scholarly journals Case Report: Interventricular Septal Hematoma Complicating Left Bundle Branch Pacing Lead Implantation

2021 ◽  
Vol 8 ◽  
Author(s):  
Rujie Zheng ◽  
Shengjie Wu ◽  
Songjie Wang ◽  
Lan Su ◽  
Kenneth A. Ellenbogen ◽  
...  
Keyword(s):  
Case Report ◽  
Chest Pain ◽  
Coronary Angiography ◽  
Contrast Agent ◽  
Interventricular Septum ◽  
High Grade ◽  
Case Summary ◽  
Bedside Echocardiography ◽  
Pacing Lead

Background: Left bundle branch pacing (LBBP) is a novel physiological pacing and previous studies have confirmed the feasibility and safety of it. The incidence of complications in LBBP is relatively low as reported. Here we present a case of interventricular septal hematoma complicating LBBP lead implantation.Case summary: LBBP was achieved for treatment of high-grade atrioventricular block in a 67-year-old female. Chest pain began 1 h after implantation when the electrocardiogram showed ST-T changes. Then bedside echocardiography confirmed the formation of interventricular septal hematoma. Urgent coronary angiography showed the contrast agent retention and overflow in the interventricular septum. The symptom was relieved half an hour later. Echocardiogram performed 2 h later revealed the size of the hematoma was the same as before. The electrocardiography, coronary angiography and CTA confirmed the resolution of the hematoma at 1-month follow-up. Pacing parameters and cardiac function remained stable during 6-month follow-up.Conclusion: This is the first reported case describing the clinic features and management of interventricular septum hematoma complicating LBBP. The importance of routine echocardiograms after implantation for identifying the hematoma should be highlighted.

Left bundle branch pacing improved heart function in a 10-year-old child after a 3-month follow-up

EP Europace ◽  
2020 ◽  
Vol 22 (8) ◽  
pp. 1234-1239
Author(s):  
Wei Ji ◽  
Xueying Chen ◽  
Jie Shen ◽  
Diqi Zhu ◽  
Yiwei Chen ◽  
...  
Keyword(s):  
Heart Function ◽  
Interventricular Septum ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Bundle Branch Block ◽  
Ventricular Ejection Fraction ◽  
Intracardiac Electrogram ◽  
Ventricular Activation ◽  
Pacing Lead

Abstract Aims As a physiological pacing strategy, left bundle branch pacing (LBBP) were used to correct left bundle branch block (LBBB), however, there is no relevant report in children. We aimed to evaluate the feasibility of LBBP in children. Methods and results Left bundle branch pacing was performed in a 10-year-old girl with a second-degree atrioventricular and LBBB. Under the guide of fluoroscopy, the pacing lead was deeply screwed into the interventricular septum to gain right bundle branch block (RBBB) pattern of paced QRS. Selective LBBP was achieved with a typical RBBB pattern of paced morphology and a discrete component between stimulus and ventricular activation in intracardiac electrogram and reached the standard of the stimulus to left ventricular activation time of 56 ms. At a 3-month follow-up, the LBBP acquired the reduction of left ventricular size and enhancement of left ventricular ejection fraction. Conclusion The application of LBBP in a child was first achieved with inspiring preliminary results. The LBBP can be carried out in children by cautiousness under the premise of strict grasp of indications.

Relative clinical value of coronary computed tomography and stress echocardiography-guided management of stable chest pain patients: a propensity-matched analysis

2020 ◽  
Author(s):  
Anastasia Vamvakidou ◽  
Oleksandr Danylenko ◽  
Jiwan Pradhan ◽  
Mihir Kelshiker ◽  
Timothy Jones ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Chest Pain ◽  
Coronary Angiography ◽  
Stress Echocardiography ◽  
Invasive Coronary Angiography ◽  
Low Risk ◽  
Clinical Value ◽  
Coronary Computed Tomography ◽  
Stable Chest Pain

Abstract Aims The European Society of Cardiology recommends coronary computed tomography (CCT) for the assessment of low-risk patients with suspected stable angina. We aimed to assess in a real-life setting the relative clinical value of stress echocardiography (SE)- and CCT-guided management in this population. Methods and results Patients with stable chest pain and no prior history of coronary artery disease (CAD) who underwent CCT or SE as the initial investigative strategy were propensity-matched (990 patients each group-age: 59 ± 13.2 years, males: 47.9%) to account for baseline differences in cardiovascular risk factors. Inconclusive tests were 6% vs. 3% (P < 0.005) in CCT vs. SE. Severe (≥70% stenosis) on CCT and inducible ischaemia on SE detected obstructive CAD by invasive coronary angiography in 63% vs. 57% patients (P = 0.33). Over the follow-up period (median 717, interquartile range 93–1069 days) more patients underwent invasive coronary angiography (21.5% vs. 7.3%, P < 0.005), revascularization (7.3% vs. 3.5%, P < 0.005), further functional testing 33.4% vs. 8.7% (P < 0.005), but more patients were prescribed statins 8.8% vs. 3.8% (P < 0.005) in the CCT vs. the SE arm, respectively. Combined all-cause mortality and acute myocardial infarction was low—CCT-2.3% and SE-3.3%—with no significant difference (P = 0.16). Conclusion Initial SE-guided management was similar for the detection of obstructive CAD, demonstrated better resource utilization, but was associated with reduced prescription of statins although with no difference in medium-term outcome compared to CCT in this very low-risk population. However, a randomized study with longer follow-up is needed to confirm the clinical value of our findings.

scholarly journals A Rare Coincidence of Two Coronary Anomalies in an Adult

2010 ◽  
Vol 2010 ◽  
pp. 1-4 ◽  
Author(s):  
Cesar Cruz ◽  
Dalton Mclean ◽  
Matthew Janik ◽  
Paolo Raggi ◽  
A. Maziar Zafari
Keyword(s):  
Computed Tomography ◽  
Case Report ◽  
Chest Pain ◽  
Coronary Angiography ◽  
Coronary Arteries ◽  
Coronary Anomalies ◽  
Left Main ◽  
Atypical Chest Pain ◽  
Selective Coronary Angiography ◽  
Type Iv

Anomalous right-sided left main coronary arteries and dual type IV left anterior descending arteries are rare coronary anomalies. In this case report, we present a 59 year old man with atypical chest pain and a combination of the above coronary anomalies as identified by selective coronary angiography and computed tomography angiography. To the best of our knowledge, the coincidence of these coronary anomalies has not been previously described.

scholarly journals Case Report: Unexplained Fever and Chest Pain in a 5-Year-Old

2021 ◽  
Vol 9 ◽  
Author(s):  
Paulina Lubocka ◽  
Robert Sabiniewicz
Keyword(s):  
Case Report ◽  
Chest Pain ◽  
Blunt Trauma ◽  
Broad Spectrum ◽  
Oral Prednisone ◽  
Etiological Factor ◽  
Rapid Improvement ◽  
Routine Diagnostics ◽  
Unexplained Fever

Pericarditis is a rare, but severe cause of chest pain in children that can easily be overlooked during routine diagnostics. Fibrinous pericarditis was recognized in a 5-year old patient who presented with fever and chest pain. Despite thorough diagnostics, no evident etiological factor was found. Furthermore, the disease was unresponsive to broad-spectrum antibiotics and NSAIDs, however oral prednisone was found to cause rapid improvement in the patients' condition. It was presumed that the patient's condition was caused by a blunt trauma to the chest experienced 3 days prior to the onset of symptoms. In an 8-month follow-up the patient remains in good overall condition and no recurrences were observed.

scholarly journals ATP stress MCE in evaluating coronary microvascular spasm: a case report

2021 ◽  
Author(s):  
Liu xuebing ◽  
Chun-Mei Li ◽  
Zhang Qing-Feng
Keyword(s):  
Case Report ◽  
Chest Pain ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Myocardial Perfusion ◽  
Recovery Period ◽  
Peak Stress ◽  
Left Anterior Descending Artery ◽  
Microvascular Spasm

We report a case of coronary microvascular spasm assessed by ATP stress MCE (myocardial contrast electrocardiography). The patient had chest pain, but the coronary angiography was normal. There was apical ventricular septal perfusion delay before ATP stress, and the perfusion was significantly improved at peak stress, which was similar to the radionuclide myocardial perfusion characteristics of coronary microvascular spasm, In the recovery period, the flow spectrum resistance of the distal coronary artery of the left anterior descending artery increased compared with that before stress, which further confirmed that local coronary microvascular spasm was induced after vasodilation.

scholarly journals Total Arterial Coronary Revascularization with Aorto-bifemoral Bipopliteal Bypass – A Case Report

2015 ◽  
Vol 7 (2) ◽  
pp. 159-161
Author(s):  
Nuruddin Mohammod Zahangir ◽  
Syed Tanvir Ahmad ◽  
Firoz Ahmed ◽  
Md Mainul Kabir ◽  
Tamjid Mohammad Najmus Sakib Khan ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Case Report ◽  
Chest Pain ◽  
Coronary Revascularization ◽  
Peripheral Vascular ◽  
Vessel Disease ◽  
Triple Vessel Disease ◽  
Good General Condition ◽  
Artery Disease

The management of combined Coronary Artery Disease and Peripheral Vascular Disease is a challenge and brings with it numerous clinical dilemmas. The 56 year old gentleman presented to our department with significant triple vessel disease with occluded lower end of aorta just before bifurcation and occluded bilateral superficial femoral arteries. CABG with aorto-femoral and femoro popliteal bypass was done on the same setting. On 12th postoperative day he was discharged from hospital in good general condition. Follow up after 6 months of operation the patient is doing well and free of chest pain and claudication pain. DOI: http://dx.doi.org/10.3329/cardio.v7i2.22266 Cardiovasc. j. 2015; 7(2): 159-161

scholarly journals Texidor’s twinge a rare cause of benign paroxysmal chest pain

2020 ◽  
Vol 0 (Ahead of Print) ◽  
Author(s):  
Narendra Kumar ◽  
Rachna Pasi ◽  
Swathi Chacham ◽  
Prashant Kumar Verma
Keyword(s):  
Computed Tomography ◽  
Case Report ◽  
Chest Pain ◽  
Deep Inspiration ◽  
High Resolution Computed Tomography ◽  
Cardiac Enzymes ◽  
Case Summary ◽  
Long Duration ◽  
Case Characteristics ◽  
Lying Down

Objective: Precordial catch syndrome was described by Miller and Texidor in 1955. It deserves wider recognition because it is rarely discussed in the differential diagnosis of precordial pain. Case summary: Case characteristics include a young 8-year-old female that presented with 4th episode of chest pain to the hospital. On attempting maneuver like deep breaths slowly in lying down position, pain subsided within 5 minutes although all other modalities of chest pain investigation as electrocardiography, echocardiography, chest high-resolution computed tomography, cardiac enzymes were normal. Discussion and conclusion: Various maneuvers like lying down or sitting upright and attempting deep inspiration tends to help in such conditions. This case report is reporting an unusual presentation of this syndrome due to its long duration of episode than the duration described in the previous reports. Prognosis is good. Key words: precordial catch syndrome, sharp chest pain, sagged posture, Texidor’s twinge, case report

scholarly journals A case report of unusually long episodes of asystole in a severe COVID-19 patient treated with a leadless pacemaker

2020 ◽  
Vol 4 (FI1) ◽  
pp. 1-6
Author(s):  
Ivan Cakulev ◽  
Jayakumar Sahadevan ◽  
Mohammed Najeeb Osman
Keyword(s):  
Atrial Fibrillation ◽  
Case Report ◽  
Pacemaker Implantation ◽  
Av Block ◽  
Leadless Pacemaker ◽  
Case Summary ◽  
Cardiac Manifestations

Abstract Background Experience has been emerging about cardiac manifestations of COVID-19-positive patients. The full cardiac spectrum is still unknown, and management of these patients is challenging. Case summary We report a COVID-19 patient who developed unusually long asystolic pauses associated with atriventricular block (AV) block and atrial fibrillation who underwent leadless pacemaker implantation. Discussion Asystole may be a manifestation of COVID-19 infection. A leadless pacemaker is a secure remedy, with limited requirements for follow-up, close interactions, and number of procedures in a COVID-19 patient.

Abstract 1631: Exclusion of Coronary Artery Stenosis by Non-invasive Coronary Angiography Using Multislice Computed Tomography Determines a Good Long-term Prognosis in Patients With Chest Pain - Follow-Up Study in 1017 Patients

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Peter Steinbigler ◽  
Eike Böhme ◽  
Carla Weber ◽  
Andreas Czernik ◽  
Jürgen Buck ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Chest Pain ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Multislice Computed Tomography ◽  
Coronary Artery Stenosis ◽  
Invasive Coronary Angiography ◽  
Artery Stenosis ◽  
Noninvasive Coronary Angiography

Long-term prognosis following exclusion of coronary artery stenosis by noninvasive coronary angiography using multislice computed tomography (MSCT) up to now has not been determined. We therefore performed noninvasive coronary angiography using MSCT (Philips Brilliance, 4 – 64 slices, retrospective ECG gating, 0.625mm collimation, 0.4sec gantry rotation time) in 1017 consecutive patients (657 male, 360 female, age 64±11years, 240 patients with known coronary artery disease (CAD)) referred to MSCT-study with chest pain. Patients with acute coronary syndromes, stents, atrial fibrillation and calcium scores > 1500 were not included. Based on MSCT results invasive study was recommended or not. All patients or the referring clinician were contacted by telephone or mail at least 6 months after their scan. Diagnostic image quality could be obtained in 992/1017 (98%) patients. In 620 of 992 patients (=63%) coronary artery stenosis could be excluded and invasive study was not recommended. Despite these recommendations invasive study was performed due to other clinical indications in 83/620 patients within < 30 days and in 43/537 patients within > 30days after the scan. Only in 13/126 patients stenoses >50% were found but no treatment was necessary. During the mean follow-up period of 612±192days 7/620 patients died but no patient suffered from cardiac death or acute myocardial infarction. In 372 of 992 patients invasive coronary angiography was recommended and performed in 230 patients (n=167 within < 30days, n=63 within >30days). In 165/230 patients stenoses >50% were found, treated by angioplasty or stents in 139/165 patients. During the mean follow-up period of 602±161days 11/372 patients died, two patients suffered from sudden, two patients from non-sudden cardiac death and one patient survived acute myocardial infarction. Thus, exclusion of coronary artery stenoses by noninvasive coronary angiography using multislice computed tomography determines a good lomg-term prognosis in patients with chest pain.

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