1/26. lung cancer presenting as cardiac tamponade associated with transmural myocardial ischaemia.cardiac tamponade due to carcinomatous pericarditis is a life-threatening complication of malignancy and is uncommon as its initial manifestation [Chest 88 (1985) 70; Cancer 45 (1980) 1697; J Am Med Assoc 257 (1987) 1088]. A case of lung cancer presenting with cardiac tamponade associated with transient ST-segment elevation and life-threatening arrhythmias is presented. To our knowledge, this is the first reported case of transmural myocardial ischaemia related to malignancy.- - - - - - - - - - ranking = 1keywords = life (Clic here for more details about this article) |
2/26. Long-term treatment of ischemic dilated cardiomyopathy with continuous positive airway pressure.An 81-year-old man with ischemic dilated cardiomyopathy complained of frequently awakening from sleep due to choking; subsequent polysomnography revealed cheyne-stokes respiration (CSR) with sleep apnea. With continuous positive airway pressure (CPAP) through a nasal mask, both the CSR and symptoms disappeared. After 6-12 months, chest X-ray and echocardiographic findings continued to improve without any change in pharmacological treatment. For three years, CPAP had been effective to eliminate CSR during sleep. Long-term CPAP treatment, which is rarely applied for congestive heart failure in japan, is useful in alleviating the adverse effects of CSR and, thereby, maintaining a good quality of life in these patients.- - - - - - - - - - ranking = 0.5keywords = life (Clic here for more details about this article) |
3/26. Incessant ventricular tachycardia.The case of an 87-year-old woman with a significant history of coronary artery disease illustrates the challenge associated with intractable ventricular tachycardias, and demonstrates the various options available for terminating and controlling the potentially fatal arrhythmia. A favorable outcome was obtained using advanced cardiac life support guidelines, current pharmacological regimens, ventricular burst pacing with overdrive suppression, intra-aortic balloon counterpulsation, coronary revascularization and implantable cardioverter-defibrillator insertion. These modalities, as well as other therapeutic alternatives, are discussed in the management of incessant ventricular tachycardia.- - - - - - - - - - ranking = 0.5keywords = life (Clic here for more details about this article) |
4/26. Severe transient myocardial ischaemia caused by hypertrophic cardiomyopathy in a patient with congenital disorder of glycosylation type Ia.Severely affected children with congenital disorder of glycosylation type Ia (CDG-Ia; MIM 212065) may develop hypertrophic cardiomyopathy. In this report we describe the near-death of a 10-month-old girl with CDG-Ia due to acute left-ventricular outlet obstruction caused by hypertrophic cardiomyopathy and acute dehydration. The girl had multi-organ failure and signs of severe myocardial damage mimicking myocardial infarction. CONCLUSION: hypertrophic cardiomyopathy contributes to the high mortality of young children with congenital disorder of glycosylation type Ia. Even if cardiomyopathy in this disease is non-obstructive, acute fluid-loss might cause left ventricular outflow tract obstruction and life-threatening myocardial ischaemia. patients with congenital disorder of glycosylation type Ia are at risk for cardiac complications and should be monitored regularly by echocardiography.- - - - - - - - - - ranking = 0.5keywords = life (Clic here for more details about this article) |
5/26. Posterior non-ischemic left ventricular aneurysm. Report of 2 surgical cases.Posterior non-ischemic left ventricular aneurysms are unusual aneurysms of different etiology that develop adjacent to the mitral valve annulus causing mitral regurgitation and progressive heart failure. Surgical correction is mandatory and involves repair of the aneurysm along with repair or replacement of the mitral valve. Two cases of posterior non-ischemic left ventricular aneurysms are reported. Both patients were females (19 and 9 years old) and they presented with symptoms of progressive heart failure. Definite diagnosis was made with transesophageal echocardiography (TEE) and confirmed with left ventriculography. Both patients were successfully treated by surgery. The first patient underwent repair of the aneurysm from inside the left ventricle and mitral valve replacement. The second patient had resection of the aneurysm through an extracardiac route. Both patients are in NYHA class 1, 5 and 4 years respectively after their operation with no evidence of mitral valve dysfunction. Posterior non-ischemic left ventricular aneurysms can securely be diagnosed by TEE and angiocardiography. Surgical treatment is mandatory in order to forestall potential life threatening cardiovascular events and should be tailored to the operative findings.- - - - - - - - - - ranking = 0.5keywords = life (Clic here for more details about this article) |
6/26. Myocardial ischaemia precipitated by acute normovolaemic haemodilution.Acute normovolaemic haemodilution (ANH) is widely used as part of a blood conservation strategy to minimize the use of allogenic blood in the peri-operative period. Its role has not been proven in a prospective randomized trial. The potential benefits must not blind clinicians to the possible hazards. We report a life-threatening complication of ANH prior to induction of anaesthesia for aortic aneurysm repair.- - - - - - - - - - ranking = 0.5keywords = life (Clic here for more details about this article) |
7/26. Tc-99m sestamibi myocardial imaging at rest for evaluation of cocaine-induced myocardial ischemia and infarction.Many clinical cases of cocaine-induced myocardial infarction have been reported in the literature. Of the reported cases, patients tend to be young (in the third decade of life), chronic abusers with myocardial infarction typically involving the anterior left ventricular wall. This case report demonstrates the usefulness of two-phase (symptomatic and asymptomatic) Tc-99m sestamibi myocardial imaging at rest for definitive diagnosis of cocaine-induced myocardial ischemia and infarction.- - - - - - - - - - ranking = 0.5keywords = life (Clic here for more details about this article) |
8/26. Anomalous origin of the coronary arteries from the pulmonary trunk in two separate patients with a review of the clinical implications and current treatment recommendations.Anomalous origin of a coronary artery from the pulmonary artery (PA) is an unusual abnormality. These anomalies are often hemodynamically significant and can lead to myocardial ischemia, myocardial infarction, and sudden cardiac death. Anomalous origin of the left coronary artery (LCA) from the pulmonary trunk is known as Bland-White-Garland syndrome and causes death in 80% to 85% of affected children in the first year of life. Treatment of the LCA arising from the PA is typically surgical, with ligation and reimplantation of the LCA to the aorta. In contrast, origination of the right coronary artery from the PA is usually a benign anomaly, although clinically significant sequelae can develop. Controversy exists regarding the need to intervene in the cases of patients with this usually incidentally discovered anomaly. We review the clinical presentation and treatment of patients with each anomaly and the current recommendations regarding the clinical course and management of such patients.- - - - - - - - - - ranking = 0.5keywords = life (Clic here for more details about this article) |
9/26. Coronary artery angioplasty for treatment of peri-operative myocardial ischaemia.Increasing numbers of elderly patients with severe co-existing medical diseases undergo major surgery. With these patients there is also an accompanying risk of age-related cardiovascular complications such as life-threatening myocardial ischaemia. We present a patient who suffered a myocardial infarction after a hemicolectomy and suffered a cardiac arrest in the recovery room. The therapeutic options available (e.g. coronary artery bypass grafting, acute percutaneous coronary angioplasty and peri-operative thrombolysis) are discussed and the successful management of the case by coronary angioplasty and stent implantation is described.- - - - - - - - - - ranking = 0.5keywords = life (Clic here for more details about this article) |
10/26. Long term retention and excretion of 201Tl in a patient after myocardial perfusion imaging.201Tl is widely used in nuclear medicine to carry out myocardial perfusion imaging (MPI). However, very limited data is available on long-term distribution in the body, excretion and corresponding dose. In this study we performed a 2 month follow-up of a patient who underwent MPI, by urine analysis and in vivo measurements. The biological half-life of thallium was consequently estimated to be 11.6-27 d, which is in partial agreement with previous studies. We also estimated excretion and retention of 200Tl, 201Tl and 202Tl isotopes using the biokinetic parameters from ICRP publication 53 and compared the forecast result with actual measurements. The latter demonstrated a higher urinary excretion and a higher body retention than what was expected. Our results therefore suggest that the long-term retention and consequently the effective dose coefficient for 201Tl considered in ICRP publications 53 and 80 may be slightly underestimated.- - - - - - - - - - ranking = 0.5keywords = life (Clic here for more details about this article) |
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