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https://www.readbyqxmd.com/read/29904455/high-grade-atrioventricular-block-in-von-recklinghausen-disease-a-rare-phenomenon
#1
Glenmore Lasam, Marcelina Lasam
A case of a 73-year-old woman with a history of von Recklinghausen disease (neurofibromatosis type 1) who presented initially with a gradual onset of shortness of breath and lightheadedness with no associated fever, chills, angina, palpitations, cough, weight loss, night sweats, nausea, vomiting, or constipation. She was found to be severely bradycardic and in third degree atrioventricular block by her primary care physician. She was admitted in the hospital because of intermittent bouts of lightheadedness and progression of the shortness of breath...
June 2018: Cardiology Research
https://www.readbyqxmd.com/read/29895572/pulseless-electrical-activity-a-misdiagnosed-entity-during-asphyxia-in-newborn-infants
#2
Sparsh Patel, Po-Yin Cheung, Anne Lee Solevåg, Keith J Barrington, C Omar Farouk Kamlin, Peter G Davis, Georg M Schmölzer
BACKGROUND: The 2015 neonatal resuscitation guidelines added ECG as a recommended method of assessment of an infant's heart rate (HR) when determining the need for resuscitation at birth. However, a recent case report raised concerns about this technique in the delivery room. OBJECTIVES: To compare accuracy of ECG with auscultation to assess asystole in asphyxiated piglets. METHODS: Neonatal piglets had the right common carotid artery exposed and enclosed with a real-time ultrasonic flow probe and HR was continuously measured and recorded using ECG...
June 12, 2018: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/29859968/safety-of-ticagrelor-in-patients-with-baseline-conduction-abnormalities-a-plato-study-of-platelet-inhibition-and-patient-outcomes-analysis
#3
Benjamin M Scirica, Sameer Bansilal, Farideh Davoudi, Paul W Armstrong, Robert M Clare, Phillip J Schulte, Karen S Pieper, Richard C Becker, Stefan K James, Robert F Storey, Philippe Gabriel Steg, Claes Held, Anders Himmelmann, Kenneth W Mahaffey, Lars Wallentin, Christopher P Cannon
BACKGROUND: Although bradyarrhythmias have been observed with ticagrelor and its use with advanced atrioventricular block is not recommended, questions arise regarding its use in patients with mild conduction abnormalities. The objectives were to compare rates of clinically relevant arrhythmias in relation to any mild baseline conduction abnormality in patients with acute coronary syndrome randomized to ticagrelor versus clopidogrel. METHODS: We included all subjects in the electrocardiographic (ECG) substudy of the Platelet Inhibition and Patient Outcomes trial, excluding those with missing baseline ECG or with a pacemaker at baseline (N = 15,460)...
May 7, 2018: American Heart Journal
https://www.readbyqxmd.com/read/29858143/security-hunger-strike-prisoners-in-the-emergency-department-physiological-and-laboratory-findings
#4
Danielle Gordon, Michael Drescher, Shachaf Shiber
BACKGROUND: Medical treatment of hunger-strike patients, especially those in incarceration facilities, may pose clinical and treatment challenges for the treating physicians. OBJECTIVE: The aim of our study is to describe the epidemiology and clinical and laboratory characteristics of hunger-strike prisoners presenting to the emergency department (ED) and to describe etiologies of hospitalization and complications among this group. METHOD: We retrospectively examined clinical and laboratory manifestations of 50 hunger-strike prisoners who were referred for evaluation to the ED after a longstanding fast...
May 30, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29851022/cardiovascular-outcomes-of-cholinesterase-inhibitors-in-individuals-with-dementia-a-meta-analysis-and-systematic-review
#5
Ahmet Turan Isik, Pinar Soysal, Brendon Stubbs, Marco Solmi, Cristina Basso, Stefania Maggi, Patricia Schofield, Nicola Veronese, Christoph Mueller
OBJECTIVES: To evaluate the cardiovascular (CV) effects of acetylcholinesterase inhibitors (AChEIs) in individuals with dementia DESIGN: Systematic review and meta-analysis. SETTING: Two authors independently searched major electronic databases from inception until June 17, 2017, for longitudinal (without a control group) and cohort (with a control group) studies reporting CV outcomes in relation to AChEIs. Randomized controlled trials were excluded because they included relatively healthy subjects...
May 30, 2018: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29845313/medial-prefrontal-cortex-trpv1-and-cb1-receptors-modulate-cardiac-baroreflex-activity-by-regulating-the-nmda-receptor-nitric-oxide-pathway
#6
Davi C Lagatta, Luciana B Kuntze, Nilson C Ferreira-Junior, Leonardo B M Resstel
The ventral medial prefrontal cortex (vMPFC) facilitates the cardiac baroreflex response through N-methyl-D-aspartate (NMDA) receptor activation and nitric oxide (NO) formation by neuronal NO synthase (nNOS) and soluble guanylate cyclase (sGC) triggering. Glutamatergic transmission is modulated by the cannabinoid receptor type 1 (CB1 ) and transient receptor potential vanilloid type 1 (TRPV1 ) receptors, which may inhibit or stimulate glutamate release in the brain, respectively. Interestingly, vMPFC CB1 receptors decrease cardiac baroreflex responses, while TRPV1 channels facilitate them...
May 29, 2018: Pflügers Archiv: European Journal of Physiology
https://www.readbyqxmd.com/read/29775659/%C3%AE-2-receptors-in-the-lateral-parabrachial-nucleus-generates-the-pressor-response-of-the-cardiovascular-chemoreflex-effects-of-gaba-a-receptor
#7
Nafiseh Mirzaei Damabi, Gholam Reza Namvar, Fahimeh Yeganeh, Masoumeh Hatam
The lateral parabrachial nucleus (LPBN) is a pontine area involved in cardiovascular chemoreflex. This study was performed to find the effects of reversible synaptic blockade of the LPBN on the chemoreflex responses, and to find the roles of GABAA receptor and α2 -adenoreceptor (α2 -AR) in chemoreflex. It also aimed to seek possible interaction between GABA and noradrenergic systems of the LPBN in urethane-anesthetized male rats. Cardiovascular chemoreflex was activated by intravenous injection of potassium cyanide (KCN, 80 μg/kg)...
May 15, 2018: Brain Research Bulletin
https://www.readbyqxmd.com/read/29764227/responsiveness-of-%C3%AE-2-adrenoceptor-i1-imidazoline-receptor-in-the-rostral-ventrolateral-medulla-to-cardiovascular-regulation-is-enhanced-in-conscious-spontaneously-hypertensive-rat
#8
Masanobu Yamazato, Minori Nakamoto, Atsushi Sakima, Yoriko Yamazato, Shuichi Takishita, Yusuke Ohya
Stimulation of α2-adrenoceptor/I1-imidazoline receptors in the rostral ventrolateral medulla decreases the blood pressure via sympathoinhibition. However, alteration of receptor responses in genetically hypertensive rats remains unclear. We examined cardiovascular responses of α2-adrenoceptor/I1-imidazoline receptor agonist and antagonists microinjected into the rostral ventrolateral medulla of conscious spontaneously hypertensive rats and normotensive Wistar Kyoto rats. Injection of 2-nmol clonidine-an α2-adrenoceptor/I1-imidazoline receptor agonist-unilaterally into the rostral ventrolateral medulla decreased the blood pressure, heart rate, and renal sympathetic nerve activity; the responses were significantly enhanced in spontaneously hypertensive rats than in Wistar Kyoto rats...
May 15, 2018: Clinical and Experimental Hypertension: CHE
https://www.readbyqxmd.com/read/29755798/bradycardia-after-tube-thoracostomy-for-spontaneous-pneumothorax
#9
Yomi Fashola, Sanjeev Kaul, Douglas Finefrock
We present the case of an elderly patient who became bradycardic after chest tube insertion for spontaneous pneumothorax. Arrhythmia is a rare complication of tube thoracostomy. Unlike other reported cases of chest tube induced arrhythmias, the bradycardia in our patient responded to resuscitative measures without removal or repositioning of the tube. Our patient, who had COPD, presented with shortness of breath due to spontaneous pneumothorax. Moments after tube insertion, patient developed severe bradycardia that responded to Atropine...
2018: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/29751997/modulation-of-nesfatin-1-induced-cardiovascular-effects-by-the-central-cholinergic-system
#10
Begum Aydin, Gokcen Guvenc, Burcin Altinbas, Nasir Niaz, Murat Yalcin
Nesfatin-1, a peptide whose receptor is yet to be identified, has been shown to be involved in the modulation of feeding, stress, and metabolic responses. Recently, increasing evidence has supported a modulatory role of nesfatin-1 in cardiovascular activity. We have previously reported that nesfatin-1 causes an increase in blood pressure in normotensive and hypotensive rats by increasing plasma catecholamine, vasopressin, and renin levels. Recent reports suggest that nesfatin-1 may activate the central cholinergic system...
May 4, 2018: Neuropeptides
https://www.readbyqxmd.com/read/29736746/mechano-chronotropic-unloading-during-the-acute-phase-of-myocardial-infarction-markedly-reduces-infarct-size-via-the-suppression-of-myocardial-oxygen-consumption
#11
Genya Sunagawa, Keita Saku, Takahiro Arimura, Takuya Nishikawa, Hiroshi Mannoji, Kazuhiro Kamada, Kiyokazu Abe, Takuya Kishi, Hiroyuki Tsutsui, Kenji Sunagawa
The oxygen supply-demand imbalance is the fundamental pathophysiology of myocardial infarction (MI). Reducing myocardial oxygen consumption (MVO2 ) in acute MI (AMI) reduces infarct size. Since left ventricular (LV) mechanical work and heart rate are major determinants of MVO2 , we hypothesized that the combination of LV mechanical unloading and chronotropic unloading during AMI can reduce infarct size via synergistic suppression of MVO2 . In a dog model of ischemia-reperfusion, as we predicted, the combination of mechanical unloading by Impella and bradycardic agent, ivabradine (IVA), synergistically reduced MVO2 ...
May 7, 2018: Journal of Cardiovascular Translational Research
https://www.readbyqxmd.com/read/29614895/heart-rate-reducing-therapy-with-add-on-ivabradine-and-bisoprolol-before-coronary-computed-tomographic-angiography-in-a-fast-track-ambulatory-setting
#12
Viktoria Muster, Markus Wallner, Albrecht Schmidt, Martin Kapl, Friederike von Lewinski, Peter Rainer, Pia Reittner, Manfred Tillich, Peter Brader, Dieter Hm Szolar, Dirk von Lewinski
Objective This study was performed to determine whether add-on oral ivabradine in patients treated with beta blockers 1 hour before coronary computed tomographic angiography (CCTA) is effective in lowering the heart rate and thus improving CCTA quality. Methods In this single-center cohort study, the data of 294 patients referred for ambulant CCTA were retrospectively screened. Patients with an initial heart rate of ≥75 bpm (n = 112) were pretreated with either a combination of bisoprolol and ivabradine or with bisoprolol alone...
January 1, 2018: Journal of International Medical Research
https://www.readbyqxmd.com/read/29544366/naloxone-reversal-of-clonidine-toxicity-dose-dose-dose
#13
Donna L Seger, Justin K Loden
CONTEXT: Following clonidine ingestion, naloxone is seldom administered as it is considered ineffective in reversing somnolence, bradycardia, or hypotension. However, this conclusion has been based on administration of small doses (2 mg or less) of naloxone. The somnolence is frequently treated with endotracheal intubation (ETI), a procedure with significant morbidity. OBJECTIVE: We aimed to determine if naloxone administration reversed the effects of clonidine or caused any adverse effects...
March 16, 2018: Clinical Toxicology
https://www.readbyqxmd.com/read/29524166/antithymocyte-globuline-therapy-and-bradycardia-in-children
#14
Krisztián Kállay, Dávid Zakariás, Katalin Csordás, Gábor Benyó, Csaba Kassa, János Sinkó, Anita Stréhn, Orsolya Horváth, Barna Vásárhelyi, Gergely Kriván
In antithymocyte globulin (ATG) treated patients occasionally bradycardia has been noticed. Therefore, we retrospectively analyzed the occurrence of bradycardia in ATG-treated children. Using medical records between 2007 and 2012 we identified children undergoing a combined therapy with ATG and glucocorticoids (ATG group, n = 22). The incidence of bradycardia was compared to that registered in children treated with glucocorticoids alone (glucocorticoid alone group, n = 21). Heart rates (HR) were registered before and on days 0-3, 4-7 and 8-14 after the ATG or steroid administration...
March 9, 2018: Pathology Oncology Research: POR
https://www.readbyqxmd.com/read/29506704/ivabradine-does-not-acutely-affect-open-loop-baroreflex-static-characteristics-and-spares-sympathetic-heart-rate-control-in-rats
#15
Hiromi Yamamoto, Toru Kawada, Shuji Shimizu, Kazunori Uemura, Masashi Inagaki, Kazuyoshi Kakehi, Yoshitaka Iwanaga, Kanji Fukuda, Tadayoshi Miyamoto, Shunichi Miyazaki, Masaru Sugimachi
AIMS: To assess the acute effects of intravenous ivabradine, a selective bradycardic agent, on carotid sinus baroreflex-mediated sympathetic arterial pressure (AP) and heart rate (HR) responses. METHODS AND RESULTS: In anesthetized and vagotomized Wistar-Kyoto rats (n=6), carotid sinus baroreceptor regions were isolated. Changes in splanchnic sympathetic nerve activity (SNA), AP, and HR in response to a step-wise pressure input were examined before and after intravenous ivabradine (2mg/kg)...
April 15, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29493727/syncope-caused-by-a-pleomorphic-adenoma-case-report-and-literature-review
#16
Anas Minkara, Reena Dhanda-Patil, Yash Patil
Pleomorphic adenomas are considered the most common salivary gland tumors, although they rarely occur in the parapharyngeal space. To the best of our knowledge, this is the first case report of a parapharyngeal parotid pleomorphic adenoma causing syncope. A 57-year-old man was admitted for left-sided blurred vision, left-sided weakness, dysarthria, lightheadedness, and syncope. Upon his admission, an electrocardiogram showed sinus bradycardia, and computed tomography of the neck with contrast showed a large parapharyngeal mass involving the prestyloid compartment, leading to compression of blood flow through the internal carotid artery...
January 2018: Ear, Nose, & Throat Journal
https://www.readbyqxmd.com/read/29471072/neuroreflex-control-of-cardiovascular-function-is-impaired-after-acute-poisoning-with-chlorpyrifos-an-organophosphorus-insecticide-possible-short-and-long-term-clinical-implications
#17
Alexandre F Cunha, Igor S A Felippe, Nilson C Ferreira-Junior, Leonardo B M Resstel, Daniela A M Guimarães, Vanessa Beijamini, Julian F R Paton, Karla N Sampaio
Although it is well-established that severe poisoning by organophosphorus (OP) compounds strongly affects the cardiorespiratory system, the effects of sub-lethal exposure to these compounds on the neural control of cardiovascular function are poorly explored. The aim of this study was to evaluate the effects of acute sub-lethal exposure to chlorpyrifos (CPF), a commonly used OP insecticide, on three basic reflex mechanisms involved in blood pressure regulation, the peripheral chemoreflex, the baroreflex and the Bezold-Jarisch reflex...
April 1, 2018: Toxicology
https://www.readbyqxmd.com/read/29466684/cardiovascular-response-to-trigeminal-nerve-stimulation-at-rest-and-during-exercise-in-humans-does-sex-matter
#18
Eliza Prodel, Thales C Barbosa, Antonio Claudio Lucas da Nóbrega, Lauro C Vianna
We sought to investigate the possibility that there are sex differences in the cardiovascular responses to trigeminal nerve stimulation (TGS) with cold exposure to the face, at rest and during dynamic exercise. In nine healthy men (age 28{plus minus}3 yr; height 178{plus minus}1 cm; weight 77{plus minus}8 kg) and thirteen women (age 26{plus minus}5 yr; height 164{plus minus}3 cm; weight 63{plus minus}7 kg) beat-to-beat heart rate (HR) and blood pressure were recorded. Mean arterial pressure (MAP), stroke volume (SV), cardiac index (CI) and total vascular resistance index (TVRI) were calculated...
February 21, 2018: American Journal of Physiology. Regulatory, Integrative and Comparative Physiology
https://www.readbyqxmd.com/read/29316267/elderly-patients-with-suspected-chronic-digoxin-toxicity-a-comparison-of-clinical-characteristics-of-patients-receiving-and-not-receiving-digoxin-fab
#19
Hooman Arbabian, Hwee Min Lee, Andis Graudins
OBJECTIVE: The aim of the present study was to compare clinical features of patients with elevated serum digoxin concentrations who were treated with digoxin-Fab with those where the immunotherapy was not given by a tertiary hospital toxicology service. METHODS: This was a retrospective series of patients with supratherapeutic serum digoxin concentrations referred to the toxicology service from August 2013 to October 2015. Data collected included demographics, presenting complaint, digoxin dose, other medications taken, serum digoxin, potassium and creatinine concentration on presentation and initial and post-digoxin-Fab heart rate...
April 2018: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29244075/the-athlete-s-heart-is-a-proarrhythmic-heart-and-what-that-means-for-clinical-decision-making
#20
Hein Heidbuchel
Recurring questions when dealing with arrhythmias in athletes are about the cause of the arrhythmia and, more importantly, about the eligibility of the athlete to continue sports activities. In essence, the relation between sports and arrhythmias can be understood along three lines: sports as arrhythmia trigger on top of an underlying problem, sports as arrhythmic substrate promotor, or sports as substrate inducer. Often, there is no sharp divider line between these entities. The athlete's heart, a heart that adapts so magically to cope with the demands of exercise, harbours many structural and functional changes that by themselves predispose to arrhythmia development, at the atrial, nodal and ventricular levels...
December 13, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
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