scholarly journals Fulminant Myocarditis: Brief Review

2021 ◽  
Vol 3 (3) ◽  
pp. 01-04
Author(s):  
Ezra A Amsterdam ◽  
Muhammad Majid
Keyword(s):  
Heart Transplantation ◽  
Cardiac Imaging ◽  
Ventricular Arrhythmias ◽  
Early Recognition ◽  
Standard Test ◽  
Fulminant Myocarditis ◽  
Myocardial Inflammation ◽  
Aggressive Management ◽  
Hemodynamic Impairment ◽  
Malignant Arrhythmias

Fulminant myocarditis (FM) is a rare disease characterized by acute hemodynamic impairment and ventricular arrhythmias due to severe myocardial inflammation. It is typically preceded by a viral infection but any of multiple other toxic and infective agents may also be the inciting agent. Diagnosis is based on biomarkers and/or cardiac imaging, but endomyocardial biopsy is the standard test for confirming the diagnosis. FM usually requires therapeutic support of cardiac function and treatment of malignant arrhythmias. Contrary to prior concepts, recent evidence has revealed that patients with FM are more likely to die or need heart transplantation than those with the nonfulminant form of the disease. Early recognition and aggressive management are essential for favorable outcomes.

scholarly journals Pediatric Malignant Arrhythmias Caused by Rare Homozygous Genetic Variants in TRDN: A Comprehensive Interpretation

2021 ◽  
Vol 8 ◽  
Author(s):  
Georgia Sarquella-Brugada ◽  
Anna Fernandez-Falgueras ◽  
Sergi Cesar ◽  
Elena Arbelo ◽  
Paloma Jordà ◽  
...  
Keyword(s):  
Ventricular Arrhythmias ◽  
Rare Variants ◽  
Early Recognition ◽  
Hot Spot ◽  
Pediatric Population ◽  
Specific Area ◽  
Implantable Defibrillator ◽  
Genetic Alterations ◽  
Malignant Arrhythmias ◽  
Genotype Correlation

Aim: To perform a comprehensive phenotype-genotype correlation of all rare variants in Triadin leading to malignant arrhythmias in pediatrics.Methods: Triadin knockout syndrome is a rare entity reported in pediatric population. This syndrome is caused by rare variants in the TRDN gene. Malignant ventricular arrhythmias and sudden cardiac death can be a primary manifestation of disease. Although pharmacological measures are effective, some patients require an implantable defibrillator due to high risk of arrhythmogenic episodes.Main Results: Fourteen rare genetic alterations in TRDN have been reported to date. All of these potentially pathogenic alterations are located in a specific area of TRDN, highlighting this hot spot as an arrhythmogenic gene region.Conclusions: Early recognition and comprehensive interpretation of alterations in Triadin are crucial to adopt preventive measures and avoid malignant arrhythmogenic episodes in pediatric population.

scholarly journals Case Report: Hypothyroidism Misdiagnosed as Fulminant Myocarditis in a Child

2021 ◽  
Vol 8 ◽  
Author(s):  
Nanjun Zhang ◽  
Shuran Shao ◽  
Yu Yan ◽  
Yimin Hua ◽  
Kaiyu Zhou ◽  
...  
Keyword(s):  
Pediatric Patients ◽  
Gamma Globulin ◽  
Hemodynamic Instability ◽  
Fulminant Myocarditis ◽  
Common Disease ◽  
Delay In Diagnosis ◽  
Possible Cause ◽  
Cardiac Enlargement ◽  
Malignant Arrhythmias ◽  
Third Degree Atrioventricular Block

Background: Hypothyroidism can lead to bradycardia, reduced cardiac output, cardiac enlargement, and abnormal electrocardiogram. However, hemodynamic instability and malignant arrhythmias due to hypothyroidism is rarely reported in children.Patient Findings: We report the case of a child with third-degree atrioventricular block, cardiogenic shock, and Adams Stokes Syndrome, who was initially misdiagnosed with fulminant myocarditis and was later found to have hypothyroidism during treatment.Summary: The child's condition did not improve after the administration of gamma globulin, methylprednisolone, and isoproterenol. Even after the placement of temporary pacemakers, the therapeutic effect was still not ideal. Upon reviewing the medical history, the child's condition improved rapidly after levothyroxine supplementation.Conclusions: Hypothyroidism is a common disease, but secondary severe cardiovascular lesions are particularly rare in children. Therefore, the delay in diagnosis can lead to serious cardiovascular manifestations. When pediatric patients develop severe AVB and bradycardia, hypothyroidism should be considered as a possible cause.

scholarly journals Cardio-Oncology: The Role of Echocardiography in Cancer Patients

2021 ◽  
Author(s):  
Theodoros Ntoskas
Keyword(s):  
Cancer Therapy ◽  
Cancer Patients ◽  
Cardiac Imaging ◽  
Early Recognition ◽  
Cardiac Injury ◽  
Three Dimensional ◽  
Cardiovascular Complications ◽  
Cardiac Events ◽  
Ongoing Research ◽  
Wide Availability

Cardio-oncology is a rapidly emerging medical field that focusses on the improvement of the quality of life of cancer patients by preventing and treating the adverse cardiovascular complications of cancer therapy. Early recognition of cancer therapy-related cardiac dysfunction (CTRCD) provides an opportunity to mitigate cardiac injury and risk of developing late cardiac events. Cardiac imaging, and in particular, transthoracic echocardiography, plays an essential role in the baseline assessment, the detection and the surveillance of CRTCD in patients during and after the cancer therapy. Although the frequency of screening for the cardiotoxicity in patients undergoing active treatments and cancer survivors remains a topic of debate and ongoing research, echocardiography continues to be the leader for continuous monitoring by imaging due to the wide availability, lack of exposure to radiation, ability to recognise the effects on cardiac function and assess haemodynamics and other cardiac structures. The cardiac imaging applied to cardio-oncology includes standard and advanced (speckle tracking and three-dimensional (3D)) echocardiography.

scholarly journals Pulmonary Mucormycosis: An Emerging Infection

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Mohammed Muqeetadnan ◽  
Ambreen Rahman ◽  
Syed Amer ◽  
Salman Nusrat ◽  
Syed Hassan ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Fungal Infection ◽  
Diabetic Patient ◽  
Patient Survival ◽  
Early Recognition ◽  
Immunocompromised Patients ◽  
Delay In Diagnosis ◽  
Pulmonary Mucormycosis ◽  
Aggressive Management ◽  
Life Threatening

Mucormycosis is a rare, but emerging, life-threatening, rapidly progressive, angioinvasive fungal infection that usually occurs in immunocompromised patients. We present a case of pulmonary mucormycosis in a diabetic patient who was on chronic steroid therapy for ulcerative colitis. Early recognition of this diagnosis, along with aggressive management, is critical to effective therapy and patient survival. The delay in diagnosis of this rapidly progressive infection can result in mortality.

scholarly journals A reversible hypocalcemic dilated cardiomyopathy caused by primary hypoparathyroidism

2019 ◽  
Vol 10 (2) ◽  
pp. 65-68
Author(s):  
Zhenli Cheng ◽  
Shiv Kumar Yadav ◽  
Xiaoyan Liu ◽  
Qijian Yi
Keyword(s):  
Heart Failure ◽  
Heart Transplantation ◽  
Dilated Cardiomyopathy ◽  
Systolic Function ◽  
Myocardial Dysfunction ◽  
Case Presentation ◽  
Aggressive Management

Dilated cardiomyopathy (DCM) is characterized by dilation and impaired contraction of one or both ventricles. Affected patients have impaired systolic function and may or may not develop overt heart failure (HF). Prognosis is generally poor without heart transplantation. We experienced a case of a 10-year-old child with dilated cardiomyopathy (DCM) accompanied by undiagnosed primary hypoparathyroidism. In our case,aggressive management of hypoparathyroidism significantly improved the manifestations of DCM. The case presentation highlights the importance of considering hypoparathyroidism as a cause of reversible myocardial dysfunction.

Thoracic duct injury during anterior cervical discectomy: a rare complication

1998 ◽  
Vol 88 (1) ◽  
pp. 151-154 ◽  
Author(s):  
Anna Kristina E. Hart ◽  
John H. Greinwald ◽  
Christopher I. Shaffrey ◽  
Gregory N. Postma
Keyword(s):  
Thoracic Duct ◽  
Early Recognition ◽  
Rare Complication ◽  
Content Type ◽  
Cervical Discectomy ◽  
Aggressive Management ◽  
Thoracic Duct Injury ◽  
First Case ◽  
Chyle Leakage ◽  
Chylous Fistula

✓ Chylous fistula resulting from intraoperative injury to the cervical thoracic duct is well described as a complication of neck dissection. However, injury to the thoracic duct during spinal surgery is rarely reported. The authors present the first case of thoracic duct injury occurring during cervical discectomy and fusion via an anterior approach. The anomalous location of the terminal arch of the thoracic duct in this patient contributed to the complication. The morbidity of chyle leakage is minimized by its early recognition, a thorough understanding of lymphatic system anatomy, and aggressive management of the thoracic duct injury.

Heterotopic heart transplantation and native heart ventricular arrhythmias

1991 ◽  
Vol 51 (6) ◽  
pp. 987-991 ◽  
Author(s):  
Carol Kotliar ◽  
Frank W. Smart ◽  
Michael E. Sekela ◽  
Antonio Pacifico ◽  
Craig M. Pratt ◽  
...  
Keyword(s):  
Heart Transplantation ◽  
Ventricular Arrhythmias ◽  
Heterotopic Heart Transplantation

Torsades de pointes in 3 patients with leukemia treated with arsenic trioxide

Blood ◽  
2001 ◽  
Vol 97 (5) ◽  
pp. 1514-1516 ◽  
Author(s):  
Dilip Unnikrishnan ◽  
Janice P. Dutcher ◽  
Nikita Varshneya ◽  
Richard Lucariello ◽  
Marietta Api ◽  
...  
Keyword(s):  
Arsenic Trioxide ◽  
Ventricular Arrhythmias ◽  
Early Recognition ◽  
Torsades De Pointes ◽  
Hematologic Malignancies ◽  
Interval Prolongation ◽  
Chemical Methods ◽  
T Wave ◽  
Qt Interval Prolongation ◽  
Therapeutic Doses

Arsenic trioxide is used in clinical trials in the treatment of relapsed and resistant cases of acute promyelocytic leukemia. Adverse effects from arsenic in these studies have been multisystemic. Arsenic is known to cause corrected QT-interval prolongation and T-wave changes, but the potential for serious ventricular arrhythmias is less well understood. Torsades de pointes, a form of ventricular tachycardia, has been reported with arsenic poisoning but not at therapeutic doses used in protocols for hematologic malignancies. We describe 3 patients in whom this arrhythmia developed while they were treated with arsenic trioxide. Early recognition of the arrhythmia or correction of contributory factors is important because arsenic induced ventricular arrhythmias are known to be resistant to most chemical methods and electrical cardioversion.

Procalcitonin in myocarditis patients: role in aetiology identification and risk stratification

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
G Peretto ◽  
A Villatore ◽  
S Sala ◽  
A Riccio ◽  
M Ripa ◽  
...  
Keyword(s):  
Bacterial Infections ◽  
Univariate Analysis ◽  
Fulminant Myocarditis ◽  
Short Term ◽  
Potential Biomarker ◽  
The Mean ◽  
Malignant Arrhythmias

Abstract Background Procalcitonin (PCT) is an established predictor of bacterial infections and sepsis. However, PCT involvement in cardiovascular diseases has been scarcely investigated so far. In particular, no studies at all ever addressed the role of PCT in myocarditis patients. We aimed at evaluating PCT in myocarditis patients, as a potential biomarker of: a) aetiologic diagnosis; b) prognosis. Methods A cohort of 130 consecutive patients with a novel diagnosis of myocarditis confirmed by both endomyocardial biopsy and cardiac magnetic resonance were included in the study. Patients with known bacterial infections or bacterial myocarditis were excluded (n=5). PCT concentration was measured on admission in all patients. Prospective follow-up (FU) was performed every 6 months up to 5 years. Results Of 125 patients analyzed (mean age 45±15 years, males 62%, mean LVEF 48±15%), 22 (18%) had fulminant myocarditis (FM). The remaining 103 cases had non-fulminant myocarditis (NFM), including infarct-like presentation and non-malignant arrhythmias. Aetiology was viral or virus-negative in 23 and 102 patients, respectively. The mean PCT value was 0.44±0.18 mcg/ml, with no significant differences between viral and virus-negative myocarditis (0.43±0.19 vs. 0.44±0.18 mcg/ml, p=0.90). Baseline PCT concentration was significantly higher in FM patients (0.69±0.21 vs. 0.39±0.16 mcg/ml, p=0.07). Consistently, PCT was higher in patients with LVEF <60% (0.51±0.20 vs. 0.30±0.14 mcg/ml, p=0.03) and in those with elevated (>400 pg/mL) NT-proBNP (0.55±0.19 vs. 0.36±0.17 mcg/ml, p=0.03). As for inflammatory biomarkers, patients with high ESR (>20 mm/h) had also higher PCT values (0.56±0.20 vs. 0.37±0.16 mcg/ml, p=0.03). By converse, no association was found between PCT and CRP abnormal values (p>0.05). At univariate analysis, high PCT (≥0.20 mcg/ml) was predictive of heart failure recurrence (OR 2.77, 95% CI 1.18–6.48, p=0.02) or arrhythmic cardiac arrest (OR 3.22, 95% CI 1.19–8.71, p=0.02) by discharge, with overall hospitalization prolonged by 10±4 days (p<0.05). Furthermore, patients with high PCT were more prone to myocarditis recurrences (13/80 vs. 4/45, p=0.03) by 5-year FU. Conclusions In myocarditis patients, elevated PCT values at presentation are not associated with myocarditis aetiology. Nonetheless, PCT suggests a worse short-term clinical outcome, and also a higher risk of myocarditis recurrences at long-term FU. Funding Acknowledgement Type of funding source: None

Pretreatment Tumor Lysis Syndrome Associated with Bulky Retroperitoneal Tumors. Recognition is the Mainstay of Therapy

2006 ◽  
Vol 92 (6) ◽  
pp. 540-541
Author(s):  
Dimitrios Theodorou ◽  
Emmanuel Lagoudianakis ◽  
Michael Pattas ◽  
Panagiotis Drimousis ◽  
Dimitrios K Tsekouras ◽  
...  
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Differential Diagnosis ◽  
Early Recognition ◽  
Rare Complication ◽  
Tumor Lysis Syndrome ◽  
Clinical Entity ◽  
Tumor Lysis ◽  
Aggressive Management ◽  
Retroperitoneal Tumors

Acute pretreatment tumor lysis syndrome is a rare complication of cancer. Early recognition and aggressive management are mandatory for prevention of the adverse sequelae of the syndrome. Here we present 2 cases of pretreatment tumor lysis syndrome, concluding that this clinical entity should be in the differential diagnosis of acute renal failure associated with malignancy, as early recognition is in fact the mainstay of treatment.

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