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Saurabh Rajpal

Saurabh Rajpal, Alexander R Opotowsky, Anna Rutherford, Fred Wu
Recurrent ascites is a common manifestation of failing Fontan circulation. We present the hemodynamic response to large-volume paracentesis in a patient with Fontan circulation and Fontan-associated liver disease, documenting an immediate and substantial decline in systemic venous pressure and increase in cardiac output. These preliminary observations may have implications for the management of ascites in adults with Fontan circulation.
October 24, 2018: World Journal for Pediatric & Congenital Heart Surgery
Laith Alshawabkeh, Saurabh Rajpal, Michael J Landzberg, Sitaram Emani, Georges Ephrem, Catherine Gray, Michael N Singh, Fred Wu, Alexander R Opotowsky
Red cell distribution width (RDW), a measure of variability in red cell size, predicts adverse outcomes in acquired causes of heart failure. We examined the relation of RDW and outcomes in adults with congenital heart disease. We performed a prospective cohort study on 696 ambulatory patients ≥18years old enrolled in the Boston Adult Congenital Heart Disease Biobank between 2012 and 2016 (mean age 38.7 ± 13.5 years; 49.9% women). The combined outcome was all-cause mortality or nonelective cardiovascular hospitalization...
November 1, 2018: American Journal of Cardiology
Saurabh Rajpal, Curt Daniels, Michael Landzberg
No abstract text is available yet for this article.
June 2018: Heart: Official Journal of the British Cardiac Society
Saurabh Rajpal, Subha V Raman
No abstract text is available yet for this article.
May 2018: Journal of Cardiovascular Computed Tomography
Saurabh Rajpal, Laith Alshawabkeh, Nureddin Almaddah, Caroline M Joyce, Keri Shafer, Michelle Gurvitz, Sushrut S Waikar, Finnian R Mc Causland, Michael J Landzberg, Alexander R Opotowsky
Importance: Albuminuria is associated with adverse outcomes in diverse groups of patients, but the importance of albuminuria in the emerging population of increasingly complex adults with congenital heart disease (ACHD) remains unknown. Objective: To assess the prevalence, risk factors, and prognostic implications of albuminuria in ACHD. Design, Setting, and Participants: This prospective study assessed a cohort of ambulatory patients aged 18 years and older who were examined at an ACHD referral center and enrolled in the Boston ACHD Biobank between May 17, 2012, to August 5, 2016...
April 1, 2018: JAMA Cardiology
Saurabh Rajpal, Pavan Katikaneni, Matthew Deshotels, Sibile Pardue, John Glawe, Xinggui Shen, Nuri Akkus, Kalgi Modi, Ruchi Bhandari, Paari Dominic, Pratap Reddy, Gopi K Kolluru, Christopher G Kevil
Hydrogen sulfide (H2 S) has emerged as an important physiological and pathophysiological signaling molecule in the cardiovascular system influencing vascular tone, cytoprotective responses, redox reactions, vascular adaptation, and mitochondrial respiration. However, bioavailable levels of H2 S in its various biochemical metabolite forms during clinical cardiovascular disease remain poorly understood. We performed a case-controlled study to quantify and compare the bioavailability of various biochemical forms of H2 S in patients with and without cardiovascular disease (CVD)...
May 2018: Redox Biology
Rohan Chawla, Vinod Kumar, Koushik Tripathy, Atul Kumar, Pradeep Venkatesh, Farin Shaikh, Rajpal Vohra, Kabiruddin Molla, Saurabh Verma
PURPOSE: To analyze the optical coherence tomography (OCT) characteristics of combined hamartoma of the retina and retinal pigment epithelium (CHRRPE) involving the macula. DESIGN: Retrospective, observational case series. METHODS: setting: Single institutional. STUDY POPULATION: Fourteen consecutive patients of CHRRPE were included. OBSERVATION PROCEDURES: The authors analyzed the clinical features, color fundus photography, and swept-source or spectral-domain OCT of all the involved eyes...
September 2017: American Journal of Ophthalmology
Saurabh Rajpal, Laith Alshawabkeh, Alexander R Opotowsky
PURPOSE OF REVIEW: There is an increasing number of adult patients with congenital heart disease (CHD). While several biomarkers have been validated and integrated into general cardiology clinical practice, these tests are often applied to adults with CHD in the absence of disease-specific validation. Although these patients are often grouped into a single population, there is heterogeneous pathophysiology, variable disease chronicity, extensive multisystem involvement, and a low event rate relative to acquired heart disease...
June 2017: Current Cardiology Reports
Nuri Ilker Akkus, Saurabh Rajpal, Andres Vargas, Anderson Penuela, Ashish Dwary, Shivang H Shah, Pratap C Reddy
Increased mean platelet volume (MPV) is a marker of platelet activation. Platelet activation with cocaine use is not well studied. We wanted to investigate MPV levels in patients with cocaine-associated chest pain (CACP) as a marker of platelet activation. Retrospectively, MPV of 82 consecutive patients with CACP (group 1) with positive urine drug screen (UDS), without acute myocardial infarction (AMI) (group 1A) and with AMI with elevated troponin (group 1B), were included in the study. The control group (group 2) consisted of 89 consecutive patients admitted during the same time period with acute chest pain (ACP) who had negative UDS and negative cardiac markers with a normal cardiac stress test or normal coronary angiogram...
June 2015: Interventional Medicine & Applied Science
Abhishek Seth, Saurabh Rajpal, Taru Saigal, John Bienvenu, Ankur Sheth, Jonathan S Alexander, Moheb Boktor, Kenneth Manas, James D Morris, Paul A Jordan
Diabetic ketoacidosis (DKA)-induced hypertriglyceridemia causing pancreatitis is an interesting phenomenon that has rarely been reported in literature. Plasmapharesis is a well known treatment modality for hypertriglyceridemia-induced pancreatitis. We report a patient with DKA-induced hypertriglyceridemic acute pancreatitis treated successfully with plasmapharesis.
2014: Clinical Medicine Insights. Gastroenterology
Saurabh Rajpal, Amandeep S Mundi, Pratap C Reddy, Nuri I Akkus
Methadone maintenance treatment (MMT) is commonly used for chronic pain control and for substitution in heroin addicts undergoing rehabilitation. Methadone is known to prolong QT interval and sometimes cause torsade de pointes (TdP) and ventricular fibrillation (VF). Treatment of TdP by antiarrhythmic drugs that prolong QT interval may worsen TdP. To our knowledge, worsening of methadone-induced TdP by amiodarone has not been reported before. We describe here a case of methadone-induced TdP that deteriorated into ventricular fibrillation upon treatment with intravenous (IV) amiodarone and resolved after discontinuation of amiodarone and treatment with IV magnesium, potassium, and lidocaine...
November 2013: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
Saurabh Rajpal, Liam A Morris, Nuri I Akkus
Oxymetazoline is an alpha-1 adrenergic receptor agonist that is commonly used for nasal decongestion and is readily available without a prescription. We report the case of a 64-year-old woman who developed prolonged chest pain associated with elevation of cardiac biomarkers after using oxymetazoline.
January 2014: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
Abhishek Seth, Saurabh Rajpal, Robert L Penn
Klinefelter's syndrome is the most common cause of primary testicular failure. Previous reports have associated Klinefelter's syndrome with increased risk of thrombosis. The exact cause for this association is unknown, but hypoandrogenism affecting fibrinolysis has been implicated. The authors described a unique patient with Klinefelter's syndrome who presented with deep vein thrombosis of the leg and underlying mutations of MTHFR gene, increased factor VIII coagulant activity and an elevated anticardiolipin antibody...
August 2013: American Journal of the Medical Sciences
Nuri I Akkus, Saurabh Rajpal, Elvis Peter
Nebivolol is a novel beta1-selective beta-blocker with vasodilator properties mediated through activation of the l-arginine-nitric oxide pathway. There is no published report of coronary artery spasm associated with nebivolol. We describe a 64-year-old female patient who developed unstable angina secondary to nebivolol-induced vasospastic angina which was also visible during coronary angiography.
December 2012: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
Nuri Ilker Akkus, Saurabh Rajpal, Jai Varma
Superficial femoral artery (SFA) is commonly diseased in patients with symptomatic peripheral arterial disease. Endovascular treatments have been more effectively used for SFA occlusions with new techniques and devices. Retrograde popliteal access has been used as an alternative to increase the success rate of percutaneous transluminal angioplasty (PTA) of SFA after a failed antegrade attempt. Although orbital atherectomy (OA) has been used effectively to treat SFA occlusions, there are no reports of use of OA by retrograde popliteal approach...
March 2013: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Saurabh Rajpal, Jagan Beedupalli, Pratap Reddy
A 53-year-old woman presented with digitalis toxicity caused by acute overdose that manifested as atrial tachycardia with block, sinus pauses, and competing AV junctional rhythm with atrial fibrillation. Patient admitted to overdosing with digoxin 15-20 h before presentation with intent to commit suicide. Serum digoxin level was 35.6 ng/ml and renal function was normal. Patient was treated with 1,040 mg of digoxin-specific antibody Fab fragment with prompt resolution of arrhythmias and restoration of sinus rhythm...
December 2012: Cardiovascular Toxicology
Nuri I Akkus, Saurabh Rajpal, Sujata Agnani
Stent thrombosis is not unusual in a post-operative setting. Use of heparin, aspirin, clopidogrel, and glycoprotein (GP) IIb/IIIa inhibitors in this setting needs to be balanced because of the increased risk of perioperative bleeding. This is of special concern in neurosurgery, where postoperative mass effect from bleeding in a closed space is a serious risk. We describe a unique case of inferior and anterior ST-elevation myocardial infarction in cardiogenic shock during spinal surgery with acute, very late bare-metal stent (BMS) thrombosis in the left anterior descending coronary artery and simultaneous acute thrombotic occlusion of the right coronary artery, treated by primary percutaneous intervention, intra-aortic balloon pump (IABP) support and use of GP IIb/IIIa inhibitor in addition to clopidogrel, aspirin, and heparin with good surgical and cardiac outcome...
February 2012: Journal of Invasive Cardiology
Saurabh Rajpal, Lucien Abboud, Dipan J Shah
No abstract text is available yet for this article.
July 2011: Methodist DeBakey Cardiovascular Journal
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