International journal of cardiology
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Modern coronary care unit interventions have not reduced the high mortality rate associated with cardiogenic shock due to acute myocardial infarction. Results with thrombolytic therapy have also been disappointing because of poor infarct artery patency rates in a low coronary flow state. ⋯ Intraaortic balloon counterpulsation provides temporary hemodynamic and clinical improvement in the majority of patients with cardiogenic shock. The use of intraaortic counterpulsation to augment patency rates with thrombolytic therapy or to stabilize patients for transfer to a hospital with angioplasty services appears to be a promising strategy for hospitals without an interventional cardiac catheterization laboratory.
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Review Case Reports
Group B streptococcal tricuspid valve endocarditis: a case report and review of literature.
Group B streptococcal endocarditis involving the tricuspid valve is an uncommon disease. We describe herein a young healthy woman who developed this disease following an elective abortion. She was treated with penicillin and gentamycin with no response. ⋯ Five of them were IV drug abusers, four patients suffered from debilitating diseases and in five women endocarditis developed following an obstetric procedure. In general the mortality from tricuspid valve endocarditis is low, indeed 2/13 (15%) died. The drug of choice is penicillin with gentamycin.
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We describe a patient with a deep vein thrombosis causing multiple pulmonary emboli. After inferior vena cava filter insertion, a large embolus was trapped by the filter. Anticoagulation following filter insertion decreased the pulmonary artery pressure, and there was no recurrence of pulmonary embolization. Thus, in the presence of large, multiple thrombi in the proximal veins, inferior vena cava filter had better be inserted before thrombolytic treatment to prevent a lethal pulmonary embolism, and anticoagulant therapy is important after filter insertion.