Myocardial infarction secondary to unintentional ingestion of hydrogen peroxide

Ingestion of acid-containing household products, either accidentally or as a suicide attempt, is a common form of intoxication. A clear and odorless liquid, hydrogen peroxide is an oxidizing agent found in most households and many industrial environments. Cardiovascular manifestations of hydrogen peroxide ingestion are extremely rare. Here we report a 60 year-old woman with acute inferolateral myocardial infarction (MI) after hydrogen peroxide ingestion, who had no history of coronary artery disease. Physicians dealing with hydrogen peroxide ingestion in the emergency department should be aware of the probability of MI and obtain an electrocardiogram, even if the patient has no cardiac complaint. (Cardiol J 2012; 19, 1: 86–88

Value of MitraClip in Reducing Functional Mitral Regurgitation

Patients with heart failure who have secondary severe mitral regurgitation due to left ventricular dysfunction have a poor prognosis, with high rates of rehospitalization and mortality. Percutaneous mitral valve repair using the MitraClip (Abbott) has been shown to be safe and effective in secondary severe mitral regurgitation with heart failure. The number of MitraClip procedures performed has increased significantly, as recently published large, randomized clinical studies have shown. However, these studies have drawn different conclusions. This review aims to summarize the current evidence for the MitraClip procedure and provide information for its safe and successful implementation, comparing the studies that examined the use of MitraClip versus medical therapy alone or surgical repair for severe secondary mitral regurgitation

Early assessment of percutaneous coronary interventions for chronic total occlusions analyzed by novel echocardiographic techniques

OBJECTIVE: Successful revascularization of chronic total occlusions has been associated with improved left ventricular systolic function, reduced anginal symptoms, increased exercise capacity, and increased survival. This study was conducted to determine the impact of revascularization in chronic total occlusion on left ventricular function using novel echocardiographic techniques. METHODS: A total of 129 patients with chronic total occlusion who underwent revascularization between April 2011 and November 2012 were included in this study. Echocardiographic assessments with two-dimensional speckle tracking echocardiography and real-time three-dimensional echocardiography were performed before the procedure and one month after the procedure. The left ventricular ejection fraction, left ventricular volumes, and three-dimensional systolic dyssynchrony index were quantified. RESULTS: An immediate procedural success was obtained in 118 patients (91.5%). There were no acute or subacute stent thromboses during follow-up. The mean left ventricular ejection fraction significantly increased (

Predictors of mortality in patients with prosthetic valve infective endocarditis: A nation-wide multicenter study

Background: Our aim was to investigate the clinical and prognostic features of the patients with prosthetic valve endocarditis (PVE) in a multicenter nation-wide study.Methods: The present nation-wide study consisted of 75 consecutive patients with PVE treatedat 13 major hospitals in Turkey from 2005 to 2012.Results: The patients who died during follow-up were significantly older than the survivors and had higher C-reactive protein (CRP), creatinine, poor NYHA functional class and large vegetations. High creatinine level (odds ratio [OR] 2.6, 95% confidence interval [CI] 1.14–6.13), poor functional status (OR 24.5; 95% CI 3.1–196.5) and high CRP (OR 1.02; 95% CI1.00–1.03) measured on admission were independent risk associates for in-hospital mortality.Conclusions: High creatinine level, poor functional status and high CRP measured on admission were independent risk associates for in-hospital mortality, whereas a NYHA class ofIII/IV and high CRP reflected independent risk for stroke/mortality end point

Effect of metoprolol treatment on myocardial velocities in patients with heart failure in sinus rhythm

Amaç: Bu çalışma kalp yetersizliği olan hastalarda metoprolol tedavisinin miyokardiyal hızlar üzerine etkisini gözlemek amacıyla planlandı. Gereç ve Yöntem: Kalp yetersizliği bulunan 32 hasta (yaş ort 58$\pm$10) ve 20 sağlıklı birey çalışmaya dahil edildi. Hastalara 12.5 mg'dan başlayıp, haftalık aralıklarla titre edilerek 50 mg metoprolol, kontrollü salınım tableti verildi. Tedavi öncesi ve 1 ay sonrası konvansiyonel ekokardiyografi ve miyokardiyal doku Doppler görüntüleme uygulandı. Miyokardiyal hızlar doku Doppler görüntüleme tekniği ile mitral ve triküspit halka düzeyinden sağlandı. Mitral halka düzeyinde apikal 4 ve 2 boşlukta septal, lateral, inferior ve anterior kenarlardan ölçüm yapıldı. Mitral halka hızları için 4 kenarın ölçümlerinin ortalamaları alındı. Sağ ventrikül longitidünal fonksiyonunu değerlendirmek için triküspit halkasının lateral kenarı seçildi. Sistolik hız, erken diyastolik hız ve geç diyastolik hızlar kaydedildi. Tedavi sonrası elde edilen sonuçlar tedavi öncesi ile karşılaştırıldı. Bulgular: Kalp yetersizliği bulunan hastalarda kontrole göre mitral ve triküspit halka sistolik hızları anlamlı olarak düşük bulundu (mitral halka için 3.8$\pm$1.1'e karşı 9.3$\pm$0.9 cm/s, p <0.01, triküspit halka için 5.1$\pm$2.5'e karşı 14.6$\pm$1.9 cm/s, P<0.001). Erken diyastolik hız sağlıklı bireylere göre belirgin azalmış idi (mitral halka için 3.9$\pm$1.1 cm/s'e karşın 11.9$\pm$2.1 cm/s, P<0.001, triküspit halka için 4.8$\pm$1.2 cm/s'ye karşı 12.9$\pm$2.4 cm/s, p<0.01). Metoprolol tedavisi sonrası sistolik miyokardiyal hızda anlamlı değişiklik olmazken erken diyastolik hızda ise anlamlı artış izlendi (mitral halka için 3.9$\pm$1.1'e karşı 4.6$\pm$1.2, triküspit halka için 4.8$\pm$1.2 ye karşı 5.7$\pm$1.4, p<0.05, p<0.05 sırasıyla). Sonuç: Metoprolol tedavisi ile erken dönemde sistolik miyokardiyal hızlarda düzelme olmadan erken diyastolik hızlarda artış izlenmiştirAim: Beneficial effects of beta blockers on cardiac failure has been clearly defined. This study was planned to observe effect of metoprolol treatment on myocardial velocities in patients with heart failure. Material and Method: Thirty-two patients with heart failure (mean age: 58$\pm$10) and 20 healthy individuals were included in the study. Patients were given metoprolol, starting with 12.5 mg daily dose, and dose is increased weekly up to 50 mg/d given as controlled release tablets. Conventional echocardiography and myocardial tissue Doppler imaging were performed before the treatment and 1 month after. Myocardial velocities were acquired at the level of mitral and tricuspid annulus by tissue Doppler imaging method. Measurements were made at septal, lateral, inferior and anterior sides of (4 and 2 chambers) at mitral annulus. Average of measurements at 4 sides was taken for mitral annular velocities. Lateral side of tricuspid annulus was selected to evaluate longitudinal function of right ventricule. Systolic, early and late diastolic velocities were recorded. Posttreatment outcomes were compared with the pretreatment data. Results: Mitral and tricuspid annular systolic velocities were found to be significantly lower in patients with heart failure (3.8$\pm$1.1versus 9.3$\pm$0.9 cm/s for mitral annulus, p <0.01, 5.1$\pm$2.5 versus 14.6$\pm$1.9 cm/s for tricuspid annulus, P<0.001). Early diastolic velocity was significantly decreased compared to healthy individuals (3.9$\pm$1.1 cm/s versus 11.9$\pm$2.1 cm/s, p<0.001 for mitral annulus, 4.8$\pm$1.2 cm/s versus 12.9$\pm$2.4 cm/s for tricuspid annulus, p<0.01). While no significant change was observed in systolic myocardial velocity after metoprolol treament, early diastolic velocity was significantly increased (3.9$\pm$1.1 cm/s versus 4.6$\pm$1.2 cm/s for mitral annulus, 4.8$\pm$12 cms versus 5.7$\pm$1.4 cm/s, p<0.05, p<0.05 respectively). Conclusion: In the early period after metoprolol treatment, increase of early diastolic velocity was observed without any improvement of systolic myocardial velocities. Symptomatic improvement by metoprolol treatment can be explained by improvement of diastolic functions