Cardiac and cerebral manifestations of the antiphospholipid syndrome

2001 ◽  
Vol 21 (02) ◽  
pp. 60-65
Author(s):  
F. Jung ◽  
I. Scharrer
Keyword(s):  
Aortic Valve ◽  
Antiphospholipid Syndrome ◽  
The Other ◽  
Prior History ◽  
Review Of The Literature ◽  
Left Main ◽  
Vessel Occlusion ◽  
History Of ◽  
Artery Disease ◽  
Valvular Lesions

Summary Aim: To describe cardiac and cerebral manifestations in eight patients with the antiphospholipid syndrome and a review of the literature. Patients and Methods: We studied eight patients with the antiphospholipid syndrome (APS) with either cardiac or cerebral or both manifestations. All patients fulfilled the proposed classification criteria for the APS according to the SSC of the ISTH. One patient died and had an autopsy. Results: Five of the eight patients had coronary artery disease with either thrombotic coronary occlusions or high grade stenosis, of which three patients had an occlusion of the left main artery or LAD. As valvular lesions have been described in association with the APS it is to note that three patients had thickening either of the mitral valve or aortic valve and one patient had an aortic valve replacement. The other two patients presented with a history of cerebral infarction. One of these patients also had a prior history of myocardial infarction, whereas the other patient had a history of aortic valve endocarditis. Conclusion: The APS can be associated with cardiac and cerebral manifestations. Acute thrombotic vessel occlusion presents as one of the most frequent vascular manifestations. Also valvular lesions can be associated with the APS.

Myeloid neoplasms in the setting of chronic lymphocytic leukaemia/chronic lymphocytic leukaemia-like disease: a clinicopathological study of 66 cases comparing cases with prior history of treatment to those without

2021 ◽  
pp. jclinpath-2020-207334
Author(s):  
Catherine Luedke ◽  
Yue Zhao ◽  
Jenna McCracken ◽  
Jake Maule ◽  
Lian-He Yang ◽  
...  
Keyword(s):  
Chronic Lymphocytic Leukaemia ◽  
Lymphocytic Leukaemia ◽  
The Other ◽  
Prior History ◽  
Myeloid Neoplasm ◽  
Myeloid Neoplasms ◽  
History Of ◽  
Cytogenetic Profile ◽  
Group 2 ◽  
Group 1

AimsMyeloid neoplasms occur in the setting of chronic lymphocytic leukaemia (CLL)/CLL-like disease. The underlying pathogenesis has not been elucidated.MethodsRetrospectively analysed 66 cases of myeloid neoplasms in patients with CLL/CLL-like disease.ResultsOf these, 33 patients (group 1) had received treatment for CLL/CLL-like disease, while the other 33 patients (group 2) had either concurrent diagnoses or untreated CLL/CLL-like disease before identifying myeloid neoplasms. The two categories had distinct features in clinical presentation, spectrum of myeloid neoplasm, morphology, cytogenetic profile and clinical outcome. Compared with group 2, group 1 demonstrated a younger age at the diagnosis of myeloid neoplasm (median, 65 vs 71 years), a higher fraction of myelodysplastic syndrome (64% vs 36%; OR: 3.1; p<0.05), a higher rate of adverse unbalanced cytogenetic abnormalities, including complex changes, −5/5q- and/or −7/7q- (83% vs 28%; OR: 13.1; p<0.001) and a shorter overall survival (median, 12 vs 44 months; p<0.05).ConclusionsMyeloid neoplasm in the setting of CLL/CLL-like disease can be divided into two categories, one with prior treatment for CLL/CLL-like disease and the other without. CLL-type treatment may accelerate myeloid leukaemogenesis. The risk is estimated to be 13-fold higher in patients with treatment than those without. The causative agent could be attributed to fludarabine in combination with alkylators, based on the latency of myeloid leukaemogenesis and the cytogenetic profile.

scholarly journals STEMI due to septic embolism from prosthetic aortic valve Aspergillus spp. Endocarditis in an immunocompetent patient.

2021 ◽  
Author(s):  
coral Serrano Arroyo ◽  
Luis Sánchez Trujillo ◽  
Alan León Bojórquez ◽  
José Leal Franco ◽  
Amalia Castro Rodríguez ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Immunocompetent Patient ◽  
Artery Occlusion ◽  
Etiologic Agent ◽  
Pathology Report ◽  
St Segment Elevation ◽  
Replacement Surgery ◽  
St Segment ◽  
History Of ◽  
Artery Disease

A 65-year-old man with a history of aortic valve replacement surgery and non-coronary artery disease was admitted to the emergency department with acute ST-segment elevation myocardial infarction (STEMI). Coronary angiography revealed left anterior descending (LAD) artery occlusion, which was treated successfully with angioplasty. The patient developed obstructive valvular dysfunction, and large vegetation was observed on echocardiography. The patient subsequently developed irreversible septic shock and died several days later. The pathology report identified Aspergillus as the etiologic agent.

scholarly journals TRANSCATHETER VERSUS SURGICAL AORTIC VALVE REPLACEMENT IN PATIENTS WITH PRIOR HISTORY OF CHEST RADIATION

2016 ◽  
Vol 67 (13) ◽  
pp. 175
Author(s):  
Akhil Parashar ◽  
Karan Sud ◽  
Karim A. Rehman ◽  
Shikhar Agarwal ◽  
Eugene Blackstone ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Prior History ◽  
Surgical Aortic Valve Replacement ◽  
History Of

scholarly journals Spontaneous regression of severe aortic stenosis after massive embolization in a patient with antiphospholipid syndrome

2019 ◽  
Vol 25 (1) ◽  
pp. 4-8
Author(s):  
Ali Youssef ◽  
Mustafa Alrefae ◽  
Sayed Abouelsoud
Keyword(s):  
Aortic Valve ◽  
Aortic Stenosis ◽  
Antiphospholipid Syndrome ◽  
Severe Aortic Stenosis ◽  
Valve Surgery ◽  
Lower Limbs ◽  
Acute Ischemia ◽  
Primary Antiphospholipid Syndrome ◽  
Aortic Valve Surgery ◽  
History Of

Summary We present a case of probably unreported aortic stenosis evolution in a patient with primary antiphospholipid syndrome (APS). A female patient, 54 years old, with a history of recurrent deep venous thrombosis, an episode of pulmonary embolism and was positive for APS antibodies. She was kept on warfarin and aspirin. The patient was admitted with acute pulmonary edema and severe aortic stenosis. While preparing for aortic valve surgery, the patient developed acute stroke, and a week later developed concurrent acute ischemia of both lower limbs. Emergency surgery salvaged the lower limbs and follow up transthoracic echocardiography showed marked regression of the thickening of the aortic valve leaflets, only mild aortic stenosis and moderate aortic regurgitation. Aortic valve surgery was cancelled, and the patient was kept on warfarin and aspirin. Conclusion Development of severe aortic stenosis is uncommon in primary APS, and this scenario of spontaneous improvement from a severe to a mild aortic stenosis, is probably unreported before.

Patients with Coronary Artery Disease Have an Increased Incidence of Aspirin Resistance: Association of PFA-100 Closure Time with Clinical Findings.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 1859-1859 ◽  
Author(s):  
Andrew L. Frelinger ◽  
Matthew D. Linden ◽  
Mark I. Furman ◽  
Marsha L. Fox ◽  
Marc R. Barnard ◽  
...  
Keyword(s):  
Platelet Function ◽  
Aspirin Resistance ◽  
Clinical Findings ◽  
Prior History ◽  
Limited Data ◽  
Closure Time ◽  
Cyclooxygenase 1 ◽  
History Of ◽  
Artery Disease

Abstract Background: The occurrence of thrombotic events despite aspirin (ASA) therapy in patients with vascular disease has been termed ASA resistance. However, limited data are available correlating laboratory evidence of platelet function with clinical ASA resistance. The PFA-100 collagen/epinephrine (COL/EPI) cartridge can detect the ASA-induced inhibition of platelet cyclooxygenase 1 in a high shear flow environment that mimics in vivo arterial conditions. Aim: To investigate whether there is an association of PFA-100 test results with clinical ASA resistance. Methods: Peripheral blood was collected prior to angiography from 560 sequential ASA-treated patients (81 or 325 mg > 3 d). Patients receiving thienopyridines were not excluded but those receiving GPIIb-IIIa antagonists were. Patients with normal angiographic arteries ("No CAD", low probability of ASA resistance) were compared to those with angiographic CAD or a single prior CAD event and to those with multiple CAD events ("CAD" and "Repeat CAD" respectively, higher probability of ASA resistance). Citrate 3.8% anticoagulated blood was tested in the PFA-100 in duplicate using the COL/EPI test cartridge. Patients in the No CAD group were younger, more often female, and less often diabetic, hypertensive, and lipidemic than CAD or Repeat CAD patients. Results: A short (< 142 s) closure time (CT) in at least one of the duplicate PFA-100 COL/EPI cartridges occurred more frequently in CAD and Repeat CAD patients compared to No CAD patients (p < 0.05, Table). Conclusions: Failure of ASA to inhibit platelet function, as measured by the PFA-100, is associated with CAD, even in patients without prior history of CAD. The PFA-100, a shear-dependent system, may therefore be a useful test to assess the presence of ASA resistance. This test, unlike some tests for aspirin resistance, does not include ADP and therefore can be used in patients receiving thienopyridines (a frequent co-medication with aspirin). No CAD CAD Repeat CAD *p<0.05 vs. No CAD PFA-100 CT < 142 s (no. of patients) 4 45 26 PFA-100 CD ≥ 142 s (no. of patients) 79 251 155 Total (no. of patients) 83 296 181 % PFA-100 CT < 142 s 5% 15%* 14%*

Prosthetic valve evaluation

ESC CardioMed ◽  
2018 ◽  
pp. 482-485
Author(s):  
Felix C. Tanner ◽  
Rolf Jenni
Keyword(s):  
Aortic Valve ◽  
Valve Replacement ◽  
Prosthetic Valve ◽  
The Other ◽  
Cardiac Valves ◽  
Prosthetic Valves ◽  
Echocardiographic Evaluation ◽  
Valve Function ◽  
Promising Development ◽  
Valvular Lesions

In patients with severe valvular lesions, an intervention for correction of valve function is indicated. This aim can be achieved by valvuloplasty, valve repair, or valve replacement. A promising development is the percutaneous replacement of diseased cardiac valves, in particular for the aortic valve, but increasingly for the other valves as well. This chapter summarizes the echocardiographic evaluation of prosthetic valves with particular emphasis on general principles and echocardiographic pitfalls.

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