International journal of cardiology
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Letter Case Reports
Revelation of Brugada electrocardiographic pattern during a febrile state associated with acute myocardial infarction.
The prevalence of the Brugada-type ECG and its natural history are still unclear. The Brugada syndrome is usually identified by a characteristic Brugada-type ECG that consists of ST elevation of a coved type in the precordial leads V1 to V3 and ventricular fibrillation that can lead to sudden cardiac death, although affected individuals may have a normal ECG. Mutations in the cardiac sodium channel gene SCN5A, which encodes the alpha-subunit of the human cardiac voltage-dependent Na+ channel (Na(v)1.5), are identified in 15-30% of patients with Brugada syndrome. ⋯ It has been also reported chest pain and ST elevation Brugada pattern during febrile states. We present a case of revelation of Brugada pattern in a 69-year-old Italian man during a febrile state associated with acute myocardial infarction. Also this report confirms that Brugada pattern should be considered as one of differential diagnoses when we examine the patients during a febrile state.
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Kounis syndrome is potentially a life-threatening medical emergency with both a severe allergic reaction and acute coronary syndrome. Most of the information about this syndrome has come from the case reports. ⋯ We have summarized our recommendations for the work-up and treatment of Kounis syndrome from available data. Obviously, larger prospective studies are needed to establish definitive treatment guidelines for these patients.
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Letter Comparative Study
Impedance cardiography versus invasive measurements of stroke volume index in patients with chronic heart failure.
We assessed the hypothesis that non-invasive measurement of stroke volume index can replace invasive measurements in patients with chronic heart failure. Non-invasive impedance cardiography (ICG) measurements together with invasive hemodynamic thermodilution (TD) measurements were performed in 13 patients with severe chronic heart failure (NYHA III-IV). ⋯ Correlation between non-invasive and invasive hemodynamic measurements was low (r=0.29). In conclusion, non-invasive measurements of stroke volume index using impedance cardiography did not result in sufficient agreement with invasive thermodilution measurements in this study with patients suffering from severe chronic heart failure.
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Limited data are available on long-term mortality and morbidity of patients with chronic obstructive pulmonary disease (COPD) and ischemic heart disease. We examined how COPD affects long-term mortality and morbidity after undergoing percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG). ⋯ COPD is an independent risk factor for long-term cardiac and cardiovascular mortality in patients with ischemic heart disease.
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To evaluate the utility of plasma BNP measurement in the long term follow-up of patients with surgically repaired tetralogy of Fallot (TOF). ⋯ In patients with surgically repaired TOF, plasma BNP is significantly correlated with right ventricular volume load. In clinical practice a considerable overlap limits the estimation of right ventricular volume load by BNP, but longitudinal evaluation helps to appoint the appropriate timing of pulmonary valve replacement.