scholarly journals 148 ECG abnormalities in COVID-19 pneumonia: acute pericarditis, silent cad, or both? A case report

2021 ◽  
Vol 23 (Supplement_G) ◽  
Author(s):  
Erica Franco ◽  
Massimiliano Visconti ◽  
Vittorio Taglialatela ◽  
Silvana Panella ◽  
Chiara Rovera ◽  
...  
Keyword(s):  
Vascular Diseases ◽  
Nasopharyngeal Swab ◽  
Acute Pericarditis ◽  
Wave Inversion ◽  
High Flow Oxygen ◽  
Liver And Kidney ◽  
Initial Improvement ◽  
Ecg Alterations ◽  
Artery Disease ◽  
Ecg Abnormalities

Abstract Aims We report the case of a hypertensive 70 year-old man, who presented to the Emergency Department (ED) with fever, dry cough, malaise, dyspnoea. A nasopharyngeal swab for SARS-CoV-2 test was done, being positive. Methods and results Chest TC demonstrated ground glass bilateral pneumonia. Laboratory test showed WBC 10680/mmc, CRP 20 mg/l, TnT 0.03 ng/l, NTproBNP 147 ng/l. The liver and kidney function were within normal values. ECG was normal. He was treated with high flow oxygen (cPAP), enoxaparin, dexamethasone, doxycycline. After an initial improvement, dyspnoea got worse in 8th day, with the evidence of a new rise of inflammatory markers (PCR 95 mg/l, IL6 49 pg/ml) and the clinical new onset of cardiac rubbings on medical examination. The ECG revealed a sinus rhythm with T wave inversion everywhere. TnT remained normal. Echocardiography revealed a normal ventricular function, without segmentary alterations, absence of valvular disease. A mild pericardial effusion was evidenced, without signs of tamponade. We treated the patient with tocilizumab, after exclusion of other active infective foci. The clinical response was good, the patient was progressively weaned by oxygen and he was discharged asymptomatic. After 15 days, for ECG alterations persistence, despite no signs of ACS, a Coronary TC was done and a subcritical multivessel coronary artery disease was demonstrated: a subcritical IVA stenosis and a calcific MO. Conclusions In conclusion we report a successful treatment of COVID pneumonia likely complicated by acute pericarditis, and we observe that in these patients hypoxemia and cytochine storm possibly bring out silent vascular diseases, otherwise neglected.

scholarly journals Presence of Periodontopathic Bacteria DNA in Atheromatous Plaques from Coronary and Carotid Arteries

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Malgorzata Szulc ◽  
Wojciech Kustrzycki ◽  
Dariusz Janczak ◽  
Dagmara Michalowska ◽  
Dagmara Baczynska ◽  
...  
Keyword(s):  
Porphyromonas Gingivalis ◽  
Carotid Arteries ◽  
Periodontal Diseases ◽  
Vascular Diseases ◽  
Bacterial Dna ◽  
Chronic Inflammatory Response ◽  
Atheromatous Plaques ◽  
Patients At Risk ◽  
Study Population ◽  
Artery Disease

Objectives. Interest in periodontitis as a potential risk factor for atherosclerosis and its complications resulted from the fact that the global prevalence of periodontal diseases is significant and periodontitis may induce a chronic inflammatory response. Many studies have analyzed the potential impact of thePorphyromonas gingivalis, major pathogen of periodontitis, on general health. The purpose of this study was to find the presence of thePorphyromonas gingivalisDNA in the atherosclerotic plaques of coronary and carotid arteries and in the periodontal pockets in patients with chronic periodontitis, who underwent surgery because of vascular diseases.Methods and Results. The study population consisted of 91 patients with coronary artery disease or scheduled for carotid endarterectomy. The presence ofPorphyromonas gingivalisDNA in atheromatous plaques and in subgingival samples was determined by PCR. Bacterial DNA was found in 21 of 91 (23%) samples taken from vessels and in 47 of 63 (74.6%) samples from periodontal pockets.Conclusions.Porphyromonas gingivalisDNA is frequently found in atheromatous plaques of patients with periodontitis. That is why more research should be conducted to prove if this periopathogen may have an impact on endothelium of patients at risk of atherosclerosis.

scholarly journals Electrocardiographic abnormalities in severe anaemia and its reversibility after correction of anaemia

2020 ◽  
Vol 7 (10) ◽  
pp. 1566
Author(s):  
S. M. Biradar ◽  
Renuka Holiyachi ◽  
Mohd Shannawaz ◽  
V. Ravi Teja
Keyword(s):  
Clinical Manifestations ◽  
Severe Anaemia ◽  
Ecg Changes ◽  
College Hospital ◽  
Medical College ◽  
Wave Inversion ◽  
Pre Treatment ◽  
Organic Heart Disease ◽  
Hb Concentration ◽  
Ecg Abnormalities

Background: Anaemia is one of the commonest clinical problems in our country. It affects various organs including the heart. Clinical manifestations of anaemia referable to cardiovascular system may closely simulate symptoms and signs of organic heart disease. It includes some electrocardiogram (ECG) changes also. ECG changes in anaemia show correlation to haemoglobin (Hb) concentration and the changes are reversible after correction of anaemia. In this study, the main objective was to study electrocardiographic changes in patients with severe anaemia and ECG reversibility after treatment of anaemia.Methods: 50 patients admitted in medicine wards of Shri B. M. Patil Medical College, Hospital and Research Center, Vijayapura for severe anaemia (Hb concentration less than or equal to 7 gm %) were studied for ECG changes. All patients were reassessed for reversibility of changes after treatment.Results: Out of 50 patients with severe anaemia, 20 patients were having Hb % of 3 to 5 gm %. Of which 16 patients were having ECG changes (10 were females and 6 were males). All ECG changes were reverted to normal after correction of anaemia, except one patient (showed pre-treatment T wave inversion and post-treatment flat T waves).Conclusions: ECG abnormalities in patients with severe anaemia are more common in females. ECG abnormalities in patients with severe anaemia (Hb 5 gm %) can get reverted to normal after correction of anaemia.

Peripheral Vascular Disease

2014 ◽  
pp. 881-892
Author(s):  
Mark A. Creager
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Carotid Artery ◽  
Diagnostic Imaging ◽  
Carotid Artery Disease ◽  
Vascular Diseases ◽  
Peripheral Vascular ◽  
Abdominal Aortic ◽  
Systemic Disorder ◽  
Artery Disease

Atherosclerosis is a systemic disorder with regional manifestations in the heart, limbs, brain, and other organs. Advances in vascular biology, diagnostic imaging, pharmacotherapeutics, and intervention have provided physicians with greater opportunities to evaluate and manage patients with atherosclerotic vascular diseases. This chapter reviews several of these peripheral vascular diseases, including peripheral artery disease, abdominal aortic aneurysm, and carotid artery disease.

Nitric oxide and regulation of vascular tone: pharmacological and physiological considerations

1998 ◽  
Vol 7 (2) ◽  
pp. 131-140 ◽  
Author(s):  
J McHugh ◽  
DJ Cheek
Keyword(s):  
Nitric Oxide ◽  
Smooth Muscle ◽  
Vascular Smooth Muscle ◽  
Vascular System ◽  
Biological Activities ◽  
Vascular Diseases ◽  
Cyclic Guanosine Monophosphate ◽  
Guanosine Monophosphate ◽  
Physical Stimuli ◽  
Artery Disease

The endothelial cells of the vascular system are responsible for many biological activities that maintain vascular homeostasis. Responding to a variety of chemical and physical stimuli, the endothelium elaborates a host of vasoactive agents. One of these agents, endothelium-derived relaxing factor, now accepted as nitric oxide, influences both cellular constituents of the blood and vascular smooth muscle. A principal intracellular target for nitric oxide is guanylate cyclase, which, when activated, increases the intracellular concentration of cyclic guanosine monophosphate, which in turn activates protein kinase G. Acting by this pathway, nitric oxide induces relaxation of vascular smooth muscle and inhibits platelet activation and aggregation. Derangements in endothelial production of nitric oxide are implicated as both cause and consequence of vascular diseases, including hypertension, atherosclerosis, and coronary artery disease.

scholarly journals Electrocardiographic Abnormalities of Takotsubo Cardiomyopathy in a Patient with Paced Ventricular Rhythm

2010 ◽  
Vol 2010 ◽  
pp. 1-3 ◽  
Author(s):  
Krati Chauhan ◽  
Siva P. Sontineni ◽  
Venkata M. Alla ◽  
Mark J. Holmberg
Keyword(s):  
Takotsubo Cardiomyopathy ◽  
Significant Coronary Artery Disease ◽  
Regional Wall Motion ◽  
T Wave ◽  
Wave Inversion ◽  
Qt Interval Prolongation ◽  
Regional Wall Motion Abnormalities ◽  
St Elevation ◽  
Wall Motion Abnormalities ◽  
Artery Disease

Takotsubo cardiomyopathy (TCM) is a unique cardiomyopathy characterized by chest pain, ECG, and regional wall motion abnormalities closely mimicking acute myocardial infarction, in the absence of significant coronary artery disease. Classic ECG changes of TCM include ST elevation or T wave inversion. However, ECG abnormalities of TCM in patients with paced ventricular rhythms have not been well characterized. Herein, we report the case of an 85-year-old pacemaker dependant female who was diagnosed with TCM four weeks following the demise of her husband. Abnormal negative T wave concordance in precordial leads and QT interval prolongation were the only new ECG findings and these reverted back to baseline on followup.

scholarly journals Prevalence, Correlates, and Prognosis of Peripheral Artery Disease in Rural Ecuador—Rationale, Protocol, andPhase IResults of a Population-Based Survey: An Atahualpa Project-Ancillary Study

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Oscar H. Del Brutto ◽  
Mark J. Sedler ◽  
Robertino M. Mera ◽  
Pablo R. Castillo ◽  
Elizabeth H. Cusick ◽  
...  
Keyword(s):  
Phase I ◽  
Peripheral Artery Disease ◽  
Cardiovascular Health ◽  
Ankle Brachial Index ◽  
Vascular Diseases ◽  
Population Based ◽  
Test Reliability ◽  
Phase Iii ◽  
Peripheral Artery ◽  
Artery Disease

Background. Little is known on the prevalence of peripheral artery disease (PAD) in developing countries.Study design. Population-based study in Atahualpa. InPhase I, the Edinburgh claudication questionnaire (ECQ) was used for detection of suspected symptomatic PAD; persons with a negative ECQ but a pulse pressure ≥65 mmHg were suspected of asymptomatic PAD. InPhase II, the ankle-brachial index will be used to test reliability of screening instruments and to determine PAD prevalence. InPhase III, participants will be followed up to estimate the relevance of PAD as a predictor of vascular outcomes.Results. DuringPhase I, 665 Atahualpa residents aged ≥40 years were enrolled (mean age: 59.5 ± 12.6 years, 58% women). A poor cardiovascular health status was noticed in 464 (70%) persons of which 27 (4%) had a stroke and 14 (2%) had ischemic heart disease. Forty-four subjects (7%) had suspected symptomatic PAD and 170 (26%) had suspected asymptomatic PAD. Individuals with suspected PAD were older, more often women, and had a worse cardiovascular profile than those with nonsuspected PAD.Conclusions. Prevalence of suspected PAD in this underserved population is high. Subsequent phases of this study will determine whether prompt detection of PAD is useful to reduce the incidence of catastrophic vascular diseases in the region.

Management of airway obstruction with nebulised adrenaline resulting in takotsubo cardiomyopathy: case report

2016 ◽  
Vol 130 (9) ◽  
pp. 883-886 ◽  
Author(s):  
F Keshtkar ◽  
O T Dale ◽  
W O Bennett ◽  
C E Hall
Keyword(s):  
Case Report ◽  
Airway Obstruction ◽  
Takotsubo Cardiomyopathy ◽  
Apical Ballooning ◽  
Left Ventricular ◽  
Coronary Syndrome ◽  
Wave Inversion ◽  
Acute Airway Obstruction ◽  
Artery Disease ◽  
High Index Of Suspicion

AbstractBackground:Takotsubo cardiomyopathy has been associated with the use of catecholamines; however, its development after the use of nebulised adrenaline for the management of acute airway obstruction has not previously been described.Case report:A 66-year-old man with squamous cell carcinoma of the larynx, with tumour–node–metastasis staging of T3N2cM0, confirmed by biopsy and computed tomography, presented to the emergency department with acute airway obstruction. He was treated twice with nebulised adrenaline and intravenous dexamethasone. After a period of 24 hours, cardiac rhythm changes were noted on telemetry. A 12-lead electrocardiogram showed widespread T-wave inversion and QT prolongation suggestive of an acute coronary syndrome. Coronary angiography demonstrated no coronary artery disease, but left ventricular angiography showed marked apical ballooning and apical wall akinesia consistent with a diagnosis of takotsubo cardiomyopathy.Conclusion:Takotsubo cardiomyopathy can mimic true ischaemic heart disease and the diagnosis requires a high index of suspicion in patients managed with nebulised adrenaline.

scholarly journals 383 ECG in biopsy-proven and clinically suspected myocarditis: morpho-functional correlates and prognostic implications

2021 ◽  
Vol 23 (Supplement_G) ◽  
Author(s):  
Andrea Silvio Giordani ◽  
Alex Panzarella ◽  
Andrea Candelora ◽  
Davide Marcolongo ◽  
Chiara Merola ◽  
...  
Keyword(s):  
Nyha Class ◽  
Left Ventricular ◽  
Long Qt ◽  
Bundle Branch Block ◽  
Entire Cohort ◽  
Surrogate Outcome ◽  
Wave Inversion ◽  
Significant Difference ◽  
Ecg Alterations

Abstract Aims A distinction exists between biopsy-proven (BP) and clinically suspected (CS) myocarditis, the latter being an exclusion diagnosis based on clinical and instrumental findings. A clear diagnostic and prognostic role of the ECG in these two groups of patients has not yet been defined. (i) To describe frequency and characteristics of ECG findings in myocarditis, and to assess any difference between CS and BP myocarditis; (2) to identify morpho-functional correlates between ECG and cardiac magnetic resonance (CMR); and (iii) to evaluate the prognostic value of ECG findings. Methods and results 162 patients were included (median age 36 years, 70% male, median follow-up 32.9 months), 36 with BP and 126 with CS myocarditis. All patients underwent CMR; for ECG-CMR correlates, the ECG nearest in time to CMR was assessed. Surrogate outcome was defined as left ventricular (LV) ejection fraction (EF) <50% and/or NYHA class >I during follow-up. In the entire cohort ECG alterations were numerous: T-wave inversion (TWI) (82%), fragmented QRS (34%), low voltages (14%), ST elevation (STE) (13%). Compared to CS myocarditis, BP myocarditis patients showed higher frequency of non-sinus rhythm (17% vs. 2%, P < 0.001), long QT (28% vs. 0%, P < 0.001), lateral TWI (36% vs. 19%, P = 0.031) and bundle branch block (19% vs. 2%, P < 0.001). BP myocarditis patients had worse clinical features at diagnosis: heart failure (64% vs. 6%, P < 0.001), arrhythmic (14% vs. 4%, P = 0.029) and fulminant presentation (14% vs. 0%, P < 0.001), and presented higher LV end-diastolic volume and lower LVEF by echocardiography and CMR (109.5 mL/m2 vs. 85.50 ml/m2, P < 0.001; 31.5% vs. 59%, P < 0.001). A correlation was observed between number of myocardial segments with oedema at CMR and low ECG voltages (P = 0.010) and between late gadolinium enhancement (LGE) mass at CMR and lateral STE (P = 0.004 and P = 0.049, respectively). Several ECG alterations correlated with the surrogate outcome: long QT (P = 0.029), lateral TWI (P = 0.006), left bundle branch block (P < 0.001), ventricular ectopic beats (P = 0.020), and atrial fibrillation (P < 0.001). Conclusions A significant difference in ECG findings between CS and BP myocarditis has been demonstrated: ECG alterations are more frequent and more severe in BP myocarditis and correlate with prognosis. Moreover, ECG alterations identified patients with pathologic morpho-functional correlates.

scholarly journals Neutropenia and T-Wave Inversion as Toxin-Mediated Complications of a Streptococcal Infection

2017 ◽  
Vol 3 (4) ◽  
pp. 166-171 ◽  
Author(s):  
Cristina Popescu ◽  
Anca Leuştean ◽  
Alina Elena Orfanu ◽  
Codruţa Georgiana Carp ◽  
Victoria Aramă
Keyword(s):  
Streptococcal Infection ◽  
Penicillin G ◽  
Severe Neutropenia ◽  
Case Presentation ◽  
Wave Inversion ◽  
History Of ◽  
Ecg Abnormalities ◽  
Allergic Disorders ◽  
Streptococcal Tonsillitis ◽  
T Waves

Abstract Introduction: Streptococcal infection can be responsible for multiple complications, such as toxic, septic or allergic disorders. Toxin-mediated complications (TMC) can appear during the acute phase of disease and can involve any organ, causing carditis, arthritis, nephritis, hepatitis etc. Case presentation: The case of a young woman without a history of recurrent streptococcal tonsillitis, admitted to “Matei Balş” National Institute for Infectious Diseases, Bucharest, Romania, presenting with fever, sore throat and exudative tonsillitis, is detailed. The initial test for Streptococcus pyogenes was negative. The patient had leukopenia with severe neutropenia, high values of inflammatory biomarkers and electrocardiographic (ECG) changes with inverted T waves in leads V1-4 and flattened T waves in V5-6. There were no other cardiac signs or symptoms. The patient received cefuroxime for two days. On admission, the patient was prescribed Penicillin G and dexamethasone which resulted in a rapid recovery. The leucocytes count returned to normal as did the ECG abnormalities. At the time of discharge, the antistreptolysin O titre was high. Conclusions: The case highlights the toxin-mediated complications (TMC) of streptococcal infection which occur from the outset of the disease.

scholarly journals Complex Percutaneous Coronary Intervention Salvages a Patient with Recurrent Acute Coronary Syndrome and Ischaemic Heart Failure with Multiple Life Threatening Co-morbidities: A Case Report

2021 ◽  
Author(s):  
Brajesh Kunwar ◽  
Farah Ingle ◽  
Atul Ingle ◽  
Chandrasekhar Tulagseri
Keyword(s):  
Heart Failure ◽  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Artery Bypass ◽  
Kidney Injury ◽  
Vascular Diseases ◽  
Coronary Intervention ◽  
Middle Income ◽  
Coronary Syndrome ◽  
Artery Disease

More than 422 million people are suffering from Diabetes Mellitus (DM) worldwide. Majority of the affected population resides in lower and middle income countries. This chronic, metabolic disease gradually does serious damage to heart, blood vessels, eyes, kidneys and nerves; eventually causing cardiovascular diseases, peripheral vascular diseases, retinopathy, nephropathy and neuropathy. Here, a rare case of a 58-year-old male was present who had history of uncontrolled DM with dry gangrene in right forefoot, acute kidney injury and Coronary Artery Disease (CAD) involving Left Main (LM) bifurcation presented with recurrent acute coronary syndrome with heart failure. Patient in view of multiple co-morbidities was unfit for Coronary Artery Bypass Grafting (CABG) was managed successfully with complex coronary intervention involving LM bifurcation.

Sign in / Sign up

Export Citation Format

Share Document