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https://www.readbyqxmd.com/read/29045853/symptomatic-vasospasms-as-a-life-threatening-complication-after-transsphenoidal-surgery
#1
Katharina Osterhage, Patrick Czorlich, Till R Burkhardt, Roman Rotermund, Ulrich Grzyska, Jörg Flitsch
OBJECTIVE: To identify symptomatic vasospasms as a rare complication after pituitary surgery with emphasis on management and outcome. DESIGN AND METHODS: In a retrospective design, 1997 patient charts undergoing microscopic transsphenoidal surgery from 2008 till 2016 were retrospectively analyzed regarding postoperative vasospastic events, its' clinical management, and neurological outcome. RESULTS: Four patients (0.2%) were identified, who developed neurological deficits in the postoperative phase caused by proven vasospasms due to subarachnoid hemorrhage (SAH)...
October 15, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29036457/feasibility-evaluation-of-long-term-use-of-beta-blockers-and-calcium-antagonists-in-patients-with-brugada-syndrome
#2
Tsukasa Kamakura, Mitsuru Wada, Kohei Ishibashi, Yuko Y Inoue, Koji Miyamoto, Hideo Okamura, Satoshi Nagase, Takashi Noda, Takeshi Aiba, Satoshi Yasuda, Wataru Shimizu, Shiro Kamakura, Kengo Kusano
Aims: Beta-blockers (BBs) and calcium antagonists (CAs) are reported to aggravate ST-segment elevation in some patients with Brugada syndrome (BrS). The feasibility of their long-term use in BrS still remains unknown. We investigated the safety of long-term use of BB and CA in BrS patients. Methods and results: Of the 360 consecutive BrS patients, 29 [5: a history of ventricular fibrillation (VF), 17: syncope, 7: asymptomatic] took BB and/or CA (BB: 22, CA: 8) for more than 1 year for the treatment of co-morbidities such as atrial tachyarrhythmia, vasospastic angina, and neurally mediated syncope...
September 23, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/29030499/unexpected-early-radiographic-findings-associated-with-a-ruptured-blister-like-carotid-wall-aneurysm
#3
James West, Jasmeet Singh, Stacey Q Wolfe, Kyle M Fargen
A 33-year-old man presented with aneurysmal subarachnoid hemorrhage from a ruptured, blister-type sidewall internal carotid artery (ICA) aneurysm. Balloon-assisted coiling was performed with residual neck. He subsequently developed severe vasospasm requiring intra-arterial therapies on multiple occasions, during which it was noted that despite widespread vasospasm, a focal segment of the ICA at the site of the aneurysm showed no significant spasm, suggesting underlying vessel abnormality. He was discharged without deficit and scheduled for flow diversion given concern over this potentially pathologic segment of vessel...
October 13, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29026580/-123-i-bmipp-single-photon-emission-computed-tomography-for-diagnosing-chest-pain-in-patients-with-nonobstructive-coronary-angiograms-takotsubo-or-vasospasm
#4
Yuta Seko, Kenichi Sasaki, Takao Kato, Moriaki Inoko
The decreased 123I-BMIPP uptake, while having normal perfusion, in the correspondent coronary artery territory is caused by a delayed metabolic recovery after the recovery of perfusion. This phenomenon termed ischemic memory can clearly differentiate vasospastic angina from other chest pain syndromes.
October 2017: Clinical Case Reports
https://www.readbyqxmd.com/read/29021861/three-cases-of-vasospastic-angina-following-catheter-ablation-of-atrial-fibrillation
#5
Yoshihiko Kagawa, Eitaro Fujii, Satoshi Fujita, Norikazu Yamada, Masaaki Ito
Pulmonary vein isolation is an effective treatment for patients with atrial fibrillation (AF).Although vasospastic angina (VSA) is not a common complication after ablation of AF, we report 3 cases of VSA following ablation of persistent AF. Two of the 3 patients felt chest pain following pulmonary vein isolation, and complex fractionated atrial electrogram ablations were performed. ST elevation in the inferior leads and atrioventricular block occurred because of severe coronary vasospasm. In the third patient, the electrocardiography monitor detected transient ST elevation within an hour after ablation...
October 2017: Journal of Arrhythmia
https://www.readbyqxmd.com/read/29021844/intracoronary-acetylcholine-application-as-a-possible-probe-inducing-j-waves-in-patients-with-early-repolarization-syndrome
#6
REVIEW
Toru Maruyama, Kazumasa Fujita, Kei Irie, Shouhei Moriyama, Mitsuhiro Fukata
Acetylcholine is widely used for a diagnostic provocation test of coronary spasm in patients with vasospastic angina. Acetylcholine usually induces coronary vasodilatation mediated by muscarinic receptor activation, but sometimes it evokes vasoconstriction of coronary arteries where the endothelium is damaged. Early repolarization syndrome is characterized by a J wave observed at the end of the QRS complex in a surface electrocardiogram. The J wave is attributed to the transmural voltage gradient at the early repolarization phase across the ventricular wall, which stems mainly from prominent transient outward current in the epicardium, but not in the endocardium...
October 2017: Journal of Arrhythmia
https://www.readbyqxmd.com/read/29019475/orofacial-pain-associated-with-vasospastic-angina-a-case-report
#7
Makoto Adachi, Mio Hayashi, Tomonori Segawa, Takahiko Yamaki, Yasunori Muramatsu, Shinichiro Sumitomo
The primary symptom of ischemic heart disease is typically chest pain, but in some cases, this pain may radiate to the maxillofacial region. This article describes the case of a 44-year-old man with orofacial pain of cardiac origin. The patient was suspected to be suffering from cardiac disease by the oral and maxillofacial surgeon and was referred to a cardiologist, where he received a heart examination. The patient was diagnosed by means of cardiac catheterization as having coronary spastic angina. During catheterization, intracoronary ergonovine maleate induced orofacial pain that was almost the same in character and intensity as the patient's first episode...
October 10, 2017: Journal of Oral & Facial Pain and Headache
https://www.readbyqxmd.com/read/28992170/points-to-consider-raynaud-s-phenomenon-in-systemic-sclerosis
#8
REVIEW
Maurizio Cutolo, Vanessa Smith, Daniel E Furst, Dinesh Khanna, Ariane L Herrick
RP is an exaggerated vasospastic response to cold or emotion. Randomized, double-blind, placebo-controlled trials with either parallel group or cross-over trials should be mainly considered. Cross-over design, which is good for early phase trials of immediate or very short-term outcomes, is important in a condition as heterogeneous as RP: a wash-out period between treatment arms should always be included to minimize the possibility of a period (carry-over) effect. Duration of RP trials is usually constrained by the need to complete these over a single season, usually winter when the weather is colder...
September 1, 2017: Rheumatology
https://www.readbyqxmd.com/read/28990946/stent-and-implantable-cardioverter-defibrillator-implantation-in-medically-resistant-vasospastic-angina-patient
#9
Nil Özyüncü, Hüseyin Göksülük, Veysel Kutay Vurgun, Onur Yıldırım, Türkan Seda Tan Kürklü
Vasospastic angina, also known as Prinzmetal's angina, is thought to occur due to vascular hyper-reactivity to various stimuli. Response to medical therapy is usually good; however, 1 out of 5 patients has resistant symptoms. Rarely, potentially lethal arrhythmias can occur due to vasospasm, and those patients are reported to have a poorer prognosis. Presently described is a case of resistant vasospastic angina with persistent symptoms under calcium channel blocker and nitrate treatment. The patient presented with hemodynamically unstable rapid-rate ventricular tachycardia, which was quite resistant to recurrent cardioversion...
October 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/28989933/spontaneous-left-main-and-right-coronary-artery-spasm-in-a-patient-with-vasospastic-angina
#10
Analkumar Parikh, Thomas Paul Vacek
Coronary spasm is a well-documented, though rare, condition that can mimic myocardial infarction and is usually found in only a single vessel during an event. We describe the case of a 43-year-old male with past medical history of hypertension, hyperlipidemia, tobacco abuse, and with no known coronary disease. The patient developed chest pain 3 days postadmission for primary diagnosis of psychiatric disorder. The patient had a positive stress study with moderate reversible ischemia in the anterolateral region...
July 2017: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/28957956/inducible-transient-central-retinal-artery-vasospasm-a-case-report
#11
Aleksey Mishulin, Sachin Ghandi, Daniel Apple, Xihui Lin, Jonathan Hu, Gary W Abrams
PURPOSE: To report a case of inducible transient central retinal artery vasospasm with associated imaging. METHODS: Observational case report. RESULTS: A 51-year-old man presented for outpatient follow-up for recurrent inducible transient vision loss in his right eye. He experienced an episode during examination and was found to have central retinal artery vasospasm. Fundus photography and fluorescein angiography obtained during his vasospastic attack confirmed retinal arterial vasospasm...
September 27, 2017: Retinal Cases & Brief Reports
https://www.readbyqxmd.com/read/28956512/higher-dose-intra-arterial-milrinone-and-intra-arterial-combined-milrinone-nimodipine-infusion-as-a-rescue-therapy-for-refractory-cerebral-vasospasm
#12
Enes Duman, Fatma Karakoç, H Ulas Pinar, Rafi Dogan, Ali Fırat, Erkan Yıldırım
Background Cerebral vasospasm (CV) is a major cause of delayed morbidity and mortality in patients with subarachnoid hemorrhage (SAH). Various cerebral protectants have been tested in patients with aneurysmal SAH. We aimed to research the success rate of treatment of CV via intra-arterial milrinone injection and aggressive pharmacological therapy for refractory CV. Methods A total of 25 consecutive patients who received intra-arterial milrinone and nimodipine treatment for CV following SAH between 2014 and 2017 were included in the study...
January 1, 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28902610/transient-vasospastic-response-following-the-injection-of-corticosteroid-into-the-hand
#13
Jacob Tulipan, Kevin Lutsky, Pedro Beredjiklian
A sixty-year-old right hand dominant woman with longstanding left basal joint arthritis and right small trigger finger presented for corticosteroid injections to both areas. She had previously received injections with no adverse effects and good relief of symptoms. Following this most recent injection of corticosteroid, she experienced transient ischemia of the left hand and the right long and ring fingers. Corticosteroid injections can rarely cause local vasospasm, even when not inadvertently injected into the vascular system...
May 2017: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/28895077/vasospastic-angina-in-a-16-year-old-female
#14
Takuya Sumi, Akihito Tanaka, Hideki Ishii, Susumu Suzuki, Mitsutoshi Oguri, Toyoaki Murohara
No abstract text is available yet for this article.
September 11, 2017: Cardiovascular Intervention and Therapeutics
https://www.readbyqxmd.com/read/28877324/t786c-mutation-in-the-endothelial-nitric-oxide-synthase-gene-in-patients-with-primary-osteonecrosis
#15
Amir M Khan, Joshua Choi, Richard A Freiberg, Charles J Glueck, Naila Goldenberg, Ping Wang
Mutations in the T786C endothelial nitric oxide synthase gene (eNOS) are associated with osteonecrosis and Prinzmetal's angina. Nitric oxide is necessary for bone health and ameliorates Prinzmetal's angina. This study compared mutations of T786C eNOS in 146 patients with primary osteonecrosis, 114 patients with Prinzmetal's angina, and 83 normal control subjects. Patients with osteonecrosis had more mutant eNOS alleles than control subjects (42% vs 22%, respectively; P<.0001) but had the same number of mutant alleles as patients with Prinzmetal's angina (42% vs 41%, respectively; P=...
September 1, 2017: Orthopedics
https://www.readbyqxmd.com/read/28868071/verapamil-and-vasospastic-angina-underuse-in-the-elderly-population
#16
Xavier Humbert, Vincent Roule, Paul Milliez, Joachim Alexandre
No abstract text is available yet for this article.
July 2017: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/28819899/significance-of-intravascular-ultrasound-and-exercise-stress-echocardiography-in-diagnosis-of-exercise-induced-vasospastic-angina-at-the-site-of-moderate-stenosis
#17
Makio Muraishi, Kentaro Shibayama, Masahiko Noguchi, Hiroyuki Watanabe, Kotaro Obunai
Recently, exercise-induced spastic coronary artery occlusion at the site of moderate stenosis, which Prinzmetal's angina or cardiac syndrome X does not cover, was reported. Multi-modality imaging is important for the diagnosis of coronary artery disease with a complex ischemic mechanism. However, the previous report did not include findings from intracoronary imaging at the site of moderate coronary stenosis. We report a case of exercise-induced vasospastic angina at the site of moderate stenosis, where multi-modality imaging, including exercise stress echocardiography and intravascular ultrasound, was utilized to make a definitive diagnosis and investigate underlying causes...
August 17, 2017: Journal of Medical Ultrasonics
https://www.readbyqxmd.com/read/28801137/the-challenges-of-treating-recurrent-polymorphic-ventricular-tachycardia-due-to-coronary-vasospasm-lessons-from-an-interesting-case
#18
Naveen Trehan, Mobeen Ur Rehman, Anupama Kottam
Coronary artery vasospasm can cause recurrent anginal episodes with ST-segment elevation. Vasospasm induced myocardial ischemia can lead to arrhythmias including life threatening ventricular tachycardia (VT). Percutaneous coronary intervention (PCI), although not routinely recommended for treating vasospastic angina, can be considered for discrete coronary spasm that is not amenable to vasodilator therapy. We present a challenging case of a 41-year-old lady with recurrent episodes of vasospastic angina and VT refractory to medical therapy, which was successfully treated with PCI and an implantable cardioverter defibrillator...
July 12, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/28781824/effectiveness-of-continuous-low-dose-fasudil-on-refractory-coronary-vasospasm-subsequent-to-cardiopulmonary-arrest
#19
Daisuke Ooshiro, Satoshi Yamaguchi, Masanori Kakazu, Osamu Arasaki
Refractory coronary vasospasm subsequent to reperfusion, such as cardiopulmonary resuscitation or revascularization, for myocardial infarction may respond to fasudil in the superacute phase. Continuous low-dose fasudil administration should be an option for refractory coronary vasospastic angina (VSA).
August 2017: Clinical Case Reports
https://www.readbyqxmd.com/read/28730843/clinical-value-of-st-segment-change-after-return-of-spontaneous-cardiac-arrest-and-emergent-coronary-angiography-in-patients-with-out-of-hospital-cardiac-arrest-diagnostic-and-therapeutic-importance-of-vasospastic-angina
#20
Kazuya Tateishi, Daisuke Abe, Tooru Iwama, Yuichi Hamabe, Kazutaka Aonuma, Akira Sato
BACKGROUND: We investigated the association between initial ST-segment change after return of spontaneous circulation (ROSC) and the incidence of acute coronary lesions in patients with out-of-hospital cardiac arrest (OHCA), and clinical outcomes of patients with OHCA caused by vasospastic angina pectoris (VSA). METHODS: Among 2779 OHCA patients in our institution, all patients with ROSC underwent emergent coronary angiography (CAG) except for those with an obvious extra-cardiac cause of OHCA...
July 1, 2017: European Heart Journal. Acute Cardiovascular Care
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