Acta cardiologica
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Review Case Reports
Intimal sarcoma of the pulmonary artery--diagnostic challenge.
Pulmonary artery intimal sarcoma is a rare tumour and the diagnosis is often delayed. We report the case of a woman with a primary pulmonary artery intimal sarcoma who presented with massive pulmonary embolism. The definitive diagnosis was elucidated after the patient's death by autopsy specimen. We discuss the diagnosis and lessons learned from this case.
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Randomized Controlled Trial
Prophylactic intra-aortic balloon pump reduces C-reactive protein levels and early mortality in high-risk patients undergoing percutaneous coronary intervention.
Intra-aortic balloon pump (IABP) plays a pivotal role in the treatment of cardiogenic shock complicating acute myocardial infarction. However, the usefulness of prophylactic IABP support in high-risk patients during percutaneous coronary intervention (PCI) is still controversial, and its influence on the inflammatory response following PCI has not been well evaluated. In this study we sought to assess the impact of prophylactic IABP support upon C-reactive protein (CRP) level and clinical prognosis in high-risk patients undergoing PCI. ⋯ The use of a prophylactic IABP in high-risk patients before PCI could reduce the CRP level and reduce mortality during the early phase following PCI.
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The exact causes of death in India are not known because autopsy studies are difficult to conduct due to religious considerations. There are rapid changes in diet and lifestyle amongst social classes causing changes in the pattern of risk factors and mortality. In the present study, we attempt to develop a verbal autopsy questionnaire based on medical records and interview of a family member, for the assessment of causes of death, social class, tobacco consumption and dietary intakes among urban decedents in north India. ⋯ This study indicates that causes of death, social class, tobacco and dietary intakes, can be accurately assessed by a modified verbal autopsy questionnaire based on medical records and by interview of family members. Circulatory diseases, injury-accidents and maligant diseases have become the major causes of death in India, apart from infections.
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Domperidone is a dopamine antagonist with anti-nausea and anti-emetic activity. There have been several reports of sudden cardiac death (SCD) associated with the compound. Recently it was estimated to increase SCD nearly fourfold. I therefore tested domperidone for liability of cardiac repolarization disturbances (triangulation, reverse use dependence, instability and dispersion or TRIaD) and induction of arrhythmias. ⋯ In light of these new preclinical and of recent clinical warnings, domperidone should best be restricted to patients in whom its benefit is proven to justify the risks. Availability without prescription and advertising as an 'innocent' relief is incorrect and unsafe, and needs to be reconsidered.