scholarly journals Cardiovascular complications and acute ischemic stroke after the treatment with epinephrine in an anaphylactic patient

2019 ◽  
Vol 5 (1) ◽  
pp. 32-34
Author(s):  
Ataman Köse ◽  
Akif Yarkaç ◽  
Gülten Bozali ◽  
Seyran Bozkurt Babuş ◽  
Ersin Altınsoy
Keyword(s):  
Coronary Artery ◽  
Emergency Service ◽  
Case Reports ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Cardiovascular Complications ◽  
Acute Ischemia ◽  
Epinephrine Administration ◽  
Cerebrovascular Complications ◽  
Artery Disease

Anaphylaxis is a serious clinical condition that can affect all ages and many systems (skin, gastrointestinal system, respiratory and cardiovascular systems). There are a few case reports of cardiac and cerebrovascular complications due to the anaphylaxis and/or the treatment with epinephrine. A 69-year-old female patient with known coronary artery disease (CAD), coronary artery bypass graft (CABG), and diabetes mellitus (DM) was admitted to the emergency department. She was brought to the emergency service with the complaints of shortness of breath, swelling of the tongue and lip, widespread itching and nausea after the use of amoxicillin-clavulonic acid due to soft tissue infection. The patient was considered as having anaphylaxis. 0.5 mg intramuscular (IM) epinephrine was administered. Following the emergency electrocardiography (ECG), the rate was 140/min and the rhythm was evaluated as atrial fibrillation. We present a case of cardiovascular complications and acute ischemia stroke following intramuscular epinephrine administration with anaphylactic diagnosis in this study. As a result, anaphylaxis management is extremely important in elderly patients with preexisting cardiovascular conditions.

scholarly journals Usefulness of the Electrocardiogram in a Patient Presenting with Right-Sided Pneumothorax and Presyncope

Diagnostics ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 1069
Author(s):  
Lavinia Maria Florescu ◽  
Călina-Patricia Țentea ◽  
Csilla-Andrea Eötvös ◽  
Roxana-Daiana Lazar ◽  
Iulia-Georgiana Zehan ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Case Reports ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Sudden Onset ◽  
Artery Bypass Graft ◽  
Multivessel Coronary Artery Disease ◽  
Ecg Changes ◽  
History Of ◽  
Artery Disease

We present the case of a 71-year-old man with history of smoking, pulmonary emphysema, hypertension, multivessel coronary artery disease and prior coronary artery bypass graft surgery who presented with spontaneous right-sided pneumothorax associated with phasic changes of the QRS amplitude on the electrocardiogram. While several case reports have described QRS amplitude changes associated with left-sided pneumothorax, reports of phasic ECG changes in right-sided pneumothorax are exceedingly rare. Such changes, when present in a patient with sudden onset chest pain and dyspnea, should prompt a diagnostic workup for possible pneumothorax.

scholarly journals Perivascular Adipose Tissue Inflammation in Ischemic Heart Disease

2021 ◽  
Vol 41 (3) ◽  
pp. 1239-1250
Author(s):  
Celestina Mazzotta ◽  
Sanchita Basu ◽  
Adam C. Gower ◽  
Shakun Karki ◽  
Melissa G. Farb ◽  
...  
Keyword(s):  
Adipose Tissue ◽  
Coronary Artery ◽  
Quantitative Polymerase Chain Reaction ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Artery Bypass Graft ◽  
Chain Reaction ◽  
Perivascular Adipose Tissue ◽  
Polymerase Chain ◽  
Artery Disease

Objective: There is growing recognition that adipose tissue–derived proatherogenic mediators contribute to obesity-related cardiovascular disease. We sought to characterize regional differences in perivascular adipose tissue (PVAT) phenotype in relation to atherosclerosis susceptibility. Approach and Results: We examined thoracic PVAT samples in 34 subjects (body mass index 32±6 kg/m 2 , age 59±11 years) undergoing valvular, aortic, or coronary artery bypass graft surgeries and performed transcriptomic characterization using whole-genome expression profiling and quantitative polymerase chain reaction analyses. We identified a highly inflamed region of PVAT surrounding the human aortic root in close proximity to coronary takeoff and adjoining epicardial fat. In subjects undergoing coronary artery bypass graft, we found 300 genes significantly upregulated (false discovery rate Q <0.1) in paired samples of PVAT surrounding the aortic root compared with nonatherosclerotic left internal mammary artery. Genes encoding proteins mechanistically implicated in atherogenesis were enriched in aortic PVAT consisting of signaling pathways linked to inflammation, WNT (wingless-related integration site) signaling, matrix remodeling, coagulation, and angiogenesis. Overexpression of several proatherogenic transcripts, including IL1β , CCL2 ( MCP-1 ), and IL6 , were confirmed by quantitative polymerase chain reaction and significantly bolstered in coronary artery disease subjects. Angiographic coronary artery disease burden quantified by the Gensini score positively correlated with the expression of inflammatory genes in PVAT. Moreover, periaortic adipose inflammation was markedly higher in obese subjects with striking upregulation (≈8-fold) of IL1β expression compared to nonobese individuals. Conclusions: Proatherogenic mediators that originate from dysfunctional PVAT may contribute to vascular disease mechanisms in human vessels. Moreover, PVAT may adopt detrimental properties under obese conditions that play a key role in the pathophysiology of ischemic heart disease. Graphic Abstract: A graphic abstract is available for this article.

Coronary Artery Disease as a Relevant Risk Factor in Screening of Abdominal Aortic Ectasia and Aneurysm

2018 ◽  
Author(s):  
Ahmed Koshty ◽  
Magdalena Bork ◽  
Andreas Böning ◽  
Dursun Gündüz ◽  
Sebastian Pleger
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Screening Program ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Sonographic Examination ◽  
Screening Programs ◽  
Abdominal Aortic ◽  
Artery Disease ◽  
Aortic Ectasia

Background The aim of this study was to investigate the prevalence of abdominal aortic aneurysm (AAA) and abdominal aortic ectasia (AAE) in coronary artery disease (CAD) patients in a multicenter setting to obtain significant data to establish an AAA screening program in our departments. Methods Between January and September 2016, 500 patients with suspected or diagnosed CAD planned for coronary angiography or coronary artery bypass graft (CABG) underwent a sonographic examination of the infrarenal abdominal aorta to diagnose AAA or AAE. We calculated the prevalence of AAA and AAE in patients diagnosed of CAD and investigated factors potentially associated with the occurrence of AAA. Results The overall prevalence in all grades of CAD for AAE was 35.1% and for AAA 5.4%. In patients with three-vessel CAD, the prevalence of AAE was 34% and of AAA 6.8%. Significant correlation was found between the three-vessel CAD and AAA (p = 0.039). The logistic regression analysis showed significant correlation between AAA and age > 65 years (p = 0.05). The multivariate analysis of risk factors and CAD revealed significant correlations between one-vessel CAD and arterial hypertension (AH) (p = 0.004) and age > 65 years (p = 0.001) as well as between three-vessel CAD and AH (p = 0.01), peripheral artery disease (p = 0.01), and age > 65 years (p = 0.03). Conclusion Our results confirm, that in comparison to other data, the prevalence of AAA in patients with CAD is high. Thus, it is recommended to include patients with CAD, especially elderly patients with three-vessel CAD, in future AAA screening programs.

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