International journal of cardiology
-
Letter Case Reports
Takotsubo cardiomyopathy--a new variant and widening disease spectrum.
Classic takotsubo cardiomyopathy had left ventricular apical ballooning. Variants with mid-ventricular ballooning without involvement of the apex have been described. We describe a new variant of takotsubo cardiomyopathy where apical contraction was preserved while the rest of the ventricle was dyskinetic.
-
Aortic valve stenosis is known to be associated with loss of high molecular von Willebrand multimers. This can lead to gastrointestinal bleeding in patients with gastrointestinal angiodysplasia, the Heyde syndrome. Here we present a case of anaemia and severe epistaxis associated with acquired von Willebrand syndrome. ⋯ Calcifying aortic stenosis was confirmed by echocardiography. Loss of high molecular weight multimers of von Willebrand factor in our patient was shown by immunoblot analysis. If severe epistaxis occurs in the context of symptomatic aortic valve stenosis, it might be an additional reason to recommend valve replacement surgery to the patient.
-
The occurrence of eccentric retrograde atrial activation has been demonstrated to be from 6 to 8% in patients with atrioventricular nodal reentrant tachycardia (AVNRT) by several previous reports. However, most of those reports were limited by the absence of coronary sinus venography to confirm if the retrograde activation was truly left sided. The purposes of this study were to 1) determine the incidence of left sided retrograde atrial activation in our center, 2) determine the specific electrophysiologic characteristics of eccentric and concentric atrial activation and 3) determine the outcome of radiofrequency catheter ablation for AVNRT with eccentric retrograde atrial activation. ⋯ This study demonstrated the different electrophysiologic characteristics between the AVNRT patients with eccentric and concentric retrograde atrial activation. Successful ablation sites were similar to the standard RA ablation sites in patients with retrograde eccentric conduction.
-
Comparative Study
Benefit of direct ambulance to coronary care unit admission of acute myocardial infarction patients undergoing primary percutaneous intervention.
Early reperfusion therapy in ST-segment elevation myocardial infarction (STEMI) patients improves left ventricular (LV) function and survival. However, emergency room (ER) triage may unnecessarily delay this time-dependent treatment. We sought to determine whether direct admission of STEMI patients from the mobile intensive care units to the intensive coronary care unit (ICCU), bypassing the ER, can shorten the time intervals for primary PCI (PPCI) and improve prognosis. ⋯ Directly admitted STEMI patients differ from patients admitted via the ER; Direct ICCU admission, based on a pre-hospital ECG, can substantially shorten time to treatment.
-
Controlled Clinical Trial
Pre-hospital detection of acute myocardial infarction with ultra-rapid human fatty acid-binding protein (H-FABP) immunoassay.
To evaluate the diagnostic performance of a portable semi-quantitative whole blood immunoassay measuring soluble human fatty acid-binding protein [H-FABP] (CardioDetect) for the pre-hospital detection of myocardial infarction (MI). ⋯ Early assessment of H-FABP in patients presenting with chest pain improves the diagnosis of ongoing MI.