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https://www.readbyqxmd.com/read/27920693/capecitabine-induced-coronary-vasospasm
#1
Danish Henry, Francine Rudzik, Allison Butts, Aju Mathew
Capecitabine, an oral prodrug of 5-fluorouracil (5-FU), is approved for early-stage and advanced colorectal cancer and metastatic breast cancer. Cardiotoxicity of 5-FU is well described in the literature. However, cardiac adverse effects of capecitabine are poorly described. We report a case of coronary vasospasm induced by capecitabine. A 41-year-old female with metastatic breast cancer presented with chest pain 3 days after starting capecitabine. The chest pain was relieved by rest and exacerbated by exertion...
September 2016: Case Reports in Oncology
https://www.readbyqxmd.com/read/27896330/biventricular-thrombus-in-hypereosinophilic-syndrome-presenting-with-shortness-of-breath
#2
Abdul Baqi, Shahan Waheed, Fateh Ali Tipoo, Aamir Hameed Khan
A 48 years old male presented to clinic with 12 months of low grade fever with shortness of breath which has progressively worsened with no associated weight loss, night sweats or loss of appetite. There was no prior history of chronic illness before the current illness. Laboratory workup revealed a high white blood cell count with predominant eosinophils. Chest X-ray was normal. Transthoracic echocardiography and Cardiac Magnetic Resonance showed biventricular thrombi. On further extensive workup the findings were consistent with hypereosinophilic syndrome...
June 2016: Turkish Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27886933/the-role-of-cardiovascular-magnetic-resonance-in-cardiac-resynchronization-therapy
#3
REVIEW
Francisco Leyva
Randomized, controlled trials have shown that cardiac resynchronization therapy (CRT) is beneficial in patients with heart failure, impaired left ventricular (LV) systolic function, and a wide QRS complex. Other studies have shown that targeting the LV pacing site can also improve patient outcomes. Cardiovascular magnetic resonance (CMR) is a radiation-free imaging modality that provides unparalleled spatial resolution. In addition, emerging data suggest that targeted LV lead deployment over viable myocardium improves the outcome of patients undergoing CRT...
January 2017: Heart Failure Clinics
https://www.readbyqxmd.com/read/27867529/coexistence-of-apical-hypertrophic-cardiomyopathy-and-endomyocardial-fibrosis-with-calcification-diagnosis-using-multimodality-imaging
#4
Lakshmi Muthukumar, M Fuad Jan, Joseph Whitnah, A Jamil Tajik
A 48-year-old man from West Africa was evaluated for dyspnea. Echocardiography showed an echolucent mass at the left ventricular apex surrounded by a dense ridge of tissue, suggesting endomyocardial fibrosis (EMF). Doppler echocardiography showed restrictive hemodynamics and intramyocardial coronary blood flow at the hypertrophied apex, suggesting apical hypertrophic cardiomyopathy (ApHCM) with calcified thrombus. Cardiac magnetic resonance imaging showed a thickened myocardium with apical cavity obliteration and endomyocardial calcification, and gadolinium contrast demonstrated marked bright subendocardial and diffuse patchy intramyocardial hyperenhancement in the hypertrophied apical wall segment, confirming coexistence of EMF and ApHCM...
December 2016: ESC Heart Failure
https://www.readbyqxmd.com/read/27847557/thoracic-ultrasound-a-complementary-diagnostic-tool-in-cardiology
#5
REVIEW
Guglielmo M Trovato
Clinical assessment and workup of patients referred to cardiologists may need an extension to chest disease. This requires more in-depth examination of respiratory co-morbidities due to uncertainty or severity of the clinical presentation. The filter and integration of ecg and echocardiographic information, addressing to the clues of right ventricular impairment, pulmonary embolism and pulmonary hypertension, and other less frequent conditions, such as congenital, inherited and systemic disease, usually allow more timely diagnosis and therapeutic choice...
October 26, 2016: World Journal of Cardiology
https://www.readbyqxmd.com/read/27804073/early-phase-myocardial-uptake-intensity-of-99m-tc-hmdp-vs-99m-tc-dpd-in-patients-with-hereditary-transthyretin-related-cardiac-amyloidosis
#6
Mukedaisi Abulizi, Anne-Ségolène Cottereau, Aziz Guellich, Stéphanie Vandeventer, Arnault Galat, Axel Van Der Gucht, Violaine Plante-Bordeneuve, Jean-Luc Dubois-Randé, Diane Bodez, Jean Rosso, Thibaud Damy, Emmanuel Itti
BACKGROUND: This study sought to compare the intensity of early-phase myocardial uptake of two phosphonate-based radiotracers, (99m)Tc-hydroxymethylene diphosphonate (HMDP) and (99m)Tc-3,3-diphosphono-1,2-propanodicarboxylic acid (DPD), in patients with hereditary transthyretin-related cardiac amyloidosis (TTR-CA). METHODS: Six patients with biopsy-proven diagnosis of TTR-CA and characteristic amyloid fibril composition underwent early-phase (99m)Tc-HMDP myocardial scintigraphy as part of their routine workup; they were later assessed by (99m)Tc-DPD scintigraphy after having signed informed written consent...
November 1, 2016: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
https://www.readbyqxmd.com/read/27802861/financial-impact-of-a-targeted-reduction-in-cardiac-enzyme-testing-at-a-community-hospital
#7
Li Zhang, Anne M Sill, Ilene Young, Sabreen Ahmed, Maria Morales, Sapna Kuehl
OBJECTIVES: Nearly one-third of healthcare costs are potentially avoidable and would not compromise medical care if eliminated. Therefore, we sought to evaluate the financial impact of reduction in use of creatinine kinase (CK)-MB and myoglobin tests after removing them from the cardiac enzyme order set at a community hospital. METHODS: Grand rounds were held, and an email notification was sent to de-emphasize the use of CK, CK-MB, myoglobin, SGOT (glutamic-oxaloacetic transaminase), and SGPT (serum glutamic-pyruvic transaminase) in acute coronary syndrome (ACS) work up...
2016: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/27788995/persistent-fever-after-pacemaker-lead-extraction
#8
Maria Carmo Pereira Nunes, Túlio Pinho Navarro, Mariana de Braga Lima Carvalho, Nicole de Paula Aarão Faleiro Maia, Ricardo Jayme Procópio, Teresa Cristina Abreu Ferrari
The implant indication of cardiac electronic devices continues to expand; therefore, we have observed increasing complications related to their removal. We describe the case of a patient who presented with prolonged bloodstream infection after having undergone removal of a pacemaker. After extensive workup for fever of unknown origin and antibiotic therapy without any improvement, it was possible to demonstrate a foreign body in the right subclavian vein and superior vena cava corresponding to the distal part of the right ventricular lead...
May 2016: Indian Pacing and Electrophysiology Journal
https://www.readbyqxmd.com/read/27769754/long-term-prognostic-value-of-a-negative-work-up-for-acute-coronary-disease-in-emergency-department-chest-pain-patients-without-known-coronary-artery-disease-a-cohort-study
#9
Anne-Maree Kelly, Sharon Klim
BACKGROUND: To determine the rate of all cause and cardiac death, new myocardial infarction (MI) or coronary revascularisation at over three years from index visit in emergency department chest pain patients without known coronary artery disease (CAD) at index presentation who had a negative electrocardiogram (ECG) and biomarker workup for acute coronary syndrome (ACS). METHODS: An unplanned sub-study of a prospective observational study of consecutive adult patients presenting to the ED with atraumatic chest pain (or equivalents)...
September 13, 2016: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/27754710/extrinsic-compression-of-left-main-coronary-artery-due-to-dilated-pulmonary-trunk-resulting-in-ischaemic-symptoms
#10
Rohit Bhoil, Shikha Sood, Sabina Bhoil, Anshul Chamail, R G Sood
Left coronary artery compression syndrome is an uncommon entity and characterized by compression of the LMCA in-between the aorta and an enlarged main pulmonary arterial trunk. It is usually associated with a congenital cardiac defect. Cardiac 64-slice MDCT provides a non-invasive and an accurate method for assessing the degree of dynamic LMCA compression throughout the cardiac cycle, its angulation relative to the left sinus of Valsalva and depiction of pulmonary pathology, making it a valuable tool in the workup of patients suspected of left coronary artery compression...
October 18, 2016: Acute Cardiac Care
https://www.readbyqxmd.com/read/27752409/the-first-case-of-severe-takotsubo-cardiomyopathy-associated-with-5-fluorouracil-in-a-patient-with-abnormalities-of-both-dihydropyrimidine-dehydrogenase-dpyd-and-thymidylate-synthase-tyms-genes
#11
Muhammad W Saif, Melissa Smith, Antonio Maloney
5-Fluorouracil (5-FU) is the backbone of the chemotherapy regimens approved for treatment of many malignancies, especially colorectal cancer (CRC). The incidence of cardiotoxicity associated with 5-FU ranges between 1.5% to 18% and is most commonly manifested as anginal symptoms. Cardiomyopathy is very rarely reported with 5-FU and capecitabine. A 35-year-old Caucasian male with T3, N1, M0 rectal cancer after the initial neoadjuvant chemoradiation with 5FU/LV followed by surgical abdominoperineal resection (APR), began mFOLFOX6 in the adjuvant setting...
September 14, 2016: Curēus
https://www.readbyqxmd.com/read/27752355/cardiac-involvement-in-adult-and-juvenile-idiopathic-inflammatory-myopathies
#12
REVIEW
Thomas Schwartz, Louise Pyndt Diederichsen, Ingrid E Lundberg, Ivar Sjaastad, Helga Sanner
Idiopathic inflammatory myopathies (IIM) include the main subgroups polymyositis (PM), dermatomyositis (DM), inclusion body myositis (IBM) and juvenile DM (JDM). The mentioned subgroups are characterised by inflammation of skeletal muscles leading to muscle weakness and other organs can also be affected as well. Even though clinically significant heart involvement is uncommon, heart disease is one of the major causes of death in IIM. Recent studies show an increased prevalence of traditional cardiovascular risk factors in JDM and DM/PM, which need attention...
2016: RMD Open
https://www.readbyqxmd.com/read/27734652/takotsubo-cardiomyopathy-masquerading-as-acute-coronary-syndrome
#13
Shankar Iyer, Subhash Shivtarkar, Ameya Udyavar
Takotsubo cardiomyopathy, also called transient left ventricular apical ballooning syndrome or Gebrochenes-Herz-Syndrome, is a rare entity which may masquerade as acute coronary syndrome (ACS) with sudden onset of chest pain and/or dyspnea, transient left ventricle apical akinesia, electrocardiographic changes typical of ACS and mild increase in cardiac enzymes in the background of normal coronary arteries. Here, we present a case of a 45 year old female who presented with acute onset dyspnea and chest pain with severe ischemic changes on the ECG and raised troponin levels...
April 2016: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/27676163/sudden-cardiac-arrest-due-to-a-single-sodium-channel-mutation-producing-a-mixed-phenotype-of-brugada-and-long-qt3-syndromes
#14
U Lakshmanadoss, A Mertens, M Gallagher, I Kutinsky, B Williamson
Inherited arrhythmia syndromes are a known, albeit rare, cause of sudden cardiac arrest which may present with characteristic electrocardiogram changes in patients with structurally normal heart. There are a variety of distinct arrhythmogenic syndromes that arise from mutations in voltage gated sodium channels, resulting in either gain or loss of function. We describe a patient with a primary inherited arrhythmia syndrome which presented as sudden cardiac arrest. Further workup revealed that her arrest was due to a combination of Brugada syndrome and Long QT3 syndrome secondary to a deleterious mutation of voltage-gated, sodium channel, type V alpha subunit (SCN5A Thr1709Met)...
March 2016: Indian Pacing and Electrophysiology Journal
https://www.readbyqxmd.com/read/27638745/feasibility-of-fdg-pet-in-myocarditis-comparison-to-cmr-using-integrated-pet-mri
#15
Felix Nensa, Julia Kloth, Ercan Tezgah, Thorsten D Poeppel, Philipp Heusch, Juliane Goebel, Kai Nassenstein, Thomas Schlosser
OBJECTIVE: Besides cardiac sarcoidosis, FDG-PET is rarely used in the diagnosis of myocardial inflammation, while cardiac MRI (CMR) is the actual imaging reference for the workup of myocarditis. Using integrated PET/MRI in patients with suspected myocarditis, we prospectively compared FDG-PET to CMR and the feasibility of integrated FDG-PET/MRI in myocarditis. METHODS: A total of 65 consecutive patients with suspected myocarditis were prospectively assessed using integrated cardiac FDG-PET/MRI...
September 8, 2016: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
https://www.readbyqxmd.com/read/27635072/cardiac-abnormalities-in-first-degree-relatives-of-unexplained-cardiac-arrest-victims-a-report-from-the-cardiac-arrest-survivors-with-preserved-ejection-fraction-registry
#16
Christian Steinberg, Gareth J Padfield, Jean Champagne, Shubhayan Sanatani, Paul Angaran, Jason G Andrade, Jason D Roberts, Jeffrey S Healey, Vijay S Chauhan, David H Birnie, Mikyla Janzen, Brenda Gerull, George J Klein, Richard Leather, Christopher S Simpson, Colette Seifer, Mario Talajic, Martin Gardner, Andrew D Krahn
BACKGROUND: Unexplained cardiac arrest (UCA) may be explained by inherited arrhythmia syndromes. The Cardiac Arrest Survivors With Preserved Ejection Fraction Registry prospectively assessed first-degree relatives of UCA or sudden unexplained death victims to screen for cardiac abnormalities. METHODS AND RESULTS: Around 398 first-degree family members (186 UCA, 212 sudden unexplained death victims' relatives; mean age, 44±17 years) underwent extensive cardiac workup, including ECG, signal averaged ECG, exercise testing, cardiac imaging, Holter-monitoring, and selective provocative drug testing with epinephrine or procainamide...
September 2016: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/27625910/thymic-tumor-extension-into-the-heart-a-rare-finding-found-by-point-of-care-ultrasound
#17
Elizabeth Kaufman, Michelle Hunter-Behrend, Eric Leroux, Laleh Gharahbaghian, Viveta Lobo
We report a cardiac mass detected by point-of-care ultrasound performed within the emergency department on a 65-year-old male with thymic cancer who presented with chronic cough and fever. Results from the initial emergency workup, which included blood tests, urinalysis, and a computerized tomography with angiography scan with venous phasing of the chest, did not result in a definitive diagnosis. A point-of-care echocardiogram was performed to evaluate for possible infective endocarditis, but alternatively identified a large mass in the right atria and ventricle...
August 4, 2016: Curēus
https://www.readbyqxmd.com/read/27613494/differential-diagnosis-of-left-ventricular-hypertrophy-usefulness-of-multimodality-imaging-and-tissue-characterization-with-cardiac-magnetic-resonance
#18
Cemil Izgi, Vassilis Vassiliou, A John Baksi, Sanjay K Prasad
Differential diagnosis of asymmetrical left ventricular hypertrophy may be challenging, particularly in patients with history of hypertension. A middle-aged man underwent an echocardiographic examination during workup for hypertension, which unexpectedly showed significant asymmetrical septal hypertrophy and raised suspicion for hypertrophic cardiomyopathy. Cardiovascular magnetic resonance confirmed the asymmetrical hypertrophy. No myocardial late gadolinium contrast enhancement was seen. However, precontrast T1 mapping revealed a low native myocardial T1 value...
November 2016: Echocardiography
https://www.readbyqxmd.com/read/27607324/multifocal-vascular-lesions
#19
Laura E Levin, Christine T Lauren
Multifocal vascular lesions are important to recognize and appropriately diagnose. Generally first noticed on the skin, multifocal vascular lesions may have systemic involvement. Distinguishing among the different types of multifocal vascular lesions is often based on clinical features; however, radiological imaging and/or biopsy are frequently needed to identify distinct features and guide treatment. Knowledge of the systemic associations that can occur with different vascular anomalies may reduce life-threatening complications, such as coagulopathy, bleeding, cardiac compromise, and neurologic sequelae...
September 2016: Seminars in Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/27584084/thoracic-splenosis-report-of-a-case-and-review-of-the-diagnostic-workup
#20
Walter Bugiantella, Federico Crusco, Nicola Avenia, Rondelli Fabio
UNLABELLED: Splenosis is the autoimplantation of splenic tissue to ectopic sites after spleen injury. Although splenosis most commonly occurs in the abdomen, it may occur in the thorax in case of diaphragm rupture. Thoracic splenosis (TS) is often asymptomatic and is diagnosed incidentally in the course of chest examination. We describe the case of a man, with a history of thoracoabdominal trauma, undergoing routine chest radiography with the evidence of radio-opaque images close to the inferior left curvature of the cardiac shadow, which resulted to be nodules of TS at the contrast enhanced CT scan...
2016: Annali Italiani di Chirurgia
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