Journal of cardiology
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Journal of cardiology · Feb 2004
Case Reports[Tako-tsubo-like transient left ventricular dysfunction with apical thrombus formation: a case report].
A 76-year-old woman with oppressive chest pain was admitted to our hospital. Initial electrocardiography revealed normal sinus rhythm with ST-segment elevation in leads V2-V5. The patient underwent emergent coronary angiography, which demonstrated no significant coronary stenosis. ⋯ Left ventricular function normalizes within several days or weeks in most cases of tako-tsubo-like transient left ventricular dysfunction. Therefore, if the thrombus remains within the left ventricle, the risk of embolism might be relatively high. Careful management must be required in patients with tako-tsubo-like transient left ventricular dysfunction.
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Journal of cardiology · Jan 2004
Case Reports[Acute myocardial infarction due to septic emboli in a patient with severe pneumonia: a case report].
A 77-year-old man presented with acute anterior myocardial infarction and cardiogenic shock. We successfully performed coronary angioplasty and stenting with intra-aortic balloon pumping for a proximal lesion of the left anterior descending artery, which supplied the territory of the totally occluded right coronary artery. He also had pneumonia resistant to antibiotic therapy. ⋯ Postmortem histological examination demonstrated multiple septic emboli with neutrophil infiltration, resulting in myocardial infarctions. There was no occlusion at the stenting site. Severe pneumonia was found in both lungs, which may have been the embolic source in this case.
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Journal of cardiology · Dec 2003
Rhythm-independent feature of heart rate dynamics common to atrial fibrillation and sinus rhythm in patients with paroxysmal atrial fibrillation.
To examine if the long-range correlation in heart rate variability is a rhythm-independent characteristic common to both atrial fibrillation (AF) and sinus rhythm (SR) periods in patients with paroxysmal atrial fibrillation (PAF). ⋯ The long-range correlation in heart rate variability during sleep was a rhythm-independent characteristic and so may have a similar clinical value during atrial fibrillation and sinus rhythm in patients with paroxysmal atrial fibrillation.
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Journal of cardiology · Jun 2003
Case Reports[Cauliflower-like giant left atrial thrombus successfully treated by anticoagulants without systemic complication: a case report].
A 64-year-old woman with hypertension presented with a left atrial giant mass during the treatment of congestive heart failure. She was admitted to our hospital for intensive treatment. Transesophageal echocardiography demonstrated a cauliflower-like, large (3 x 2 cm), mobile echogenic mass attached to the left atrial wall. ⋯ She remained asymptomatic during the anticoagulant therapy. The diagnosis was thrombus based on the response to treatment. Surgical removal should be considered for such a large thrombus, but the present case of giant thrombus was successfully treated by anticoagulants without systemic complication.
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Journal of cardiology · Mar 2003
[Efficacy of Nifekalant hydrochloride for life-threatening ventricular tachyarrhythmias in patients with resistance to lidocaine: a study of patients with out-of-hospital cardiac arrest].
Class I antiarrhythmic agents are not always effective in the treatment of life-threatening ventricular tachycardia/ventricular fibrillation (VT/VF) especially in patients with cardiopulmonary arrest. Nifekalant hydrochloride(NIF) is a novel class III antiarrhythmic agent for malignant VT/VF. This study prospectively evaluated NIF efficacy for life-threatening VT/VF observed after cardiopulmonary arrest. ⋯ NIF effectively suppresses VT/VF which is refractory to direct current shock in patients with cardiopulmonary arrest. However, NIF may rather worsen electrophysiological function in the sinus node after administration of high doses of epinephrine, and may induce sinus bradycardia and/or sinus arrest. Careful observation, such as monitoring of electrocardiography and blood pressure and temporary cardiac pacemaker use, is needed to prevent death in patients surviving after cardiopulmonary arrest if NIF is administered following high dose epinephrine infusion.