International journal of cardiology
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Letter Case Reports
Prolonged cardiogenic shock caused by a high-dose intravenous administration of dopamine in a patient with takotsubo cardiomyopathy.
We report a patient with takotsubo cardiomyopathy in whom cardiogenic shock continued with a high intraventricular pressure gradient (IVPG) under a high-dose intravenous administration of dopamine and in whom cessation of the administration improved the hemodynamics dramatically. The present case report suggests that the administration of dopamine may lead to further hemodynamic deterioration in patients with takotsubo cardiomyopathy who exhibits an IVPG.
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People of Chinese ethnicity make up one of the largest populations in the world. Heart and vessel diseases remain the leading cause of morbidity and mortality in China. The research status in cardiology and cardiovasology among Chinese individuals in the three major regions of China--Mainland (ML), Hong Kong (HK) and Taiwan (TW)--are unknown. The outputs of cardiology and cardiovasology articles published in international journals from the three regions were compared in this study. ⋯ The total number of articles from the three major regions of China increased significantly from 1998 to 2007. The number of articles published per year from the ML have exceeded those from TW and HK. However, the quality of articles from TW and HK is better than that from ML.
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Comment Letter
Atrial fibrillation: adverse effects of "pill-in-the-pocket" treatment and propafenone-carvedilol interaction.
Propafenone and carvedilol share a common hepatic metabolism involving the oxidative pathway (CYP2D6). Therefore, oral loading with propafenone (as "pill-in-the-pocket" treatment of recent-onset atrial fibrillation) in a patient on concurrent carvedilol treatment may lead to a pharmacokinetic interaction, with high plasma levels of propafenone and potential drug-related adverse effects. In clinical practice, in order to improve the safety of "pill-in-the-pocket" treatment, use of propafenone loading should, in our view, be discouraged in patients on concurrent treatment with carvedilol.
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Letter Case Reports
Cardiac arrest caused by Barlow's syndrome or by stress cardiomyopathy?
We describe a case of out-of-hospital Cardiac Arrest (CA) in a patient with Barlow's Syndrome (BS) and features of Stress Cardiomyopathy (SC) (or Apical Ballooning Syndrome or Tako-Tsubo). The patient experienced CA during physical stress and was resuscitated thanks to DC-Shock. The Electrocardiogram (ECG) after resuscitation was unremarkable. ⋯ In conclusion it is impossible to say if, in our patient, the CA has been caused by BS or by SC. However, even if CA has been probably caused by the BS, we hypothesize that the CA, in its turn determined, might have caused the SC via stress mechanisms. In few words, the CA is a complication of SC, but should probably be regarded also as a cause of SC.