Ebubechukwu Ezeh, Maddie Perdoncin, M. Moroi, M. Amro, Mohammed Ruzieh, Paul Okhumale
Class IC antiarrhythmics are generally considered a safe means of treating many common arrhythmias such as atrial fibrillation (a-fib), atrial flutter (a-flutter), and paroxysmal supraventricular tachycardia (PSVT). Essentially, flecainide works by binding and blocking sodium channels more effectively at higher heart rates. However, this class of drugs is known to exhibit use dependence which could predispose patients to the development of malignant arrhythmias during episodes of tachycardia. In this case, we present a patient who was being treated with flecainide for a-fib who ultimately developed a wide complex tachycardia after her metoprolol was held.
{"title":"The Slower, the Better: Wide Complex Tachycardia Triggered by Flecainide in an Elderly Female","authors":"Ebubechukwu Ezeh, Maddie Perdoncin, M. Moroi, M. Amro, Mohammed Ruzieh, Paul Okhumale","doi":"10.1155/2022/1409498","DOIUrl":"https://doi.org/10.1155/2022/1409498","url":null,"abstract":"Class IC antiarrhythmics are generally considered a safe means of treating many common arrhythmias such as atrial fibrillation (a-fib), atrial flutter (a-flutter), and paroxysmal supraventricular tachycardia (PSVT). Essentially, flecainide works by binding and blocking sodium channels more effectively at higher heart rates. However, this class of drugs is known to exhibit use dependence which could predispose patients to the development of malignant arrhythmias during episodes of tachycardia. In this case, we present a patient who was being treated with flecainide for a-fib who ultimately developed a wide complex tachycardia after her metoprolol was held.","PeriodicalId":51760,"journal":{"name":"Case Reports in Cardiology","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2022-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48382881","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}
The candlenut tree is a tropical plant that has a vast number of uses which include fertilizer, dye, ink for tattooing, and fuel. The inner seed of the nut is the most utilized portion of the plant and is often sold as a food additive, natural laxative, or a weight loss supplement. Unfortunately, the seed itself is very toxic when consumed whole and in its raw state. Typical symptoms of toxicity include abdominal pain, vomiting, and diarrhea. Rarely, it can cause cardiac dysrhythmias, most commonly bradycardia and atrioventricular heart block. We present a case of a young adult female with no significant past medical history who developed typical symptoms of toxicity, as well as atrioventricular heart block following ingestion of a candlenut. Most documented cases describe complete resolution of gastrointestinal and cardiac symptoms about one week following ingestion; however, treatment while inpatient can consist of inotropes or vasopressor support, intravenous fluid hydration, electrolyte replacement, and antiemetics. Although the mechanism of action remains unclear, this report provides physicians with an understanding of the risks of ingestion and the knowledge of typical management of the toxic effects of the candlenut.
{"title":"Heart Block Initiated by Candlenut Ingestion","authors":"O. Lawani, M. Winter","doi":"10.1155/2022/3679968","DOIUrl":"https://doi.org/10.1155/2022/3679968","url":null,"abstract":"The candlenut tree is a tropical plant that has a vast number of uses which include fertilizer, dye, ink for tattooing, and fuel. The inner seed of the nut is the most utilized portion of the plant and is often sold as a food additive, natural laxative, or a weight loss supplement. Unfortunately, the seed itself is very toxic when consumed whole and in its raw state. Typical symptoms of toxicity include abdominal pain, vomiting, and diarrhea. Rarely, it can cause cardiac dysrhythmias, most commonly bradycardia and atrioventricular heart block. We present a case of a young adult female with no significant past medical history who developed typical symptoms of toxicity, as well as atrioventricular heart block following ingestion of a candlenut. Most documented cases describe complete resolution of gastrointestinal and cardiac symptoms about one week following ingestion; however, treatment while inpatient can consist of inotropes or vasopressor support, intravenous fluid hydration, electrolyte replacement, and antiemetics. Although the mechanism of action remains unclear, this report provides physicians with an understanding of the risks of ingestion and the knowledge of typical management of the toxic effects of the candlenut.","PeriodicalId":51760,"journal":{"name":"Case Reports in Cardiology","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2022-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43204091","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}
F. Alaei, M. Shakiba, Hedyeh Saneifard, K. Vahidshahi, Mastaneh Alaei
Cardiac involvement may accompany various inborn errors of metabolism (IEM) including fatty acid oxidation (FAO) disorders, presenting as rhythm disturbances, conduction abnormalities, cardiomyopathies, pericardial effusion, and sudden cardiac death. FAO disorders are rare mitochondrial diseases with variable organ involvements and clinical presentations. Very long-chain acyl-CoA dehydrogenase deficiency (VLCADD) is a FAO disorder with diverse clinical presentations. We report two VLCADD patients with cardiac involvement and diverse presentations. The first patient represents with cardiogenic shock and dilated cardiomyopathy (DCM) at childhood. The second patient represents with suspicious sepsis at early infancy and hypertrophic cardiomyopathy (HCM) at further evaluation. IEM should be thought of in every individual case with suspicious sepsis or cardiac failure regardless of age or previous history.
{"title":"Defects in Very Long-Chain Fatty Acid Oxidation Presenting as Different Types of Cardiomyopathy","authors":"F. Alaei, M. Shakiba, Hedyeh Saneifard, K. Vahidshahi, Mastaneh Alaei","doi":"10.1155/2022/5529355","DOIUrl":"https://doi.org/10.1155/2022/5529355","url":null,"abstract":"Cardiac involvement may accompany various inborn errors of metabolism (IEM) including fatty acid oxidation (FAO) disorders, presenting as rhythm disturbances, conduction abnormalities, cardiomyopathies, pericardial effusion, and sudden cardiac death. FAO disorders are rare mitochondrial diseases with variable organ involvements and clinical presentations. Very long-chain acyl-CoA dehydrogenase deficiency (VLCADD) is a FAO disorder with diverse clinical presentations. We report two VLCADD patients with cardiac involvement and diverse presentations. The first patient represents with cardiogenic shock and dilated cardiomyopathy (DCM) at childhood. The second patient represents with suspicious sepsis at early infancy and hypertrophic cardiomyopathy (HCM) at further evaluation. IEM should be thought of in every individual case with suspicious sepsis or cardiac failure regardless of age or previous history.","PeriodicalId":51760,"journal":{"name":"Case Reports in Cardiology","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2022-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43070927","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 27-year-old female presented to our emergency department in ventricular tachycardia. During her workup, she was found to have an extremely rare giant aneurysmal left anterior descending artery (LAD) ending in a coronary fistula to the right ventricle (RV). After stabilization, a variety of treatment options were considered, as there is no standard first-line treatment.
{"title":"Presentation and Management of a Giant Coronary Artery Aneurysm with a Fistula to the Right Ventricle","authors":"Nicholas J Peterman, Brad Kaptur, Naveed A. Adoni","doi":"10.1155/2022/7700086","DOIUrl":"https://doi.org/10.1155/2022/7700086","url":null,"abstract":"A 27-year-old female presented to our emergency department in ventricular tachycardia. During her workup, she was found to have an extremely rare giant aneurysmal left anterior descending artery (LAD) ending in a coronary fistula to the right ventricle (RV). After stabilization, a variety of treatment options were considered, as there is no standard first-line treatment.","PeriodicalId":51760,"journal":{"name":"Case Reports in Cardiology","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2022-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45673378","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. Schreiber, Michael Gardner, Chris Soussu, N. Green, C. Ahsan
Bidirectional ventricular tachycardia (BDVT) is a rare electrocardiographic finding characterized by rapid, wide complex, alternating QRS morphology with 180-degree swings in the frontal plane axis or, less commonly, alternating right bundle branch and left bundle branch block morphology. The most proposed mechanisms for BDVT involve triggered activity or enhanced automaticity resulting from calcium dysregulation. Catecholamine surge can cause myocardial injury as well as calcium dysregulation resulting in enhanced automaticity that can lead to arrhythmias such as BDVT. This case report stands to describe a unique presentation of BDVT and stress-induced cardiomyopathy, resulting from catecholamine surge following multiple traumatic gunshot wounds in the setting of methamphetamine use.
{"title":"Bidirectional Ventricular Tachycardia with Stress-Induced Cardiomyopathy","authors":"A. Schreiber, Michael Gardner, Chris Soussu, N. Green, C. Ahsan","doi":"10.1155/2022/1065847","DOIUrl":"https://doi.org/10.1155/2022/1065847","url":null,"abstract":"Bidirectional ventricular tachycardia (BDVT) is a rare electrocardiographic finding characterized by rapid, wide complex, alternating QRS morphology with 180-degree swings in the frontal plane axis or, less commonly, alternating right bundle branch and left bundle branch block morphology. The most proposed mechanisms for BDVT involve triggered activity or enhanced automaticity resulting from calcium dysregulation. Catecholamine surge can cause myocardial injury as well as calcium dysregulation resulting in enhanced automaticity that can lead to arrhythmias such as BDVT. This case report stands to describe a unique presentation of BDVT and stress-induced cardiomyopathy, resulting from catecholamine surge following multiple traumatic gunshot wounds in the setting of methamphetamine use.","PeriodicalId":51760,"journal":{"name":"Case Reports in Cardiology","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2022-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45257062","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}
Both COVID-19 disease and cocaine consumption have prothrombotic and hypercoagulable effects and are associated with increased risk of cardiovascular events. We report the case of a patient with acute myocardial infarction in the setting of active COVID-19 disease and recent cocaine consumption. We hypothesize that COVID-19 and cocaine synergistically provoke cardiovascular events. Identifying COVID-19 disease and/or cocaine abuse as potential triggers of acute myocardial infarction can be crucial due to distinctive therapeutic consequences.
{"title":"Cocaine and COVID-19 in ST-Elevation Myocardial Infarction","authors":"Florian Appenzeller, M. Gawaz, I. Müller","doi":"10.1155/2022/5640965","DOIUrl":"https://doi.org/10.1155/2022/5640965","url":null,"abstract":"Both COVID-19 disease and cocaine consumption have prothrombotic and hypercoagulable effects and are associated with increased risk of cardiovascular events. We report the case of a patient with acute myocardial infarction in the setting of active COVID-19 disease and recent cocaine consumption. We hypothesize that COVID-19 and cocaine synergistically provoke cardiovascular events. Identifying COVID-19 disease and/or cocaine abuse as potential triggers of acute myocardial infarction can be crucial due to distinctive therapeutic consequences.","PeriodicalId":51760,"journal":{"name":"Case Reports in Cardiology","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2022-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42756614","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}
In patients with a patent foramen ovale (PFO) who have had a cryptogenic ischemic stroke, percutaneous closure reduces its recurrence risk. However, its role in spinal cord infarction (SCI) is less well-established. A few case reports describe the putative causative role of PFO in SCI. We present a case of a teenager with cryptogenic anterior SCI in the setting of a deep vein thrombosis and a high risk-PFO who underwent successful percutaneous closure.
{"title":"Percutaneous Closure of Patent Foramen Ovale after Anterior Spinal Cord Infarction","authors":"J. F. Reis, P. Loureiro, R. Silva, J. D. Martins","doi":"10.1155/2022/2171350","DOIUrl":"https://doi.org/10.1155/2022/2171350","url":null,"abstract":"In patients with a patent foramen ovale (PFO) who have had a cryptogenic ischemic stroke, percutaneous closure reduces its recurrence risk. However, its role in spinal cord infarction (SCI) is less well-established. A few case reports describe the putative causative role of PFO in SCI. We present a case of a teenager with cryptogenic anterior SCI in the setting of a deep vein thrombosis and a high risk-PFO who underwent successful percutaneous closure.","PeriodicalId":51760,"journal":{"name":"Case Reports in Cardiology","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2022-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46535641","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}
Mohammad Dlewati, Kyeeun Park, S. Rawat, Jorge I Conte, Kashmira Bhadha
Myocarditis has been recognized as a rare complication of coronavirus disease 2019 (COVID-19) mRNA vaccinations. Young adult and adolescent males < 30 years of age are the most commonly affected group, with decreased incidence with older age. This is a case of a 48-year-old male who presented with chest pain and EKG findings of STEMI shortly after receiving the second dose of the Moderna COVID-19 mRNA vaccine. Emergent left heart catheterization revealed normal coronaries. Subsequently, the patient had rapid resolution of his symptoms and improvement in serum markers. The exact etiology factors to this new and rare phenomenon are yet to be fully understood. This patient did have a history of previous viral myocarditis 7 years ago; however, it remains unclear if this could be a predisposing factor to the development of mRNA vaccine-associated myocarditis.
{"title":"COVID-19 mRNA Vaccine-Associated Myocarditis Presenting as STEMI in a 48-Year-Old Male","authors":"Mohammad Dlewati, Kyeeun Park, S. Rawat, Jorge I Conte, Kashmira Bhadha","doi":"10.1155/2022/2284530","DOIUrl":"https://doi.org/10.1155/2022/2284530","url":null,"abstract":"Myocarditis has been recognized as a rare complication of coronavirus disease 2019 (COVID-19) mRNA vaccinations. Young adult and adolescent males < 30 years of age are the most commonly affected group, with decreased incidence with older age. This is a case of a 48-year-old male who presented with chest pain and EKG findings of STEMI shortly after receiving the second dose of the Moderna COVID-19 mRNA vaccine. Emergent left heart catheterization revealed normal coronaries. Subsequently, the patient had rapid resolution of his symptoms and improvement in serum markers. The exact etiology factors to this new and rare phenomenon are yet to be fully understood. This patient did have a history of previous viral myocarditis 7 years ago; however, it remains unclear if this could be a predisposing factor to the development of mRNA vaccine-associated myocarditis.","PeriodicalId":51760,"journal":{"name":"Case Reports in Cardiology","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2022-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44648728","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}
Bdoor Bamousa, Taher Sbitli, Tahir I. Mohamed, Khalid Al Johani, A. Almasood
Woven coronary artery anomaly is a rare description of an epicardial vessel segment that divides into multiple intertwining segments with eventual convergence of the distal vessel. We present our case, a 57-year-old male with an incidental woven coronary artery anomaly found during work-up investigations for a possible lung transplant, and we conduct a literature review on woven anomaly cases reported from 1988 to 2021 and provide a thorough analysis of its diversified clinical presentation. Imaging identification and various treatment modalities are also discussed.
{"title":"Woven Coronary Artery Anomaly: An Incidental Finding and Literature Review","authors":"Bdoor Bamousa, Taher Sbitli, Tahir I. Mohamed, Khalid Al Johani, A. Almasood","doi":"10.1155/2022/3235663","DOIUrl":"https://doi.org/10.1155/2022/3235663","url":null,"abstract":"Woven coronary artery anomaly is a rare description of an epicardial vessel segment that divides into multiple intertwining segments with eventual convergence of the distal vessel. We present our case, a 57-year-old male with an incidental woven coronary artery anomaly found during work-up investigations for a possible lung transplant, and we conduct a literature review on woven anomaly cases reported from 1988 to 2021 and provide a thorough analysis of its diversified clinical presentation. Imaging identification and various treatment modalities are also discussed.","PeriodicalId":51760,"journal":{"name":"Case Reports in Cardiology","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2022-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45754647","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. Cordova Sanchez, M. Vasigh, O. Olatunde, D. Chaudhuri
Massive pulmonary embolism (PE) is a life-threatening condition. The mainstay treatment is thrombolysis. Catheter-directed thrombectomy involves a group of new techniques that appear to have relatively low complications and mortality. These techniques have so far been studied mostly in submassive PE. We present a patient with massive PE that was successfully treated with catheter-directed thrombectomy.
{"title":"Catheter-Directed Thrombectomy: An Alternative in Massive Pulmonary Embolism","authors":"A. Cordova Sanchez, M. Vasigh, O. Olatunde, D. Chaudhuri","doi":"10.1155/2022/3562017","DOIUrl":"https://doi.org/10.1155/2022/3562017","url":null,"abstract":"Massive pulmonary embolism (PE) is a life-threatening condition. The mainstay treatment is thrombolysis. Catheter-directed thrombectomy involves a group of new techniques that appear to have relatively low complications and mortality. These techniques have so far been studied mostly in submassive PE. We present a patient with massive PE that was successfully treated with catheter-directed thrombectomy.","PeriodicalId":51760,"journal":{"name":"Case Reports in Cardiology","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2022-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44393486","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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