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Julia W Erath, Valentina O Puntmann, Emmanouil Chavakis, Stefan H Hohnloser
No abstract text is available yet for this article.
July 2018: HeartRhythm Case Reports
Alex J Thompson, Joseph A Dearani, Jonathan N Johnson, Hartzell V Schaff, Eric C Towe, Jared Palfreeman, Philip L Wackel, Frank Cetta
BACKGROUND: The transapical approach has been utilized in adult HCM patients with either midventricular obstruction or a small LV cavity; however, there are little data on its use in children. METHODS: We retrospectively reviewed all patients (age <21 years) with HCM who underwent a transapical myectomy from January 2002 to December 2016. Indication for surgery was midventricular obstruction in 19/23 (83%) and small LV cavity in 4 (17%). Preoperative symptoms included: dyspnea (96%), chest pain (65%), presyncope (61%), and syncope (35%)...
July 17, 2018: Congenital Heart Disease
Jennifer L White, Anna Marie Chang, Judd E Hollander, Erica Su, Robert E Weiss, Annick N Yagapen, Susan E Malveau, David H Adler, Aveh Bastani, Christopher W Baugh, Jeffrey M Caterino, Carol L Clark, Deborah B Diercks, Bret A Nicks, Daniel K Nishijima, Manish N Shah, Kirk A Stiffler, Alan B Storrow, Scott T Wilber, Benjamin C Sun
BACKGROUND: Syncope is a common chief complaint in the ED, and the electrocardiogram (ECG) is a routine diagnostic tool in the evaluation of syncope. We assessed whether increasingly prolonged QTc intervals are associated with composite 30-day serious outcomes in older adults presenting to the ED with syncope. METHODS: This is a secondary analysis of a prospective, observational study at 11 EDs in adults 60 years or older who presented with syncope or near syncope...
July 11, 2018: American Journal of Emergency Medicine
Cynthia M Chweya, Neil S Patel, William F Young, Bruce E Pollock, Michael J Link, Matthew L Carlson
OBJECTIVES: Catecholamine-secreting jugular paragangliomas (JPs) represent a rare subset of head and neck paragangliomas that may present with hypertension, arrhythmia, or syncopal episodes. Subtotal resection to protect critical neurovascular structures may result in persistent catecholamine excess from residual tumor. Herein, we report our experience with stereotactic radiosurgery (SRS) for salvage treatment of catecholamine-secreting JP following subtotal microsurgical resection. PATIENTS: Adult patients treated with SRS after subtotal microsurgical resection of catecholamine-secreting JP...
July 13, 2018: Otology & Neurotology
C Kill, S Betz, E Bösl
Loss of consciousness is a frequent cause for an emergency call to the emergency medical services (EMS). It can be associated with life-threatening conditions. A distinction must be made between transient loss of consciousness (TLOC) and syncope, which is of cardiovascular origin by definition. Initial assessment in prehospital emergency care should follow the ABCDE algorithm including a 12-lead ECG. The presence of important risk factors such as occurrence in supine position, physical stress, palpitations, history of heart diseases, and any abnormalities in the ECG warrants hospital admission...
July 16, 2018: Medizinische Klinik, Intensivmedizin und Notfallmedizin
Pooja Palkar, Dipti Kothari
Loperamide is an antidiarrheal agent available as an inexpensive over-the-counter (OTC) medication. In general, it is considered to be safe, but lately, loperamide drug abuse has been reported due to its opioid properties. When used in high doses, several harmful effects including cardiotoxicity, central nervous system (CNS) and respiratory depression have been reported. This prompted the FDA to release a warning in 2016 regarding the arrhythmogenic potential of loperamide. We present a case of a 32-year-old male with a history of polysubstance abuse who presented to the emergency department (ED) requesting "detoxification" from loperamide...
May 9, 2018: Curēus
Pyotr G Platonov, Scott McNitt, Bronislava Polonsky, Spencer Z Rosero, Valentina Kutyifa, Allison Huang, Arthur J Moss, Wojciech Zareba
BACKGROUND: Long-QT (LQT) syndrome mutation carriers have higher risk of cardiac events than unaffected family members even in the absence of QTc prolongation. Changes in T-wave morphology may reflect penetrance of LQT syndrome mutations. We aimed to assess whether T-wave morphology may improve risk stratification of LQT2 mutation carriers with normal QTc interval. METHODS: LQT2 mutation carriers with QTc <460 ms in men and <470 ms in women (n=154) were compared with unaffected family members (n=1007)...
July 2018: Circulation. Arrhythmia and Electrophysiology
Xiao-Meng Chen, Kai Guo, Hong Li, Qiu-Fen Lu, Chao Yang, Ying Yu, Jian-Wen Hou, Yu-Dong Fei, Jian Sun, Jun Wang, Yi-Xue Li, Yi-Gang Li
Patients with high-risk long QT syndrome (LQTS) mutations may experience life-threatening cardiac events. The present study sought to characterize a novel pathogenic mutation, KCNQ1p.Thr312del, in a Chinese LQT1 family. Clinical and genetic analyses were performed to identify this novel causative gene mutation in this LQTS family. Autosomal dominant inheritance of KCNQ1p.T312del was demonstrated in the three-generation pedigree. All mutation carriers presented with prolonged QT intervals and experienced recurrent syncope during exercise or emotional stress...
July 14, 2018: Heart and Vessels
Patrizia Bonadonna, Luigi Scaffidi
Up to 7% of adult patients with Hymenoptera venom allergy may suffer from a clonal mast cell disease. Patients with clonal mast cell disease and Hymenoptera venom anaphylaxis are commonly males, without skin lesions, and anaphylaxis is characterized by hypotension and syncope in the absence of urticaria and angioedema. A normal value of tryptase does not exclude a mastocytosis. The diagnosis of a mast cell disease leads to several therapeutic consequences concerning the treatment of Hymenoptera venom allergy as matter of fact these patients have to undergo long-life venom immunotherapy, to prevent further, potentially fatal severe reactions...
August 2018: Immunology and Allergy Clinics of North America
B P Ernst, K Helling, S Strieth
This article presents the case of a 39-year-old woman receiving injection therapy for cervicalgia. Due to accidental injection into the cervical spinal cord, the patient suffered from syncope, sensomotoric deficit, and bilateral neural hearing loss. Injection therapies for spinal disorders are routinely carried out in clinical practice, despite a low level of evidence and potentially severe complications. In the event of neuro-otologic complications, prompt evaluation by an otologist should be sought and rehabilitation initiated if necessary...
July 13, 2018: HNO
Justin Morgenstern, Corey Heitz, Chris Bond, William K Milne
This is a retrospective cohort study with a before and after design, comparing the admission rate for patients with AFib during a one-year period before the initiation of a new management algorithm to a one-year period after the algorithm was introduced. Physicians were first instructed to determine whether the AFib was secondary to another important diagnosis, such as sepsis or pulmonary embolism. (These patients were admitted to hospital). Among the patients with primary AFib, physicians assessed for four high-risk criteria: hemodynamic instability, acute heart failure, syncope, and acute coronary syndrome...
July 12, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Katie Allen, Katie M Chuter, Katherine Fithon, Lisa Marshall, David Hauton
Orthostatic stress triggers a response to maintain cerebral perfusion and prevent syncope. Given the hypotensive effects of inorganic nitrate this response to orthostasis may be altered by acute supplementation with inorganic nitrate and modified by ethnic origin. Caucasian and SE Asian (n=30 for both), were recruited and subjected to an 'active stand test' and brachial artery blood pressure, digit blood flow and ECG were recorded. Following inorganic nitrate supplementation (10mg/kg body mass) the tests were repeated...
July 13, 2018: Clinical and Experimental Pharmacology & Physiology
Daiana A Trovato, Jorge E de Sousa, Julio E Bruetman, Bárbara C Finn, Pablo Young
Cough may be associated with complications such as syncope, urinary incontinence, pneumothorax, and less frequently, pulmonary hernia and costal fractures. Chronic cough is a cause of rib fractures and when they occur it is likely to affect more than one rib. We report a 53 year-old obese male in treatment with enalapril 10 mg for hypertension with a dry cough lasting five months. He consulted for bilateral chest pain and a Chest X ray examination showed symmetrical fractures in the seventh left and right ribs...
March 2018: Revista Médica de Chile
Boon Yew Tan, Luokai Wang, Mahesh Uttamchandani, Hector Barajas-Martinez, Robert Dumaine, Nathalie Morin, Chi Keong Ching, Kah Leng Ho, Daniel Thuan Tee Chong, Weien Chow, Eric Peng Huat Yap, Shabbir Moochhala, Dan Hu, Rita Yu Yin Yong, Wee Siong Teo
INTRODUCTION: Mutations within SCN5A are found in a significant proportion (15-30%) of Brugada syndrome (BrS) cases and impair sodium transport across excitable cardiac cells that mediate ventricular contractions. Genetic testing offers a means to clinically assess and manage affected individuals and their family members. METHODS AND RESULTS: The proband at age 44 years old exhibited a syncopal event during exercise, and presented later with a spontaneous type-I BrS pattern on 12‑lead resting electrocardiogram (ECG)...
July 2018: Journal of Electrocardiology
Paulina Przyżycka, Michał Kałowski, Izabela Poddębska, Krzysztof Kaczmarek, Paweł Ptaszyński, Jerzy K Wranicz, Iwona Cygankiewicz
Ventricular fibrillation (VF) is the most common arrhythmia leading to sudden cardiac death, but in rare cases VF can manifest as a syncope, provided that it will self-terminate. We present a case of a 45-year old female with a history of unexplained syncopal episodes despite exhaustive diagnostics. Implantable loop recorder documented an episode of idiopathic, self-terminating VF as a cause of syncope.
July 2018: Journal of Electrocardiology
Yoshiaki Yamaguchi, Koichi Mizumaki, Tamotsu Sakamoto, Yosuke Nakatani, Yasushi Tsujino, Hiroshi Inoue, Koichiro Kinugawa
Swallow syncope is a relatively rare syndrome and caused by various foods and drinks. A 76-year-old man was admitted with frequent syncope while eating. Holter electrocardiogram revealed frequent occurrence of atrioventricular block during meals. Both atrioventricular block and sinus arrest were induced by only eating citrus fruits, citrus jelly, and acidic foods but not by other drinks and foods. These arrhythmias were suppressed after administration of atropine. No further episodes of syncope recurred after the implantation of a DDD pacemaker...
July 2018: Journal of Electrocardiology
Yanhui Li, Teerapat Nantsupawat, Matthew Olson, Venkatakrishna Tholakanahalli, Selcuk Adabag, Zhong Wang, David G Benditt, Jian-Ming Li
BACKGROUND: The evaluation of insertable cardiac monitor (ICM) has been largely on the device performance and safety with only limited studies on the clinical utility. The aim of this study was to evaluate the clinical utility of ICM in patients with a variety of clinical presentations. METHODS: A single-center retrospective study on the clinical utility, as measured by both expected and unexpected clinical useful ICM findings and the initiation of therapeutic interventions, was conducted...
July 2018: Journal of Electrocardiology
Ciorsti MacIntyre, Chinyere Iwuala, Ratika Parkash
PURPOSE OF REVIEWS: In this review, the challenges of managing cardiac arrhythmias and syncope in the setting of pregnancy will be discussed. RECENT FINDINGS: Arrhythmias in pregnancy are increasing, as diagnostic and therapeutic options have advanced and women are older at the time of gestation. Atrial fibrillation has become the most common arrhythmia in pregnancy. Inherited arrhythmia has become a more common entity, with advances in treatments and genetic testing, and require specialized treatments in pregnancy...
July 11, 2018: Current Treatment Options in Cardiovascular Medicine
Wesley J Wu, Leonard H Goldberg, Marc K Rubenzik, Blake R Zelickson
BACKGROUND: A vasovagal reaction is a commonly encountered event in outpatient procedures. There is a paucity of discussion on vasovagal reactions (VVRs) in the dermatologic surgery literature. However, recent investigations in the physiology, evaluation, and treatment of VVRs have been reported in other specialties. OBJECTIVE: A comprehensive review of the physiology, evaluation, treatment, and prevention of VVRs. MATERIALS AND METHODS: A search as performed using the PubMed/MEDLINE databases...
July 9, 2018: Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et Al.]
Valentina Kutyifa, Arthur J Moss, Helmut Klein, Scott McNitt, Wojciech Zareba, Ilan Goldenberg
BACKGROUND: The WEARIT-II Registry demonstrated efficacy and safety of the WCD for at-risk cardiac patients. However, one-year outcomes in this population have not been reported. METHODS: The WEARIT-II Registry enrolled 2000 US patients prescribed the WCD. One-year mortality data from start of WCD use were prospectively collected for 1846 patients (93%). Outcome data were analyzed by disease etiology, and ICD implantation following WCD use. RESULTS: During 12 months of follow-up, 73 patients died (4%)...
July 10, 2018: Pacing and Clinical Electrophysiology: PACE
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