International journal of cardiology
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Comparative Study
Serum blood urea nitrogen and long-term mortality in acute ST-elevation myocardial infarction.
Renal dysfunction is associated with increased mortality in acute coronary syndromes and other cardiovascular diseases. The prognostic value of kidney dysfunction has been investigated using creatinine-based measures of renal function. Few data are available on the prognostic significance of blood urea nitrogen (BUN), a sensitive marker of hemodynamic alterations and renal perfusion. ⋯ Elevated BUN and BUN/creatinine ratio on admission are independent predictors of long-term mortality in patients with STEMI. An increase in BUN level during hospital course portends adverse outcome independent of eGFR and BUN on admission.
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Letter Case Reports
Ventricular outflow tract obstruction, systolic anterior motion and acute mitral regurgitation in Tako-Tsubo syndrome.
Tako-Tsubo syndrome is characterized by ECG changes mimicking acute myocardial infarction, left ventricular wall motion abnormalities in the apical region with preserved function of base, and normal coronary arteries. We report the cases of two old women, presenting apical akinesis, basal hyperkinesis, severe systolic dysfunction and severe mitral regurgitation (MR). ⋯ The patients recovered and, early later, left ventricular ejection fraction was documented as normal at echocardiography. The contemporary presence of LVOTO, SAM and MR might explain worsening of heart failure or incidence of cardiogenic shock in some patients with Tako-Tsubo syndrome.
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Letter Case Reports
Isolated severe tricuspid regurgitation: the importance of identifying underlying mechanism.
An 88-year-old woman presented with right heart failure, history of diarrhoea, abdominal pain, weight lost, dyspnoea over several weeks and a new pan-systolic murmur. Echocardiography showed retracted tricuspid leaflets with incomplete coaptation resulting in severe regurgitation. ⋯ The unifying diagnosis was carcinoid syndrome for which she was treated. Echocardiography is an important tool for diagnosis, management and prognosis of carcinoid heart disease.
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Letter Case Reports
Hypernatremia in a patient with cyanotic congenital heart disease.
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Randomized Controlled Trial
The effect of double dose of omeprazole on the course of angina pectoris and treadmill stress test in patients with coronary artery disease--a randomised, double-blind, placebo controlled, crossover trial.
Gastroesophageal reflux (GER) and coronary artery disease (CAD) frequently overlap, making the proper diagnosis of chest pain more difficult. GER symptoms may mistake anginal chest pain, and oesophageal acidification may induce myocardial ischaemia both in the rest and in the effort. Increase of oesophageal pH should prevent these conditions. ⋯ Double dose of omeprazole significantly decreased symptoms severity in 35% of patients with CAD, as well as frequency of some electrocardiographic signs of myocardial ischaemia during stress test.