Emily F. Campbell, Ramya Ramesh, Cody Kuhel, Sathyanarayana Machani
This report describes the case of a 70-year-old female with a history of bioprosthetic aortic valve replacement. She presented to the emergency department with significant shortness of breath and bilateral lower extremity edema, which was found to be secondary to new-onset acute symptomatic congestive heart failure in the setting of Heyde syndrome.
{"title":"Heyde Syndrome as Cause of New-onset Heart Failure in the Setting of Bioprosthetic Aortic Valve: A Case Report","authors":"Emily F. Campbell, Ramya Ramesh, Cody Kuhel, Sathyanarayana Machani","doi":"10.17140/hroj-9-161","DOIUrl":"https://doi.org/10.17140/hroj-9-161","url":null,"abstract":"This report describes the case of a 70-year-old female with a history of bioprosthetic aortic valve replacement. She presented to the emergency department with significant shortness of breath and bilateral lower extremity edema, which was found to be secondary to new-onset acute symptomatic congestive heart failure in the setting of Heyde syndrome.","PeriodicalId":114945,"journal":{"name":"Heart Research – Open Journal","volume":" 30","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139145252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Wan-Li Chu, Y. Hsu, Mon-Chien Lee, Chi-Chang Huang
Background With the rapid development of society, lifestyles and dietary habits are gradually changing. Due to the rich variety of food, highfat and high-sugar diets are becoming more common. Humans who consume high-fat diets for a long time are prone to dyslipidemia, which is one of the main risk factors for the development of cardiovascular diseases (CVDs) such as coronary heart disease, myocardial infarction, atherosclerosis and hypertension. It is becoming a major health problem facing the world. Based on many studies, it is known that bergamot (Citrus bergamia) extract, red yeast rice (Monascus anka) powder, pine bark (Pinus radiata) extract, vitamin E and sesame (Sesamum indicum) extract have the potential to regulate blood lipids. However, there are no actual investigations or studies on this novel combination to control blood lipids. Objective This trial investigated whether lipid-clearing capsules (LCC) containing bergamot extract, red yeast rice powder, pine bark extract, vitamin E and sesame extract had an improved effect on regulating blood lipids. Design In this experiment, a high-cholesterol diet (HCD) containing 0.2% cholesterol was used to induce hyperlipidemia in experimental animals. Experimental animals (hamsters, male, n=50, 5-6-weeks old, mean weight about 90 g) were purchased from the National Center for Experimental Animal Reproduction and Research (NCEAR) and randomly divided into 5 groups (n=10) after a oneweek adaptation period: (1) normal control group (Control), (2) high cholesterol diet group (HCD, fed high cholesterol diet), (3) 1-time dose of LCC group (LCC-1X, fed HCD+1-fold daily dose of LCC), (4) 2-times dose of LCC group (LCC-2X, fed HCD+2-fold daily dose of LCC), (5) 5-times dose of LCC group (LCC-5X, fed HCD+5-fold daily dose of LCC). Blood biochemistry, liver and stool analyses were performed after 8-weeks to assess the lipid-regulating effect of the capsules. Results Eight weeks of HCD feeding resulted in significant increases in serum triglyceride (TG), total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) concentrations, as well as significant increases in hepatic TG and TC-levels and fecal TG and TClevels. Thus, feeding a high-cholesterol diet resulted in significant dyslipidemia and fatty liver formation in experimental animals. Supplementation with 1, 2, or 5 times the dose of LCC for 8-weeks resulted in a significant decrease in serum TG, TC, LDL-C and LDL-C/high-density lipoprotein cholesterol (HDL-C) ratio (p<0.05) and a significant decrease in TG and TC in the liver (p<0.05). Supplementation with LCC also significantly increased TC excretion in the feces. Conclusion The results of this study confirm that LCC has lipid-regulating effects. By translating the experimental data into a daily supplement for adults, it is recommended that a daily intake of 2 LCC (1000 mg internal volume) can help reduce serum TG, TC and LDL-C concentrations, leading to a healthy effect on cardiovascular di
{"title":"Investigating the Lipid-Regulating Effects of Bergamot, Red Yeast Rice, Pine Bark, Vitamin E and Sesame Seed Extracts in Hamsters","authors":"Wan-Li Chu, Y. Hsu, Mon-Chien Lee, Chi-Chang Huang","doi":"10.17140/hroj-9-160","DOIUrl":"https://doi.org/10.17140/hroj-9-160","url":null,"abstract":"Background With the rapid development of society, lifestyles and dietary habits are gradually changing. Due to the rich variety of food, highfat and high-sugar diets are becoming more common. Humans who consume high-fat diets for a long time are prone to dyslipidemia, which is one of the main risk factors for the development of cardiovascular diseases (CVDs) such as coronary heart disease, myocardial infarction, atherosclerosis and hypertension. It is becoming a major health problem facing the world. Based on many studies, it is known that bergamot (Citrus bergamia) extract, red yeast rice (Monascus anka) powder, pine bark (Pinus radiata) extract, vitamin E and sesame (Sesamum indicum) extract have the potential to regulate blood lipids. However, there are no actual investigations or studies on this novel combination to control blood lipids. Objective This trial investigated whether lipid-clearing capsules (LCC) containing bergamot extract, red yeast rice powder, pine bark extract, vitamin E and sesame extract had an improved effect on regulating blood lipids. Design In this experiment, a high-cholesterol diet (HCD) containing 0.2% cholesterol was used to induce hyperlipidemia in experimental animals. Experimental animals (hamsters, male, n=50, 5-6-weeks old, mean weight about 90 g) were purchased from the National Center for Experimental Animal Reproduction and Research (NCEAR) and randomly divided into 5 groups (n=10) after a oneweek adaptation period: (1) normal control group (Control), (2) high cholesterol diet group (HCD, fed high cholesterol diet), (3) 1-time dose of LCC group (LCC-1X, fed HCD+1-fold daily dose of LCC), (4) 2-times dose of LCC group (LCC-2X, fed HCD+2-fold daily dose of LCC), (5) 5-times dose of LCC group (LCC-5X, fed HCD+5-fold daily dose of LCC). Blood biochemistry, liver and stool analyses were performed after 8-weeks to assess the lipid-regulating effect of the capsules. Results Eight weeks of HCD feeding resulted in significant increases in serum triglyceride (TG), total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) concentrations, as well as significant increases in hepatic TG and TC-levels and fecal TG and TClevels. Thus, feeding a high-cholesterol diet resulted in significant dyslipidemia and fatty liver formation in experimental animals. Supplementation with 1, 2, or 5 times the dose of LCC for 8-weeks resulted in a significant decrease in serum TG, TC, LDL-C and LDL-C/high-density lipoprotein cholesterol (HDL-C) ratio (p<0.05) and a significant decrease in TG and TC in the liver (p<0.05). Supplementation with LCC also significantly increased TC excretion in the feces. Conclusion The results of this study confirm that LCC has lipid-regulating effects. By translating the experimental data into a daily supplement for adults, it is recommended that a daily intake of 2 LCC (1000 mg internal volume) can help reduce serum TG, TC and LDL-C concentrations, leading to a healthy effect on cardiovascular di","PeriodicalId":114945,"journal":{"name":"Heart Research – Open Journal","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139146014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction Cardiovascular disease (CVD) is the leading cause of death globally, with Blacks in the United States (U.S.) is proportionately affected. Healthcare access and utilization have been reported as risk factors for poorer cardiovascular health among several U.S. populations. Aims and Objectives The purpose of this systematic literature review was to examine the results of existing studies reporting on cardiovascular health and healthcare utilization by African-born compared to U. S. -born Blacks. Methods A systematic literature review was conducted using keywords and medical subject headings (MESHs) in the PUBMED, Web of Science and CINAHL electronic databases. Exclusion and inclusion criteria determined articles to be reviewed for eligibility and methodological soundness. A pooled analysis was performed on all studies. Results Only seven studies met inclusion criteria. Four compared U. S. -born with African-born Blacks residing in the United States, while three compared U. S. -born Blacks with Blacks residing elsewhere. None of the studies examined the associations between healthcare utilization and cardiovascular health for these populations. Conclusion The results of this review indicate a need to examine the impact of healthcare utilization for increasing awareness, prevention and treatment of CVD in Blacks who reside in the United States regardless of their nativity.
心血管疾病(CVD)是全球死亡的主要原因，在美国黑人(美国)的比例受到影响。据报道，在一些美国人群中，医疗保健的获取和利用是心血管健康状况较差的危险因素。目的和目的:本系统文献综述的目的是比较非洲裔和美国裔黑人在心血管健康和医疗保健利用方面的现有研究结果。方法采用PUBMED、Web of Science和CINAHL电子数据库中的关键词和医学主题词(MESHs)进行系统的文献综述。排除和纳入标准确定了要审查的文章的资格和方法的合理性。对所有研究进行汇总分析。结果只有7项研究符合纳入标准。四项研究比较了美国出生的黑人和居住在美国的非洲出生的黑人，三项研究比较了美国出生的黑人和居住在其他地方的黑人。没有一项研究调查了这些人群的医疗保健利用与心血管健康之间的关系。结论本综述的结果表明，有必要研究医疗保健利用对提高居住在美国的黑人心血管疾病的认识、预防和治疗的影响，无论他们的出生地。
{"title":"Cardiovascular Health and Healthcare Use of United States-Born and African-Born Blacks: A Review","authors":"Olubukunola Oyedele, D. Schneider","doi":"10.17140/hroj-8-157","DOIUrl":"https://doi.org/10.17140/hroj-8-157","url":null,"abstract":"Introduction Cardiovascular disease (CVD) is the leading cause of death globally, with Blacks in the United States (U.S.) is proportionately affected. Healthcare access and utilization have been reported as risk factors for poorer cardiovascular health among several U.S. populations. Aims and Objectives The purpose of this systematic literature review was to examine the results of existing studies reporting on cardiovascular health and healthcare utilization by African-born compared to U. S. -born Blacks. Methods A systematic literature review was conducted using keywords and medical subject headings (MESHs) in the PUBMED, Web of Science and CINAHL electronic databases. Exclusion and inclusion criteria determined articles to be reviewed for eligibility and methodological soundness. A pooled analysis was performed on all studies. Results Only seven studies met inclusion criteria. Four compared U. S. -born with African-born Blacks residing in the United States, while three compared U. S. -born Blacks with Blacks residing elsewhere. None of the studies examined the associations between healthcare utilization and cardiovascular health for these populations. Conclusion The results of this review indicate a need to examine the impact of healthcare utilization for increasing awareness, prevention and treatment of CVD in Blacks who reside in the United States regardless of their nativity.","PeriodicalId":114945,"journal":{"name":"Heart Research – Open Journal","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123524875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
N. Ali, C. Dospinescu, M. Cunnington, C. Malkin, D. Blackman
Aims Access site vascular complications remain a recognised complication following transcatheter aortic valve implantation (TAVI). Suture-based vascular closure devices (VCDs) such as ProGlide® (Abbott Vascular Inc., Santa Clara, CA, USA) are widely used in order to achieve rapid haemostasis. The MANTATM (Essential Medical Inc., Malvern, PA, USA) is a collagen plug-based VCD which can be used as an alternative to traditional suture-based devices, but is significantly more expensive per-unit. We compare the efficacy, safety and total cost associated with the use of the MANTATM and ProGlide® VCDs. Methods This retrospective study included all consecutive patients who underwent transfemoral (TF) TAVI between November 2017-June 2018. The primary endpoints were primary access site-related VARC-2 vascular complications, VARC-2 bleeding and the overall per-patient cost incorporating treatment for complications or use of additional VCDs. Results A total of 136 patients were included in this study; 86 in the ProGlide® group and 50 in the MANTATM group. Baseline characteristics of the two groups were well-matched. Three patients in the ProGlide® group required surgical repair compared to none in the MANTATM group. However, no significant differences were observed with respect to overall primary access site-related VARC-2 vascular complications (10.5% vs. 10%; p=0.93) or VARC-2 bleeding (9.3% vs. 4.0%; p=0.25). There was no significant difference in the mean cost per patient when taking into consideration the use of additional VCDs and treatments for vascular complications (£568.79 vs. £599.95; p=0.90). Conclusion The use of the MANTATM VCD following TF TAVI is cost-neutral compared to ProGlide® VCDs, whilst being associated with no increase in VARC-2 vascular or bleeding complications.
目的经导管主动脉瓣植入术(TAVI)后，通路部位血管并发症仍然是公认的并发症。基于缝合的血管闭合装置(vcd)，如ProGlide®(Abbott vascular Inc.， Santa Clara, CA, USA)被广泛用于实现快速止血。MANTATM (Essential Medical Inc.， Malvern, PA, USA)是一种基于胶原蛋白插入的VCD，可以作为传统基于缝合线的设备的替代品，但单位价格要贵得多。我们比较了使用MANTATM和ProGlide®vcd的有效性、安全性和总成本。方法:本回顾性研究纳入2017年11月至2018年6月期间所有连续接受经股(TF) TAVI的患者。主要终点是主要通路部位相关的VARC-2血管并发症、VARC-2出血和合并并发症治疗或使用额外vcd的每位患者总成本。结果本研究共纳入136例患者;ProGlide组86例，MANTATM组50例。两组患者的基线特征吻合良好。ProGlide组中有3例患者需要手术修复，而MANTATM组中没有患者需要手术修复。然而，在总体主要通路部位相关的VARC-2血管并发症方面，没有观察到显著差异(10.5% vs 10%;p=0.93)或VARC-2出血(9.3% vs. 4.0%;p = 0.25)。考虑到额外vcd的使用和血管并发症的治疗，每位患者的平均费用没有显著差异(568.79英镑vs 599.95英镑;p = 0.90)。结论:与ProGlide®VCD相比，在TF TAVI后使用MANTATM VCD是成本中性的，同时没有增加VARC-2血管或出血并发症。
{"title":"A Comparison of Efficacy, Safety and Cost Between MANTATM and Proglide Vascular Closure Devices Following Transfemoral Transcatheter Aortic Valve Implantation","authors":"N. Ali, C. Dospinescu, M. Cunnington, C. Malkin, D. Blackman","doi":"10.17140/hroj-8-156","DOIUrl":"https://doi.org/10.17140/hroj-8-156","url":null,"abstract":"Aims Access site vascular complications remain a recognised complication following transcatheter aortic valve implantation (TAVI). Suture-based vascular closure devices (VCDs) such as ProGlide® (Abbott Vascular Inc., Santa Clara, CA, USA) are widely used in order to achieve rapid haemostasis. The MANTATM (Essential Medical Inc., Malvern, PA, USA) is a collagen plug-based VCD which can be used as an alternative to traditional suture-based devices, but is significantly more expensive per-unit. We compare the efficacy, safety and total cost associated with the use of the MANTATM and ProGlide® VCDs. Methods This retrospective study included all consecutive patients who underwent transfemoral (TF) TAVI between November 2017-June 2018. The primary endpoints were primary access site-related VARC-2 vascular complications, VARC-2 bleeding and the overall per-patient cost incorporating treatment for complications or use of additional VCDs. Results A total of 136 patients were included in this study; 86 in the ProGlide® group and 50 in the MANTATM group. Baseline characteristics of the two groups were well-matched. Three patients in the ProGlide® group required surgical repair compared to none in the MANTATM group. However, no significant differences were observed with respect to overall primary access site-related VARC-2 vascular complications (10.5% vs. 10%; p=0.93) or VARC-2 bleeding (9.3% vs. 4.0%; p=0.25). There was no significant difference in the mean cost per patient when taking into consideration the use of additional VCDs and treatments for vascular complications (£568.79 vs. £599.95; p=0.90). Conclusion The use of the MANTATM VCD following TF TAVI is cost-neutral compared to ProGlide® VCDs, whilst being associated with no increase in VARC-2 vascular or bleeding complications.","PeriodicalId":114945,"journal":{"name":"Heart Research – Open Journal","volume":"174 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122956151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction Several challenges with radiation protection and safety culture in radiology departments needs to be addressed as few studies done in this aspect in our country. Especially with regard to the awareness about radiation protection, hazards, dosimetry usage and measurement. Objective The objective of this study is to find knowledge about radiation exposure hazard and practices among various auxiliary staff working in radiation units. Material and Methods Cross-sectional study done by using stratified random sampling method. A questionnaire made to check the awareness level of the radiological staff regarding radiation protection working in angiography suite. The questionnaire had two parts with various questions about radiation protection measures and safety related knowledge for staff and patient. Data collected from angiography suite of three public sector hospitals of Lahore, Pakistan. All the data entered in statistical package for the social science (SSPS) version 16 and analyzed for statistically significant outcomes. Results Total of 67 staff members were included in this study from three different public sector hospitals, 55.2% were males 44.77% were females. Twenty-nine (29) persons belonged to the age group of 20-30-years. Twenty (20) doctors, 21 nurses, 12 radiographers and 14 paramedical staff were included. 89.55% staff members were aware of radiation hazard. 55.22% had training on radiation protection and 44.77%. 56.71% were aware of dosimeter. Only 16% were aware of as low as reasonably achievable (ALARA). Conclusion The radiological staff members were partially aware about radiation hazards and radiation safety. They were lacking from training and workshops. Essential steps required to develop nationwide strategies for improving the situation and maintaining a safe working environment.
{"title":"Assessment of Level of Awareness Towards Radiation Protection Among the Staff Working at Angiography Suite at Public Hospitals","authors":"Ruby Niaz, Syed N. Hyder, U. Ahmed, Munawer Ghous","doi":"10.17140/hroj-8-159","DOIUrl":"https://doi.org/10.17140/hroj-8-159","url":null,"abstract":"Introduction Several challenges with radiation protection and safety culture in radiology departments needs to be addressed as few studies done in this aspect in our country. Especially with regard to the awareness about radiation protection, hazards, dosimetry usage and measurement. Objective The objective of this study is to find knowledge about radiation exposure hazard and practices among various auxiliary staff working in radiation units. Material and Methods Cross-sectional study done by using stratified random sampling method. A questionnaire made to check the awareness level of the radiological staff regarding radiation protection working in angiography suite. The questionnaire had two parts with various questions about radiation protection measures and safety related knowledge for staff and patient. Data collected from angiography suite of three public sector hospitals of Lahore, Pakistan. All the data entered in statistical package for the social science (SSPS) version 16 and analyzed for statistically significant outcomes. Results Total of 67 staff members were included in this study from three different public sector hospitals, 55.2% were males 44.77% were females. Twenty-nine (29) persons belonged to the age group of 20-30-years. Twenty (20) doctors, 21 nurses, 12 radiographers and 14 paramedical staff were included. 89.55% staff members were aware of radiation hazard. 55.22% had training on radiation protection and 44.77%. 56.71% were aware of dosimeter. Only 16% were aware of as low as reasonably achievable (ALARA). Conclusion The radiological staff members were partially aware about radiation hazards and radiation safety. They were lacking from training and workshops. Essential steps required to develop nationwide strategies for improving the situation and maintaining a safe working environment.","PeriodicalId":114945,"journal":{"name":"Heart Research – Open Journal","volume":"31 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132485467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ebstein’s anomaly is a congenital malformation of the heart that is characterized by downward displacement of an abnormal tricuspid valve into the right ventricle. It is rare, with an incidence of 1 in 200,000 live births. Etiology is unknown. Our patient was exposed to artemether-lumefantrine, ciprofloxacin, and ibuprofen (not previously linked with Ebstein’s anomaly) at about four weeks of gestation. An obstetric scan at 33 weeks’ gestation, was the first clue to the diagnosis.
{"title":"Ebstein’s Anomaly, Possible Newly Implicated Drug Aetiology? A Case Report","authors":"B. Animasahun, O. A. Ajayi, F. O. Lawani, E. Disu","doi":"10.17140/hroj-8-158","DOIUrl":"https://doi.org/10.17140/hroj-8-158","url":null,"abstract":"Ebstein’s anomaly is a congenital malformation of the heart that is characterized by downward displacement of an abnormal tricuspid valve into the right ventricle. It is rare, with an incidence of 1 in 200,000 live births. Etiology is unknown. Our patient was exposed to artemether-lumefantrine, ciprofloxacin, and ibuprofen (not previously linked with Ebstein’s anomaly) at about four weeks of gestation. An obstetric scan at 33 weeks’ gestation, was the first clue to the diagnosis.","PeriodicalId":114945,"journal":{"name":"Heart Research – Open Journal","volume":"42 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129376512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Giant cell myocarditis is a rare condition first described in 1905. It has a reported incidence range from 0.007% to 0.051%. It affects female and male individuals, equally, and usually occurs in young and middle-aged persons. The underlying aetiology of giant cell myocarditis is unknown but it is thought to be mediated by T-lymphocytes. Diagnosis is made via histological examination of myocardial tissue and is characterized by a mixed inflammatory cell infiltrate with multinucleated giant cells and cardiomyocyte necrosis, predominantly affecting the ventricles. The following report describes a rare case of giant cell myocarditis in a 71-yearold man with a history of hypertension and heart failure, who died while waiting to be seen in the emergency department. Autopsy findings revealed an enlarged, dilated heart with histologic features in keeping with giant cell myocarditis, along with features of heart failure. Diagnosis of giant cell myocarditis is less common in the elderly age group, possibly due to a less severe disease process in this age group and it may be misdiagnosed because older individuals may have other cardiovascular diseases (CVDs).
{"title":"A Rare Case of Giant Cell Myocarditis","authors":"A. Neblett","doi":"10.17140/HROJ-7-154","DOIUrl":"https://doi.org/10.17140/HROJ-7-154","url":null,"abstract":"Giant cell myocarditis is a rare condition first described in 1905. It has a reported incidence range from 0.007% to 0.051%. It affects female and male individuals, equally, and usually occurs in young and middle-aged persons. The underlying aetiology of giant cell myocarditis is unknown but it is thought to be mediated by T-lymphocytes. Diagnosis is made via histological examination of myocardial tissue and is characterized by a mixed inflammatory cell infiltrate with multinucleated giant cells and cardiomyocyte necrosis, predominantly affecting the ventricles. The following report describes a rare case of giant cell myocarditis in a 71-yearold man with a history of hypertension and heart failure, who died while waiting to be seen in the emergency department. Autopsy findings revealed an enlarged, dilated heart with histologic features in keeping with giant cell myocarditis, along with features of heart failure. Diagnosis of giant cell myocarditis is less common in the elderly age group, possibly due to a less severe disease process in this age group and it may be misdiagnosed because older individuals may have other cardiovascular diseases (CVDs).","PeriodicalId":114945,"journal":{"name":"Heart Research – Open Journal","volume":"89 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121723396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background Sudden death is the principal cause of fatality in Chagas disease, afflicting to non-symptomatic patients younger than 50-years. For this, sudden death associated with chagasic malignant arrhythmias is underdiagnosed and their pathophysiological basis is poorly understood. Aims In this sense, this work aimed to analyze the histopathological alterations in cardiac structures specialized in the generation/conduction of action potential in an anatomopathological case of non-diagnosed sudden death living in a Chagasic endemic area. Methods The donor was a woman, 62-year-old, which ingressed without vital signs to the emergency room of “Antonio María Pineda” hospital, without any apparent antecedents of cardiac disease. The gross examination was normal, with no external evidence of structural/ischemic disease. Results Microscopic examination revealed nodal like cell depopulation, microvascular disturbances, chronic myocarditis with mononuclear and mast cell infiltrate plus extracellular matrix reaction, and profuse damage of neural structures placed in nodal region. Amastigote nest of Trypanosoma cruzi (T. cruzi) was detected. Conclusion These findings suggest a complex association among parasite persistence, sinus disease, micro-ischemia foci, and neural inflammation in the genesis of malignant arrhythmias of Chagas disease despite the absence of structural disease or massive necrosis. It is important to perform a protocol of examination for no explained sudden death cases in chagasic endemic countries, to avoid misdiagnosed of sudden death associated with Chagas disease.
背景突然死亡是恰加斯病的主要死亡原因，困扰着50岁以下无症状的患者。因此，与偶发性恶性心律失常相关的猝死未被充分诊断，其病理生理基础也知之甚少。从这个意义上说，本研究旨在分析一个生活在马达加斯加流行地区的未确诊猝死的解剖病理病例中，专门用于动作电位产生/传导的心脏结构的组织病理学改变。方法供体为女性，62岁，无生命体征，无明显心脏病史，于Antonio María Pineda医院急诊就诊。大体检查正常，无结构性/缺血性疾病的外部证据。结果显微镜检查显示结节样细胞减少，微血管紊乱，慢性心肌炎伴单核细胞和肥大细胞浸润及细胞外基质反应，结节区神经结构大量损伤。检测到克氏锥虫(T.克氏锥虫)的无鞭虫巢。结论尽管没有结构性疾病或大量坏死，但寄生虫持续存在、窦性疾病、微缺血灶和神经炎症与恰加斯病恶性心律失常的发生存在复杂的联系。重要的是在恰加斯病流行国家对无法解释的猝死病例执行检查方案，以避免误诊与恰加斯病相关的猝死。
{"title":"Histopathological Analysis of the Pro-Arrhythmogenic Changes in a Suspected Chagas Disease Sudden Death","authors":"Héctor O. Rodríguez","doi":"10.17140/HROJ-7-155","DOIUrl":"https://doi.org/10.17140/HROJ-7-155","url":null,"abstract":"Background Sudden death is the principal cause of fatality in Chagas disease, afflicting to non-symptomatic patients younger than 50-years. For this, sudden death associated with chagasic malignant arrhythmias is underdiagnosed and their pathophysiological basis is poorly understood. Aims In this sense, this work aimed to analyze the histopathological alterations in cardiac structures specialized in the generation/conduction of action potential in an anatomopathological case of non-diagnosed sudden death living in a Chagasic endemic area. Methods The donor was a woman, 62-year-old, which ingressed without vital signs to the emergency room of “Antonio María Pineda” hospital, without any apparent antecedents of cardiac disease. The gross examination was normal, with no external evidence of structural/ischemic disease. Results Microscopic examination revealed nodal like cell depopulation, microvascular disturbances, chronic myocarditis with mononuclear and mast cell infiltrate plus extracellular matrix reaction, and profuse damage of neural structures placed in nodal region. Amastigote nest of Trypanosoma cruzi (T. cruzi) was detected. Conclusion These findings suggest a complex association among parasite persistence, sinus disease, micro-ischemia foci, and neural inflammation in the genesis of malignant arrhythmias of Chagas disease despite the absence of structural disease or massive necrosis. It is important to perform a protocol of examination for no explained sudden death cases in chagasic endemic countries, to avoid misdiagnosed of sudden death associated with Chagas disease.","PeriodicalId":114945,"journal":{"name":"Heart Research – Open Journal","volume":"41 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125538747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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