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Articles 1 - 10 of 10
Full-Text Articles in Cardiology
Stemi In A Young Patient With Covid-19; Too Great A Burden?, Naman Upadhyay, Md, Gillian Naro, Md, Med, Gregary Marhefka, Md
Stemi In A Young Patient With Covid-19; Too Great A Burden?, Naman Upadhyay, Md, Gillian Naro, Md, Med, Gregary Marhefka, Md
The Medicine Forum
Myocardial infarcts (MIs) can be especially devastating when their pathogenesis stems from a coronary artery occlusion by an intracoronary thrombus (ICT). ICTs are most frequently a result of an underlying atherosclerotic plaque rupture, however, can also be a result of emboli, vasospasm, hypercoagulable states, among other etiologies. Patients suffering from the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) appear to be in both a hypercoagulable and proinflammatory state resulting in an increased risk of clot formation, endothelial damage, and plaque destabilization, thus increasing the ICT burden in infected patients.1 The literature does reflect an increase in ICT ST-segment elevation …
Acute Mitral Regurgitation Presenting With Right Upper Lobe Opacification, John Wallis, Md, Mark Decaro, Md
Acute Mitral Regurgitation Presenting With Right Upper Lobe Opacification, John Wallis, Md, Mark Decaro, Md
The Medicine Forum
We describe a rare entity in which acute mitral regurgitation causes asymmetric findings on chest radiograph. The patient presented with rapid-onset respiratory failure from flash pulmonary edema. She had unilateral infiltrates on chest radiograph, which evoked infectious etiology. However, we identified a flail mitral valve leaflet, for which the patient received an emergent mitral valve replacement. Fortunately, she made a full recovery. We discuss the mechanism of the asymmetric chest radiograph findings, which we were able to confirm using a transesophageal echocardiogram.
Effusive-Constrictive Pericarditis Due To Poorly Differentiated Carcinoma Of The Mediastinum, John Wallis, Md, Naman Upadhyay, Md, Fred Karaisz, Md, Mark Decaro, Md, René Alvarez, Md
Effusive-Constrictive Pericarditis Due To Poorly Differentiated Carcinoma Of The Mediastinum, John Wallis, Md, Naman Upadhyay, Md, Fred Karaisz, Md, Mark Decaro, Md, René Alvarez, Md
The Medicine Forum
A 33-year-old male developed subacute effusiveconstrictive pericarditis with recurrent pleural effusions and mediastinal lymphadenopathy. He was found to have poorly differentiated carcinoma of the mediastinum that led to constrictive physiology not amenable to medical or surgical management, ultimately requiring hospice. This case was remarkable for its rare etiology and presentation.
Heart Failure With Preserved Ejection Fraction: A Review Of The Acc/Aha Guidelines And Evidence-Based Management Strategy, Vikas Sunder, Md
Heart Failure With Preserved Ejection Fraction: A Review Of The Acc/Aha Guidelines And Evidence-Based Management Strategy, Vikas Sunder, Md
The Medicine Forum
Introduction
Heart failure with preserved ejection fraction (HFpEF) is a clinical syndrome in which a patient has signs and symptoms of heart failure including dyspnea, fatigue, pulmonary rales, peripheral edema and an ejection fraction greater than 50%.1-4 Approximately half of patients with heart failure have a preserved ejection fraction.2-5 HFpEF is considered a distinct clinical entity from other causes of heart failure with a preserved ejection fraction such as valvular heart disease, pericardial disease, and infiltrative cardiomyopathy. HFpEF carries a poor prognosis, with an annual mortality of 29% in patients discharged after an acute decompensated heart failure admission.5 5-year survival …
Can Our Hearts Take The New Guidelines?, Eitan Frankel, Md
Can Our Hearts Take The New Guidelines?, Eitan Frankel, Md
The Medicine Forum
No abstract provided.
Limitations Of The Perioperative Cardiovascular Evaluation For Assessing Coronary Artery Disease: A Case Report, Rady Ho, Md, Mitul Kanzaria, Md, Paul Walinsky, Md
Limitations Of The Perioperative Cardiovascular Evaluation For Assessing Coronary Artery Disease: A Case Report, Rady Ho, Md, Mitul Kanzaria, Md, Paul Walinsky, Md
The Medicine Forum
INTRODUCTION
The American College of Cardiology (ACC) and the American Heart Association (AHA) publ ished pre-operative risk stratification guidelines in 2014. These guidelines have routinely been used by physicians to pre-operatively risk stratify patients. In this case report, a patient was found to have multi-vessel coronary artery disease post-operatively in the setting of unremarkable cardiac work-up preoperatively. This case highlights a limitation of the 2014 ACC/AHA guidelines.
Case Report: Diagnosis Of Dual-Biopsy Negative Severe Cardiac Amyloidosis, Kristin Lohr, Md, Eric Kasprowicz, Md
Case Report: Diagnosis Of Dual-Biopsy Negative Severe Cardiac Amyloidosis, Kristin Lohr, Md, Eric Kasprowicz, Md
The Medicine Forum
INTRODUCTION
Amyloidosis is a rare disorder that involves the deposition of misfolded protein in extracellular tissue. Disease manifestations vary depending on the affected organs. Areas most often involved include the kidneys, gastrointestinal tract, heart, nervous system, and musculoskeletal system. The most common type is AL amyloidosis, in which plasma cells produce an abundance of a monoclonal proteins that affect numerous organ systems. A second variety, AA amyloidosis, is associated with inflammatory diseases such as rheumatoid arthritis and inflammatory bowel disease. Finally, a heritable version of amyloidosis mediated by mutations in the transthyretin protein (TTR) has a predilection for deposition in …
Coronary Subclavian Steal Syndrome, Rady Ho, Md, Jonathan A. Dunn, Md
Coronary Subclavian Steal Syndrome, Rady Ho, Md, Jonathan A. Dunn, Md
The Medicine Forum
INTRODUCTION
Coronary subclavian steal (CSS) syndrome is a rare complication of coronary artery bypass graft surgery (CABG) involving the left internal mammary artery (LIMA) graft to the left anterior descending (LAD) artery. It results from stenosis of the left subclavian artery proximal to the LIMA, which compromises myocardial blood flow. The incidence of CSS syndrome is between 0.1-3.4% in the United States.1 Most cases occur as a result of long-standing subclavian stenosis due to progres-sion of the stenosis following CABG. We report a case of CSS syndrome, which presented as a non-ST elevation myocardial infarction (NSTEMI).
Allergic Inflammatory Mediated Coronary Artery Vasospasm: A Case Report Of Kounis Syndrome, Jonathan Hullman, Ms4, Jaehee Kim, Md, Gregary D. Marhefka, Md, Facc, Facp
Allergic Inflammatory Mediated Coronary Artery Vasospasm: A Case Report Of Kounis Syndrome, Jonathan Hullman, Ms4, Jaehee Kim, Md, Gregary D. Marhefka, Md, Facc, Facp
The Medicine Forum
INTRODUCTION
Kounis syndrome is an acute coronary syndrome occurring secondary to an anaphylactic reaction. A wide variety of triggers such as drugs and environmental exposures have been described for the so-called allergic myocardial infarction. The pathophysiology of Kounis syndrome is thought to be due to the release of inflammatory mediators such as histamine and cytokines by mast cells and eosinophils resulting in either coronary vasospasm, myocardial infarction or stent thrombosis.
Squamous Cell Carcinoma Metastatic To The Heart Mimicking St-Elevation Myocardial Infarction, Jason Chen, Md, Colin Craft, Md, Andrew W. Panakos, Md, Gregary D. Marhefka, Md, Facc, Facp
Squamous Cell Carcinoma Metastatic To The Heart Mimicking St-Elevation Myocardial Infarction, Jason Chen, Md, Colin Craft, Md, Andrew W. Panakos, Md, Gregary D. Marhefka, Md, Facc, Facp
The Medicine Forum
INTRODUCTION
Heart disease remains the leading cause of mortality in the United States, accounting for about one quarter of all deaths in 20131. Acute ischemic heart disease is a major subpopulation of this group, and typically presents with characteristic electrocardiographic (EKG) changes. The most concerning of these findings are ST-elevations, as ST Elevation Myocardial Infarction (STEMI) typically indicates the need for emergent reperfusion therapy because 30-day mortality of untreated STEMI is approximately 10-15% versus 5% in treated cases2. As a result, clinicians are taught to recognize the symptoms and signs of myocardial ischemia and STEMI in order to achieve timely …