International journal of cardiology
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Case Reports
Two vascular arteriovenous malformations with left-to-right shunting and right-heart failure in a single patient.
Arteriovenous malformations may lead to right-heart failure in cases of hemodynamically significant left-to-right shunting. Here, we report the case of a 37-year-old female who presented with congestive heart failure related to an isolated anomalous connection of the left pulmonary vein to the left brachiocephalic vein (partial anomalous pulmonary venous connection). ⋯ Target embolization led to right-ventricular remodeling, and persistent clinical improvement. To our knowledge, this is the first report of two rare AV-malformations with left-to-right shunting and progressive right-heart failure in a single individual.
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Case Reports
Late asymptomatic sirolimus-eluting stent fracture in a female with systemic lupus erythematosus.
We report a case of a sirolimus eluting (Cypher, Johnson-Johnson) stent fracture (SF) incidentally depicted 3 years post PCI in an asymptomatic female with systemic lupus erythematosus (SLE). The vessel was assessed with intravascular ultrasound (IVUS) and optical coherence tomography (OCT). Different imaging modalities results are presented. OCT may offer superior imaging of SF compared to fluoroscopy and IVUS and might prove useful for the detailed assessment and tailored treatment of this rare complication.
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Letter Comparative Study
How to explain the reduced cardiovascular mortality in the ticagrelor arm of the PLATO trial?
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Conventional echocardiography has limited accuracy in detecting diastolic dysfunction and NT-proBNP is known to be a reliable biomarker to rule out heart failure. Therefore NT-proBNP on top to conventional mitral flow Doppler might improve the diagnostic of diastolic dysfunction in patients with heart failure despite normal EF (HFNEF) without using tissue Doppler. ⋯ Plasma NT-proBNP levels are associated with increased LV stiffness and cardiac collagen content. On top measurements of plasma NT-proBNP improve the echocardiography diagnostic of diastolic function and prognostic of rehospitalization in HFNEF.
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Letter Case Reports
Instantaneous electrocardiographic changes and transient sinus rhythm restoration in severe hyperkalaemia.
Severe hyperkalaemia is a life threatening electrolyte abnormality that if not treated urgently, might cause electric death. Hyperkalaemia induced electrocardiogram (ECG) alterations vary according to the levels and rate of increase of potassium concentration ([K(+)]) in the extracellular milieu but the paradox is that not all these cases provide ECG changes. We describe the first case in the literature of transient sinus rhythm (SR) recovery despite severe hyperkalaemia in a 57-year-old (yo) male patient with impressive ECG changes considering the heart rhythm and QRS morphology. We also review the literature for the mechanism of ECG alterations induced by hyperkalaemia.