International journal of cardiology
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Letter Case Reports
Latent left ventricular outflow tract obstruction induced by abnormal hypertrophic papillary muscle caused myocardial ischemia.
Left ventricular outflow tract (LVOT) obstruction is a typical recognized feature in hypertrophic cardiomyopathy. However, it has been shown in other clinical scenarios such as acute ischemia. ⋯ Accurate and timely diagnosis, therefore, relies on recognizing an echocardiographic substrate in which LVOT obstruction may occur, such as ventricular hypertrophy. This report describes the case of a patient presenting with effort ECG and signs of myocardial ischemia, with no significant narrowing of coronary arteries but with latent LVOT obstruction due to the presence of an abnormal hypertrophic papillary muscle instead of a typical ventricle hypertrophy.
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Letter Case Reports
Acute subarachnoid haemorrhage as a precipitant for takotsubo cardiomyopathy: a case report and discussion.
Takotsubo cardiomyopathy is a recently recognised acute cardiac entity. It involves transient left ventricular apical ballooning, which is usually preceded by an episode of physiological or emotional stress. ⋯ Precipitating factors vary widely, including acute medical conditions and emotional stressors. We present a case of takotsubo cardiomyopathy precipitated by acute subarachnoid haemorrhage, the first report of this association in a Caucasian patient, and discuss the implications for clinicians involved in the management of such a case.
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There is a relationship between obstructive sleep apnea (OSA) and heart failure (HF). Peak oxygen consumption (peak VO(2)), heart rate recovery, and N-terminal-pro-BNP (NT-proBNP) are strong prognostic predictors in HF. The effects of nasal continuous positive airway pressure (nCPAP) on these parameters in OSA patients are not well defined. ⋯ Treatment with nCPAP is associated with an improvement in peak VO(2) and heart rate recovery in patients with OSA.
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Medical practice is moving fast towards non-invasive and non-surgical disease management. While significant progress has been made with coronary artery disease prevention, MDCT stands as an ideal non-invasive tool for its progression. ⋯ Although the main concern of current cardiology practice is the coronary stenotic disease, arterial wall calcification itself may significantly contribute to patients' symptoms. Thus, in addition to the beneficial use of MDCT in patients with mild to moderate risk for coronary disease, the unique information it provides on wall disease may assist the management of symptomatic patients with no flow-limiting lesions.
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Takotsubo cardiomyopathy is recently defined reversible left ventricular dysfunction and apical ballooning resembling acute myocardial infarction. Although electrocardiographic, echocardiographic, biochemical and clinical findings indicate a possible acute coronary syndrome, coronary angiography reveals normal epicardial coronary arteries without any obstructing lesion. Here we describe a 52 year old woman admitted with chest pain and ST elevation with mildly increased cardiac enzymes. She was diagnosed as Takotsubo cardiomyopathy after 1 week of hospital stay and evaluation.