Lithium intoxication related multiple temporary ecg changes: A case report

Lithium is a widely used mood stabilizer, which may cause cardiac side effects. In this article, we present the case of a 39-year-old woman who had presented with pre-syncope and developed multiple ECG abnormalities that are caused by lithium intoxication and are disappeared after hemodialysis

The effects of ultrafiltration and diuretic therapies on oxidative stress markers in patients with cardio-renal syndrome

WOS: 000406380900012PubMed: 27097156BACKGROUND: Cardiorenal syndrome (CRS) is defined as complex pathophysiological disorder of the heart and kidneys. Both heart and renal failure are characterized by increased systemic oxidative stress in CRS. The aim of the present study is to assess the impacts of ultrafiltration (UF) and furosemide treatment on oxidative stress markers and renal functions in patients with CRS. METHODS: In the study 77 patients with CRS (37 patients in the UF group and 40 patients in the furosemide group) were included. Plasma superoxide dismutase (SOD), catalase (CAT), malondialdehyde (MDA), glutathione peroxidase (GSH-Px) levels were studied in all patients on admission and at the end of the study. RESULTS: Plasma SOD, CAT, MDA and GSH-Px levels did not show significant difference between the groups. CONCLUSIONS: The effects of UF and furosemide therapies were similar on oxidative stress markers in patients with CRS. These methods safely decrease volume overload in a short-term period

Acute myocardial infarction due to a bee sting manifested with ST wave elevation after hospital admission

WOS: 000254806700034PubMed: 18391739

Action mechanisms of statins and early statin therapy in acute coronary syndrome

Akut koroner sendrom (AKS); anstabil (kararsız) angina pektoris, ST segment yükselmeli-yükselmesiz miyokard infarktüsü gibi yüksek morbidite ve mortalite ile seyreden klinik durumları kapsayan bir tanımdır. AKS gelişimde rol oynayan en önemli faktör aterosklerotik plak zeminininde gelişen aterotrombozdur. Günümüzde koroner aterosklerozun yalnızca erken yaşlarda başlayan yağlı çizgilenmelerin zamanla artışına bağlı pasif bir olay olmayıp aynı zamanda dinamik inflamatuar bir süreç olduğu bilinmektedir. İnflamasyonun yoğun olduğu, lipidden zengin, ince fibröz kapsülle çevrili kararsız plağın rüptürü sonucunda plak içeriğinin kanla temas etmesi platelet agregasyonunu ve koagülasyonu tetikleyerek tromboz oluşumuna yol açar. Bu nedenle platelet fonksiyonlarına, koagülasyon kaskadına ve kardiyak arz-talep dengesine yönelik geleneksel tedavi iskeminin süre ve boyutunu etkilemekle birlikte, altta yatan aterosklerotik hastalığın tedavisine yönelik bir etkisi bulunmamaktadır. Bu veriler ışığında AKS gelişimden sorumlu dinamik inflamatuar plağın stabilize edilmesine, altta yatan aterosklerotik hastalığın durdurulması veya geriletilmesine yönelik yeni tedavi stratejilerinin geliştirilmesine ihtiyaç vardır. Bu derlememizde akut koroner sendromda uygulanan konvansiyonel tedavi stratejilerine ek olarak lipid düşürücü, anti inflamatuar, antiagregan ve endotel fonksiyonlarını iyileştirici etkileri olan statinlerin rolü irdelenecektir.Acute coronary syndrome (ACS), which is associated with high rates of morbidity and mortality, refers to the spectrum of acute myocardial ischemia, including unstable angina (UA), ST-segment elevated myocardial infarction and acute myocardial infarction without ST-segment elevation. Atherothrombosis is the major cause of ACS. It has now become clear that coronary atherosclerosis is not simply an inevitable consequence of aging but rather a chronic inflammatory process that can be converted into an acute clinical event by plaque rupture and arterial thrombosis. The rupture of an unstable atherosclerotic plaque results in the lipid core coming into contact with circulating blood, which triggers platelet activation and coagulation, leading to thrombosis. Although significant therapeutic advances in the treatment of ACS have been made with antiplatelet and antithrombotic therapy, these alone do not appear to completely stabilize unstable plaques. This review will present the efficacy of early statin therapy in patients with acute coronary syndrome in addition to conventional medical therap

Evaluation of transfer parameters in patients admitted to our hospital with ST-elevation myocardial infarction

WOS: 000371267200007PubMed: 26875128Amaç: Akut koroner sendrom (AKS), ciddi morbidite ve mortalite ile seyreden yaygın bir hastalıktır. Hızlı damar reperfüzyonu, AKS alt tipi olan ST-yükselmeli miyokart enfarktüsü (STYME) tedavisinin en önemli aşamasıdır. Sonuçların başarısı sadece merkezin deneyimine değil, reperfüzyonun ne kadar kısa sürede sağlandığına da bağlıdır. Çalışmamızda merkezimize başvuran STYME’li hastaların transfer parametreleri değerlendirildi. Yöntemler: Çalışmamıza Ocak 2011-Mart 2013 tarihleri arasında, STYME nedeniyle primer perkütan koroner girişim (PKG) uygulanan ardışık 200 hasta (160 erkek, 40 kadın) dahil edildi. Hastaların semptom başlangıcından ilk damar açıcı tedaviye kadar olan transfer parametreleri, klinik özellikleri ve laboratuvar değerleri kaydedildi. Bulgular: Hastaların 36’sının ilk hastane başvurusunu 112 Acil Servis ambulansı ile yaptığı, 70 hastanın ilk olarak PKG yapılamayan bir merkeze başvurduğu ve bu hastaların merkezimize transfer süresinin ortalama 73.9±12.5 dakika (dk) olduğu tespit edildi. Ağrı-ilk tıbbi temas süresinin medyan 105 (dağılım, 5–600) dk, ilk tıbbi temas-balon süresinin 115.5 (dağılım, 20–414) dk olduğu görüldü. Kadınlarda toplam ağrı-balon süresi erkeklere göre anlamlı olarak daha yüksekti (sırasıyla 246 [70–840]dk ve 195 [45–684] dk; p=0.032). Ayrıca ilk tıbbi teması 112 Acil Servis sistemi ile sağlayan hastalarda ağrı balon süresi, kendi imkanları ile acil başvuru yapan hastalara göre istatiksel olarak anlamlı düzeyde daha düşük tespit edildi (sırasıyla 185 [45–439] dk ve 248 [65–840] dk; p=0.017). Sonuç: Çalışmamızda hastanemiz kapı-balon süresinin Avrupa Kardiyoloji Derneği ve Amerikan Kardiyoloji Koleji STEME kılavuzu hedefleri ile uyumlu olduğu, ilk tıbbi temas-balon süresinin güncel kılavuz önerilerinin üzerinde olduğu saptandı.Objective: Acute coronary syndrom (ACS) is a common disease that causes severe morbidity and mortality. The most important aspect of ST-elevation myocardial infarction (STEMI) as a subgroup of ACS treatment is the rapid reperfusion of arteries. Successful results depend not only on the experience of the center but also on the rapidity in which reperfusion is achieved. In our study, the transfer parameters were evaluated in patients who were admitted to our hospital with STEMI. Methods: Two hundred consecutive patients (160 males, 40 females) who underwent primary percutaneous coronary intervention (PCI) for acute STEMI between January 2011 and March 2013 were included in our study. Transfer parameters of symptom-to-reperfusion treatment, clinical characteristics, and laboratory parameters were recorded. Results: Thirty-six patients were admitted to our hospital with ambulances; 70 patients were admitted to centers without PCI capability, with a mean transfer time to our hospital of 73.9±12.5 min. Median pain-to-first medical contact time was 105 min (range: 5–600 min), and average first medical contact-to-balloon time was 115.5 min (range: 20–414 min). Total pain-to-balloon time in females was significantly higher than males (246 min [range: 70–840 min], 195 min [range: 45–684 min], respectively, p=0.032). Mean pain-to-balloon time was significantly lower in patients delivered to the hospital by ambulance than in patients admitted to emergency departments independently (185 min [range: 45–439 min], 248 min [range: 65–840 min], respectively, p=0.017). Conclusion: In this study, our hospital door-to-balloon time was found compatible with the target specified in the European Society of Cardiology and American College of Cardiology STEMI guidelines; however, first medical contact-to-balloon time was found to be above that advised by the current guidelines

Thrombus formation on angioplasty equipment during primary Percutaneous coronary intervention for acute st elevation myocardial infarction despite intravenous Enoxaparin use: Case report

ABS TRACT Unfractionated heparin (UFH) has been traditionally used as the choice of antithrombin treatment during percutaneous coronary intervention. Increasing evidence suggests that treatment with the low molecular weight heparin enoxaparin during percutaneous coronary intervention (PCI) is safe and effective. Insufficient anticoagulation increases the risk of catheter thrombus formation during PCI. We report here a case with acute ST elevation myocardial infarction that periprocedural macroscopic thrombus formation on PCI equipment following antithrombin therapy with 0.75 mg/kg intravenously enoxaparin. All PCI equipments were removed and a bolus of intravenous UFH 100 U/kg was administered. New PCI equipments were inserted and the procedure was completed with stent implantation. Low molecular- weight heparin enoxaparin in the absence of a glycoprotein IIb/IIIa receptor blocker may be insufficient during percutaneous coronary intervention. Copyright © 2013 by Türkiye Klinik leri

Relation between QT characteristics and transthoracic echocardiographic parameters in patients with uncomplicated isolated mitral valve prolapse

Congress of the European-Society-of-Cardiology -- AUG 31-SEP 04, 2002 -- BERLIN, GERMANYWOS: 000179753302731…European Soc Cardio

Prerequisite Revascularization of Unprotected Left Main Coronary Artery Before Culprit Lesion Stenting

Güncel kılavuzlar ana koroner arter hastalığı olan asemptomatik iskemi, stabil anjina yada unstabil anjina / non-STEMI olan hastalarda CABG önerir. Ancak eşlik eden ciddi ana koroner arter hastalığı olan STEMI ile başvuran hastalarda hiç bir öneri yoktur. Bizim vakamızda suçlu lezyonu revaskülarizasyon amacıyla önce ciddi ana koroner arter lezyonu ile uğraşmak zorunda kaldık.Current guidelines recommend CABG as the treatment of choice for patients with asymptomatic ischemia, stable angina, or unstable angina/non-ST elevation myocardial infarction who have left main coronary artery disease. However there is no suggestion for patients presenting with ST elevation MI who have concomitant severe LMCA disease. In our case we had to deal with the stable but severe LMCA lesion first, in order to revascularize the culprit lesion