scholarly journals Atrial standstill presenting as cerebral infarction in a 7-year-old girl

2019 ◽  
Vol 7 ◽  
pp. 2050313X1982773
Author(s):  
Agnethe May Ahnfeldt ◽  
Victoria Elizabeth de Knegt ◽  
Jesper Irving Reimers ◽  
Malene Landbo Børresen
Keyword(s):  
Cerebral Infarction ◽  
Treatment Guidelines ◽  
Cardiac Pacemaker ◽  
Cardiac Events ◽  
Unique Case ◽  
Anticoagulation Treatment ◽  
Permanent Cardiac Pacemaker ◽  
Irregular Pulse ◽  
Established Treatment

Atrial standstill is a rare arrhythmia defined by the absence of mechanical and electrical activity in the atria. Few cases of atrial standstill have been described in children, none of which have presented with cerebral infarction confirmed by imaging. We report a unique case of a 7-year-old girl presenting with expressive aphasia, central facial palsy and irregular pulse with cerebral infarction secondary to atrial standstill. This case illustrates that cardiogenic cerebral embolism in children can be caused by rare conditions like atrial standstill and should be considered in paediatric patients undergoing evaluation for stroke. There are no established treatment guidelines for atrial standstill. We recommend that treatment be directed towards any potential underlying cause. All patients with atrial standstill should receive long-term oral anticoagulation treatment and a permanent cardiac pacemaker implant to reduce the risk of further strokes or other cardiac events.

scholarly journals Anxiety in patients with permanent cardiac pacemaker aged > 60 years old

2020 ◽  
Vol 6 (2) ◽  
pp. 66
Author(s):  
Stella Vasileiou ◽  
Moschoula Mina Iordani ◽  
Illias Martinis ◽  
Alexandra Nikitopoulou ◽  
Jona Sakiqi ◽  
...  
Keyword(s):  
Associated Factors ◽  
Cardiac Pacemaker ◽  
Permanent Pacemaker ◽  
Systematic Assessment ◽  
Long Term Follow Up ◽  
Low Levels ◽  
Permanent Cardiac Pacemaker ◽  
Implanted Device

Introduction: A cardiac pacemaker is a small implanted device to control abnormal heart rhythms. According to estimates, 3 million individuals worldwide live with an implanted permanent pacemaker (PPM) while about 600 thousand pacemakers are implanted, annually.Purpose: to explore anxiety of pacemaker recipients as well as all the associated demographic and self-reported characteristics.Material and Method: 100 outpatients with PPM were enrolled in the study. Collection of data was performed by the completion of the “Self-rating Anxiety Scale Zung (SAS)” which included patients' characteristics.  Results: From the 100 participants 65% were men, 66% were >70 years old, 60% married, 50,5% of primary education and 90% lived in Attica. In terms of anxiety, 50% of recipients scored less than 48 on SAS scale (wide of range: 20-80) indicating mild to low levels of anxiety. Regarding associated factors, anxiety was found to be statistically significantly associated with gender (p=<0,001), understanding of provided information (p=<0,001), understanding of precautions in electromagnetic fields (p=0,021), desire for more frequent and long term follow-up and devise assessment (p=<0,001 and p=<0,001, respectively).Conclusions: Though pacemaker is an opportunity to prolong survival, however systematic assessment of anxiety and all the associated factors is considered to be of primary importance in clinical pacemaker settings.

scholarly journals Cardio-Cerebral Infarction, Free-Floating Thrombosis and Hyperperfusion in COVID-19

2021 ◽  
Vol 13 (2) ◽  
pp. 266-268
Author(s):  
Sitara Koneru ◽  
Dinesh V. Jillella ◽  
Raul G. Nogueira
Keyword(s):  
Ischemic Stroke ◽  
Cerebral Infarction ◽  
Inflammatory Responses ◽  
Imaging Finding ◽  
Ct Perfusion ◽  
Hypercoagulable State ◽  
Left Internal Carotid Artery ◽  
Intraluminal Thrombus ◽  
Unique Case ◽  
Ct Perfusion Imaging

Cardio-cerebral infarction, which refers to an acute ischemic stroke (AIS) and acute myocardial infarction (AMI) that occur concurrently, is an uncommon phenomenon with a grave prognosis. Intraluminal carotid thrombus (ICT) is an infrequently encountered cause of ischemic stroke and can be associated with an underlying hypercoagulable state. One severe yet prevalent complication of infection with Coronavirus Disease 2019 (COVID-19) is thrombosis from multi-pathway inflammatory responses. Here, we present a unique case of cardio-cerebral infarction, with a free-floating intraluminal thrombus in the left internal carotid artery, in the setting of recent COVID-19 infection, and with the etiology of both events attributed to a COVID-19 hypercoagulable state. CT perfusion imaging also showed an interesting imaging finding of hyperperfusion, which is believed to be a form of dysfunctional cerebral autoregulation.

Combined impact of residual inflammatory risk and chronic kidney disease on long-term clinical outcomes in patients undergoing percutaneous coronary intervention

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
N Takahashi ◽  
T Dohi ◽  
T Funamizu ◽  
H Endo ◽  
H Wada ◽  
...  
Keyword(s):  
Coronary Intervention ◽  
Cardiac Events ◽  
Adverse Cardiac Events ◽  
Percutaneous Coronary ◽  
Hs Crp ◽  
Stable Cad ◽  
Combined Impact ◽  
Group 1

Abstract Background Inflammatory status pre-percutaneous coronary intervention (PCI) and post-PCI has been reported not only associated with poor prognosis, but also to impair renal function. Statins reduce cardiovascular events by lowering lipids and have anti-inflammatory impacts, but residual inflammatory risk (RIR) exists. It remains unclear that the synergistic effect of RIR and chronic kidney disease (CKD) on long-term clinical outcome in stable coronary artery disease (CAD) patients undergoing PCI in statin era. Aim The aim of this study was to investigate the long-term combined impact of RIR evaluating hs-CRP at follow-up and CKD among stable CAD patients undergoing PCI in statin era. Methods This is a single-center, observational, retrospective cohort study assessing consecutive 2,984 stable CAD patients who underwent first PCI from 2000 to 2016. We analyzed 2,087 patients for whom hs-CRP at follow-up (6–9 months later) was available. High residual inflammatory risk was defined as hs-CRP &gt;0.6 mg/L according to the median value at follow up. Patients were assigned to four groups as Group1 (high RIR and CKD), Group2 (low RIR and CKD), Group3 (high RIR and non-CKD) or Group4 (low RIR and non-CKD). We evaluated all-cause death and major adverse cardiac events (MACE), defined as a composite of cardiovascular (CV) death, non-fatal myocardial infarction (MI) and non-fatal stroke. Results Of patients (83% men; mean age 67 years), there were 299 (14.3%) patients in group 1, 201 (9.6%) patients in group 2, 754 (36.1%) patients in group 3, and 833 (39.9%) patients in group 4. The median follow-up period was 5.2 years (IQR, 1.9–9.9 years). In total, 189 (frequency, 16.1%) cases of all-cause death and 128 (11.2%) MACE were identified during follow-up, including 53 (4.6%) CV deaths, 27 (2.4%) MIs and 52 (4.8%) strokes. The rate of all-cause death and MACE in group 1 was significantly higher than other groups (p&lt;0.001, respectively). There was a stepwise increase in the incidence rates of all-cause death and MACE. After adjustment for important covariates, the presence of high RIR and/or CKD were independently associated with higher incidence of MACE and higher all-cause mortality. (shown on figure). Conclusion The presence of both high RIR and CKD conferred a synergistic adverse effect on the risk for long-term adverse cardiac events in patients undergoing PCI. Kaplan-Meier curve Funding Acknowledgement Type of funding source: None

scholarly journals Long-Term Safety and Efficacy of Antiplatelet Therapy in Patients With Cerebral Infarction With Thrombocytopenia

2021 ◽  
Vol 27 ◽  
pp. 107602962098006
Author(s):  
Shijie Guo ◽  
Yingying Lin ◽  
Xiaoye Ma ◽  
Yanxin Zhao ◽  
Aiping Jin ◽  
...  
Keyword(s):  
Cerebral Infarction ◽  
Antiplatelet Therapy ◽  
Multivariate Regression Analysis ◽  
Acute Cerebral Infarction ◽  
Score Change ◽  
Recurrence Rates ◽  
Primary Endpoints ◽  
Hemorrhagic Events

This study aimed to investigate the long-term safety and benefits of antiplatelet therapy in patients with cerebral infarction with thrombocytopenia, as evidence regarding this was limited. This cohort trial assessed patients with acute cerebral infarction with thrombocytopenia treated in the Neurology Department of Shanghai Tenth People’s Hospital from January 2016 to December 2018, and enrolled patients were followed up for 9 months. The patients were divided into non-antiplatelet and antiplatelet groups based on the actual intake of antiplatelet drugs. Primary endpoints included hemorrhagic events, recurrence of cerebral infarction, and activity of daily living (ADL) score changes. To balance baseline clinical data, propensity score matching was applied, and there were finally 65 matched patients, including 30 and 35 in the antiplatelet and non-antiplatelet groups, respectively. There were no differences in hemorrhagic and cerebral infarction recurrence rates between the 2 groups. ADL score change was higher in the antiplatelet group than in the non-antiplatelet group (10 vs 5, p = 0.039). In multivariate regression analysis, antiplatelet therapy significantly predicted a positive change in ADL scores [B = 8.381, 95% confidence interval (0.56-16.19)]. In patients with acute cerebral infarction with thrombocytopenia, antiplatelet therapy could the improve the quality of life in the chronic stage.

scholarly journals A case of repeat hepatectomy for liver metastasis from solid pseudopapillary neoplasm of the pancreas: a case report

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Atsushi Morito ◽  
Kojiro Eto ◽  
Kozue Matsuishi ◽  
Hirokazu Hamasaki ◽  
Keisuke Morita ◽  
...  
Keyword(s):  
Liver Metastasis ◽  
Liver Metastases ◽  
Distal Pancreatectomy ◽  
Treatment Guidelines ◽  
Histopathological Examination ◽  
Repeat Hepatectomy ◽  
R0 Resection ◽  
Solid Pseudopapillary Neoplasm ◽  
Long Term Prognosis

Abstract Background Solid pseudopapillary neoplasm of the pancreas is a rare tumor in young women, metastasizing in only 5–15% of cases, and most commonly to the liver. Although treatment guidelines have not been established, surgical resection is usually performed. We report a rare case of repeat hepatectomy for liver metastases after distal pancreatectomy with solid pseudopapillary neoplasm. Case presentation The patient was a 71-year-old woman who underwent distal pancreatectomy for solid pseudopapillary neoplasm, and liver metastasis occurred 4 years after the first surgery. Partial liver resection was performed for four liver metastases, and histopathological examination revealed a diagnosis of liver metastasis from solid pseudopapillary neoplasm. However, 18 months later, liver metastases were detected again; three tumors were identified, and partial resection was performed, which has provided 18 months’ recurrence-free survival. Conclusions Long-term prognosis can be expected following R0 resection for resectable liver metastasis from solid pseudopapillary neoplasm.

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