-aortic balloon pump (IABP) and extracorporal membrane oxygenation (ECMO) may be useful in providing hemodynamic stability and time for myocardial scarring. However, the optimal timing for surgical repair remains an enigma. Retrospective analysis of 14 consecutive patients diagnosed with VSR after AMI at Montefiore Medical Center between January 2009 and June 2015...
2016: American Journal of Cardiovascular Disease
https://www.readbyqxmd.com/read/26988903/patent-foramen-ovale-pfo-stroke-and-pregnancy
#14
REVIEW
Lei Chen, Wenjun Deng, Igor Palacios, Ignacio Inglessis-Azuaje, David McMullin, Dong Zhou, Eng H Lo, Ferdinando Buonanno, MingMing Ning
Patent foramen ovale (PFO)-related stroke is increasingly recognized as an important etiology of ischemic embolic stroke-accounting for up to 50% of strokes previously considered 'cryptogenic' or with an unknown mechanism. As a 'back door to the brain,' PFO can allow venous clots to enter arterial circulation via interatrial right-to-left shunting, potentially resulting in ischemic stroke. We observe that clinically, PFO-related stroke affects women of childbearing age, and that pregnancy-owing to major changes in hemocoagulative, hormonal, and cardiovascular parameters-can enhance stroke risks...
June 2016: Journal of Investigative Medicine: the Official Publication of the American Federation for Clinical Research
https://www.readbyqxmd.com/read/26964999/acute-and-long-term-effect-of-percutaneous-coronary-intervention-on-serially-measured-oxidative-inflammatory-and-coagulation-biomarkers-in-patients-with-stable-angina
#15
Gregor Leibundgut, Jun-Hee Lee, Bradley H Strauss, Amit Segev, Sotirios Tsimikas
To derive insights into the temporal changes in oxidative, inflammatory and coagulation biomarkers in patients with stable angina undergoing percutaneous coronary intervention (PCI). PCI is associated with a variety of biochemical and mechanical stresses to the vessel wall. Oxidized phospholipids are present on plasminogen (OxPL-PLG) and potentiate fibrinolysis in vitro. We recently showed that OxPL-PLG increase following acute myocardial infarction, suggesting that they are involved in atherothrombosis. Plasma samples were collected before, immediately after, 6 and 24 h, 3 and 7 days, and 1, 3, and 6 months after PCI in 125 patients with stable angina undergoing uncomplicated PCI...
May 2016: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/26957711/leg-amputation-a-rare-complication-of-intra-aortic-balloon-pump
#16
Alka Gupta, Vinod Bala Dhir, Michell Gulabani, Anupama Gill Sharma
Intra-aortic balloon pump (IABP) is a bridge to definitive management in a patient with compromised systolic function. It is a life-saving mechanical support to the failing myocardium. It is a procedure that should be employed judiciously with utmost caution. In this correspondence, we aim to highlight a rather serious complication associated with IABP use. A patient with triple vessel disease was posted for coronary artery bypass grafting with poor left ventricular function (ejection fraction 30%) and previous myocardial infarction 4 months back...
January 2016: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/26886878/cardiovascular-disease-as-a-complication-of-community-acquired-pneumonia
#17
REVIEW
Nikolas Rae, Simon Finch, James D Chalmers
PURPOSE OF REVIEW: Here, we review the incidence, prognosis, potential mechanisms and therapeutic implications of cardiovascular disease in community-acquired pneumonia (CAP). RECENT FINDINGS: Recent evidence suggests that a large proportion of deaths from CAP are attributable to cardiovascular disease, including sudden cardiac death, acute myocardial infarction (MI), arrhythmias and cardiac failure. Up to one-third of patients with CAP may experience cardiovascular complications within 30 days of hospital admission, while data also suggest that CAP managed in the community is associated with increased risk of acute MI...
May 2016: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/26880720/effective-percutaneous-edge-to-edge-mitral-valve-repair-with-mitraclip-in-a-patient-with-acute-post-mi-regurgitation-not-related-to-papillary-muscle-rupture
#18
Giandomenico Tarsia, Costantino Smaldone, Marco F Costantino
A 65-year-old woman was admitted to our institution for rest dyspnea and hypotension. EKG showed sinus tachycardia with signs of infero-posterior STEMI. 2D-echocardiogram showed severe left ventricular systolic dysfunction with a- diskynesia of the inferior and posterior walls and severe functional mitral regurgitation (MR). The patient underwent urgent coronary angiography that showed 3-vessels disease with total occlusion of both first obtuse marginal (OM) branch of the left circumflex artery and right coronary artery (RCA) and critical stenosis of left anterior descending (LAD)...
February 16, 2016: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/26798393/transatrial-approach-for-the-repair-of-the-posterior-post-infarct-ventricular-septal-rupture
#19
Seong Ho Cho, Wook Sung Kim
Ventricular septal rupture (VSR) is a disastrous mechanical complication of myocardial infarction. Although several surgical interventions have been developed, mortality due to surgical management remains high, especially in the case of posterior VSR. We report a successful case of repair of posterior VSR using an alternative transatrial approach to avoid the complications related to ventricular incision.
January 2016: Korean Circulation Journal
https://www.readbyqxmd.com/read/26766900/effect-of-milrinone-on-cardiac-functions-in-patients-undergoing-coronary-artery-bypass-graft-a-meta-analysis-of-randomized-clinical-trials
#20
Zhigang You, Lin Huang, Xiaoshu Cheng, Qinghua Wu, Xinghua Jiang, Yanqing Wu
BACKGROUND AND AIM: Inotropes are commonly used to treat myocardial dysfunction, which is the major complication after coronary artery bypass graft (CABG). Milrinone, a phosphodiesterase 3 inhibitor, is one of these inotropes. Recently, a number of clinical studies have been carried out to evaluate the effects of milrinone on cardiac function in patients with low ventricular ejection fraction undergoing CABG. However, it has been inconclusive because of the inconsistent results. In addition, some studies found that milrinone increased the incidence of postoperative atrial arrhythmias and did not show any long-term beneficial effects on survival...
2016: Drug Design, Development and Therapy
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