44 research outputs found
Acute myocardial infarction in a patient with post-splenectomy thrombocytosis: A case report and review of literature
Unlike essential thrombocytosis, which is associated with thrombotic and hemorrhagic complications,
reactive thrombocytosis (RT) is usually considered a benign process without thrombotic
complications.
We describe a case of acute myocardial infarction in a young heavy smoker with RT following
splenectomy. Coronary angiography showed a linear filling defect at mid-part of left anterior
descending artery. We performed balloon angioplasty and stenting for this lesion. Aspirin and
clopidogrel were administered. His in-hospital course was uneventful and platelet count returned
to the normal range at four month follow-up. We concluded that RT may not be an
entirely benign process, especially in patients with a history of smoking. Regular monitoring of
platelet count, and possibly antithrombotic agents like aspirin prescription for high risk patients
with moderate thrombocytosis, may be useful. (Cardiol J 2010; 17, 1: 79-82
Aneurysmal coronary arteriovenous fistula closing with covered stent deployment: A case report and review of literature
Coronary arteriovenous fistula (CAVF) is a rarely encountered congenital coronary anomaly,
in which coronary artery blood flow bypasses the myocardial capillary network and usually
drains to a heart chamber or great vessel. It is usually asymptomatic. However, the risk of
symptoms and complications increases with age. High output heart failure, pulmonary hypertension,
myocardial ischemia and infective endocarditis may complicate the course of this
anomaly. The appearance, and even rupture, of a saccular aneurysm is one of the even rarer
complications of CAVF. Here we describe a 57 year-old patient with incidental finding of an
aneurysmal CAVF which was treated successfully using covered stent. (Cardiol J 2011; 18, 5:
556–559
Izolowana b膮blowica serca - opis przypadku
Cardiac hydatidosis is rarely encountered. A case of isolated cardiac hydatid cyst of the left ventricle in a young woman is described.
The diagnosis was suggested by echocardiography and was confirmed later by pathological evaluation. Serological tests were
negative. The patient underwent a successful operation for cyst resection
Zamkni臋cie t臋tniakowato poszerzonej przetoki t臋tniczo-偶ylnej naczy艅 wie艅cowych z u偶yciem stentu powlekanego: opis przypadku i przegl膮d pi艣miennictwa
Przetoka t臋tniczo-偶ylna naczy艅 wie艅cowych (CAVF) jest rzadko spotykan膮 wrodzon膮 wad膮
naczy艅 wie艅cowych, w kt贸rej krew omija uk艂ad w艂o艣niczek miokardium i wp艂ywa bezpo艣rednio
do kom贸r serca lub du偶ych naczy艅. Najcz臋艣ciej nie powoduje 偶adnych objaw贸w, ale ryzyko
ich pojawienia si臋 oraz wyst膮pienia powik艂a艅 wzrasta wraz z wiekiem. Do g艂贸wnych powik艂a艅
zalicza si臋 niewydolno艣膰 serca, nadci艣nienie p艂ucne, chorob臋 niedokrwienn膮 serca oraz infekcyjne
zapalenie wsierdzia. Powstanie, a nawet p臋kni臋cie, t臋tniaka workowatego stanowi jedno
z najrzadszych powik艂a艅 CAVF. W niniejszej pracy opisano 57-letniego pacjenta z przypadkowo
wykrytym t臋tniakiem CAVF skutecznie leczonym wszczepieniem stentu powlekanego (Folia
Cardiologica Excerpta 2012; 7, 2: 115-119
Association of Vitamin D Deficiency and Thyroid Function in Postmenopausal Women
Pupose: Although there are reports of vitamin D (VitD) insufficiency in immune-mediated hypothyroidism, an association between VitD and thyroid-stimulating hormone (TSH) levels has yet to be shown. We aim to examine VitD and TSH levels among postmenopausal women, as both conditions are more prevalent in elderly women.
Methods: The clinic records of postmenopausal women during their routine maintenance visits were reviewed. All patients were examined for the symptoms related to thyroid function and osteoporosis. Participants were divided into three subgroups according to their TSH levels (below 4.0 mIU/L). Patient characteristics and VitD levels were compared between these subgroups. Multivariate linear regression model was constructed using serum VitD and serum TSH as the dependent variables to identify factors independently associated with these laboratory values.
Results: Two-hundred and nighty nine postmenopausal women were included. Average age was 62.2卤7.5 years old. VitD was insufficient (10-30 ng/mL) in 12.0% and deficient (<10 ng/mL) in 60.9% of the participants. In 11.3%, TSH was low and in 7.6% of women, TSH was high, while the remaining 80.1%, had normal TSH levels. Subjects with low TSH had significantly higher VitD concentrations (34.2卤29.1 ng/mL) compared to the other two groups (P-value: 0.039). In multivariate regression analysis, TSH was not a contributing factor, as age was the only significant predictor of VitD levels. Meanwhile, no predictor (including age and VitD) was identified for TSH levels in linear regression analysis.
Conclusion: Age was the only independent predictor of serum VitD in this study population. Though suppressed TSH was associated with higher VitD levels, the association was not linear between TSH and VitD in postmenopausal women
Sevoflurane-mediated modulation of oxidative myocardial injury
Introduction: Volatile anesthetics offer protection when administered throughout an ischemic injury. We examined how volatile anesthetics modulate the cardiac myocytic injury associated with hydrogen peroxide. Methods: Forty-eight Long-Evans rats were divided into four groups depending on the treatment: none (CONT), Glibenclamide (GLB); Sevoflurane (SEV); or GLB+SEV. Each group was further divided into two, one of which was exposed to hydrogen peroxide (H2 O2 ). Oral GLB was administered 48 hours before myocardial isolation. All rats were anesthetized by intraperitoneal injection of Ketamine, and the hearts were harvested after heparinization. Cardiomyocytes were isolated using a combination of mechanical mincing and enzymatic digestion. After isolation, the aliquots of cells were exposed to H2 O2 and FeSO4 for 30 minutes. The cell suspensions were then bubbled for 10 minutes with 100% oxygen and 1.5% SEV if appropriate. Apoptosis was detected by fluorescein-bound annexin-V (ANX-V), necrosis by propidium iodide, and ELISA assessed caspase-3 activity in all groups. Results: There was an increase in apoptosis, necrosis, and caspase-3 activity in the cells following exposure to hydrogen peroxide. SEV reduced the rate of cell necrosis and apoptosis. Pretreatment with GLB did not alter the effects of SEV. Similarly, caspase-3 activity did not change with GLB, although SEV administration reduced this enzymatic activity in response to hydrogen peroxide. Conclusion: In this oxidant injury model, we demonstrated that incubating isolated cardiomyocytes with SEV profoundly diminished H2 O2 -induced apoptotic and necrotic cells compared to their CONTs. These results support the hypothesis that KATP channels are not the sole mediators associated with anesthetic preconditioning
Zatorowo艣膰 p艂ucna u pacjentki z rzadk膮 anomali膮 t臋tnic wie艅cowych - wskaz贸wka dotycz膮ca znaczenia proksymalnych ga艂臋zi prawej t臋tnicy wie艅cowej
A 65 year-old female was admitted with acute pulmonary embolism and hypotension. Intravenous streptokinase was administered
but severe hypotension persisted. Pulmonary angiography was performed and partial recanalisation of the culprit
branch was noted. Echocardiography showed severe right ventricular (RV) dysfunction and free wall akinesia. Due to exaggerated
RV dysfunction and severe haemodynamic compromise a coronary angiography was done and showed abnormal
origin of right coronary artery (RCA) from left circumflex artery (LCx) with rudimentary RV branches and absent conus artery
and right atrial (RA) branch. Inotropic agents were necessary to stabilize the patient’s haemodynamic condition for the next
four days. We concluded that this coronary anomaly was an important contributory factor in our patient’s prolonged unstable
condition. This emphasizes the critical role of normal RCA flow under acute haemodynamic stress. Evaluation of the condition
of RV perfusion and RCA patency might be justified in any prolonged and disproportionate RV dysfunction following
acute pulmonary embolism. Kardiol Pol 2010; 68, 7: 844-84
Left ventricular non-compaction in a patient with ankylosing spondylitis
A 58 years old male with a long-standing history of HLA-B27 positive ankylosing spondylitis presented with increasing fatigue and dyspnea on exertion. He had left ventricular dysfunction and enlargement, flail right coronary leaflet of aortic valve with severe eccentric aortic insufficiency along with left ventricular non-compaction in echocardiography. The most common cardiac manifestations of ankylosing spondylitis are aortic insufficiency and conduction disturbances. Involvement of myocardium, in the form of dilated cardiomyopathy and restrictive cardiomyopathy, has also been reported. This case presents a very rare association of ankylosing spondylitis with non-compaction cardiomyopathy