scholarly journals Cardiovascular Manifestations and Complications of Pheochromocytomas and Paragangliomas

2020 ◽  
Vol 9 (8) ◽  
pp. 2435
Author(s):  
Shams Y-Hassan ◽  
Henrik Falhammar
Keyword(s):  
Secondary Hypertension ◽  
Cardiac Complications ◽  
Endocrine Tumors ◽  
Ecg Changes ◽  
Coronary Syndrome ◽  
Cerebrovascular Complications ◽  
Life Threatening ◽  
Sympathetic Nerve Terminal ◽  
Myofibrillar Degeneration ◽  
Cardiac Manifestations

Pheochromocytomas and paragangliomas (PPGLs) are rare neuro-endocrine tumors. The catecholamine surge causes paroxysmal or chronic secondary hypertension. PPGLs may present as hypertensive- or PPGL-crisis with severe life-threatening cardiac and cerebrovascular complications. PPGLs-induced cardiac manifestations have been reported with diagnoses as PPGLs-induced electrocardiogram (ECG) changes “mimicking acute myocardial infarction”, arrhythmias, myocarditis, acute coronary syndrome, dilated cardiomyopathy, and lately as takotsubo syndrome. Critical analysis of these reports reveals that most of these cardiac manifestations have certain features in common. They have a dramatic clinical presentation and are reversible if the disease is treated with appropriate medical therapy and surgical resection of the PPGL tumor. They may have the same repolarization ECG changes irrespective of the clinical cardiac diagnosis, usually associated with mild to moderate elevations of myocardial biomarkers as troponins and normal coronary arteries. The histopathological findings are usually focal or multifocal in the form hypercontracted sarcomeres and contraction band necrosis (myofibrillar degeneration) with subsequent secondary mononuclear cell infiltration. Evidences argue the PPGL caused surge of catecholamines triggers hyperactivation of the sympathetic nervous system with cardiac sympathetic nerve terminal disruption with norepinephrine spillover causing the cardiac complications. A comprehensive review of various reported cardiovascular manifestations and complications of PPGLs are presented.

scholarly journals Update on COVID-19 Myocarditis

Medicina ◽  
2020 ◽  
Vol 56 (12) ◽  
pp. 678
Author(s):  
Arianne Clare C. Agdamag ◽  
Jonathan B. Edmiston ◽  
Victoria Charpentier ◽  
Mohammed Chowdhury ◽  
Meg Fraser ◽  
...  
Keyword(s):  
Cardiogenic Shock ◽  
Early Recognition ◽  
Imaging Modality ◽  
Systolic Heart Failure ◽  
Circulatory Support ◽  
Cardiac Complications ◽  
Laboratory Findings ◽  
Coronary Syndrome ◽  
Organ Systems ◽  
Life Threatening

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) gained worldwide attention at the end of 2019 when it was identified to cause severe respiratory distress syndrome. While it primarily affects the respiratory system, we now have evidence that it affects multiple organ systems in the human body. Cardiac manifestations may include myocarditis, life threatening arrhythmias, acute coronary syndrome, systolic heart failure, and cardiogenic shock. Myocarditis is increasingly recognized as a complication of Coronavirus-19 (COVID-19) and may result from direct viral injury or from exaggerated host immune response. The diagnosis is established similar to other etiologies, and is based on detailed history, clinical exam, laboratory findings and non-invasive imaging studies. When available, cardiac MRI is the preferred imaging modality. Endomyocardial biopsy may be performed if the diagnosis remains uncertain. Current management is mainly supportive with the potential addition of interventions recommended for severe COVID-19 disease, such as remdesivir, steroids, and convalescent plasma. In the setting of cardiogenic shock and refractory, life-threatening arrhythmias that persist despite medical therapy, advanced mechanical circulatory support devices should be considered. Ultimately, early recognition and aggressive intervention are key factors in reducing morbidity and mortality. Our management strategy is expected to evolve further as we learn more about COVID-19 disease and the associated cardiac complications.

scholarly journals Metamizole-Induced Type I Kounis Syndrome

2021 ◽  
Author(s):  
Catarina Lameiras ◽  
Ana Corte-Real ◽  
Ana Órfão ◽  
Marta Mendes Lopes ◽  
Maria do Céu Dória
Keyword(s):  
Previous History ◽  
Clinical Manifestations ◽  
Type I ◽  
Kounis Syndrome ◽  
St Segment Elevation ◽  
Acute Urticaria ◽  
Coronary Syndrome ◽  
St Segment ◽  
Life Threatening ◽  
Cardiac Manifestations

Kounis syndrome (KS) is defined as acute coronary syndrome (ACS) triggered by mast cell and platelet activation in the setting of allergic or anaphylactic insults. KS is a unique and complex cause of ACS and many cases may be missed due to its highly variable clinical manifestations. In this report, we present a case of KS type I triggered by metamizole in the absence of a previous history of allergy to this drug. Following the administration of metamizole, the patient developed generalized acute urticaria, chest pain and diaphoresis. Electrocardiography (ECG) showed ST-segment elevation suggestive of myocardial infarction complicated by ventricular tachycardia. No coronary disease was observed on coronary angiography. The cardiac manifestations of KS may be life-threatening, and so it is important to appropriately recognize and treat this condition.

Cardiac Manifestations Following Electrical Injury: An Overview

2020 ◽  
Vol 6 (4) ◽  
pp. 1-8
Author(s):  
I Gusti AIH Pratiwi ◽  
I Gusti AP Purwanthi
Keyword(s):  
Cardiovascular Complications ◽  
Cardiac Complications ◽  
Myocardial Tissue ◽  
Electrical Injury ◽  
Cardiac Effects ◽  
Life Threatening ◽  
Tissue Injuries ◽  
Cardiac Manifestations ◽  
Electrical Injuries

Cardiac manifestations are the effects of an electrical injury that could be life-threatening. Although it is rare, arrhythmias and myocardial tissue injuries are the two major cardiac complications that can happen after electrical injury. Lack of recommendation and review makes it confusing to physicians in managing electrical injury patients with cardiovascular complications. This article provides an overview of electrical injuries, the cardiac manifestations that can occur, and management of electrical injuries that focus on cardiac effects.

scholarly journals Differential Diagnosis of Fulminant Myocarditis and Acute Coronary Syndromes in the Case of Failure of Coronary Angiography: A Case Report

2021 ◽  
Vol 8 ◽  
Author(s):  
Xiangfei Huang ◽  
Yi Gao ◽  
Fuzhou Hua ◽  
Jun Ying
Keyword(s):  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Severe Disease ◽  
Fulminant Myocarditis ◽  
Ecg Changes ◽  
Laboratory Findings ◽  
Coronary Syndrome ◽  
Life Threatening ◽  
Coronary Syndromes

Fulminant myocarditis (FM) is a severe disease with a rapidly progressive and life-threatening course caused mainly by viral infection. The symptoms, laboratory findings, and presence of ECG changes resemble acute coronary syndrome. Therefore, coronary angiography is usually helpful in making the appropriate diagnosis. However, failure to obtain complete coronary artery images due to coronary artery anatomic variations poses a challenge for the diagnosis of FM. Here, we report a case of FM preliminarily diagnosed as acute coronary syndrome (ACS) due to the presence of coronary artery anomaly.

A Review of the Therapeutic Benefits of Moringa oleifera in Controlling High Blood Pressure (Hypertension)

2019 ◽  
Vol 5 (3) ◽  
pp. 232-245
Author(s):  
Chuku Okorie ◽  
Kola Ajibesin ◽  
Adekunle Sanyaolu ◽  
Adeena Islam ◽  
Selciya Lamech ◽  
...  
Keyword(s):  
Blood Pressure ◽  
High Blood Pressure ◽  
Moringa Oleifera ◽  
Kidney Diseases ◽  
Treatment Strategies ◽  
Secondary Hypertension ◽  
Therapeutic Benefits ◽  
Northern Regions ◽  
Long Time ◽  
Life Threatening

Moringa oleifera (M. oleifera) is an angiosperm plant that is a member of the Moringaceae family. It is a natural plant that is native to the sub-Himalayan northern regions of India, Bangladesh, Pakistan, and Afghanistan. The plant grows abundantly throughout tropical and subtropical areas of the world. For several centuries, many cultures have utilized various parts of the moringa plant as traditional medicine to treat common illnesses and control life-threatening conditions such as hypertension (HTN), diabetes, hyperlipidemia, inflammation, etc. This article reviewed the current literature on the therapeutic benefits of M. oleifera on hypertension, primarily focusing on identifying the plant’s key components and its roles in hindering the common pathophysiological pathways associated with hypertension. The number of people living with HTN has been predicted to increase to 1.56 billion worldwide by 2025 in spite of the myriads of preventive and treatment strategies available today. Therefore, it would be of great value to explore alternative complementary ways of controlling high blood pressure. HTN is commonly defined as blood pressure equal to or higher than 140/90 mm Hg. HTN itself is not a disease condition and does not elicit specific symptoms, however, if left untreated for a long time, it can lead to complicated cardiovascular diseases such as angina, congestive heart failure, myocardial infarction as well as stroke and chronic kidney diseases. Primary hypertension is diagnosed when there is no known identifiable underlying cause for the onset of the condition. Secondary hypertension is diagnosed when there is evidence of a disease or disorder triggering the onset of the condition. It is apparent that understanding the role of M. oleifera in the management of hypertension would expand the valuable strategies for the control of this condition.

scholarly journals P1296CARDIAC COMPLICATIONS OF ARTERIOVENOUS FISTULAS IN PATIENTS WITH END-STAGE RENAL DISEASE

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Nessrine Breik ◽  
Hela Jbeli ◽  
Safa Fattoum ◽  
Imen Ouertani ◽  
Badreddine Ben kaab ◽  
...  
Keyword(s):  
Vascular Access ◽  
Interventricular Septum ◽  
Left Ventricular ◽  
Chronic Hemodialysis ◽  
Cardiac Complications ◽  
Arteriovenous Fistulas ◽  
Coronary Syndrome ◽  
Group 2 ◽  
Stage Renal Disease ◽  
Cardiac Status

Abstract Background and Aims Current literature suggests the arteriovenous fistula (AVF) to be the preferred type of vascular access for hemodialysis. However, AVFs have significant and potentially deleterious effects on cardiac functions particularly in the setting of preexisting heart disease. The aim of this study is to compare the clinical and echocardiographic evolution after creation of a proximal AVF and a radial AVF. Method We conducted a retrospective descriptive study including all chronic hemodialysis patients through AVF. Group 1 (G1) included patients with proximal AVF and group 2 (G2) patients with radial AVF. Results Twenty-four patients were collected in G1 and the average age was 55 years. G2 included 13 patients with a mean age of 44 years. Systolic blood pressure decreased after AVF creation in both groups (G1: 62.5%, G2: 45%, NS). A dyspnea was noted in 70% of cases of G1 and 38.4% of cases of G2 (NS). The interventricular septum was thickened in 20.8% of cases of G1 and 38.4% of G2 (NS). Left ventricular (LV) dilatation was observed in both groups with LV diastolic telegram diameter increase of 58% in G1 versus 10% in G2 (p = 0.04). A decrease in LV ejection fraction was found in 62.5% in G1 and 46.1% in G2 (p = 0.066). The major cardiac complications in G1 were acute coronary syndrome in 5 patients and atrial fibrillation in 4 cases after an average of 60 months and 35 months, respectively. No cardiac complications were noted in G2. Conclusion AVFs remain the preferred type of vascular access for chronic hemodialysis therapy because they are associated with better long-term patency and fewer complications compared with synthetic grafts. Its seat will depend on the vascular state and the cardiac status of the dialysis patient.

scholarly journals Assessment of arrhythmias in 50 patients of ST-elevation myocardial infarction after thrombolysis: a 24 hour Holter study

2017 ◽  
Vol 4 (3) ◽  
pp. 734 ◽  
Author(s):  
Rishi Rajhans ◽  
M. Narayanan
Keyword(s):  
Myocardial Infarction ◽  
Sinus Tachycardia ◽  
Anterior Wall ◽  
Warning Sign ◽  
Inferior Wall ◽  
Inclusion Criteria ◽  
Global Epidemic ◽  
Coronary Syndrome ◽  
Life Threatening ◽  
St Elevation

Background: Acute coronary syndrome represents a global epidemic. The purpose of this study was to evaluate the incidence of cardiac arrhythmias in acute myocardial infarction (AMI) in the first 24 hours of hospitalization post thrombolysis.Methods: 50 patients of AMI satisfying the inclusion criteria were included for this observational study. Philips Digitrak Holter was attached to the patient's chest for 24 hours and arrhythmias were noted.Results: In the study group 70% of cases were males, rest 30% females. Maximum incidence of AMI was seen between 4th and 7th decade of life. Incidence of diabetes and hypertension were 54% and 66% respectively either alone or in combination. Overall incidence of anterior wall was higher 56% than inferior wall which was 44%. Sinus tachycardia was seen in 54% of cases with higher incidence in anterior wall MI. Among the reperfusion arrhythmias incidence of frequent VPCs was highest with 66% followed by AIVR (42%) and NSVT (30%). AF was found in 3 cases i.e. 6% of which one died. One patient had VF to which she succumbed.Conclusions: It is a matter of debate whether arrhythmias being so common in AMI, should be considered under clinical spectrum or complication of AMI. An increasing belief that less serious arrhythmias may serve as a warning sign for potentially life threatening arrhythmias and timely intervention by drugs, D.C. shock or pacemakers can prevent mortality in these sets of patients.

An unusual case of concurrent Kounis syndrome and prolonged QT in a young patient

2021 ◽  
pp. 1-3
Author(s):  
Emrah Erdogan ◽  
Murat Cap ◽  
Gorkem Kus ◽  
Cem Gokhan ◽  
Yakup Kilic
Keyword(s):  
Acute Coronary Syndrome ◽  
Young Patient ◽  
Unusual Case ◽  
Allergic Reactions ◽  
Kounis Syndrome ◽  
Unique Case ◽  
Coronary Syndrome ◽  
Life Threatening ◽  
Anaphylactoid Reactions ◽  
Prolonged Qt

Abstract Allergic reactions related to drug use is a common entity presenting often from minor urticaria to life-threatening anaphylactoid reactions. A common but easily overlooked diagnosis, Kounis syndrome, is an established hypersensitivity coronary disorder induced by drugs, foods, environmental factors, and coronary stents that can present in the same way as non-allergy-induced acute coronary syndrome. Here within, we present a unique case of dual presentation of Kounis syndrome and prolonged QTc in a young patient after a single dose of Domperidone and Lansoprazole.

PP23 Accuracy of emergency medical services (EMS) telephone triage in identifying acute coronary syndrome (ACS) for chest pain patients. A systematic review abstract

2021 ◽  
Vol 38 (9) ◽  
pp. A10.2-A10
Author(s):  
Ahmed Alotaibi ◽  
Abdulrhman Alghamdi ◽  
Charles Reynard ◽  
Richard Body
Keyword(s):  
Systematic Review ◽  
Acute Coronary Syndrome ◽  
Chest Pain ◽  
Prediction Models ◽  
Meta Analysis ◽  
Final Diagnosis ◽  
Telephone Triage ◽  
Coronary Syndrome ◽  
Life Threatening ◽  
Pain Patients

IntroductionChest pain is one of the most common reasons for ambulance callouts and presentation to Emergency Departments (EDs). Differentiating patients with serious conditions (e.g. acute coronary syndrome [ACS]) from the majority, who have self-limiting, non-cardiac conditions is extremely challenging. This causes over-triage and over-use of healthcare resources. We aimed to systematically review existing evidence on the accuracy of emergency telephone triage to detect ACS or life-threatening conditions associated with chest pain.MethodsWe conducted a systematic review in accordance with PRISMA guidelines. Two independent investigators searched the Embase, Medline, and Cinahl databases for relevant papers. We included retrospective and prospective cohort studies written in English and investigating EMS telephone triage for chest pain patients linked with final diagnosis of ACS. Studies were summarised in a narrative format as the data were not suitable for meta-analysis.ResultIn total, 553 studies were identified from the literature search and cross-referencing. After excluding 550 studies, three were eligible for inclusion. Among those 3 studies, there are different prediction models developed by authors with variation in variables to detect ACS. The result showed that dispatch triage tools have good sensitivity to detect ACS and life-threatening conditions although they are used to triage sign and symptoms rather than diagnosing the patients. On the other hand, prediction models were built to detect ACS and life-threatening conditions and therefore it showed better sensitivity and NPV.ConclusionEMS dispatch systems accuracy for ACS and life-threatening conditions associated with chest pain is good. Since the dispatch tools were built to triage ambulance response priority based on sign and symptoms, this led to over triage among non-life-threatening chest pain patients. Over triage were slightly reduced by deriving prediction models and showed better sensitivity.

Undetected Long-Term Hypothyroidism Caused by Hashimoto’s Thyroiditis with Severe Cardiac Complications – An Unusual Case of Child Neglect

2021 ◽  
Author(s):  
Karl Otto Schneider
Keyword(s):  
Child Neglect ◽  
Trisomy 21 ◽  
Unusual Case ◽  
Complex Congenital Heart Disease ◽  
Cardiac Complications ◽  
Feeding Difficulties ◽  
Abuse And Neglect ◽  
Long Time ◽  
Life Threatening

IntroductionNeglect in childhood may often be undetected for a long time. Parents of patients of handicapped children are often unable to cope with multiple medical and psychological problems that exist with such patients despite support by the health services [Jacobi G, Dettmeyer R, Banaschak S, Brosig B et al. Child abuse and neglect: diagnosis and management. Dtsch Arztebl Int 2010; 107: 231–240]. This is especially true for patients with trisomy 21 because they frequently suffer from complex congenital heart disease, feeding difficulties and behaviour anomalies. Additionally, various degrees of hypothyroidism are very frequent in Down syndrome but rarely lead – as in our case – to a life threatening disease.

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