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https://www.readbyqxmd.com/read/27878631/difference-in-risk-factors-for-subtypes-of-acute-cardiac-lesions-resulting-from-kawasaki-disease
#1
Maho Yamashita, Ryusuke Ae, Mayumi Yashiro, Yasuko Aoyama, Takashi Sano, Nobuko Makino, Yosikazu Nakamura
Few studies discuss the risk factors for acute cardiac lesions (within 30 days) resulting from Kawasaki disease (KD). We aimed to clarify the characteristics of patients with cardiac lesions within 30 days and determine the risk factors for acute cardiac lesion subtypes. Using the 23rd nationwide survey of KD in Japan, we analyzed data from patients with or without acute cardiac lesions resulting from KD (n = 31,380). We subdivided patients with acute cardiac lesions into three types: acute valvular lesions, coronary aneurysms, and giant coronary aneurysms (GCA), and calculated the odds ratios of potential risk factors for acute cardiac lesion subtypes...
November 23, 2016: Pediatric Cardiology
https://www.readbyqxmd.com/read/27872783/multimodality-cardiac-imaging-in-a-patient-with-kawasaki-disease-and-giant-aneurysms
#2
Ranjini Srinivasan, Rachel Weller, Anjali Chelliah, Andrew J Einstein
Kawasaki disease is a well-known cause of acquired cardiac disease in the pediatric and adult population, most prevalent in Japan but also seen commonly in the United States. In the era of intravenous immunoglobulin (IVIG) treatment, the morbidity associated with this disease has decreased, but it remains a serious illness. Here we present the case of an adolescent, initially diagnosed with Kawasaki disease as an infant, that progressed to giant aneurysm formation and calcification of the coronary arteries...
2016: Case Reports in Pediatrics
https://www.readbyqxmd.com/read/27864249/positive-predictive-value-of-cardiovascular-diagnoses-in-the-danish-national-patient-registry-a-validation-study
#3
Jens Sundbøll, Kasper Adelborg, Troels Munch, Trine Frøslev, Henrik Toft Sørensen, Hans Erik Bøtker, Morten Schmidt
OBJECTIVE: The majority of cardiovascular diagnoses in the Danish National Patient Registry (DNPR) remain to be validated despite extensive use in epidemiological research. We therefore examined the positive predictive value (PPV) of cardiovascular diagnoses in the DNPR. DESIGN: Population-based validation study. SETTING: 1 university hospital and 2 regional hospitals in the Central Denmark Region, 2010-2012. PARTICIPANTS: For each cardiovascular diagnosis, up to 100 patients from participating hospitals were randomly sampled during the study period using the DNPR...
November 18, 2016: BMJ Open
https://www.readbyqxmd.com/read/27861387/open-arterial-reconstruction-of-multiple-hepatic-artery-aneurysms-in-a-patient-with-hereditary-hemorrhagic-telangiectasia-a-case-report
#4
Hirotsugu Ozawa, Takao Ohki, Yuji Kanaoka, Koji Maeda, Shin Hagiwara
BACKGROUND: Hereditary hemorrhagic telangiectasia (HHT) is characterized by mucocutaneous telangiectasia and visceral vascular malformations (VMs). Liver involvement with VMs may lead to high-output cardiac failure, portal hypertension, and biliary disease. There is no curative treatment for the disease, and liver transplantation is indicated for life-threatening complications. Herein, we report a case of multiple hepatic artery aneurysms (HAAs) in a patient with HHT in which open arterial reconstruction was performed...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27859306/multiple-giant-coronary-artery-aneurysms-a-rare-cause-of-sudden-cardiac-death
#5
Martin Janík, Petr Hejna, Michaela Ublová, Ivo Šteiner
Multiple giant aneurysms involving the coronary arteries are uncommon and rarely reported. In the presented case, a 63-year-old man with poorly controlled hypertension died suddenly. Gross autopsy examination showed multiple giant thrombus-filled coronary artery aneurysms, atherosclerotic coronary artery disease, and cardiomegaly. Histological sections of the coronary aneurysms showed atherosclerotic changes with both organized and fresh thrombus. Giant coronary aneurysm is defined as a segmental enlargement of a coronary artery with a diameter exceeding 20 mm or more...
November 11, 2016: Journal of Forensic Sciences
https://www.readbyqxmd.com/read/27821152/a-20-year-multicentre-outcome-analysis-of-salvage-mechanical-circulatory-support-for-refractory-cardiogenic-shock-after-cardiac-surgery
#6
Maziar Khorsandi, Scott Dougherty, Andrew Sinclair, Keith Buchan, Fiona MacLennan, Omar Bouamra, Philip Curry, Vipin Zamvar, Geoffrey Berg, Nawwar Al-Attar
BACKGROUND: Refractory post-cardiotomy cardiogenic shock (PCCS) is a relatively rare phenomenon that can lead to rapid multi-organ dysfunction syndrome and is almost invariably fatal without advanced mechanical circulatory support (AMCS), namely extra-corporeal membrane oxygenation (ECMO) or ventricular assist devices (VAD). In this multicentre observational study we retrospectively analyzed the outcomes of salvage venoarterial ECMO (VA ECMO) and VAD for refractory PCCS in the 3 adult cardiothoracic surgery centres in Scotland over a 20-year period...
November 8, 2016: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/27818955/rupture-of-an-ascending-aortic-aneurysm-as-a-cause-of-sudden-death
#7
Cristielle Peres de Freitas, Carla Andrade Petrini, Ramon Souza Goes Araújo, Luiz Guilherme Cernaglia Aureliano Lima, Patrícia Picciarelli de Lima, Amaro Nunes Duarte-Neto
An 84-year-old female patient was brought to the emergency department in cardiac arrest. Cardiopulmonary resuscitation maneuvers were performed but were unsuccessful. The patient had a past medical history of systemic arterial hypertension with target-organ lesions, including stroke and myocardial infarction. The autopsy was carried out, and the most striking finding was cardiac tamponade due to the rupture of an ascending aortic aneurysm at the site of a complex atheromatous plaque. Rupture is the most serious complication of a thoracic aneurysm and must be considered in the differential diagnosis of sudden death...
July 2016: Autopsy & case reports
https://www.readbyqxmd.com/read/27806720/kawasaki-disease-in-sicily-clinical-description-and-markers-of-disease-severity
#8
Maria Cristina Maggio, Giovanni Corsello, Eugenia Prinzi, Rolando Cimaz
BACKGROUND: Kawasaki disease (KD) is an acute systemic vasculitis of small and middle size arteries; 15-25 % of untreated patients and 5 % of patients treated with intravenous immunoglobulin (IVIG) develop coronary artery lesions (CAL). Many studies tried to find the most effective treatment in the management of resistant KD and to select the risk factors for CAL. Our data are assessed on children from west Sicily, characterized by a genetic heterogeneity. METHODS: We studied the clinical data of 70 KD Sicilian children (36 males: 51 %; 34 females: 49 %), analysed retrospectively, including: demographic and laboratory parameters; echocardiographic findings at diagnosis, at 2, 6 and 8 weeks, and at 1 year after the onset of the illness...
November 2, 2016: Italian Journal of Pediatrics
https://www.readbyqxmd.com/read/27793118/a-case-of-epstein-barr-virus-associated-hemophagocytic-lymphohistiocytosis-with-severe-cardiac-complications
#9
Yoshiki Kawamura, Hiroki Miura, Yuji Matsumoto, Hidetoshi Uchida, Kazuko Kudo, Tadayoshi Hata, Yoshinori Ito, Hiroshi Kimura, Tetsushi Yoshikawa
BACKGROUND: Hemophagocytic lymphohistiocytosis (HLH) is a life threatening hematological disorder associated with severe systemic inflammation caused by an uncontrolled and ineffective immune response resulting in cytokine storm. Epstein-Barr virus (EBV) is the most common infectious agent in patients with the viral-associated HLH. Limited numbers of cases with cardiac complication have been demonstrated in other viral-associated HLH patients. Herein, we report a pediatric case of severe EBV-associated HLH with cardiac complications...
October 28, 2016: BMC Pediatrics
https://www.readbyqxmd.com/read/27754176/sy-15-2-endothelial-epigenetics-and-its-role-in-mediating-biomechanical-stress-of-hypertension
#10
Peter F Davies, Elisabetta Manduchi, Christian J Stoeckert, Yi-Zhou Jiang
Hemodynamics creates a constantly changing physical and chemical environment to which the arterial endothelium is exquisitely sensitive. Biomechanical stresses are intrinsic to blood flow characteristics and blood pressure and therefore are important considerations in hypertension. Near branching anatomical sites in arteries, blood flow separates from the main flow to undergo complex multi-directional characteristics for a part of each cardiac cycle (collectively referred to as disturbed flow). Atherosclerosis and aneurysmal pathology develop preferentially at disturbed flow locations, particularly when an additional cardiovascular risk factor such as hypercholesterolemia or high blood pressure are present...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27753855/hw-01-3-cardiac-and-vascular-mri-in-hypertension-evaluation
#11
Sang-Chol Lee
Chronic hypertension can result in deleterious effects on various vascular organs including the heart and vessels. Cardiovascular magnetic resonance (CMR) has the unique advantage of the ability to assess ventricular volumes and function, valvular abnormalities, vascular pathology, myocardial perfusion and tissue characterization with high accuracy and reproducibility and also avoid the risk of radiation. As this is the case, CMR seems to be an ideal method for comprehensive assessment of patients with systemic hypertension...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27753846/ed-02-3-clinical-implications-of-central-hemodynamics-on-aortic-and-end-organ-diseases
#12
Junichiro Hashimoto
The central aorta constitutes the main trunk of the systemic arterial tree. It dilates passively with cardiac ejection during systole and then constricts with its recoil function during diastole, thereby regulating blood pressure and blood flow. The central pulsatile hemodynamics affects local hemodynamics within as well as downstream of the aorta (e.g., end organs).The aorta progressively stiffens and dilates with advancing age, and such age-dependent change is accelerated by hypertension. According to the law of Laplace, wall stress depends on the diameter and pressure of the blood vessel...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27749539/a-huge-saccular-aortic-aneurysm-compressing-right-coronary-artery-7-years-after-aortic-valve-replacement-due-to-bicuspid-aortic-valve-insufficiency-a-rare-case-report
#13
Sang Min Park, Haemin Jeong, Kyung-Soon Hong, Christopher Kim
BACKGROUND: In a patient underwent aortic valve replacement (AVR) due to bicuspid aortic valve (BAV) insufficiency without marked dilation of ascending aorta, the development of delayed-typed aneurysmal complication of ascending aorta has been often reported because the dilated aorta tends to grow insidiously with age. CASE SUMMARY: A 58-year-old man who underwent AVR with mechanical valve due to severe aortic regurgitation secondary to BAV 7 years previously presented with exertional chest discomfort for 1 year...
October 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27737684/management-of-delayed-cerebral-ischemia-after-subarachnoid-hemorrhage
#14
REVIEW
Charles L Francoeur, Stephan A Mayer
For patients who survive the initial bleeding event of a ruptured brain aneurysm, delayed cerebral ischemia (DCI) is one of the most important causes of mortality and poor neurological outcome. New insights in the last decade have led to an important paradigm shift in the understanding of DCI pathogenesis. Large-vessel cerebral vasospasm has been challenged as the sole causal mechanism; new hypotheses now focus on the early brain injury, microcirculatory dysfunction, impaired autoregulation, and spreading depolarization...
October 14, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27733430/coronary-artery-ectasia-are-frequently-observed-in-patients-with-bicuspid-aortic-valves-with-and-without-dilatation-of-the-ascending-aorta
#15
Christine Meindl, Birgit Achatz, Deborah Huber, Andrea Baessler, Ute Hubauer, Christa Meisinger, Christian Hengstenberg, Jeanette Erdmann, Stefan Buchner, Lars Maier, Heribert Schunkert, Kurt Debl, Marcus Fischer
BACKGROUND: The presence of coronary artery ectasia (CAE) is influenced by genetic factors and related to the presence of aneurysms in other vascular beds. Bicuspid aortic valve (BAV) disease is frequently accompanied by ascending aortic aneurysm. Because the aortic valve and the proximal parts of the coronary arteries share a common embryonic origin, we hypothesized that CAE is associated with BAV disease. METHODS AND RESULTS: One hundred seventy-seven patients with suspected aortic valve disease (n=94 BAV, n=83 tricuspid aortic valve) underwent both cardiac magnetic resonance imaging and coronary angiography...
October 2016: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/27729666/-peripartum-spontaneous-coronary-artery-dissection-a-case-report
#16
Giovanni Teruzzi, Giuseppe Calligaris, Paolo Ravagnani, Daniela Trabattoni, Luca Grancini, Giovanni Monizzi, Alessandro Lualdi, Antonio L Bartorelli
Spontaneous coronary artery dissection (SCAD) accounts approximately for 0.2% of cases of acute coronary syndrome. It is defined "spontaneous" in absence of any coronary wall damage. This disease affects primarily young women in good health, with no risk factors for coronary artery disease, especially during the postpartum period. Since the clinical presentation varies widely from no symptoms to typical angina and sudden cardiac death, SCAD incidence is underestimated.A 40-year-old woman, in the 8th week after delivery, was admitted to our emergency department because of acute chest pain, and a diagnosis of inferior and posterior non-ST-elevation myocardial infarction was made...
October 2016: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/27727088/cardiac-surgery-or-interventional-cardiology-why-not-both-let-s-go-hybrid
#17
Nikolaos A Papakonstantinou, Nikolaos G Baikoussis, Panagiotis Dedeilias, Michalis Argiriou, Christos Charitos
A hybrid strategy, firstly performed in the 1990s, is a combination of tools available only in the catheterization laboratory with those available only in the operating room in order to minimize surgical morbidity and face with any cardiovascular lesion. The continuous evolution of stent technology along with the adoption of minimally invasive surgical approaches, make hybrid approaches an attractive alternative to standard surgical or transcatheter techniques for any given set of cardiovascular lesions. Examples include hybrid coronary revascularization, when an open surgical anastomosis of the left internal mammary artery to the left anterior descending coronary artery is performed along with stent implantation in non-left anterior descending coronary vessels, open heart valve surgery combined with percutaneous coronary interventions to coronary lesions, hybrid aortic arch debranching combined with endovascular grafting for thoracic aortic aneurysms, hybrid endocardial and epicardial atrial fibrillation procedures, and carotid artery stenting along with coronary artery bypass grafting...
October 8, 2016: Journal of Cardiology
https://www.readbyqxmd.com/read/27692681/infrequent-cardiac-manifestations-of-sarcoidosis
#18
Said Ashraf, Alexandros Briasoulis, Luis Afonso
Cardiac sarcoidosis (CS) is found in 2-7% of patients with systemic sarcoidosis (SS). Its diagnosis and treatment is challenging, notwithstanding the poor prognosis and treatment. Hereby, we present a case of systemic sarcoidosis with rare cardiac manifestations of severe mitral incompetence and large coronary aneurysm in a previously healthy woman. She underwent successful mitral valve replacement and coronary artery bypass surgery and was maintained on low dose glucocorticoid therapy.
November 2016: Heart & Lung: the Journal of Critical Care
https://www.readbyqxmd.com/read/27688236/cardiac-remote-ischemic-preconditioning-prior-to-elective-vascular-surgery-cripes-a-prospective-randomized-sham-controlled-phase%C3%A2-ii-clinical-trial
#19
Santiago Garcia, Thomas S Rector, Marina Zakharova, Rebekah R Herrmann, Selcuk Adabag, Stefan Bertog, Yader Sandoval, Steve Santilli, Emmanouil S Brilakis, Edward O McFalls
BACKGROUND: Remote ischemic preconditioning (RIPC) has been shown to reduce infarct size in animal models. We hypothesized that RIPC before an elective vascular operation would reduce the incidence and amount of a postoperative rise of the cardiac troponin level. METHODS AND RESULTS: Cardiac Remote Ischemic Preconditioning Prior to Elective Vascular Surgery (CRIPES) was a prospective, randomized, sham-controlled phase 2 trial using RIPC before elective vascular procedures...
September 29, 2016: Journal of the American Heart Association
https://www.readbyqxmd.com/read/27686517/a-case-of-recent-myocardial-infarction-with-cardiac-failure
#20
Anishkumar Nair, Chakanalil Govindan Sajeev, Kader Muneer
CLINICAL INTRODUCTION: A 50-year-old hypertensive smoker presented with a typical angina of 2 days duration. An urgent ECG revealed extensive anterior wall myocardial infarction. In view of the delayed presentation, the patient was conservatively managed with heparin. In-hospital echocardiogram showed akinesia of entire left anterior descending artery (LAD) territory with severe left ventricular (LV) dysfunction. He was discharged with a plan for early coronary intervention. However, he presented a fortnight later with acute pulmonary oedema...
September 29, 2016: Heart: Official Journal of the British Cardiac Society
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