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Postcardiac injury syndromes

Jan Smid, Maximilian Scherner, Oliver Wolfram, Thomas Groscheck, Jens Wippermann, Rüdiger C Braun-Dullaeus
BACKGROUND: Persistent fever of unknown cause is only rarely of cardiac origin, but heart disease must be considered in the differential diagnosis. Aside from endocarditis, pericarditis and various other conditions may be responsible. METHODS: This review is based on pertinent articles retrieved by a selective search in PubMed and Google Scholar employing the term "fever" in combination with "myocardial infarction," "pericarditis," "endocarditis," and "postcardiac injury," with additional consideration of current cardiological guidelines...
March 23, 2018: Deutsches Ärzteblatt International
Richie Robel, Peter Caroccio, Mervyn Maze
Xenon has features that make it an ideal general anesthetic agent; cost and scarcity mitigate xenon's widespread use in the operating room. Discovery of xenon's cytoprotective properties resulted in its application to thwart ongoing acute neurologic injury, an unmet clinical need. The discovery that xenon's neuroprotective effect interacts synergistically with targeted temperature management (TTM) led to its investigation in clinical settings, including in the management of the postcardiac arrest syndrome, in which TTM is indicated...
2018: Methods in Enzymology
Young-Duck Cho, Sung-Jun Park, Sung-Hyuk Choi, Young-Hoon Yoon, Jung-Youn Kim, Sung-Woo Lee, Chae-Seung Lim
Purpose: Postcardiac arrest syndrome (PCAS) shares many features with sepsis including plasma cytokine elevation with dysregulation of cytokine production, and the presence of endotoxin in plasma. PCAS is closely related to ischemia-reperfusion injury. During ischemia-reperfusion injury, neutrophil, which is the first line of innate immunity, plays a major role. In this study, we investigated the inflammatory response of human neutrophils in an in vitro model which we simulated with hypoxia-normoxia and hypoxia-hyperoxia environments...
October 2017: Annals of Surgical Treatment and Research
Michael Goldfarb, Bojan Cercek
There are over 300,000 out-of-hospital cardiac arrests (OOHCA) in the United States each year, and the long-term survival rate is less than 10%. Despite improvements in postarrest management, the greatest drop-off in survival occurs during hospitalization, mostly due to myocardial dysfunction and neurological injury. Coronary artery disease is common in postcardiac arrest patients, with an incidence of approximately 60-80%. In patients with a chest pain syndrome and an ST-segment-elevation myocardial infarction pattern evident on the presenting electrocardiogram, immediate revascularization is recommended by cardiovascular societies due to established mortality benefits...
November 2017: Cardiology in Review
Caitlin Bialy, Edmund Wee, Nizam Uddin
An 80-year-old woman initially presented with an episode of pleuritic chest pain 10 days after implantation of a dual chamber permanent pacemaker. She returned to hospital a day later with vomiting and fever. She was found to have new atrial fibrillation in addition to right-sided weakness and dysarthria. An infarct in the left anterior inferior cerebellar artery territory was later confirmed on CT. She continued to have recurrent febrile episodes associated with vomiting and dyspnoea. Extensive investigations for infection were negative, and her symptoms were initially attributed to aspiration pneumonia...
August 11, 2017: BMJ Case Reports
Tadashi Hoshiyama, Keiichi Ashikaga, Kenichi Tsujita, Yoshisato Shibata
We present a case of postcardiac injury syndrome with pericardial effusion following cardiac resynchronization therapy implantation which was treated by only colchicine. Although treatment using colchicine is not as common as NSAIDs or steroids, colchicine seems to be an effective and safe treatment option for the syndrome.
June 2017: Clinical Case Reports
Gabby Elbaz-Greener, Harindra C Wijeysundera
Retrograde dissection re-entry can cause pericardial trauma of sufficient degree to lead to the development of an auto-immune postpericardial injury syndrome. Clinical suspicion for this condition should be high in the event of fever, symptoms, pericardial/pleural effusion, and pleuritic chest pain following chronic total occlusion (CTO) Post cardiac injury syndromes (PCI).
June 2017: Clinical Case Reports
Fernanda S Hackenhaar, Tássia M Medeiros, Fernanda M Heemann, Camile S Behling, Jordana S Putti, Camila D Mahl, Cleber Verona, Ana Carolina A da Silva, Maria C Guerra, Carlos A S Gonçalves, Vanessa M Oliveira, Diego F M Riveiro, Silvia R R Vieira, Mara S Benfato
After cardiac arrest, organ damage consequent to ischemia-reperfusion has been attributed to oxidative stress. Mild therapeutic hypothermia has been applied to reduce this damage, and it may reduce oxidative damage as well. This study aimed to compare oxidative damage and antioxidant defenses in patients treated with controlled normothermia versus mild therapeutic hypothermia during postcardiac arrest syndrome. The sample consisted of 31 patients under controlled normothermia (36°C) and 11 patients treated with 24 h mild therapeutic hypothermia (33°C), victims of in- or out-of-hospital cardiac arrest...
2017: Oxidative Medicine and Cellular Longevity
José M Porcel
PURPOSE OF REVIEW: Pleural effusions are frequent in the context of acute idiopathic pericarditis and following pericardiotomy, but they have seldom been characterized. This review summarizes their most relevant clinical features. RECENT FINDINGS: In acute idiopathic pericarditis, pleural effusions tend to be left-sided and, if bilateral, they are usually larger on the left. Less than 5% are unilateral right-sided. About 90% of the effusions occupy less than one-third of the hemithorax, and 99% meet Light's exudative criteria with a predominance of lymphocytes in three fourths of the cases...
July 2017: Current Opinion in Pulmonary Medicine
Gaye Ulubay, Elif Küpeli, Balam Er Dedekargınoğlu, Şerife Savaş Bozbaş, Mahal Alekberov, Özlem Salman Sever, Atilla Sezgin
OBJECTIVES: Postoperative pleural effusions are common in patients who undergo cardiac surgery and orthotopic heart transplant. Postoperative pleural effusions may also occur as postcardiac injury syndrome. Most of these effusions are nonspecific and develop as a harmless complication of the surgical procedure itself and generally have a benign course. Here, we investigated the cause and clinical and laboratory features of postoperative early and late pleural effusions in orthotopic heart transplant patients...
November 2016: Experimental and Clinical Transplantation
Su Nam Lee, Hyun Jin Noh, Sin Seung Kim, Yunju Nam, Ki-Dong Yoo
Blunt chest trauma can cause acute myocardial infarction, which may also be associated with pericarditis. However, such cases are rare. We herein report a case of a 57-year-old man suffering from acute myocardial infarction due to a blunt chest trauma and postcardiac injury syndrome after discharge with spontaneous resolution of a total coronary occlusion.
2016: Internal Medicine
Jan J van Wingerden, Mario Maas, Richard L Braam, Bas A de Mol
PURPOSE: Poststernotomy mediastinitis (PSM), the severe chest wall and mediastinal infection that may arise at any time after a sternotomy, causes significant morbidity and mortality globally. Late recognition and diagnosis are the major contributors to a poor outcome. This review focuses on recent advances in diagnosing PSM (particularly after cardiovascular surgery) at the earliest opportunity--in the emergency department. RECENT FINDINGS: Morbidity and mortality of PSM, especially when associated with numerous other complications, remain unaltered high...
March 2016: American Journal of Emergency Medicine
Shungo Yukumi, Hiraku Ichiki, Junichi Funada, Hideaki Suzuki, Masamitsu Morimoto, Teppei Fujita, Naoki Izumi, Masahiro Abe
Postcardiac injury syndrome (PCIS) occurs following a pericardial or myocardial injury. On the other hand, PCIS following cardiac catheter intervention is rare and can be difficult to diagnose because of its delayed onset. A 24-year-old man underwent radiofrequency ablation (RFA) for paroxysmal atrial fibrillation and suffered from general fatigue and left-sided pleural effusion three months after the procedure. His symptoms and effusion were effectively treated within a month by administrating nonsteroidal anti-inflammatory drugs...
2015: Respiratory Medicine Case Reports
Alexis A Topjian, Robert A Berg, Fabio Silvio Taccone
PURPOSE OF REVIEW: The purpose of this study is to review the recent literature describing how to assess and treat postcardiac arrest syndrome associated haemodynamics and manage oxygenation and ventilation derangements. RECENT FINDINGS: Postcardiac arrest syndrome is a well described entity that includes systemic ischemia-reperfusion response, myocardial dysfunction and neurologic dysfunction. Continued resuscitation in the hours to days following return of spontaneous circulation (ROSC) is important to increase the likelihood of long-term survival and neurological recovery...
June 2015: Current Opinion in Critical Care
Dominique Biarent, Christine Fonteyne, Ariane Willems, Audrey Dupont
Although sustained return of spontaneous circulation (ROSC) can be initially established after resuscitation in children, many of the children do not survive to discharge because they developped a post cardiac arrest syndrome. The post-cardiac arrest syndrome includes systemic ischaemia/reperfusion response, post-cardiac arrest brain injury, postcardiac arrest myocardial dysfunction, and persistent precipitating pathology. The main cause of death after ROSC in children is brain injury. Physiopathology and management are reviewed in regards of pediatric specificities...
2013: Current Pediatric Reviews
Laurens L A Bisschops, Gheorghe A M Pop, Steven Teerenstra, Pieter C Struijk, Johannes G van der Hoeven, Cornelia W E Hoedemaekers
OBJECTIVES: To determine blood viscosity in adult comatose patients treated with mild therapeutic hypothermia after cardiac arrest and to assess the relation between blood viscosity, cerebral blood flow, and cerebral oxygen extraction. DESIGN: Observational study. SETTING: Tertiary care university hospital. PATIENTS: Ten comatose patients with return of spontaneous circulation after out-of-hospital cardiac arrest. INTERVENTION: Treatment with mild therapeutic hypothermia for 24 hours followed by passive rewarming to normothermia...
March 2014: Critical Care Medicine
Zhi-jun Guo, Chun-sheng Li
Survival rates after cardiac arrest have not changed substantially over the past 5 decades. Postcardiac arrest (CA) syndrome (PCAS) is the primary reason for the high mortality rate after successful restoration of spontaneous circulation (ROSC). Intravenous administration of Shenfu Injection (, SFI) may attenuate post-CA myocardial dysfunction and cerebral injury, inhibit systemic ischemia/reperfusion responses, and treat underlying diseases. In this article, we reviewed the therapeutic effects of SFI in PCAS...
September 2013: Chinese Journal of Integrative Medicine
Gudrun Bragadottir, Bengt Redfors, Sven-Erik Ricksten
OBJECTIVES: Acute kidney injury develops in a large proportion of patients after cardiac surgery because of the low cardiac output syndrome. The inodilator levosimendan increases cardiac output after cardiac surgery with cardiopulmonary bypass, but a detailed analysis of its effects on renal perfusion, glomerular filtration, and renal oxygenation in this group of patients is lacking. We therefore evaluated the effects of levosimendan on renal blood flow, glomerular filtration rate, renal oxygen consumption, and renal oxygen demand/supply relationship, i...
October 2013: Critical Care Medicine
Ben Wolk, Eric Dandes, Felipe Martinez, Marcelo Helguera, Sergio L Pinski, Jacobo Kirsch
Postcardiac injury syndrome (PCIS) is a frequent clinical entity developing as a complication of cardiac procedures. Some of these may be only minor procedures, such as the insertion of permanent pacer or defibrillator devices. The purpose of this article is to review and illustrate its common imaging findings. PCIS is expected to occur in approximately 1%-2% of patients after pacer or defibrillator device placement. The mechanism of pericarditis following implantation is unclear, but it may involve a direct irritation of the pericardium by minimally protruding electrodes, low-grade bleeding with hemorrhagic pericarditis, and a late autoimmune or inflammatory response to those insults...
July 2013: Current Problems in Diagnostic Radiology
Yang Liu, Chao Wang, Ruifu Zhao, Deli Wan, Han Xie, Guozhu Jin, Jinli Wang, Li Lin, Qigong Liu, Rong Bai
BACKGROUND: Postcardiac injury syndrome (PCIS) is a complication of a variety of cardiac injuries, of which small heart perforation is the etiology that is often unrecognized. We reported a series of patients with PCIS secondary to cardiac perforation during catheter ablation procedures. METHODS AND RESULTS: Out of 1728 radiofrequency catheter ablation procedures, 21 patients (1.2%) were complicated by echo-defined cardiac perforation not requiring surgical intervention...
October 9, 2013: International Journal of Cardiology
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