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NYHA dyspnea

Hae-Young Lee, Chan-Soon Park, Sang-Hoon Na, Kyung-Jin Kim, Chan Joo Lee, Sungha Park
A 47-year-old woman was admitted via emergency department due to dyspnea NYHA Fc II-III aggravated for 2 months after upper respiratory infection. Her height and body weight were 161 cm / 67 kg. Initial vital signs were 110/70 mmHg - 112 BPM - 24/min - 36.5°C. Chest PA showed cardiomegaly and pulmonary congestion (Figure 1). B-natriuretic peptide level was markedly increased (2002 pg/mL, normal range ≤ 100 pg/mL). The echocardiographic examination showed severely dilated LV cavity (61/72 mm) and severe LV systolic dysfunction (EF 28%) with normal left ventricular wall thickness (9/11 mm) (Figure 2)...
September 2016: Journal of Hypertension
Hae-Young Lee, Chan-Soon Park, Sang-Hoon Na, Kyung-Jin Kim, Chan Joo Lee, Sungha Park
A 47-year-old woman was admitted via emergency department due to dyspnea NYHA Fc II-III aggravated for 2 months after upper respiratory infection. Her height and body weight were 161 cm / 67 kg. Initial vital signs were 110/70 mmHg - 112 BPM - 24/min - 36.5°C. Chest PA showed cardiomegaly and pulmonary congestion (Figure 1). B-natriuretic peptide level was markedly increased (2002 pg/mL, normal range ≤ 100 pg/mL). The echocardiographic examination showed severely dilated LV cavity (61/72 mm) and severe LV systolic dysfunction (EF 28%) with normal left ventricular wall thickness (9/11 mm) (Figure 2)...
September 2016: Journal of Hypertension
Santosh Kumar Sinha, Dibbendhu Khanra, Mukesh Jitendra Jha, Karandeep Singh, Mahamdulla Razi, Amit Goel, Vikas Mishra, Mohammad Asif, Mohit Sachan, Nasar Afdaali, Ashutosh Kumar, Ramesh Thakur, Vinay Krishna, Umeshwar Pandey, Chandra Mohan Varma
ALCAPA syndrome (anomalous origin of the left coronary artery from the pulmonary artery) is a rare disease but lethal with clinical expression from myocardial infarction, congestive heart failure to death during early infancy and unusual survival to adulthood. We report a 73-year-old woman with ALCAPA who presented with exertional dyspnea (NYHA functional class II) over past 2 years. Physical examination revealed soft S, long mid diastolic rumbling murmur and apical pan-systolic murmur. Electrocardiography displayed biatrial enlargement and poor R progression and normal sinus rhythm...
October 2016: Journal of Clinical Medicine Research
Shahla Abrar, Mohammed Junaid Ansari, Mahima Mittal, K P Kushwaha
INTRODUCTION: Paediatric myocarditis can present as mild flu like symptoms to fulminent form. Early identification of the severity of illness and prioritization of intensive care is helpful especially in developing countries with limited resources. AIM: To know the factors at admission that can predict mortality in paediatric myocarditis. MATERIALS AND METHODS: This was an observational study which enrolled children who presented with fever of acute onset (less than 15 days in duration), and were diagnosed as suspected myocarditis on the basis of clinical features, Troponin I and echocardiography, according to Expanded criteria for myocarditis in Paediatric ward at our institute over a period from August 2014 to December 2015...
June 2016: Journal of Clinical and Diagnostic Research: JCDR
Fei-Ying Cheong, Adam C Gower, Harrison W Farber
OBJECTIVE: Pulmonary arterial hypertension (PAH) is one of the most devastating complications in scleroderma (SSc) patients and has a poorer outcome than other PAH subgroups. Tadalafil (Adcirca(®)) is a phosphodiesterase-5 inhibitor (PDE5-I) approved by the FDA for treatment of PAH; however, its effectiveness specifically in SSc-PAH patients is unclear. We investigated whether there were differences in gene expression associated with 16 weeks of treatment with tadalafil and, if so, whether these changes differed with respect to treatment outcome...
June 7, 2016: Seminars in Arthritis and Rheumatism
Steven Z Pantilat, David L O'Riordan, Megan A Rathfon, Kathleen A Dracup, Teresa De Marco
OBJECTIVE: Describe the etiology of pain among HF patients and examine the relationship between pain and QoL. BACKGROUND: Little is known about the etiology of pain in patients with heart failure (HF) and the impact it has on quality of life (QoL). METHODS: A prospective cohort study of outpatients with NYHA Class II or III HF were surveyed at baseline and at three-month follow-up. The study was conducted in Heart Failure clinics affiliated with a large, urban, academic medical center...
August 5, 2016: Journal of Palliative Medicine
Giuseppe Talanas, Roberto Garbo
A 43year-old male, with a long history of coronary artery disease, was electively admitted to our institution because of dyspnea for moderate physical efforts (NYHA 2) related to an in-stent chronic total occlusion of ostial RCA and with demonstration of a significant area of inducible myocardial ischemia at stress echocardiography. After a gentle attempt of antegrade approach, the in-stent CTO of ostial RCA was successfully reopened with a retrograde approach using a knuckle technique. After IVUS evaluation which showed that the course of the retrograde guidewire was mostly within the stent strut circumference with the exception of the ostial RCA where the guidewire past between the stent and the vessel wall, implantation of 4 drug-eluting stent was performed from mid to ostial RCA with a good final result...
June 17, 2016: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Shahriar Mali, Mohammadtaghi Sarebanhassanabadi
BACKGROUND: Combined open-heart surgery and thyroidectomy is a rare procedure. However, some difficulties will occur for cardiac surgery when thyromegaly extends into the retrosternal space. CASE DETAILS: A 54-year-old woman suffering from dyspnea, chest pain and decreased left ventricular function (EF=40%) was diagnosed with coronary artery disease (3 vessel disease) and became candidate for coronary artery bypass grafting (CABG). Also, she had multinodular goiter with normal thyroid function test...
May 2016: Ethiopian Journal of Health Sciences
Ali Refatllari, Ermal Likaj, Selman Dumani, Endri Hasimi, Artan Goda
BACKGROUND: An anomalous origin of the right coronary artery is rarely observed, with a reported incidence between 0.026% and 0.25%. This condition is often completely asymptomatic and is found incidentally during angiographic evaluation for other cardiac diseases. However some patients present with exertion angina or sudden death. Surgical treatment in patients with anomalous RCA is still controversial. Treatment can be conservative, angioplasty or surgery. CASE PRESENTATION: A 59-year-old man was admitted with severe mitral stenosis...
March 15, 2016: Open Access Macedonian Journal of Medical Sciences
Nobuyuki Fukuda, Hiroshi Ueno, Tadakazu Hirai, Hiroshi Inoue, Koichiro Kinugawa
An 85-year-old man with severe aortic stenosis (transaortic peak velocity 4.4 m/s, mean gradient 46 mmHg and valve area 0.71 cm(2)) was admitted to our hospital due to mild exertional dyspnea (NYHA class II). He had received low-dose prednisolone (5 mg/day) plus tacrolimus hydrate (1.5 mg/day) for rheumatic arthritis and interstitial pneumonia. Although aortic valve replacement was indicated, he was considered at high risk to undergo open heart surgery because of reduced pulmonary function (FEV1.0%, 77.2%) and long-term treatment with immunosuppressive drugs...
2016: Nihon Ronen Igakkai Zasshi. Japanese Journal of Geriatrics
Jeehoon Kang, Jonghanne Park, Joo Myung Lee, Jin Joo Park, Dong-Ju Choi
BACKGROUND: Although anemia is common in chronic heart failure (CHF), the use of erythropoiesis stimulating agents (ESAs) in CHF patients remains controversial. In this meta-analysis, we sought to clarify the efficacy and safety of ESAs in anemic patients with CHF. METHODS: We searched PubMed, Embase, Cochrane Central Register of Controlled Trials, the U.S. National Institutes of Health registry of clinical trials. We included 13 randomized clinical trials (RCTs) in the meta-analysis...
September 1, 2016: International Journal of Cardiology
E Lücke, J Schreiber, M Zencker, R Braun-Dullaeus, J Herold
A 72-year-old female patient presented with increasing dyspnea of unclear origin classified as New York Heart Association stage III (NYHA III). Using transesophageal echocardiography a patent foramen ovale (PFO) and right heart failure could be diagnosed. Right heart catheterization revealed a large left to right shunt due to an arteriovenous malformation in the liver. Because of additional telangiectasia of the lips the presumptive diagnosis was Rendu-Osler-Weber disease. Typical nosebleeds and other symptoms of the disease were lacking and only two out of four Curaçao criteria were positive; therefore, genetic testing was performed, which verified the clinical diagnosis...
June 2016: Der Internist
Mehrnoush Toufan, Seyed Sajjad Mahmoudi
A 29-year old female patient was referred to our hospital for evaluation of dyspnea NYHA class I which begun from several months ago. The only abnormal sign found on physical examination was a grade 2/6 systolic murmur at the apex position without radiation. Echocardiography revealed normal left and right ventricular sizes and systolic function, and only one papillary muscle in left ventricular (LV) cavity which all chordae tendineae inserted into that muscle. The mitral valve orifice was eccentrically located at the lateral side with mild to moderate mitral regurgitation but without significant mitral stenosis...
2016: Journal of Cardiovascular and Thoracic Research
Stefan Koester, Justin Z Lee, Kwan S Lee
Background. Partial anomalous pulmonary venous return (PAPVR) is an uncommon congenital abnormality, which may present in the adult population. It is often associated with sinus venosus defect (SVD). The diagnosis and therapy for this condition may be challenging. Case Presentation. We describe a case of an elderly woman who presented with NYHA Class IV dyspnea and was suspected to have symptomatic pulmonary hypertension. She was later found to have anomalous right upper pulmonary vein return to the superior vena cava and associated SVD with bidirectional shunting...
2016: Case Reports in Cardiology
Santosh Kumar Sinha, Ramesh Thakur, Mukesh Jitendra Jha, Karandeep Singh Sayal, Mohit Sachan, Vinay Krishna, Ashutosh Kumar, Vikas Mishra, Chandra Mohan Varma
Situs inversus totalis is a rare congenital disorder where the heart being a mirror image is situated on the right side of the body. Distorted cardiac anatomy makes fluoroscopy-guided percutaneous mitral valvotomy (PMV) technically challenging and there are only few reports of PMV in situs inversus totalis. Here we report a case where PMV was successfully done for situs inversus totalis with rare coincidence of juvenile rheumatic severe mitral stenosis in a 12-year-old boy with a few modifications of standard Inoue technique...
April 2016: Journal of Clinical Medicine Research
Rubina M Khair, Chisom Nwaneri, Rachel L Damico, Todd Kolb, Paul M Hassoun, Stephen C Mathai
RATIONALE: Despite therapeutic advances, pulmonary arterial hypertension remains a disease without a cure. Focusing on symptoms, such as dyspnea, is an important part of assessing response to therapy. OBJECTIVES: To determine the minimal important differences for the Borg dyspnea score and the Borg fatigue score in adult patients undergoing initial therapy for pulmonary arterial hypertension. METHODS: We studied 129 patients enrolled between 2003 and 2013 in the Pulmonary Arterial Hypertension Program registry at Johns Hopkins University Hospital in Baltimore, Maryland...
June 2016: Annals of the American Thoracic Society
Magnus Thorsten Jensen, Niels Risum, Peter Rossing, Jan Skov Jensen
AIMS: Identification of early signs and symptoms of heart disease is important in type 1 diabetes (T1DM). Global longitudinal strain (GLS) by speckle-tracking echocardiography can detect subtle impairments in myocardial function. We investigated the association between myocardial function and degree of dyspnea in patients with normal left ventricular ejection fraction (LVEF) and without known heart disease. METHODS: Ambulatory patients from Steno Diabetes Center...
July 2016: Journal of Diabetes and its Complications
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
Katarzyna E Gil, Agnieszka Pawlak, Małgorzata Frontczak-Baniewicz, Robert J Gil, Anna Nasierowska-Guttmejer
BACKGROUND: The appropriate condition of the coronary microcirculation is essential for proper cardiac muscle activity. The understanding of the pathological microcirculation changes in different stages of idiopathic dilated cardiomyopathy (IDCM) could provide a reliable background for proper therapeutic decisions and prognosis. METHODS AND RESULTS: The study population consisted of 116 patients (86.2% males, mean age 50.4±13.2 years) with IDCM and heart failure...
November 2015: Cardiovascular Pathology: the Official Journal of the Society for Cardiovascular Pathology
Nobuyuki Furukawa, Werner Scholtz, Nikolaus Haas, Stephan Ensminger, Jan Gummert, Jochen Börgermann
An 81-year-old man with high-grade aortic valve stenosis and status post-coronary artery bypass grafting and supracoronary replacement of the ascending aorta was referred for transcatheter aortic valve implantation. He was in New York Heart Association class III and had dyspnea. After appropriate screening, we implanted a 29-mm SAPIEN XT valve (Edwards Lifesciences, Irvine, CA USA) through a transapical approach because of severe peripheral arterial occlusive disease. Postinterventional aortography revealed correct positioning and function of the valve and free coronary ostia but contrast extravasation in the vicinity of the interposed vascular prosthesis, resulting in severe luminal narrowing...
July 2015: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
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