scholarly journals More than Meets the Eye: An Interesting Case of Cardiac Tamponade

2019 ◽  
Vol 2 (2) ◽  
Author(s):  
Camille A Clarke
Keyword(s):  
Ventricular Tachycardia ◽  
Coronary Artery ◽  
Pericardial Effusion ◽  
Cardiac Tamponade ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Interesting Case ◽  
Pericardial Fluid ◽  
Learning Objective ◽  
Artery Disease

This interesting case highlights the presentation of a 68-year-old Latino male with coronary artery disease and coronary artery bypass graft surgery eight years who presented with non-specific respiratory symptoms. At the time of his initial evaluation he was noted to have persistent bigeminy and a 5 beat run of ventricular tachycardia. During his hospital stay he was again noted to have marked arrhythmias, with a 40 beat run of ventricular tachycardia. Urgent echocardiogram was obtained and revealed significant pericardial effusion compressing his right ventricle. On cardiac catheterization patient was found to have a patent graft but trasudative pericardial fluid causing tamponade and arrhythmia both which completely resolved after drainage. Learning Objective 1: Recognize ventricular arrhythmias as an atypical presentation of pericardial effusion and cardiac tamponade. Learning Objective 2: Appreciate the utility of echocardiogram in elucidating etiologies of non-sustained ventricular tachycardia.

scholarly journals Cytokines in Pericardial Effusion of Patients with Inflammatory Pericardial Disease

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Konstantinos Karatolios ◽  
Rainer Moosdorf ◽  
Bernhard Maisch ◽  
Sabine Pankuweit
Keyword(s):  
Coronary Artery ◽  
Pericardial Effusion ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Serum Levels ◽  
Pericardial Fluid ◽  
Serum Samples ◽  
Viral Origin ◽  
Pericardial Disease ◽  
Artery Disease

Background. The role of inflammatory and angiogenic cytokines in patients with inflammatory pericardial effusion still remains uncertain.Methods. We assessed pericardial and serum levels of VEGF, bFGF, IL-1βand TNF-αby ELISA in patients with inflammatory pericardial effusion (PE) of autoreactive () and viral () origin, and for control in pericardial fluid (PF) and serum () of patients with coronary artery disease (CAD) undergoing coronary artery bypass graft surgery.Results. VEGF levels were significantly higher in patients with autoreactive and viral PE than in patients with CAD in both PE ( for autoreactive and for viral PE) and serum ( for autoreactive and for viral PE). Pericardial bFGF levels were higher compared to serum levels in patients with inflammatory PE and patients with CAD ( for CAD; for autoreactive PE; for viral PE). Pericardial VEGF levels correlated positively with markers of pericardial inflammation, whereas pericardial bFGF levels showed a negative correlation. IL-1βand TNF-αwere detectable only in few PE and serum samples.Conclusions. VEGF and bFGF levels in pericardial effusion are elevated in patients with inflammatory PE. It is thus possible that VEGF and bFGF participate in the pathogenesis of inflammatory pericardial disease.

scholarly journals Bundle Branch Re-Entrant Ventricular Tachycardia after Minimal Invasive Cardiac Surgery

Hearts ◽  
2021 ◽  
Vol 2 (4) ◽  
pp. 570-574
Author(s):  
Vincent Vandoren ◽  
Thomas Phlips ◽  
Philippe Timmermans
Keyword(s):  
Cardiac Surgery ◽  
Ventricular Tachycardia ◽  
Coronary Artery ◽  
Aortic Valve ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Minimal Invasive ◽  
Rhythm Analysis ◽  
Artery Disease ◽  
The Right

Background: Bundle branch re-entrant ventricular tachycardia (BBRVT) is a monomorphic ventricular arrhythmia with wide QRS complexes caused by re-entrant tachycardia between both bundle branches. BBRVT can occur in a variety of cardiac pathologies with His–Purkinje system (HPS) conduction abnormalities such as dilated cardiomyopathy, coronary artery disease, hypertrophic cardiomyopathy, valvular heart disease and even after aortic valve surgery. Case report: A 62-year-old male patient with an ischemic cardiomyopathy and implantable cardioverter defibrillator (ICD) underwent minimal invasive aortic valve replacement (Yil-AVR) and coronary artery bypass graft (CABG). He was remitted a week later because of relapsing sustained ventricular tachycardia (VT). Electrocardiogram showed a wide QRS tachycardia, which was remarkably similar to the patient’s sinus rhythm. Analysis of ICD revealed the presence of BBRVT. Catheter ablation of the right bundle branch (RBB) was performed. He is currently in clinical follow-up and no reoccurrence of VT has been recorded so far. Conclusion: Patients with known cardiomyopathy can develop BBRVT early after cardiac surgery. To our knowledge, this is the first time that BBRVT occurred after Yil-AVR.

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 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.

Sign in / Sign up

Export Citation Format

Share Document