Salmonella enteritidis Infection Complicated by Acute Myocarditis: A Case Report and Review of the Literature

Salmonella spp. is the cause of commonly encountered infections, with seasonal pattern of occurrence and worldwide distribution. Some of the clinical manifestations such as gastroenteritis and bacteremia are common, whereas others like mycotic aneurysms and osteomyelitis are infrequent especially in immunocompetent patients. Salmonella has been rarely described as a cause of myocarditis in the literature. We describe a case of an 18-year-old previously healthy male patient with myocarditis after Salmonella enteritidis infection. Clinical manifestations and diagnostic approach of this severe complication are discussed with a review of the literature

The clinical utility of pulse doppler, BNP, tissue doppler and left atrium echocardiographic measurements in left ventricular filling pressures estimation: a comparative simultaneous ultrasound - catheterization study

The purpose of the study was the noninvasive estimation of left ventricular filling pressures with the help of ultrasound and BNP. In particular the aim was to predict left ventricular end diastolic pressures (LVEDP) using echocardiographic indexes and BNP. (A comparative simultaneous ultrasound - catheterization study). In the context of the study 120 individuals were studied in total. These patients were driven to coronary angiography in order to investigate possible coronary artery disease. It was found that the correlation between the LVEDP, the echocardiographic indices (left atrium volume, E/E' ratio) and the BNP were statistically significant for the population studied. The combination of echocardiographic indices and BNP was able to predict the left ventricular end-diastolic pressure (LVEDP) in statistically significant way.Σκοπός της μελέτης ήταν η μη επεμβατική εκτίμηση των πιέσεων πλήρωσης της αριστεράς κοιλίας με τη βοήθεια του υπερήχου και του BNP. Ειδικότερα ο στόχος ήταν η πρόβλεψη της τελοδιαστολικής πίεσης στην αριστερά κοιλία (LVEDP) από υπερηχογραφικούς δείκτες και το BNP. (Συγκριτική υπερηχογραφική μελέτη με ταυτόχρονο καρδιακό καθετηριασμό). Στα πλαίσια της μελέτης εξετάσθηκαν 120 καρδιολογικοί ασθενείς. Οι ασθενείς αυτοί οδηγήθηκαν σε στεφανιογραφικό έλεγχο με σκοπό τη διερεύνηση πιθανής στεφανιαίας νόσου. Διαπιστώθηκε ότι η συσχέτιση ανάμεσα στην LVEDP, τους υπερηχογραφικούς δείκτες (όγκος του αριστερού κόλπου, ο λόγος Ε/Ε’) και το BNP ήταν στατιστικά σημαντική για το σύνολο του πληθυσμού που μελετήθηκε. Ο συνδυασμός υπερηχογραφικών δεικτών και του BNP ήταν σε θέση να προβλέψει την τελοδιαστολική πίεση στην αριστερά κοιλία (LVEDP) σε στατιστικά σημαντικό βαθμό

Recurrent Acute Coronary Syndromes in a Patient with Idiopathic Thrombocytopenic Purpura

A 53-year-old man was admitted to a peripheral hospital with the diagnosis of acute myocardial infarction without ST elevation. Due to the concomitant presence of first-diagnosed thrombocytopenia (platelet count 50.000/μL), it was decided to be treated conservatively with clopidogrel. Five days later, he developed an acute myocardial infarction with ST elevation (STEMI) and was transferred to our department for primary percutaneous coronary intervention (PCI). Coronary angiography revealed three-vessel disease. The left anterior descending lesion was considered culprit, and PCI was successfully performed using a drug-eluting balloon. This approach was considered safer due to the risk of intolerance of prolonged dual antiplatelet therapy in case of stent implantation. Indeed, four days later, aspirin was discontinued, and the patient remained only on clopidogrel due to a platelet fall. Meanwhile, idiopathic thrombocytopenic purpura (ITP) was diagnosed by hematology consultation, and specific ITP treatment was initiated. Seven days following the procedure, the patient was transferred to the Hematology clinic, where a continuous rise of platelet count up to 115.000/μL while on clopidogrel was observed, and he was discharged from the hospital asymptomatic. Unfortunately, twenty days later, the patient died of a lung infection. In ITP patients with STEMI, primary PCI with drug-eluting balloon angioplasty may be a reasonable approach

Patent hemostasis of radial artery: Comparison of two methods

BACKGROUND Radial artery obstruction is the most common complication of coronary angiography performed via transradial access. Patent hemostasis can significantly reduce the risk of radial artery occlusion. Previous studies utilized sophisticated methods to evaluate radial artery patency. Simplified and easily applicable methods for successful patent hemostasis are currently lacking. AIM To determine which method (pulse oximeter vs the traditional radial artery palpation) is better to achieve patent hemostasis. METHODS This prospective, single center study included 299 consecutive patients who underwent coronary angiography or percutaneous coronary intervention between November 2017 and July 2019. Patients less than 18 years old, with a history of radial artery disease, or no palpable artery pulse were excluded from the study. Patients were randomly assigned to two groups. In the first group, radial artery flow was assessed by palpation of the artery during hemostasis (traditional method). In the second group, radial artery patency was estimated with the use of a pulse oximeter. Two different compression devices were used for hemostasis (air chamber and pressure valve). The primary study endpoint was the achievement of successful patent hemostasis. RESULTS The two groups (pulse oximeter vs artery palpation) had no significant differences in age, sex, body mass index, risk factors, or comorbidities except for supraventricular arrhythmias. The percentage of patients with successful patent hemostasis was significantly higher in the pulse oximeter group (82.2% vs 68.1%, P = 0.005). A lower percentage of patients with spasm was recorded in the pulse oximeter group (9.9% vs 19.0%, P = 0.024). The incidence of local complications, edema, bleeding, hematoma, vagotonia, or pain did not differ between the two groups. In the multivariate analysis, the use of a pulse oximeter (OR: 2.35, 95%CI: 1.34-4.13, P = 0.003) and advanced age (OR: 1.04, 95%CI: 1.01-1.07, P = 0.006), were independently associated with an increased probability of successful patent hemostasis. The type of hemostatic device did not affect patent hemostasis (P = 0.450). CONCLUSION Patent hemostasis with the use of pulse oximeter is a simple, efficient, and safe method that is worthy of further investigation. Larger randomized studies are required to consider its clinical implications