Arsenic trioxide (ATO) is commonly known to cause QT prolongation with resultant ventricular tachycardia (VT). VT, independent of QT prolongation, can be a complication of ATO. We present a 46-year-old female who received ATO and during her hospital course had intermittent nonsustained VT. All usual causes of VT were considered including reduced EF < 35%, ischemia, electrolyte abnormalities, medications, and genetic polymorphisms; however, no specific cause was found. After stopping therapy, the episodes of nonsustained VT ceased indicating that there is an association between ATO and VT.
{"title":"QT Independent Ventricular Tachycardia Induced by Arsenic Trioxide.","authors":"Vicken Zeitjian, Carmel Moazez, Waqas Arslan, Mehrdad Saririan","doi":"10.1155/2019/9870283","DOIUrl":"https://doi.org/10.1155/2019/9870283","url":null,"abstract":"<p><p>Arsenic trioxide (ATO) is commonly known to cause QT prolongation with resultant ventricular tachycardia (VT). VT, independent of QT prolongation, can be a complication of ATO. We present a 46-year-old female who received ATO and during her hospital course had intermittent nonsustained VT. All usual causes of VT were considered including reduced EF < 35%, ischemia, electrolyte abnormalities, medications, and genetic polymorphisms; however, no specific cause was found. After stopping therapy, the episodes of nonsustained VT ceased indicating that there is an association between ATO and VT.</p>","PeriodicalId":51760,"journal":{"name":"Case Reports in Cardiology","volume":"2019 ","pages":"9870283"},"PeriodicalIF":0.6,"publicationDate":"2019-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2019/9870283","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41219834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
We present a case of a 64-year-old female who was supported with an HVAD as bridge-to-transplant (BTT) who presented with a gastrointestinal (GI) bleeding and underwent esophagogastroduodenoscopy (EGD) and colonoscopy. Her waveforms changed abruptly following the procedure, and she decompensated. With various imaging modalities and hemodynamic monitoring, we felt that she had thrombus in her outflow graft, which improved following systemic heparinization. She was listed for cardiac transplantation and remained hospitalized. At the time of surgery, her outflow graft was noted to be compressed externally and pathology was consistent with platelet-fibrin thrombus deposition.
{"title":"A Rare Complication of HVAD Outflow Thrombosis and the Importance of HVAD Waveform Analysis","authors":"J. Ning, N. Gaglianello","doi":"10.1155/2019/6905397","DOIUrl":"https://doi.org/10.1155/2019/6905397","url":null,"abstract":"We present a case of a 64-year-old female who was supported with an HVAD as bridge-to-transplant (BTT) who presented with a gastrointestinal (GI) bleeding and underwent esophagogastroduodenoscopy (EGD) and colonoscopy. Her waveforms changed abruptly following the procedure, and she decompensated. With various imaging modalities and hemodynamic monitoring, we felt that she had thrombus in her outflow graft, which improved following systemic heparinization. She was listed for cardiac transplantation and remained hospitalized. At the time of surgery, her outflow graft was noted to be compressed externally and pathology was consistent with platelet-fibrin thrombus deposition.","PeriodicalId":51760,"journal":{"name":"Case Reports in Cardiology","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2019-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2019/6905397","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47728113","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}
S. Wittekind, Hugo R Martinez, C. Villa, M. Bacon, A. Hammill, A. Lorts
Iron deficiency anemia has been associated with a secondary and potentially reversible cardiomyopathy. The pathophysiologic paradigm has been that the hematologic disease begets cardiac dysfunction. There may be, however, a point at which myocardial injury is irreversible in susceptible individuals. We present the case of a 4-year-old, developmentally normal, child who presented with iron deficiency anemia and a dilated cardiomyopathy with congestive heart failure. Despite appropriate correction of the anemia, the patient developed decompensated heart failure requiring milrinone therapy and eventual heart transplantation. This report will alert clinicians to the potential for irreversible adverse cardiac remodeling and the importance of close pediatric cardiology consultation and serial assessment in order to implement appropriate heart failure therapy.
{"title":"Profound Iron Deficiency Anemia and Irreversible Dilated Cardiomyopathy in a Child","authors":"S. Wittekind, Hugo R Martinez, C. Villa, M. Bacon, A. Hammill, A. Lorts","doi":"10.1155/2019/7513782","DOIUrl":"https://doi.org/10.1155/2019/7513782","url":null,"abstract":"Iron deficiency anemia has been associated with a secondary and potentially reversible cardiomyopathy. The pathophysiologic paradigm has been that the hematologic disease begets cardiac dysfunction. There may be, however, a point at which myocardial injury is irreversible in susceptible individuals. We present the case of a 4-year-old, developmentally normal, child who presented with iron deficiency anemia and a dilated cardiomyopathy with congestive heart failure. Despite appropriate correction of the anemia, the patient developed decompensated heart failure requiring milrinone therapy and eventual heart transplantation. This report will alert clinicians to the potential for irreversible adverse cardiac remodeling and the importance of close pediatric cardiology consultation and serial assessment in order to implement appropriate heart failure therapy.","PeriodicalId":51760,"journal":{"name":"Case Reports in Cardiology","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2019-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2019/7513782","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44124715","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}
H. Daoud, Ashraf Abugroun, Shruti Erramilli, Surender Kumar
Acute coronary syndrome (ACS) secondary to a coronary embolism is an unusual occurrence, yet an important consideration given the difficult diagnosis. We report a case of a 69-year-old male with a medical history of paroxysmal atrial fibrillation who presented with chest pain and shortness of breath. A coronary angiogram was significant for three focal transluminal and translucent areas in the ostial, mid, and distal circumflex artery consistent with embolic disease. The patient was subsequently managed medically with anticoagulation. Despite being a relatively rare entity, thromboembolism into the coronary arteries can provoke an acute myocardial infarction, with atrial fibrillation being the most common risk factor. Treatment modalities for ACS secondary to thromboembolism include stent placement, intracoronary thrombolysis, and thrombus aspiration.
{"title":"Acute Coronary Syndrome (ACS) due to Coronary Artery Embolism in a Patient with Atrial Fibrillation","authors":"H. Daoud, Ashraf Abugroun, Shruti Erramilli, Surender Kumar","doi":"10.1155/2019/9347198","DOIUrl":"https://doi.org/10.1155/2019/9347198","url":null,"abstract":"Acute coronary syndrome (ACS) secondary to a coronary embolism is an unusual occurrence, yet an important consideration given the difficult diagnosis. We report a case of a 69-year-old male with a medical history of paroxysmal atrial fibrillation who presented with chest pain and shortness of breath. A coronary angiogram was significant for three focal transluminal and translucent areas in the ostial, mid, and distal circumflex artery consistent with embolic disease. The patient was subsequently managed medically with anticoagulation. Despite being a relatively rare entity, thromboembolism into the coronary arteries can provoke an acute myocardial infarction, with atrial fibrillation being the most common risk factor. Treatment modalities for ACS secondary to thromboembolism include stent placement, intracoronary thrombolysis, and thrombus aspiration.","PeriodicalId":51760,"journal":{"name":"Case Reports in Cardiology","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2019-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2019/9347198","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46024983","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}
Talha Ahmed, G. Ramani, M. Ghoreishi, Ayesha Safdar, B. Griffith
Pulmonary artery aneurysms (PAAs) are defined as having pulmonary artery diameter of greater than 40 mm. PAAs are rare and can occur in various pulmonary diseases. There are no clear-cut guidelines regarding the management of PAAs, and recommendations for management are made based on expert consensus opinion, case reports, and institutional experience. This series highlights three patients with pulmonary hypertension (PH) and PAA. The clinical course and diagnostic findings and the decision-making involved in the treatment are reviewed. An overview of three distinct management strategies including medical management, heart/lung transplant, and surgical aneurysm repair is presented.
{"title":"Management of Pulmonary Artery Aneurysms in Pulmonary Hypertension: A Single-Center Review of 3 Cases","authors":"Talha Ahmed, G. Ramani, M. Ghoreishi, Ayesha Safdar, B. Griffith","doi":"10.1155/2019/1924014","DOIUrl":"https://doi.org/10.1155/2019/1924014","url":null,"abstract":"Pulmonary artery aneurysms (PAAs) are defined as having pulmonary artery diameter of greater than 40 mm. PAAs are rare and can occur in various pulmonary diseases. There are no clear-cut guidelines regarding the management of PAAs, and recommendations for management are made based on expert consensus opinion, case reports, and institutional experience. This series highlights three patients with pulmonary hypertension (PH) and PAA. The clinical course and diagnostic findings and the decision-making involved in the treatment are reviewed. An overview of three distinct management strategies including medical management, heart/lung transplant, and surgical aneurysm repair is presented.","PeriodicalId":51760,"journal":{"name":"Case Reports in Cardiology","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2019-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2019/1924014","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44121817","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 : 2019-10-09eCollection Date: 2019-01-01DOI: 10.1155/2019/2576373
N F N Sakul, Srijan Shrestha, Nikhita Balabbigari, Sapan Talati
Takotsubo syndrome was believed to be a rare acute cardiac event until recently with takotsubo cardiomyopathy being its most commonly recognized and often the diagnostic feature. Its diagnosis is becoming increasingly common with varied clinical manifestations most of whom have favorable clinical outcomes, yet it can be associated with life-threatening complications. We report a case of takotsubo syndrome leading to complete heart block which is a unique complication of an otherwise self-resolving disease.
{"title":"Complete Heart Block: A Rare Complication of Takotsubo Syndrome.","authors":"N F N Sakul, Srijan Shrestha, Nikhita Balabbigari, Sapan Talati","doi":"10.1155/2019/2576373","DOIUrl":"https://doi.org/10.1155/2019/2576373","url":null,"abstract":"<p><p>Takotsubo syndrome was believed to be a rare acute cardiac event until recently with takotsubo cardiomyopathy being its most commonly recognized and often the diagnostic feature. Its diagnosis is becoming increasingly common with varied clinical manifestations most of whom have favorable clinical outcomes, yet it can be associated with life-threatening complications. We report a case of takotsubo syndrome leading to complete heart block which is a unique complication of an otherwise self-resolving disease.</p>","PeriodicalId":51760,"journal":{"name":"Case Reports in Cardiology","volume":"2019 ","pages":"2576373"},"PeriodicalIF":0.6,"publicationDate":"2019-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2019/2576373","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41219833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sowmya Palam, R. Kapoor, A. Abdelkader, Jacquelyn Kulinski
[This corrects the article DOI: 10.1155/2018/6750264.].
[这更正了文章DOI: 10.1155/2018/6750264.]
{"title":"Corrigendum to “A Rare Presentation of Cardiac Tamponade from Metastatic Urothelial Carcinoma of the Bladder”","authors":"Sowmya Palam, R. Kapoor, A. Abdelkader, Jacquelyn Kulinski","doi":"10.1155/2019/8376360","DOIUrl":"https://doi.org/10.1155/2019/8376360","url":null,"abstract":"[This corrects the article DOI: 10.1155/2018/6750264.].","PeriodicalId":51760,"journal":{"name":"Case Reports in Cardiology","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2019-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2019/8376360","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48349167","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}
E. Harmon, Yoo Jin Lee, S. Mazimba, Kanwar P Singh, Aditya M. Sharma, Younghoon Kwon
Deep vein thrombosis (DVT) after femoral arterial access is a rare complication of left heart catheterization (LHC). The reasons for paradoxical venous clot formation after arterial access are identifiable in some cases but less clear in others. Here, we present one case of provoked DVT after femoral access followed by a second case in which clot formation appears to be spontaneous. Additionally, though each of the patients presented here demonstrated thrombus resolution, only one received anticoagulation. These cases highlight the complex pathophysiology of DVT following femoral arterial access and the challenges of management strategy selection.
{"title":"Deep Vein Thrombosis after Femoral Arterial Access: Pathophysiologic and Therapeutic Challenges","authors":"E. Harmon, Yoo Jin Lee, S. Mazimba, Kanwar P Singh, Aditya M. Sharma, Younghoon Kwon","doi":"10.1155/2019/1849256","DOIUrl":"https://doi.org/10.1155/2019/1849256","url":null,"abstract":"Deep vein thrombosis (DVT) after femoral arterial access is a rare complication of left heart catheterization (LHC). The reasons for paradoxical venous clot formation after arterial access are identifiable in some cases but less clear in others. Here, we present one case of provoked DVT after femoral access followed by a second case in which clot formation appears to be spontaneous. Additionally, though each of the patients presented here demonstrated thrombus resolution, only one received anticoagulation. These cases highlight the complex pathophysiology of DVT following femoral arterial access and the challenges of management strategy selection.","PeriodicalId":51760,"journal":{"name":"Case Reports in Cardiology","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2019-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2019/1849256","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44246047","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}
Atrial fibrillation is characterized by irregularly irregular heart rhythm with an increased morbidity and mortality. It is associated with an increased risk of thromboembolism due to formation of blood clot in the left atrium. Most of these blood clots are formed in the left atrial appendage. The risk of blood clot formation is reduced with the use of anticoagulants. The patients who cannot take anticoagulants due to an increased bleeding risk can undergo percutaneous left atrial appendage (LAA) closure. A Watchman device is used for this purpose. LAA closure with the Watchman device is associated with some adverse effects, and one of them is device-related thrombus. Currently, there are no specific guidelines for the management of device-related thrombus. We present a case of Watchman device-related thrombus which developed 16 hours after the device placement. We will also discuss various options for the management of acute thrombosis.
{"title":"Acute Device-Related Thrombus after Watchman Device Implant","authors":"M. Ajmal, V. Swarup","doi":"10.1155/2019/8397561","DOIUrl":"https://doi.org/10.1155/2019/8397561","url":null,"abstract":"Atrial fibrillation is characterized by irregularly irregular heart rhythm with an increased morbidity and mortality. It is associated with an increased risk of thromboembolism due to formation of blood clot in the left atrium. Most of these blood clots are formed in the left atrial appendage. The risk of blood clot formation is reduced with the use of anticoagulants. The patients who cannot take anticoagulants due to an increased bleeding risk can undergo percutaneous left atrial appendage (LAA) closure. A Watchman device is used for this purpose. LAA closure with the Watchman device is associated with some adverse effects, and one of them is device-related thrombus. Currently, there are no specific guidelines for the management of device-related thrombus. We present a case of Watchman device-related thrombus which developed 16 hours after the device placement. We will also discuss various options for the management of acute thrombosis.","PeriodicalId":51760,"journal":{"name":"Case Reports in Cardiology","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2019-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2019/8397561","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46313976","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}
A. Acitelli, S. Bencivenga, M. B. Giannico, C. Lanzillo, L. Maresca, R. Petroni, M. Penco, L. Calò, S. Romano
Coronary artery fistulas are rare abnormal connections between a coronary artery and a cardiac chamber or a major vessel. Often, they are asymptomatic and the diagnosis is accidental. The case we present is the incidental finding of a fistula displayed with echocardiography during acute coronary syndrome (ACS). A 73-year-old man presented in the emergency room for non-ST-elevation ACS. Echocardiogram showed in a parasternal short axis view an abnormal diastolic flow inside the ventricular inferior wall. Angiography and CT confirmed the diagnosis of coronary fistula from the right coronary into the left ventricular cavity. A literature analysis with discussion about coronary fistulas classification and management was also performed.
{"title":"Coronary Artery Fistula Diagnosed by Echocardiography during NSTEMI: Case Report and Review of Literature","authors":"A. Acitelli, S. Bencivenga, M. B. Giannico, C. Lanzillo, L. Maresca, R. Petroni, M. Penco, L. Calò, S. Romano","doi":"10.1155/2019/5956806","DOIUrl":"https://doi.org/10.1155/2019/5956806","url":null,"abstract":"Coronary artery fistulas are rare abnormal connections between a coronary artery and a cardiac chamber or a major vessel. Often, they are asymptomatic and the diagnosis is accidental. The case we present is the incidental finding of a fistula displayed with echocardiography during acute coronary syndrome (ACS). A 73-year-old man presented in the emergency room for non-ST-elevation ACS. Echocardiogram showed in a parasternal short axis view an abnormal diastolic flow inside the ventricular inferior wall. Angiography and CT confirmed the diagnosis of coronary fistula from the right coronary into the left ventricular cavity. A literature analysis with discussion about coronary fistulas classification and management was also performed.","PeriodicalId":51760,"journal":{"name":"Case Reports in Cardiology","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2019-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2019/5956806","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42501932","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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