Pub Date : 2022-09-20DOI: 10.5348/100013c03pk2022cr
P. Kaur, Syed S. Fatmi, Sidra Shakil, Saikiran Mandyam, Bsmah Abdalslam
Methamphetamine has been documented to be associated with pulmonary hypertension. Past studies have shown the association of methamphetamine abuse with pulmonary hypertension; however, cases of isolated acute to subacute right heart failure secondary to methamphetamine use have not been documented. Acute to subacute right heart failure, secondary to methamphetamine use itself represents a diagnostic challenge as there is no specific protocol in place for evaluation for pulmonary hypertension secondary to methamphetamine use and high degree of suspicion is needed to differentiate it from other cardio-pulmonary conditions. Echocardiographic findings of increased right ventricular systolic pressure along with morphological findings suggesting cardiac remodeling in the setting of methamphetamine use is highly suspicious of acute to subacute right heart failure. Early recognition and management, along with long-term abstinence from methamphetamine use is critical to prevent chronic effects on myocardium and to prevent further cardiac remodeling. Although dedicated cardiothoracic imaging and cardiac catheterization can be beneficial; neither of these modalities are needed to establish the diagnosis and to initiate primary interventions. Computed tomography (CT) scan however would be beneficial in excluding other causes of pulmonary hypertension, such as primary pulmonary conditions and pulmonary embolism.
{"title":"A case of transient right ventricular failure secondary to severe pulmonary hypertension in setting of methamphetamine use","authors":"P. Kaur, Syed S. Fatmi, Sidra Shakil, Saikiran Mandyam, Bsmah Abdalslam","doi":"10.5348/100013c03pk2022cr","DOIUrl":"https://doi.org/10.5348/100013c03pk2022cr","url":null,"abstract":"\u0000 Methamphetamine has been documented to be associated with pulmonary hypertension. Past studies have shown the association of methamphetamine abuse with pulmonary hypertension; however, cases of isolated acute to subacute right heart failure secondary to methamphetamine use have not been documented. Acute to subacute right heart failure, secondary to methamphetamine use itself represents a diagnostic challenge as there is no specific protocol in place for evaluation for pulmonary hypertension secondary to methamphetamine use and high degree of suspicion is needed to differentiate it from other cardio-pulmonary conditions. Echocardiographic findings of increased right ventricular systolic pressure along with morphological findings suggesting cardiac remodeling in the setting of methamphetamine use is highly suspicious of acute to subacute right heart failure. Early recognition and management, along with long-term abstinence from methamphetamine use is critical to prevent chronic effects on myocardium and to prevent further cardiac remodeling. Although dedicated cardiothoracic imaging and cardiac catheterization can be beneficial; neither of these modalities are needed to establish the diagnosis and to initiate primary interventions. Computed tomography (CT) scan however would be beneficial in excluding other causes of pulmonary hypertension, such as primary pulmonary conditions and pulmonary embolism.\u0000","PeriodicalId":144865,"journal":{"name":"Edorium Journal of Cardiology","volume":"07 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131191338","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}
Pub Date : 2022-06-16DOI: 10.5348/100012c03cs2022cr
Christine Sykalo, M. Herrera, A. Adams, U. Egolum
This case illustrates an atypical mitral valve prolapse presentation with superimposed stress of acute respiratory distress syndrome (ARDS) as well as the importance of extracorporeal membrane oxygenation therapy (ECMO) as a bridge to definitive surgical intervention. Switching from venovenous (VV) to venoarterial (VA) ECMO allowed bypass of the pulmonary circulation and provided cardiac support to assist in systemic circulation in the setting of severe mitral regurgitation with mitral valve prolapse. However, VA ECMO increases afterload, thus an Impella was used to offload the left ventricle and provide forward flow. Relying on evidence-based medicine for each modality despite its complexity also optimized this patient’s chance for recovery. Thereby, we demonstrate a complex case of ARDS, mitral valve prolapse secondary to myocardial infarction, and subsequent multiple arrhythmic arrests, where successful VV and VA ECMO resuscitation afforded bridge therapy to definitive surgical management. Our patient showed promising results, and we would like to encourage this strategy to bridge patients requiring surgical intervention.
{"title":"Tricky papillary muscle rupture sequelae navigated by evidence-based therapies using ECMO and Impella","authors":"Christine Sykalo, M. Herrera, A. Adams, U. Egolum","doi":"10.5348/100012c03cs2022cr","DOIUrl":"https://doi.org/10.5348/100012c03cs2022cr","url":null,"abstract":"\u0000 This case illustrates an atypical mitral valve prolapse presentation with superimposed stress of acute respiratory distress syndrome (ARDS) as well as the importance of extracorporeal membrane oxygenation therapy (ECMO) as a bridge to definitive surgical intervention. Switching from venovenous (VV) to venoarterial (VA) ECMO allowed bypass of the pulmonary circulation and provided cardiac support to assist in systemic circulation in the setting of severe mitral regurgitation with mitral valve prolapse. However, VA ECMO increases afterload, thus an Impella was used to offload the left ventricle and provide forward flow. Relying on evidence-based medicine for each modality despite its complexity also optimized this patient’s chance for recovery. Thereby, we demonstrate a complex case of ARDS, mitral valve prolapse secondary to myocardial infarction, and subsequent multiple arrhythmic arrests, where successful VV and VA ECMO resuscitation afforded bridge therapy to definitive surgical management. Our patient showed promising results, and we would like to encourage this strategy to bridge patients requiring surgical intervention.\u0000","PeriodicalId":144865,"journal":{"name":"Edorium Journal of Cardiology","volume":"99 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134483146","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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