Salla Jäämaa-Holmberg, Birgitta Salmela, Raili Suojaranta, Janne J Jokinen, Karl B Lemström, Jyri Lommi
No abstract text is available yet for this article.
August 5, 2020: European Journal of Cardio-thoracic Surgery
Y K L Pradeep, Vijay K Bhogaraju, Monika Pathania, Vyas K Rathaur, Ravi Kant
Scorpion envenomation is a major public health problem in tropical and sub-tropical countries, especially in Africa, Middle East, Latin America, and India. Even though most of the scorpion envenomation are harmless, it is generally seen with a set of clinical features, such as pain, edema, numbness, and tenderness in the area of the sting but rarely have serious clinical sequelae with involvement of vital organ systems like cardiovascular system and respiratory system leading to fatal manifestations like acute pulmonary edema, acute heart failure, and acute respiratory distress syndrome (ARDS)...
May 2020: Journal of Family Medicine and Primary Care
Min Chul Kim, Ju Yong Hyun, Youngkeun Ahn, SungA Bae, Dae Young Hyun, Kyung Hoon Cho, Doo Sun Sim, Young Joon Hong, Ju Han Kim, Myung Ho Jeong, Hyo-Soo Kim, Hyeon Cheol Gwon, In Whan Seong, Kyoung-Kook Hwang, Shung Chull Chae, Seung Ho Hur, Kwang Soo Cha, Seok Kyu Oh
Background Few studies have investigated optimal revascularization strategies in non-ST-segment-elevation myocardial infarction with multivessel disease. We investigated 3-year clinical outcomes according to revascularization strategy in patients with non-ST-segment-elevation myocardial infarction and multivessel disease. Methods and Results This retrospective, observational, multicenter study included patients with non-ST-segment-elevation myocardial infarction and multivessel disease without cardiogenic shock...
August 4, 2020: Journal of the American Heart Association
Muhammet Gürdoğan, Kenan Yalta
Immune checkpoint inhibitors (ICI) have caused radical changes in the treatment scheme of many types of cancer in the past 10 years. ICIs are specific monoclonal antibodies that increase T-cell mediated immune response against cancer cells. Despite important advances in cancer treatment, uncontrolled activation of cytotoxic T cells has brought along many autoimmune clinical side effects, especially acute myocarditis. Although the incidence of ICI-related myocarditis is about 1%, it is remarkable in terms of mortality rate reaching 46% and demonstrating the necessity of rapid diagnosis and multidisciplinary approach...
August 2020: Anatolian Journal of Cardiology
Yuji Tominaga, Koichi Toda, Shigeru Miyagawa, Daisuke Yoshioka, Satoshi Kainuma, Takuji Kawamura, Ai Kawamura, Kei Nakamoto, Yasushi Sakata, Yoshiki Sawa
We report an effective therapeutic approach of mechanical circulatory support for a patient with cardiogenic shock and respiratory insufficiency due to fulminant myocarditis. An Impella® 5.0 was utilized as a left ventricular assist device (VAD) and percutaneous veno-pulmonary extracorporeal membrane oxygenation (ECMO) as a right VAD. These devices were implanted without sternotomy or thoracotomy. Although a combination of Impella and veno-arterial ECMO has been reported as percutaneous biventricular support, there are concerns that this combination is not beneficial for myocardial recovery in patients with respiratory insufficiency, because Impella expels insufficiently oxygenated blood from the left ventricle to the coronary arteries...
August 4, 2020: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
Daniel Fernández-Bergés, Irene R Degano, Reyes Gonzalez Fernandez, Isaac Subirana, Joan Vila, Manuel Jiménez-Navarro, Silvia Perez-Fernandez, Mercé Roqué, Antoni Bayes-Genis, Francisco Fernandez-Aviles, Antonio Mayorga, Vicente Bertomeu-Gonzalez, Juan Sanchis, Marcos Rodríguez Esteban, Antonio Sanchez-Hidalgo, Esther Sanchez-Insa, Ane Elorriaga, Emad Abu Assi, Alberto Nuñez, Jose Manuel Garcia Ruiz, Pedro Morrondo Valdeolmillos, Daniel Bosch-Portell, Iñaki Lekuona, Andres Carrillo-Lopez, Alberto Zamora, Berta Vega-Hernandez, Javier Alameda Serrano, Catalina Rubert, Luis Ruiz-Valdepeñas, Laura Quintas, Luis Rodríguez-Padial, Jessica Vaquero, Luis Martinez Dolz, Jose A Barrabes, Pedro L Sanchez, Alessandro Sionis, Julio Martí-Almor, Roberto Elosua, Rosa-María Lidon, David Garcia-Dorado, Jaume Marrugat
OBJECTIVE: Primary percutaneous coronary intervention (P-PCI) has demonstrated its efficacy in patients with ST segment elevation myocardial infarction (STEMI). However, patients with STEMI ≥75 years receive less P-PCI than younger patients despite their higher in-hospital morbimortality. The objective of this analysis was to determine the effectiveness of P-PCI in patients with STEMI ≥75 years. METHODS: We included 979 patients with STEMI ≥75 years, from the ATención HOspitalaria del Síndrome coronario study, a registry of 8142 consecutive patients with acute coronary syndrome admitted at 31 Spanish hospitals in 2014-2016...
August 2020: Open Heart
Behnam N Tehrani, Abdulla A Damluji, Matthew W Sherwood, Carolyn Rosner, Alexander G Truesdell, Kelly C Epps, Edward Howard, Scott D Barnett, Anika Raja, Christopher R deFilippi, Charles E Murphy, Christopher M O'Connor, Wayne B Batchelor
BACKGROUND: Transradial access (TRA) is associated with improved survival and reduced vascular complications in acute myocardial infarction (AMI). Limited data exist regarding TRA utilization and outcomes for AMI complicated by cardiogenic shock (CS). We sought to assess the safety, feasibility, and clinical outcomes of TRA in AMI-CS. METHODS: One-hundred and fifty-three patients with AMI-CS were stratified into tertiles of disease severity using the CardShock score...
August 3, 2020: Catheterization and Cardiovascular Interventions
Kerry-Lynn Williams, Paul Crocker, Adam Dubrowski
Chest pain is a frequently encountered emergency room presentation, of which about 15% of cases are due to acute coronary syndromes. Cardiogenic shock is a relatively uncommon complication with associated high morbidity and mortality. Emergency medicine practitioners frequently encounter critically ill patients that require quick, definitive treatment to optimize patient outcomes. These high acuity presentations often are of relatively low occurrence which makes training residents and learners challenging. Simulation-based medical education has been shown to enhance patient outcomes by teaching these high acuity low occurrence (HALO) presentations in a safe environment...
June 28, 2020: Curēus
Christine Jiang, Misa Stuart, Charles Makowski, Douglas L Jennings, Long To
Background: The Impella is a percutaneous ventricular assist device (pVAD) that provides temporary hemodynamic support to patients with cardiogenic shock or for protected percutaneous coronary intervention. The manufacturer recommends a 50-U/mL concentration of heparin purge solution (or 25 U/mL as an alternative), with systemic heparin to maintain therapeutic anticoagulation during device support. Concomitant use of systemic heparin with the purge solution may increase the risk of bleeding. Objectives: The primary objective of this study was to describe the prevalence of thrombosis and bleeding using a less-concentrated heparin purge solution (25 U/mL) in combination with systemic heparin therapy...
August 1, 2020: Annals of Pharmacotherapy
Saraschandra Vallabhajosyula, Anna V Subramaniam, Pranathi R Sundaragiri, Wisit Cheungpasitporn, Zelalem Temesgen, John C O'Horo, Allan S Jaffe, Gregory W Barsness
BACKGROUND: There are limited data on the outcomes of acute myocardial infarction-cardiogenic shock (AMI-CS) in patients with human immunodeficiency virus (HIV) infection and acquired immune deficiency syndrome (AIDS). SETTING: 20% sample of all United States hospitals METHODS:: A retrospective cohort of AMI-CS during 2000-2017 from the National Inpatient Sample was evaluated for concomitant HIV and AIDS. Outcomes of interest included in-hospital mortality and use of cardiac procedures...
July 27, 2020: Journal of Acquired Immune Deficiency Syndromes: JAIDS
Catherine E Hassett, Sung-Min Cho, Saad Hasan, Cory J Rice, Ibrahim Migdady, Randall C Starling, Edward Soltesz, Ken Uchino
Impella is a percutaneously placed, ventricular assist device for short-term cardiac support. We aimed to study acute neurologic complications during short-term cardiac support with Impella. We reviewed prospectively collected data of 79 consecutive persons implanted with Impella at a single tertiary center. Acute neurologic events (ANE) were defined as ischemic strokes or intracranial hemorrhages. Among those with ANE, specific causes of ischemic and hemorrhagic events were collected and discussed. Of 79 persons with Impella with median 8 days of support (range 1-33 days), six (7...
August 2020: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Bernice Badu, Michael T Cain, Lucian A Durham, Lyle D Joyce, Sakthi Sundararajan, Nunzio Gaglianello, David Ishizawar, Mitchell Saltzberg, Asim Mohammed, David L Joyce
A right ventricular assist device (RVAD) using a dual-lumen percutaneous cannula inserted through the right internal jugular vein (IJV) might improve weaning in patients with refractory right ventricular (RV) failure. However, the reported experience with this cannula is limited. We reviewed the records of all patients receiving RVAD support with this new dual-lumen cannula at our institution between April 2017 and February 2019. We recorded data on weaning, mortality, and device-specific complications. We compared outcomes among three subgroups based on the indications for RVAD support (postcardiotomy, cardiogenic shock, and primary respiratory failure) and against similar results in the literature...
August 2020: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Sven R Olson, Catherine R Murphree, David Zonies, Andrew D Meyer, Owen J T Mccarty, Thomas G Deloughery, Joseph J Shatzel
Extracorporeal membrane oxygenation (ECMO) causes both thrombosis and bleeding. Major society guidelines recommend continuous, systemic anticoagulation to prevent thrombosis of the ECMO circuit, though this may be undesirable in those with active, or high risk of, bleeding. We aimed to systematically review thrombosis and bleeding outcomes in published cases of adults treated with ECMO without continuous systemic anticoagulation. Ovid MEDLINE, Cochrane CENTRAL and CDSR, and hand search via SCOPUS were queried...
July 23, 2020: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Cathevine Yang, Mesfer Alfadhel, Jacqueline Saw
PURPOSE OF REVIEW: Spontaneous coronary artery dissection (SCAD) is an increasingly recognized entity leading to myocardial infarction especially in women. Multiple observational studies have been published in the recent years. This review summarizes the current body of knowledge and recent developments in SCAD epidemiology, presentation, diagnosis, and management. RECENT FINDINGS: Contemporary series have estimated the incidence of SCAD to be up to ~ 4% of all patients presenting with acute coronary syndrome (ACS)...
July 30, 2020: Current Atherosclerosis Reports
Harish Sharma, Sudhakar George
Background: Left ventricular thrombus (LVT) is a complication of acute myocardial infarction (AMI) due to localised haemostasis. LVT is typically seen 3-12 days following AMI and is seldom seen within the first 24 hours. LVT increases the risk of mortality due to systemic thromboembolism. Patients with Coronavirus Disease-19 (COVID-19) are potentially hypercoagulable and this may promote early development of LVT. Case: A 50-year-old man with no past medical history was admitted with a severe diabetic ketoacidosis following a 4-day history of cough and fever...
2020: Case Reports in Cardiology
René Hameau D, Francesco Soriano, Jacopo Oreglia, Rodrigo Muñoz, José Luis Winter, Martín Valdebenito, Jorge Quitral, Dante Lindefjeld, Nicolas Veas
We report a 55-year-old woman with a history of hypothyroidism and type 2 diabetes mellitus who consulted at the emergency room because of intermittent oppressive chest discomfort. At admission, electrocardiogram showed a complete atrioventricular block. A transthoracic echocardiogram disclosed severe left ventricular dysfunction. The patient developed cardiogenic shock that required the installation of the Impella system. An emergency coronary angiography showed an ostial occlusion of the anterior descending artery...
March 2020: Revista Médica de Chile
Rae Sm Yeung, Polly J Ferguson
An alarming increase in children presenting with fever, hyperinflammation and multiorgan dysfunction frequently requiring intensive care has been observed after SARS-CoV-2 infection. The illness resembles Kawasaki Disease (KD) with coronary dilatation and aneurysm occurring in some. However, the cardiovascular manifestations were typically on the severe end of the KD spectrum with cardiogenic shock a common presentation together with other features. This led to defining a unique syndrome named multisystem inflammatory syndrome in Children (MIS-C)...
July 30, 2020: Journal of Clinical Investigation
Cosme García-García, Teresa Oliveras, Nabil El Ouaddi, Ferran Rueda, Jordi Serra, Carlos Labata, Marc Ferrer, German Cediel, Santiago Montero, Maria Jose Martínez, Helena Resta, Oriol de Diego, Joan Vila, Irene R Dégano, Roberto Elosua, Josep Lupón, Antoni Bayes-Genis
AIMS: Cardiogenic shock (CS) is an ominous complication of ST-elevation myocardial infarction (STEMI), despite the recent widespread use of reperfusion and invasive management. The Ruti-STEMI-Shock registry analysed the prevalence of and 30-day and 1-year mortality rates in ST-elevation myocardial infarction (STEMI) complicated by CS (STEMI-CS) over the last three decades. METHODS AND RESULTS: From February 1989 to December 2018, 493 STEMI-CS patients were consecutively admitted in a well-defined geographical area of ~850,000 inhabitants...
July 27, 2020: Journal of Clinical Medicine
Omar Sheikh, Tung Nguyen, Shweta Bansal, Anand Prasad
Acute kidney injury (AKI) is an ominous predictor of mortality in cardiogenic shock. The present review examines the pathophysiology of AKI in cardiogenic shock (CS), summarizes the pertinent literature including the diagnostic criteria/definitions for AKI and possible role of biomarkers, and identifies risk factors and possible therapeutic interventions for AKI in CS. Our review finds that AKI is common in patients with CS and is associated with increased morbidity and mortality. Urinary biomarkers of renal tubular injury appear more sensitive for detection of AKI but have yet to be incorporated into daily practice...
July 29, 2020: Catheterization and Cardiovascular Interventions
Salem Gaballa, Avan AlJaf, Kashyap Patel, Jane Lindsay, Kyaw M Hlaing
Since the beginning of the coronavirus disease 2019 (COVID-19) pandemic, there has been a growing and justifiable fear of catching the virus from the emergency rooms, thus decreasing the hospital visits. With Virginia State slowly reopening and HCA local hospitals resuming elective procedures, the number of emergency room visits, are recovering and increasing. We report a sad and unfortunate case of an 87-year-old female who was experiencing pressure-like chest pain but presented to the emergency room five days later out of fear of catching COVID-19 from the hospital...
June 24, 2020: Curēus
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