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https://www.readbyqxmd.com/read/29237609/diagnosis-and-prognosis-in-sudden-cardiac-arrest-survivors-without-coronary-artery-disease-utility-of-a-clinical-approach-using-cardiac-magnetic-resonance-imaging
#1
Patricia Rodrigues, Abhishek Joshi, Howell Williams, Mark Westwood, Steffen E Petersen, Filip Zemrak, Richard J Schilling, Claire Kirkby, Andrew Wragg, Charlotte Manisty, Saidi Mohiddin
BACKGROUND: Determining the pathogenesis of sudden cardiac arrest or periarrest without significant coronary artery disease is crucial for management and prognosis. Cardiovascular magnetic resonance (CMR) can detect morphological, functional, or tissue abnormalities, and we sought to evaluate the role of CMR in determining sudden cardiac arrest pathogenesis and prognosis in survivors. METHODS AND RESULTS: We retrospectively reviewed cardiac investigations and clinical outcomes in consecutive survivors of potentially fatal arrhythmias without coronary artery disease admitted to our institutions from 2008 to 2014...
December 2017: Circulation. Cardiovascular Imaging
https://www.readbyqxmd.com/read/29234842/-patients-with-a-wearable-cardioverter-defibrillator-wcd-prescription-function-and-rehabilitation-support
#2
REVIEW
A Schlitt, M Guha, M Noutsias, H H Klein, H U Klein
Assessment of a permanent risk of life-threatening ventricular arrhythmia in patients with severely reduced left ventricular ejection fraction (LVEF <35%), e. g. after myocarditis, dilated cardiomyopathy, acute myocardial infarction, in patients with postpartum cardiomyopathy or implantable cardioverter-defibrillator (ICD) and cardiac resynchronization treatment plus defibrillator (CRT-D) infection with temporary explantation of the system is a medical challenge. This is time-consuming and unsafe because life-threatening ventricular arrhythmias may occur during the time of risk assessment...
December 12, 2017: Herz
https://www.readbyqxmd.com/read/29212594/-false-positive-troponin-i-due-to-heterophile-antibodies
#3
Henrik Nørlund, Ann Bovin
The troponin I (TnI) level is essential in the diagnosis of acute myocardial infarction, but may be elevated by other cardial and non-cardial causes. We report a 32-year-old pregnant woman admitted to hospital because of chest pain and dyspnoea. TnI levels were significantly elevated, although there was no suspicion of acute coronary syndrome or myocarditis, and supplementary diagnostics excluded pulmonary embolism. The TnI level was found to be falsely elevated due to immunoassay interference. We stress the need to be aware of the possibility of false positive TnI, especially during pregnancy...
December 4, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/29186442/additional-diagnostic-value-of-cmr-to-the-european-society-of-cardiology-esc-position-statement-criteria-in-a-large-clinical-population-of-patients-with-suspected-myocarditis
#4
P Stefan Biesbroek, Alexander Hirsch, Alwin Zweerink, Peter M van de Ven, Aernout M Beek, Maarten Groenink, Fons Windhausen, R Nils Planken, Albert C van Rossum, Robin Nijveldt
Aims: To determine the diagnostic yield of tissue characterization by cardiovascular magnetic resonance (CMR) in a large clinical population of patients with suspected acute myocarditis (AM) and to establish its diagnostic value within the 2013 European Society of Cardiology position statement criteria (ESC-PSC) for clinically suspected myocarditis. Methods and results: In this retrospective study, CMR examinations of 303 hospitalized patients referred for work-up of suspected AM in two tertiary referral centres were analysed...
November 24, 2017: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/29175582/usefulness-of-coronary-postmortem-computed-tomography-angiography-to-detect-lesions-in-the-coronary-artery-and-myocardium-in-cases-of-sudden-death
#5
Hiroyuki Takei, Rie Sano, Yoichiro Takahashi, Keiko Takahashi, Yoshihiko Kominato, Hiroyuki Tokue, Takehiro Shimada, Sachiko Awata, Satoshi Hirasawa, Naoya Ohta
Coronary postmortem computed tomography angiography (coronary PMCTA) has been introduced as a routine examination procedure for autopsy at our department. Here, we reviewed eight autopsy cases in which apparent histopathological changes including acute myocardial infarction (AMI), anomalous aortic origin of a coronary artery (AAOCA), hypertrophic obstructive cardiomyopathy (HOCM) and acute myocarditis were involved in the cause of death. For investigation of the coronary artery and shape of the heart, coronary PMCTA was valuable in detecting narrowing or obstruction of coronary artery in AMI, indicating an anomalous aortic origin of the left coronary artery in AAOCA, and demonstrating septal hypertrophy and intracavitary obstruction in HOCM...
November 16, 2017: Legal Medicine
https://www.readbyqxmd.com/read/29106977/causes-of-troponin-elevation-and-associated-mortality-in-young-patients
#6
Candace Wu, Avinainder Singh, Bradley Collins, Amber Fatima, Arman Qamar, Ankur Gupta, Jon Hainer, Josh Klein, Petr Jarolim, Marcelo Di Carli, Khurram Nasir, Deepak L Bhatt, Ron Blankstein
BACKGROUND: While increased serum troponin levels are often due to myocardial infarction, increased levels may also be found in a variety of other clinical scenarios. Although these causes of troponin elevation have been characterized in several studies in older adults, they have not been well characterized in younger individuals. METHODS: We conducted a retrospective review of patients 50 years of age or younger who presented to two large tertiary care centers between January 2000 and April 2016 with elevated serum troponin levels...
October 26, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/29054842/acute-biventricular-mechanical-circulatory-support-for-cardiogenic-shock
#7
Sudeep Kuchibhotla, Michele L Esposito, Catalina Breton, Robert Pedicini, Andrew Mullin, Ryan O'Kelly, Mark Anderson, Dennis L Morris, George Batsides, Danny Ramzy, Mark Grise, Duc Thinh Pham, Navin K Kapur
BACKGROUND: Biventricular failure is associated with high in-hospital mortality. Limited data regarding the efficacy of biventricular Impella axial flow catheters (BiPella) support for biventricular failure exist. The aim of this study was to explore the clinical utility of percutaneously delivered BiPella as a novel acute mechanical support strategy for patients with cardiogenic shock complicated by biventricular failure. METHODS AND RESULTS: We retrospectively analyzed data from 20 patients receiving BiPella for biventricular failure from 5 tertiary-care hospitals in the United States...
October 20, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29025779/scorpion-bite-induced-ischaemic-stroke
#8
Rakesh Reddy C, Nandakishore Bompelli, Vikram Khardenavis, Anirudda Deshpande
We report a 54-year-old woman with scorpion bite. After 3 hours of admission, the patient developed sudden onset tachycardia with hypotension. Cardiac evaluation showed raised creatine kinase MB isoenzyme was elevated; ECG and two-dimensional echocardiography findings were suggestive of myocarditis. Subsequently, she developed transient ventricular tachycardia before developing abrupt onset, right hemiplegia, global aphasia and progressive worsening of sensorium 12 hours after the bite. MRI of brain revealed massive left middle cerebral artery (MCA) territory infarct...
October 11, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28986648/acute-myocarditis-with-infarct-like-presentation-in-a-pediatric-population-role-of-cardiovascular-magnetic-resonance
#9
Maria Martinez-Villar, Ferran Gran, Anna Sabaté-Rotés, Antonio Tello-Montoliu, Amparo Castellote, Marc Figueras-Coll, Queralt Ferrer, Ferran Roses-Noguer
Chest pain is a typical symptom of acute myocarditis in adolescents. It may be indistinguishable from myocardial ischemia so it is called "infarct-like pattern." Cardiovascular magnetic resonance has an important role as a non-invasive diagnostic tool. The aim of our study is to provide a description of an acute myocarditis series with infarct-like pattern and to evaluate the cardiovascular magnetic resonance role in a pediatric population. We included all pediatric patients (0-16 years) admitted to our hospital (May 2007-May 2016) with clinical diagnosis of acute myocarditis and infarct-like presentation (chest pain, EKG alterations, and released cardiac biomarkers)...
October 6, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28948410/protective-molecular-mechanisms-of-clusterin-against-apoptosis-in-cardiomyocytes
#10
REVIEW
Rodrigo Martins Pereira, Rania A Mekary, Kellen Cristina da Cruz Rodrigues, Chadi Pellegrini Anaruma, Eduardo Rochete Ropelle, Adelino Sanchez Ramos da Silva, Dennys Esper Cintra, José Rodrigo Pauli, Leandro Pereira de Moura
Loss of cardiomyocytes occurs with aging and contributes to cardiovascular complications. In the present study, we highlighted the role of clusterin, a protein that has recently been associated with the protection of cardiomyocytes from apoptosis. Clusterin protects cardiac cells against damage from myocardial infarction, transplant, or myocarditis. Clusterin can act directly or indirectly on apoptosis by regulating several intracellular pathways. These pathways include (1) the oxidant and inflammatory program, (2) insulin growth factor 1 (IGF-1) pathway, (3) KU70 / BCL-2-associated X protein (BAX) pathway, (4) tumor necrosis factor alpha (TNF-α) pathway, (5) BCL-2 antagonist of cell death (BAD) pathway, and (6) mitogen-activated protein kinase (MAPK) pathway...
September 25, 2017: Heart Failure Reviews
https://www.readbyqxmd.com/read/28945476/assessment-of-lungs-for-transplant-recovered-from-uncontrolled-donation-after-circulatory-determination-of-death-donors
#11
Thomas Egan, John Blackwell, Katherine Birchard, Benjamin Haithcock, Jason Long, Stephen Gazda, Nissa Casey, Caitlin Thys
RATIONALE: To address the lung donor shortage, we obtained institutional review board and US Food and Drug Administration approval to transplant lungs recovered from uncontrolled donation after circulatory determination of death donors (uDCDDs). OBJECTIVES: To compare outcomes of recipients of lungs recovered from uDCDDs vs. brain-dead donors. METHODS: After consent and screening, lungs recovered from uDCDDs were assessed by 4 hours ex vivo lung perfusion (EVLP) and computed tomography (CT) scan...
September 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28927316/cardiovascular-magnetic-resonance-detects-silent-heart-disease-missed-by-echocardiography-in-systemic-lupus-erythematosus
#12
S Mavrogeni, L Koutsogeorgopoulou, G Markousis-Mavrogenis, A Bounas, M Tektonidou, S-N C Lliossis, D Daoussis, S Plastiras, G Karabela, E Stavropoulos, G Katsifis, V Vartela, G Kolovou
Background Accurate diagnosis of cardiovascular involvement in systemic lupus erythematosus (SLE) remains challenging, due to limitations of echocardiography. We hypothesized that cardiovascular magnetic resonance can detect cardiac lesions missed by echocardiography in SLE patients with atypical symptoms. Aim To use cardiovascular magnetic resonance in SLE patients with atypical symptoms and investigate the possibility of silent heart disease, missed by echocardiography. Patients/methods From 2005 to 2015, 80 SLE patients with atypical cardiac symptoms/signs (fatigue, mild shortness of breath, early repolarization and sinus tachycardia) aged 37 ± 6 years (72 women/8 men), with normal echocardiography, were evaluated using a 1...
January 1, 2017: Lupus
https://www.readbyqxmd.com/read/28916405/love-death-a-retrospective-and-prospective-follow-up-mortality-study-over-45-years
#13
Lena Lange, Barbara Zedler, Marcel A Verhoff, Markus Parzeller
BACKGROUND: Although sexual activity can cause moderate stress, it can cause natural death in individuals with pre-existing illness. The aim of this study was to identify additional pre-existing health problems, sexual practices, and potential circumstances that may trigger fatal events. METHODS: This medicolegal postmortem, retrospective, and prospective study is based on data of autopsies performed at the Institute of Legal Medicine of the University hospital, Goethe-University, Frankfurt/Main, Germany...
October 2017: Journal of Sexual Medicine
https://www.readbyqxmd.com/read/28915139/left-and-right-ventricular-morphology-function-and-late-gadolinium-enhancement-extent-and-localization-change-with-different-clinical-presentation-of-acute-myocarditis-data-from-the-italian-multicenter-study-on-myocarditis-itamy
#14
Gianluca Di Bella, Giovanni Camastra, Lorenzo Monti, Santo Dellegrottaglie, Paolo Piaggi, Claudio Moro, Alessia Pepe, Chiara Lanzillo, Gianluca Pontone, Martina Perazzolo Marra, Mauro Di Roma, Alessandra Scatteia, Giovanni D Aquaro
AIMS: Poor data exist about cardiac magnetic resonance (CMR) findings in a large sample of acute myocarditis with different clinical presentations (heart failure, arrhythmias, and infarct-like presentation). METHODS: Five hundred and forty-three in-patients with a clinical suspected of acute myocarditis confirmed by CMR were enrolled. The clinical indications to perform CMR were chest pain and/or dyspnea and/or palpitations, or effort intolerance/malaise in the last month; elevated troponin and/or new ventricular dysfunction, and/or new ECG abnormalities; and suspected inflammatory cause...
November 2017: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/28868104/parvovirus-b19-myocarditis-of-fulminant-evolution
#15
Michael Spartalis, Eleni Tzatzaki, Eleftherios Spartalis, Christos Damaskos, Sophie Mavrogeni, Vassilis Voudris
Myocarditis is an inflammation of the myocardium. Clinical presentation ranges from non-specific systematic symptoms to fulminant collapse and sudden death. Sudden death occurs at rates of 8.6-12% and cardiomyopathy at 9%. In active myocarditis, there is inflammatory cellular infiltrate with myocardial necrosis. The disease is distinguished by clinical presentation in fulminant and non-fulminant myocarditis. We present a rare case of a parvovirus B19-induced fulminant viral myocarditis in a young female. The patient presented with acute onset heart failure mimicking a myocardial infarction, followed by non-specific symptoms that had been misdiagnosed as urinary tract infection...
August 2017: Cardiology Research
https://www.readbyqxmd.com/read/28827845/ror%C3%AE-t-expressing-cells-attenuate-cardiac-remodeling-after-myocardial-infarction
#16
Daichi Enomoto, Kotaro Matsumoto, Tomomi Yamashita, Arisa Kobayashi, Makiko Maeda, Hiroyuki Nakayama, Masanori Obana, Yasushi Fujio
AIMS: Retinoic acid receptor-related orphan nuclear receptor γt (RORγt) is a transcriptional factor responsible for IL-17-producing T-cell differentiation. Although it was demonstrated that RORγt plays essential roles in the onset of autoimmune myocarditis, pathophysiological significance of RORγt in cardiac remodeling after myocardial infarction (MI) remains to be fully elucidated. METHODS AND RESULTS: MI was generated by ligating coronary artery. The expression of RORγt and IL-17A transcripts increased in murine hearts after MI...
2017: PloS One
https://www.readbyqxmd.com/read/28813699/t1-and-t2-mapping-in-cardiology-mapping-the-obscure-object-of-desire
#17
Sophie Mavrogeni, Dimitris Apostolou, Panayiotis Argyriou, Stella Velitsista, Lilika Papa, Stelios Efentakis, Evangelos Vernardos, Mikela Kanoupaki, George Kanoupakis, Athanassios Manginas
The increasing use of cardiovascular magnetic resonance (CMR) is based on its capability to perform biventricular function assessment and tissue characterization without radiation and with high reproducibility. The use of late gadolinium enhancement (LGE) gave the potential of non-invasive biopsy for fibrosis quantification. However, LGE is unable to detect diffuse myocardial disease. Native T1 mapping and extracellular volume fraction (ECV) provide knowledge about pathologies affecting both the myocardium and interstitium that is otherwise difficult to identify...
August 17, 2017: Cardiology
https://www.readbyqxmd.com/read/28795995/toxic-myocarditis-caused-by-acetaminophen-in-a-multidrug-overdose
#18
Maxime Gosselin, Yann Dazé, Pascal Mireault, Marie Crahes
We report the case of an 18-year-old woman with personality disorders who was hospitalized a few hours after suicidal ingestion of acetaminophen, quetiapine, acetylsalicylic acid, and ethanol. Twelve hours after admission, severe liver damage was evident, but the patient was stable and awaiting hepatic transplantation. Electrolytes were successfully controlled. The condition of the liver stabilized. Cardiac biomarkers then deteriorated unexpectedly. Localized ST-segment elevations were noted on electrocardiogram, but angiography ruled out myocardial infarction...
December 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/28762928/-eosinophilic-necrotizing-myocarditis-complicated-by-myocardial-rupture
#19
O Yu Karpova, R Yu Monovtsov, L I Dvoretsky, G R Cherepantsev, A V Magnitskiy
In this female patient eosinophilic myocarditis was complicated by myocardial rupture and hemopericardium with cardiac tamponade. Special features of this case were old age of the patient, fulminant course of the disease, myocardial infarction-like ECG changes, absence of peripheral blood eosinophilia. Presentation is accompanied by discussion of issues of epidemiology, clinical course, diagnostics, and possible causes of eosinophilic myocarditis.
May 2017: Kardiologiia
https://www.readbyqxmd.com/read/28720694/myocardial-infarction-masquerading-as-myocarditis-in-a-patient-with-factor-v-leiden-unmasked-with-mr
#20
Jason Leo Walsh, Benjamin Howell Lole Harris, Walid Gharzuddine, Hussain Isma'eel
We present a case of a 21-year-old man presenting with sharp left-sided chest pain. A CT pulmonary angiogram was negative, ECG was unremarkable and a mild troponin rise was observed. Myocarditis was suspected as the most likely diagnosis, particularly in view of the patient's previous diagnosis of myocarditis 3 years prior. A cardiac MRI was indicative of an acute mid-anterior myocardial infarction (MI) and an old inferior MI with an associated aneurysm. A subsequent angiogram revealed a subtotal occlusion in the second diagonal artery, likely precipitated by homozygous factor V Leiden...
July 18, 2017: BMJ Case Reports
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