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https://www.readbyqxmd.com/read/29761112/takotsubo-cardiomyopathy-mimicking-stent-thrombosis-after-percutaneous-coronary-intervention
#1
Furqan Khattak, Muhammad Khalid, Ghulam Murtaza, Timir K Paul
Takotsubo cardiomyopathy, also known as "broken heart syndrome," is a transient left ventricular dysfunction associated with stress (usually emotional) induced myocardial injury and stunning. It often presents as myocardial infarction on surface electrocardiogram (EKG). Diagnosis is made by coronary angiography, which rules out coronary artery disease and shows pathognomonic apical ballooning. In this article, we present a case of a 72-year-old woman who initially presented with an ST segment elevation myocardial infarction on EKG...
January 2018: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/29754562/cardiology-electronic-consultation-e-consult-use-by-primary-care-providers-at-va-medical-centres-in-new-england
#2
Eun Ji Kim, Jay D Orlander, Melissa Afable, Sumeet Pawar, Sarah L Cutrona, Steven R Simon, Judith Strymish, Varsha G Vimalananda
Introduction E-consultations (e-consults) were implemented at VA medical centers to improve access to specialty care. Cardiology e-consults are among the most commonly requested, but little is known about how primary care providers (PCPs) use cardiology e-consults to access specialty care. Methods This is a retrospective analysis of 750 patients' medical charts with cardiology e-consults requested by medical providers (October 2013-September 2015) in the VA New England Healthcare System. We described the patients and referring provider characteristics, and e-consult questions...
January 1, 2018: Journal of Telemedicine and Telecare
https://www.readbyqxmd.com/read/29749582/naloxone-induced-non-cardiogenic-pulmonary-edema-a-case-report
#3
Nasheena Jiwa, Himesh Sheth, Richard Silverman
A 22-year-old man was admitted for an elective right-shoulder open subacromial decompression and distal clavicle excision. He received a single intravenous dose of fentanyl 50 μg for anesthesia. His procedure was completed without intra-operative complications; however, he developed post-operative respiratory depression in the setting of narcotic administration. He was given naloxone 0.2 mg intravenously once to reverse this effect, which subsequently led to acute hypoxic respiratory failure secondary to pulmonary edema shortly after administration of naloxone...
May 10, 2018: Drug Safety—Case Reports
https://www.readbyqxmd.com/read/29746361/prolonged-qrs-widening-after-aripiprazole-overdose
#4
Maryann Mazer-Amirshahi, Robert Porter, Kayla Dewey
BACKGROUND: Aripiprazole is an atypical antipsychotic with a long half-life. Overdose can result in protracted somnolence and cardiac disturbances, particularly QT interval prolongation. METHODS: This is a single case report of a 14-year-old boy who took an overdose of aripiprazole and developed QRS widening. CASE: A 14-year-old boy intentionally ingested 20 tablets of aripiprazole (5 mg). He was brought to the emergency department when his ingestion was discovered...
May 5, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29723224/effects-of-anthracycline-cyclophosphamide-and-taxane-chemotherapy-on-qtc-measurements-in-patients-with-breast-cancer
#5
Pedro Veronese, Denise Tessariol Hachul, Mauricio Ibrahim Scanavacca, Ludhmila Abrahão Hajjar, Tan Chen Wu, Luciana Sacilotto, Carolina Veronese, Francisco Carlos da Costa Darrieux
AIM: Acute and subacute cardiotoxicity are characterized by prolongation of the corrected QT interval (QTc) and other measures derived from the QTc interval, such as QTc dispersion (QTdc) and transmural dispersion of repolarization (DTpTe). Although anthracyclines prolong the QTc interval, it is unclear whether breast cancer patients who undergo the ACT chemotherapy regimen of anthracycline (doxorubicin: A), cyclophosphamide (C) and taxane (T) may present with QTc, QTdc and DTpTe prolongation...
2018: PloS One
https://www.readbyqxmd.com/read/29713552/persistent-hiccups-as-the-only-presenting-symptom-of-st-elevation-myocardial-infarction
#6
Nasreen Shaikh, Rishi Raj, Srinivas Movva, Charles Mattina
Clinical manifestations of acute myocardial infarction can be more than just chest pain. Patients can present with dyspnea, fatigue, heart burn, diaphoresis, syncope, and abdominal pain to name a few. Our patient was a 74-year-old male with a past medical history of type 2 diabetes mellitus, hypertension, hyperlipidemia, and COPD due to chronic tobacco use, who presented with persistent hiccups for 4 days and no other complaints. Coincidently, he was found to have a diabetic foot ulcer with sepsis and acute kidney injury and hence was admitted to the hospital...
2018: Case Reports in Cardiology
https://www.readbyqxmd.com/read/29702444/spousal-bereavement-is-associated-with-more-pronounced-ex-vivo-cytokine-production-and-lower-heart-rate-variability-mechanisms-underlying-cardiovascular-risk
#7
Christopher P Fagundes, Kyle W Murdock, Angie LeRoy, Faiza Baameur, Julian F Thayer, Cobi Heijnen
The loss of a spouse is a highly stressful event that puts people at excess risk of mortality. Excess mortality among those who are widowed is highest in the first six months after the death of a spouse and decreases over time. Heart disease accounts for the largest proportion of these deaths. The psychological stress associated with stressful life events can enhance inflammation and lower heart rate variability (HRV). Both lower HRV and higher inflammation are risk factors for cardiovascular morbidity and mortality...
April 13, 2018: Psychoneuroendocrinology
https://www.readbyqxmd.com/read/29693946/a-case-of-sudden-shock-during-caesarean-section-in-whi-ch-amniotic-fluid-embolism-is-suspected
#8
Hiroo Shimono, Satoko Haraguchi, Yuko Minoda, Mari Beppu, Naomi Shinmura, Yuki Suzuki, Mikiko Higashi, Yuichi Kanmura
We report a case of sudden shock during caesarean section under combined spinal epidural anesthesia. The patient was a 29-year-old woman. During the operation vital signs had been almost stable until a female-baby was born. But after the delivery of the placenta, the patient developed an episode of coughing and dyspnea followed by unconsciousness and bradycardia. She was given adrenaline and intubated, appearing ventricular fibrillation on a EKG. Cardiopulmonary resuscitation was immediately started and sinus rhythm returned...
May 2017: Masui. the Japanese Journal of Anesthesiology
https://www.readbyqxmd.com/read/29682358/acute-pericarditis-occurring-three-days-after-intravesical-instillation-of-mitomycin-c-after-transurethral-bladder-tumor-resection-in-a-64-year-old-woman
#9
Vineet Meghrajani, Arsalan Hashmi, Shuo Cheng Lin, Zvi Plawes, Shelly Brejt
We present a 64-year-old woman who developed symptoms of acute pericarditis three days after undergoing intravesical instillation of mitomycin C following transurethral bladder tumor resection. Mitomycin C is a chemotherapeutic agent which acts by alkylation of DNA and is known to be cardiotoxic when systemically administered. Despite classic pericarditis symptoms, the patient underwent an urgent coronary angiogram due to elevated cardiac troponin I level, EKG changes, and wall motion abnormalities on her echocardiogram...
2018: Case Reports in Cardiology
https://www.readbyqxmd.com/read/29668588/a-delayed-diagnosis-of-catecholaminergic-polymorphic-ventricular-tachycardia-with-a-mutant-of-ryr2-at-c-7580t-g-for-6-years-in-a-9-year-old-child
#10
Hongyu Duan, Yongyi Lu, Song Yan, Lina Qiao, Yimin Hua, Yifei Li, Kaiyu Zhou, Chuan Wang
RATIONALE: Catecholaminergic polymorphic ventricular tachycardia (CPVT) is a rare but potentially lethal inherited arrhythmia syndrome induced by adrenergic stress. Due to the atypical clinical manifestations in early age, limited recognition and experience of pediatric cardiologists, and low awareness of the significance of genetic diagnosis in some underdeveloped areas in China, a delayed or missed diagnosis of CPVT in children is common and concerning. PATIENT CONCERNS: A 9-year and 3-month male child with recurrent exercise-induced syncope accompanied by convulsion was initially misdiagnosed as epilepsy since the first manifestation at the age of 3 years...
April 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29663283/eeg-artifact-versus-subclinical-status-epilepticus-in-a-patient-following-cardiac-arrest
#11
Jean E Cibula, Daniel S Demos, Brenda G Fahy
BACKGROUND: A challenge in ICU EEG interpretation is identifying subclinical status epilepticus versus patterns on the ictal-interictal continuum versus other repetitive patterns. In the electrically noisy intensive care unit, identifying and eliminating interference and artifact allow accurate diagnoses from the EEG, avoiding unnecessary treatment or sedation. METHODS: We present a case during Impella (Abiomed Inc, Danvers, MA) continuous flow left ventricular assist device use where the EEG artifact was initially misinterpreted as seizure by the resident and treated as status epilepticus because of the "focal" sharply contoured repetitive pattern...
April 16, 2018: Neurocritical Care
https://www.readbyqxmd.com/read/29659354/-electrocardiographic-differences-between-apical-hypertrophic-cardiomyopathy-and-apical-non-st-segment-myocardial-infarction
#12
Iván Chillik, Andreina Gil Ramírez, Santiago Ordóñez, Leandro Tomás, Josefina Parodi, Juan Pablo Costabel
Apocal hypertrophic cardiomyopathy (AHCM) is a phenotypic variant within hypertrophic cardiomyopathies, in which ventricular repolarization alterations are present. These electrocardiographic disturbances can mimic an anterior infarction which triggers a series of studies and treatments that may be unnecessary. The aim of this study was to describe and compare electrocardiographic differences in a series of patients with AHCM and apical non-ST segment elevation myocardial infarction in patients (NSTEMI) with T-wave changes...
2018: Medicina
https://www.readbyqxmd.com/read/29657083/the-course-of-awake-breathing-disturbances-across-the-lifespan-in-rett-syndrome
#13
Daniel C Tarquinio, Wei Hou, Jeffrey L Neul, Gamze Kilic Berkmen, Jana Drummond, Elizabeth Aronoff, Jennifer Harris, Jane B Lane, Walter E Kaufmann, Kathleen J Motil, Daniel G Glaze, Steven A Skinner, Alan K Percy
Rett syndrome (RTT), an X-linked dominant neurodevelopmental disorder caused by mutations in MECP2, is associated with a peculiar breathing disturbance exclusively during wakefulness that is distressing, and can even prompt emergency resuscitation. Through the RTT Natural History Study, we characterized cross sectional and longitudinal characteristics of awake breathing abnormalities in RTT and identified associated clinical features. Participants were recruited from 2006 to 2015, and cumulative lifetime prevalence of breathing dysfunction was determined using the Kaplan-Meier estimator...
April 12, 2018: Brain & Development
https://www.readbyqxmd.com/read/29652544/acute-effects-of-device-guided-slow-breathing-on-sympathetic-nerve-activity-and-baroreflex-sensitivity-in-posttraumatic-stress-disorder
#14
Ida Fonkoue, Paul J Marvar, Seth D Norrholm, Melanie L Kankam, Yunxiao Li, Dana DaCosta, Barbara O Rothbaum, Jeanie Park
Posttraumatic stress disorder (PTSD) patients have elevated sympathetic nervous system (SNS) reactivity and impaired sympathetic and cardiovagal baroreflex sensitivity (BRS). Device-guided slow breathing (DGB) has been shown to lower blood pressure (BP) and sympathetic activity in other patient populations. We hypothesized that DGB acutely lowers BP, heart rate (HR), and improves BRS in PTSD. In 23 prehypertensive veterans with PTSD, we measured continuous BP, EKG, and muscle sympathetic nerve activity (MSNA) at rest, and during 15 minutes of device-guided slow breathing at 5 breaths/min (DGB; n=13) or identical sham device breathing at normal rates of 14 breaths/min (SHAM; n=10)...
April 13, 2018: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/29609189/changes-in-autonomic-tone-in-premature-infants-developing-necrotizing-enterocolitis
#15
Tareq Al-Shargabi, Daniel Reich, R B Govindan, Somya Shankar, Marina Metzler, Caitlin Cristante, Robert McCarter, Anthony D Sandler, Mariam Said, Adre du Plessis
BACKGROUND:  Necrotizing enterocolitis (NEC) is a complication of prematurity with a high mortality rate. Currently, there are no reliable biomarkers capable of identifying infants at risk for developing NEC. We sought to determine the autonomic nervous system antecedents of NEC in premature infants, using heart rate variability (HRV). MATERIALS AND METHODS:  HRV was quantified by retrieving archived electrocardiogram (EKG) data from 30 premature infants from 4 days prior, through 4 days after, the clinical NEC diagnosis...
April 2, 2018: American Journal of Perinatology
https://www.readbyqxmd.com/read/29609088/milrinone-associated-cardiomyopathy-and-arrhythmia-in-cerebral-vasospasm
#16
Eva M Wu, Tarek Y El Ahmadieh, Benjamin Kafka, Matthew T Davies, Salah G Aoun, Jonathan A White
BACKGROUND: Milrinone is an inotropic and vasodilatory drug proven safe for use in the treatment of cerebral vasospasm. Despite its reported safety profile, its use is not free of side effects. Milrinone-associated cardiomyopathy and arrhythmia can occur in patients with cerebral vasospasm. CASE DESCRIPTION: This is a retrospective chart review of a patient who presented with aneurysmal subarachnoid hemorrhage and developed clinical vasospasm twice over a period of two weeks...
March 30, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29589418/myocardial-injury-after-non-cardiac-surgery-a-perioperative-affair
#17
Viviana Miccichè, Cesare Baldi, Edoardo DE Robertis, Ornella Piazza
Myocardial injury after non cardiac surgery (MINS) is a rather new nosological entity and an unfortunately common perioperative complication. The diagnostic criteria for MINS, also indicated as isolated myocardi- al injury (IMI), are an elevated postoperative high sensitivity Troponin T (hsTnT level ranging between 20 and 65 ng/L with an absolute change of at least 5 ng/L or hsTnT level > 65 ng/L), in absence of symptoms and/or EKG findings suggestive of ischemia and without a non ischemic aetiology causing Troponin eleva- tion...
March 27, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29576872/pfo-closure-in-high-risk-patient-with-paradoxical-arterial-embolism-deep-vein-thrombosis-pulmonary-embolism-and-factor-v-leiden-genetic-mutation
#18
A Parikh, T P Vacek
Occurrence of paradoxical arterial embolism may cause the first symptoms in patients with a coexisting hypercoagulable state and patent foramen ovale (PFO). This can result in significant morbidity and mortality depending on the location of the embolism. The risks and benefits of closure of small PFOs have not been well elucidated in prior studies. We describe a patient with a history of Factor V Leiden heterozygosity who presented with left arm pain secondary to arterial embolism. The patient was a 51-year-old male who initially presented to the emergency department after awaking from sleep with progressive, severe, burning left arm pain...
March 2018: Oxford Medical Case Reports
https://www.readbyqxmd.com/read/29559356/alpha-lipoic-acid-intoxicat%C3%A4-on-an-adult-case-report-and-l%C3%A4-terature-rev%C3%A4-ew
#19
Duygu Ferek Emir, Ibrahim Ulas Ozturan, Serkan Yilmaz
INTRODUCTION: Alpha lipoic acid (ALA) is a potent antioxidant used to treat a variety of disorders. Although ALA is considered a very safe supplement and intoxication is very rare, acute high-dose ingestions can cause mortality. In this report, we discuss a very rare case of ALA intoxication to increase awareness of this issue. CASE REPORT: A 22-year-old female was referred to our emergency department with ALA intoxication after ingesting a total of 18g of ALA with a suicidal intention...
March 13, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29525860/improved-isolation-of-cadmium-from-paddy-soil-by-novel-technology-based-on-pore-water-drainage-with-graphite-contained-electro-kinetic-geosynthetics
#20
Xianqiang Tang, Qingyun Li, Zhenhua Wang, Yanping Hu, Yuan Hu, Miklas Scholz
Novel soil remediation equipment based on electro-kinetic geosynthetics (EKG) was developed for in situ isolation of metals from paddy soil. Two mutually independent field plot experiments A and B (with and without electric current applied) were conducted. After saturation using ferric chloride (FeCl3 ) and calcium chloride (CaCl2 ), soil water drainage capacity, soil cadmium (Cd) removal performance, energy consumption as well as soil residual of iron (Fe) and chloride (Cl) were assessed. Cadmium dissolved in the soil matrix and resulted in a 100% increase of diethylenetriamine-pentaacetic acid (DTPA) extracted phyto-available Cd...
March 10, 2018: Environmental Science and Pollution Research International
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