Cardiology
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It was the aim of this study to investigate the effect of ZP123 on prolonged ventricular fibrillation (VF) in swine. ⋯ In prolonged VF, ZP123 could decrease the defibrillation threshold and improve the rate of successful defibrillation. However, it could not improve the rate of ROSC - which may be due to its side effect of decreasing VF(ma).
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Chemotherapy-induced pericarditis has been reported in a limited number of case series. Furthermore, the management of acute pericarditis associated with chemotherapy is not standardized. In a few case reports, pericarditis associated with chemotherapy has been treated with pericardiocentesis or anti-inflammatory drugs such as steroid or nonsteroidal anti-inflammatory drugs. ⋯ We maintained colchicine when the patient required repeated chemotherapy for relapsed leukemia. And the concomitant use of colchicine prevented the patient from the full development of acute pericarditis. Colchicine may be effective in the treatment and prevention not only of idiopathic recurrent pericarditis but also of acute pericarditis associated with chemotherapy as in this case.
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Case Reports
Unplanned staged hybrid management of postmyocardial infarction ventricular septal defect.
Ventricular septal defect (VSD) is an uncommon but potentially deadly complication of transmural myocardial infarction (MI). Emergency surgical treatment has traditionally offered the best chance for survival. ⋯ Percutaneous catheter-based closure techniques can be used to treat these critically ill patients, offering a less invasive and less morbid technique. This case demonstrates the successful application of an unplanned, staged hybrid approach utilizing initial percutaneous and subsequent surgical repair after recovery of tissue integrity.
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The natural history of pericardial effusions attributable to renal disease is variable. Although aggressive hemodialysis may lead to the resolution of some effusions, some reports suggest that prompt drainage is optimal. We describe a case of a 49-year-old woman who presented with end-stage renal disease and a large pericardial effusion. ⋯ The onset of dyspnea during a session of dialysis as a symptom of tamponade physiology has not been reported previously. We believe that this case supports early pericardiocentesis in patients with any degree of echocardiographic evidence of tamponade. We discuss this in the context of existing literature, which suggests that pericardiocentesis, rather than dialysis, is the preferred management strategy for large uremic pericardial effusions, even in the absence of evidence of clinical signs of pericardial tamponade.
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Subarachnoid hemorrhage (SAH) has been associated with electrocardiographic (ECG) changes, arrhythmias, and release of cardiac enzymes. Recently, Takotsubo cardiomyopathies, presenting typical ECG changes and left ventricular (LV) regional wall-motion abnormalities (RWMAs), have been reported and considered to be a result of high norepinephrine (NE) levels. We hypothesized that ST-T-wave changes in patients with SAH may be manifestations of Takotsubo cardiomyopathy and associated with RWMAs. ⋯ Although ECG abnormalities are frequently seen in SAH patients, the incidence of RWMAs is very low. Electrocardiographic manifestations in patients with SAH and Takotsubo cardiomyopathy are similar, but ECG abnormalities in patients with SAH are mostly not related to LV dysfunction.