This issue of Case Reports presents two cases of fever of unknown origin (FUO) that illustrate the etiological diversity and diagnostic complexity of this condition.
本期病例报告介绍了两例不明原因发热(FUO)，说明了这种疾病的病因多样性和诊断复杂性。
{"title":"Fever of unknown origin. A changing clinical spectrum and a diagnostic challenge","authors":"M. Casarrubias-Ramírez","doi":"10.15446/cr.v6n2.87649","DOIUrl":"https://doi.org/10.15446/cr.v6n2.87649","url":null,"abstract":"This issue of Case Reports presents two cases of fever of unknown origin (FUO) that illustrate the etiological diversity and diagnostic complexity of this condition.","PeriodicalId":73637,"journal":{"name":"Journal of cardiology case reports","volume":"16 1","pages":"89-91"},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83169254","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}
U. Jochumsen, R. Etter, M. Hauff, G. Natalucci, B. Latal
Cerebellar injury is a common complication in preterm infants. The impact on future development and the risk for severe impairment depends on the size and location of the cerebellar hemorrhage as well as additional intracranial abnormalities. We describe the case of a preterm female infant with a large cerebellar bleeding and report the results of her follow-up assessments at 3, 12 and 24 months.
{"title":"Neuodevelopmental consequences of massive cerebellar bleeding in a preterm infant","authors":"U. Jochumsen, R. Etter, M. Hauff, G. Natalucci, B. Latal","doi":"10.5167/UZH-186107","DOIUrl":"https://doi.org/10.5167/UZH-186107","url":null,"abstract":"Cerebellar injury is a common complication in preterm infants. The impact on future development and the risk for severe impairment depends on the size and location of the cerebellar hemorrhage as well as additional intracranial abnormalities. We describe the case of a preterm female infant with a large cerebellar bleeding and report the results of her follow-up assessments at 3, 12 and 24 months.","PeriodicalId":73637,"journal":{"name":"Journal of cardiology case reports","volume":"2008 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86235519","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}
K. Shah, Abdelsalam Elshaikh, Matthew Krinock, C. Ruggeri
Cardiac catheterization via transradial approach (TRA) has increased in prevalence surpassing femoral artery approach. Radial artery occlusion (RAO), a well-known complication post cardiac catheterization, typically occurs immediately after cardiac catheterization and is usually asymptomatic not requiring any intervention. We encounter a unique case of extensive brachial and radial artery occlusion more than two months after cardiac catheterization, demonstrating the importance of a thorough history, and the need for increased awareness regarding the possibility of delayed presentation of cardiac catheterization complications.
{"title":"Delayed extensive right brachial and radial artery thrombosis: A rare complication of transradial cardiac catheterization","authors":"K. Shah, Abdelsalam Elshaikh, Matthew Krinock, C. Ruggeri","doi":"10.15761/JCCR.1000136","DOIUrl":"https://doi.org/10.15761/JCCR.1000136","url":null,"abstract":"Cardiac catheterization via transradial approach (TRA) has increased in prevalence surpassing femoral artery approach. Radial artery occlusion (RAO), a well-known complication post cardiac catheterization, typically occurs immediately after cardiac catheterization and is usually asymptomatic not requiring any intervention. We encounter a unique case of extensive brachial and radial artery occlusion more than two months after cardiac catheterization, demonstrating the importance of a thorough history, and the need for increased awareness regarding the possibility of delayed presentation of cardiac catheterization complications.","PeriodicalId":73637,"journal":{"name":"Journal of cardiology case reports","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67482014","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 use of tumor necrosis factor alpha inhibitors - anti-TNFa (infliximab, adalimumab, and certolizumab) in the treatment of Inflammatory Bowel Disease (IBD) provide a major therapeutic advance, allowing significant benefits in the induction and maintenance of remission in Crohn’s disease [1-3]. However, the safety-profile of TNF inhibitors with regard to worsening or new onset of heart failure is still very controversial. Consequently, there has been a lot of attention paid to the risk of cardiovascular side effects associated with adalimumab therapy [4-6]. A 42 year old woman treated with adalimumab for severe Crohn’s disease exacerbation; 8 days after the second dose of adalimumab (80mg), she presented with dramatic clinical features of heart failure and pulmonary edema. Echocardiography demonstrated severely depressed left ventricle contractility with ejection fraction 35%; cardiac MRI revealed no gadolinium enhancement (no ischemia, no myocarditis). Adalimumab was discontinued, and patient was treated with evidence-based oral disease-modifying HF therapy; 2 months later, cardiac function has returned to normal. This case clearly demonstrated the acute onset of decompensated heart failure with adalimumab usage.
{"title":"Severe cardiomyopathy induced by Adalimumab administration for Crohn's disease","authors":"A. Toufaily","doi":"10.15761/jccr.1000129","DOIUrl":"https://doi.org/10.15761/jccr.1000129","url":null,"abstract":"The use of tumor necrosis factor alpha inhibitors - anti-TNFa (infliximab, adalimumab, and certolizumab) in the treatment of Inflammatory Bowel Disease (IBD) provide a major therapeutic advance, allowing significant benefits in the induction and maintenance of remission in Crohn’s disease [1-3]. However, the safety-profile of TNF inhibitors with regard to worsening or new onset of heart failure is still very controversial. Consequently, there has been a lot of attention paid to the risk of cardiovascular side effects associated with adalimumab therapy [4-6]. A 42 year old woman treated with adalimumab for severe Crohn’s disease exacerbation; 8 days after the second dose of adalimumab (80mg), she presented with dramatic clinical features of heart failure and pulmonary edema. Echocardiography demonstrated severely depressed left ventricle contractility with ejection fraction 35%; cardiac MRI revealed no gadolinium enhancement (no ischemia, no myocarditis). Adalimumab was discontinued, and patient was treated with evidence-based oral disease-modifying HF therapy; 2 months later, cardiac function has returned to normal. This case clearly demonstrated the acute onset of decompensated heart failure with adalimumab usage.","PeriodicalId":73637,"journal":{"name":"Journal of cardiology case reports","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67482058","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. A. Aljadayel, Reza Abbaszadeh, B. Azari, M. Meraji, Gholamreza Azari, Yasaman Khalili, Akbar Nikpajouh
Introduction : There are still conflicting results regarding the effect of basal pulmonary arterial pressure on the consequences of Glenn surgery and require further studies in this regard. Aim of the study : Our main goal was to assess this hypothesis that the use of Glenn surgical technique (Glenn shunt implantation) can lead to better prognosis in patients with a single ventricular heart who are candidate of Fontan surgery by preserving pulmonary artery pressure, while that high baseline pulmonary artery pressure is considered a risk factor for poor prognosis. Methods: This retrospective study was conducted on 81 consecutive patients with single ventricle heart defect who underwent isolated Glenn surgery and their files were complete in Shahid Rajaei Heart Center in Tehran from 1 January 2019 till 3 March 2020 Based on the pulmonary artery pressure assessed by angiography, patients were classified into two groups, group A patients whose pulmonary artery pressure equal to or less than 15 mmHg (n=41) and group B patients whose pulmonary artery pressure above 15 mmHg (n = 40) and information on the outcome after surgery was compared between the two groups. Results: The prevalence rate of ascites (3 pts. 7.4% versus 19 pts. 48.1%, p = 0.001) and pleural effusion (33.3% versus 85.2%, p = 0.001), the mean length of hospital stay (6.00 ± 2.37 days versus 9.48 ± 6.86 days, p = 0.16) and length of ICU stay (3.93 ± 1.07 days versus 5.30 ± 2.30 days, p = 0.008) all were longer in those patients with PAP >15 mmHg (group B). But there was no difference in the rate of cardiac arrhythmia between the groups (p = 0.192) in our study. Conclusion: High pulmonary artery pressure is associated with more postoperative complications and can be considered as a prognostic factor in patients undergoing Glenn surgery as in fact, high pulmonary pressure associated with postoperative ascites, pleural effusion, and long-term hospitalization.
{"title":"Glenn procedure should be done as soon as possible and definitely before the mean Pulmonary artery pressure elevated","authors":"H. A. Aljadayel, Reza Abbaszadeh, B. Azari, M. Meraji, Gholamreza Azari, Yasaman Khalili, Akbar Nikpajouh","doi":"10.15761/jccr.1000163","DOIUrl":"https://doi.org/10.15761/jccr.1000163","url":null,"abstract":"Introduction : There are still conflicting results regarding the effect of basal pulmonary arterial pressure on the consequences of Glenn surgery and require further studies in this regard. Aim of the study : Our main goal was to assess this hypothesis that the use of Glenn surgical technique (Glenn shunt implantation) can lead to better prognosis in patients with a single ventricular heart who are candidate of Fontan surgery by preserving pulmonary artery pressure, while that high baseline pulmonary artery pressure is considered a risk factor for poor prognosis. Methods: This retrospective study was conducted on 81 consecutive patients with single ventricle heart defect who underwent isolated Glenn surgery and their files were complete in Shahid Rajaei Heart Center in Tehran from 1 January 2019 till 3 March 2020 Based on the pulmonary artery pressure assessed by angiography, patients were classified into two groups, group A patients whose pulmonary artery pressure equal to or less than 15 mmHg (n=41) and group B patients whose pulmonary artery pressure above 15 mmHg (n = 40) and information on the outcome after surgery was compared between the two groups. Results: The prevalence rate of ascites (3 pts. 7.4% versus 19 pts. 48.1%, p = 0.001) and pleural effusion (33.3% versus 85.2%, p = 0.001), the mean length of hospital stay (6.00 ± 2.37 days versus 9.48 ± 6.86 days, p = 0.16) and length of ICU stay (3.93 ± 1.07 days versus 5.30 ± 2.30 days, p = 0.008) all were longer in those patients with PAP >15 mmHg (group B). But there was no difference in the rate of cardiac arrhythmia between the groups (p = 0.192) in our study. Conclusion: High pulmonary artery pressure is associated with more postoperative complications and can be considered as a prognostic factor in patients undergoing Glenn surgery as in fact, high pulmonary pressure associated with postoperative ascites, pleural effusion, and long-term hospitalization.","PeriodicalId":73637,"journal":{"name":"Journal of cardiology case reports","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67482817","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}
Preeti Jadhav, Maleeha Zahid, Bing Yue, G. Kamalakkannan, Claude Simon, J. Bella, T. Vittorio
We present a case of anterior wall MI in a patient who was physically assaulted by a group people prior to ER arrival. Initial presentation consistent with musculoskeletal pain but due to abnormal EKG and continued chest pain further work was done that revealed single vessel CAD.
{"title":"Acute ST elevation MI with anterior descending artery obstruction after blunt chest wall trauma","authors":"Preeti Jadhav, Maleeha Zahid, Bing Yue, G. Kamalakkannan, Claude Simon, J. Bella, T. Vittorio","doi":"10.15761/jccr.1000160","DOIUrl":"https://doi.org/10.15761/jccr.1000160","url":null,"abstract":"We present a case of anterior wall MI in a patient who was physically assaulted by a group people prior to ER arrival. Initial presentation consistent with musculoskeletal pain but due to abnormal EKG and continued chest pain further work was done that revealed single vessel CAD.","PeriodicalId":73637,"journal":{"name":"Journal of cardiology case reports","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67482624","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}
Introduccion. El sindrome doloroso regional complejo (SDRC) es una patologia poco frecuente que se caracteriza por causar compromiso a nivel inflamatorio, vasomotor y del sistema nervioso central (SNC). Su presentacion clinica puede ser subaguda, aguda o cronica y puede afectar considerablemente la calidad de vida del paciente. Presentacion del caso. Paciente femenina de 21 anos con trauma en region lumbosacra asociado a dolor y limitacion funcional, a quien se le practicaron imagenes diagnosticas que evidenciaron luxofractura sacrococcigea con posterior presencia de sintomas inflamatorios y autonomicos (agudos y cronicos) que se trataron con medicamentos y cirugia. La paciente respondio al tratamiento con mejoria de la sintomatologia a largo plazo. Discusion. El SDRC se presento posterior a un traumatismo y ocasiono sintomatologia subaguda que se agudizo hasta llegar a la presentacion cronica de la enfermedad. La inflamacion, la disfuncion vasomotora y el compromiso del SNC hacen de este caso un reto diagnostico y terapeutico multidisciplinario. Conclusion. El SDRC es una patologia poco frecuente y de dificil diagnostico; sin embrago,es necesario diagnosticarlo de forma oportuna para poder iniciar un tratamiento personalizado, ya que es una enfermedad que compromete considerablemente la calidad de vida del paciente.
{"title":"Complex regional pain syndrome secondary to sacrococcygeal dislocation following trauma to the lumbosacral region. Case report","authors":"Iván Torres-Salguero, A. Rubiano","doi":"10.15446/cr.v6n1.80451","DOIUrl":"https://doi.org/10.15446/cr.v6n1.80451","url":null,"abstract":"Introduccion. El sindrome doloroso regional complejo (SDRC) es una patologia poco frecuente que se caracteriza por causar compromiso a nivel inflamatorio, vasomotor y del sistema nervioso central (SNC). Su presentacion clinica puede ser subaguda, aguda o cronica y puede afectar considerablemente la calidad de vida del paciente. Presentacion del caso. Paciente femenina de 21 anos con trauma en region lumbosacra asociado a dolor y limitacion funcional, a quien se le practicaron imagenes diagnosticas que evidenciaron luxofractura sacrococcigea con posterior presencia de sintomas inflamatorios y autonomicos (agudos y cronicos) que se trataron con medicamentos y cirugia. La paciente respondio al tratamiento con mejoria de la sintomatologia a largo plazo. Discusion. El SDRC se presento posterior a un traumatismo y ocasiono sintomatologia subaguda que se agudizo hasta llegar a la presentacion cronica de la enfermedad. La inflamacion, la disfuncion vasomotora y el compromiso del SNC hacen de este caso un reto diagnostico y terapeutico multidisciplinario. Conclusion. El SDRC es una patologia poco frecuente y de dificil diagnostico; sin embrago,es necesario diagnosticarlo de forma oportuna para poder iniciar un tratamiento personalizado, ya que es una enfermedad que compromete considerablemente la calidad de vida del paciente.","PeriodicalId":73637,"journal":{"name":"Journal of cardiology case reports","volume":"7 1","pages":"52-62"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82176012","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: Coronary aneurysms are rare and are linked to drug abuse; symptomatology depends on the coronary anatomy. This is a case of acute coronary syndrome associated with a giant right coronary aneurysm.Case description: A 40-year-old male, with history of heroin and crack use since age 20, attended consultation due to dyspnea, stable angina and diaphoresis. An electrocardiogram showed ST segment overlay on the underside and troponin problems. A coronary catheterization was performed, which revealed apparent inconclusive aortato-right atrium fistula. Based on the findings, angiotomography and magnetic resonance imaging were performed, finding a giant right coronary aneurysm. The aneurysm was resected using extracorporeal circuit, femoral cannulation, moderate hypothermia, aortic cross-clamping and cardioplegia, and the right coronary artery was revascularized with the left internal saphenous vein. The patient had a satisfactory postoperative period and was discharged after 7 days.Conclusion: There is an important association between drug use and the development of coronary aneurysms. Aneurysm size makes diagnosis difficult, so complementary studies are necessary to establish a differential diagnosis. An appropriate surgical approach allows for a complete resection of the aneurysm and optimal coronary revascularization.
{"title":"Giant right coronary artery aneurysm. Case Report","authors":"Benjamín Iván Hernández-Mejía, Edison Ricardo Espinoza-Saquicela","doi":"10.15446/cr.v6n1.82446","DOIUrl":"https://doi.org/10.15446/cr.v6n1.82446","url":null,"abstract":"Introduction: Coronary aneurysms are rare and are linked to drug abuse; symptomatology depends on the coronary anatomy. This is a case of acute coronary syndrome associated with a giant right coronary aneurysm.Case description: A 40-year-old male, with history of heroin and crack use since age 20, attended consultation due to dyspnea, stable angina and diaphoresis. An electrocardiogram showed ST segment overlay on the underside and troponin problems. A coronary catheterization was performed, which revealed apparent inconclusive aortato-right atrium fistula. Based on the findings, angiotomography and magnetic resonance imaging were performed, finding a giant right coronary aneurysm. The aneurysm was resected using extracorporeal circuit, femoral cannulation, moderate hypothermia, aortic cross-clamping and cardioplegia, and the right coronary artery was revascularized with the left internal saphenous vein. The patient had a satisfactory postoperative period and was discharged after 7 days.Conclusion: There is an important association between drug use and the development of coronary aneurysms. Aneurysm size makes diagnosis difficult, so complementary studies are necessary to establish a differential diagnosis. An appropriate surgical approach allows for a complete resection of the aneurysm and optimal coronary revascularization.","PeriodicalId":73637,"journal":{"name":"Journal of cardiology case reports","volume":"18 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72797729","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}
M. M. Oo, Muhammad Db Ismail, I. Abidin, W. A. Ahmad
We describe a 29year old gentleman who presented with acute coronary syndrome, non-ST elevation myocardial infarction. Urgent percutaneous coronary intervention was performed in view of failed medical therapy (ongoing chest pain with dynamic ECG changes). In view of huge thrombus burden in ectatic left circumflex artery, we did thrombus aspiration by using thrombus aspiration catheter (Thrombuster II). After successfully aspirating thrombus, resistance felt on withdrawal of the aspiration catheter from the ectatic coronary artery. Tip of the thrombus aspiration catheter was broken and retained in the guide wire at the level of mid circumflex artery. The broken tip of thrombuster was successfully retrieved percutaneously. This case presents previously unreported complication of thrombus aspiration catheter (Thrombuster II). *Correspondence to: Mon Myat Oo, Cardiology Unit, Department of Medicine, University of Malaya Medical Centre, 59100 Kuala Lumpur, Malaysia, E-mail: myatoo@ummc.edu.my
{"title":"A case report of broken tip of thrombus aspiration catheter (Thrombuster II) in ectatic left circumflex artery of young patient with Kawasaki disease","authors":"M. M. Oo, Muhammad Db Ismail, I. Abidin, W. A. Ahmad","doi":"10.15761/jccr.1000132","DOIUrl":"https://doi.org/10.15761/jccr.1000132","url":null,"abstract":"We describe a 29year old gentleman who presented with acute coronary syndrome, non-ST elevation myocardial infarction. Urgent percutaneous coronary intervention was performed in view of failed medical therapy (ongoing chest pain with dynamic ECG changes). In view of huge thrombus burden in ectatic left circumflex artery, we did thrombus aspiration by using thrombus aspiration catheter (Thrombuster II). After successfully aspirating thrombus, resistance felt on withdrawal of the aspiration catheter from the ectatic coronary artery. Tip of the thrombus aspiration catheter was broken and retained in the guide wire at the level of mid circumflex artery. The broken tip of thrombuster was successfully retrieved percutaneously. This case presents previously unreported complication of thrombus aspiration catheter (Thrombuster II). *Correspondence to: Mon Myat Oo, Cardiology Unit, Department of Medicine, University of Malaya Medical Centre, 59100 Kuala Lumpur, Malaysia, E-mail: myatoo@ummc.edu.my","PeriodicalId":73637,"journal":{"name":"Journal of cardiology case reports","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67481775","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}
Coronary artery vasospasm leading to angina or myocardial infarction are among the most dangerous cardiotoxic effects of chemotherapeutic agents. The most well recognized association is with antimetabolite agents 5-fluorouracil and its prodrug capecitabine [1,2]. Paclitaxel is a microtubule-targeting drug of the Taxane family. It is widely used for the treatment of a range of cancers, namely breast, ovarian and lung. Its most commonly documented cardiac adverse effects have been bradycardia and heart block. Kounis syndrome has been described in a limited number of case reports explaining Paclitaxel and its association with acute coronary syndrome due to plaque rupture (Type 2 Kounis Syndrome) [3-5]. However, in these cases, patients have had pre-existing coronary artery disease or percutaneous coronary intervention. We report a patient treated for non-small cell lung cancer who presented with acute ST elevation shortly after a second paclitaxel infusion who was found to have no evidence of angiographic coronary artery disease. This is the first case report to our knowledge describing Type 1 Kounis Syndrome with Paclitaxel.
{"title":"Type I kounis syndrome from paclitaxel infusion","authors":"Benjamen Wang, Anver Sethwala, R. Gurvitch","doi":"10.15761/JCCR.1000135","DOIUrl":"https://doi.org/10.15761/JCCR.1000135","url":null,"abstract":"Coronary artery vasospasm leading to angina or myocardial infarction are among the most dangerous cardiotoxic effects of chemotherapeutic agents. The most well recognized association is with antimetabolite agents 5-fluorouracil and its prodrug capecitabine [1,2]. Paclitaxel is a microtubule-targeting drug of the Taxane family. It is widely used for the treatment of a range of cancers, namely breast, ovarian and lung. Its most commonly documented cardiac adverse effects have been bradycardia and heart block. Kounis syndrome has been described in a limited number of case reports explaining Paclitaxel and its association with acute coronary syndrome due to plaque rupture (Type 2 Kounis Syndrome) [3-5]. However, in these cases, patients have had pre-existing coronary artery disease or percutaneous coronary intervention. We report a patient treated for non-small cell lung cancer who presented with acute ST elevation shortly after a second paclitaxel infusion who was found to have no evidence of angiographic coronary artery disease. This is the first case report to our knowledge describing Type 1 Kounis Syndrome with Paclitaxel.","PeriodicalId":73637,"journal":{"name":"Journal of cardiology case reports","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67481832","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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