Journal of cardiovascular pharmacology and therapeutics
-
J. Cardiovasc. Pharmacol. Ther. · Jun 2005
Case ReportsElevated troponins and the Churg-Strauss syndrome: a case report.
In a patient with persistently elevated troponin levels but normal ischemic work-up, a diagnostic dilemma can ensue. This is the case of a 65-year-old woman whose only cardiac risk factor was age. ⋯ Eosinophilia from CSS can lead to multi-organ damage including the heart. Therefore, one must consider CSS in the differential of eosinophilia as early detection and treatment may be critical in decreasing morbidity and mortality.
-
J. Cardiovasc. Pharmacol. Ther. · Mar 2005
Case ReportsSuccessful treatment of hypotension associated with stunned myocardium with oral midodrine therapy.
Myocardial stunning, a reversible decrease in the contractile function of the myocardium after an ischemic insult, often leads to hypotension that requires therapy with intravenous inotropes. We used the oral agent midodrine to treat hypotension that complicated myocardial stunning after successful revascularization with percutaneous coronary intervention in the setting of myocardial infarction and ischemia. Oral midodrine may offer a useful substitute to intravenous inotropic therapy and can shorten the duration of intensive care unit and hospital stay in this setting.
-
J. Cardiovasc. Pharmacol. Ther. · Dec 2004
Monocyte chemoattractant protein 1-induced monocyte infiltration produces angiogenesis but not arteriogenesis in chronically infarcted myocardium.
Monocyte chemoattractant protein 1 (MCP-1) stimulates the invasion of monocytes into ischemic tissue with concomitant adhesion to endothelial cells. Monocyte stimulation has been shown to be involved in the induction of arteriogenesis, which is the development of functional arterioles resulting in improvement of perfusion. However, angiogenesis (newly developed capillaries contribute to improved tissue perfusion) in several models has not resulted in any improvement in blood flow. ⋯ A single intramyocardial injection of MCP-1 into the infarct border zone resulted in neo-angiogenesis and monocyte infiltration but not arteriogenesis in the rat heart. There was no functional change of chronically infarcted myocardium in the present model.
-
J. Cardiovasc. Pharmacol. Ther. · Sep 2004
Review Comparative StudyCurrent medical management of chronic stable angina.
Severe atherosclerotic narrowing of one or more coronary arteries is responsible for myocardial ischemia and angina pectoris in most patients with stable angina. The coronary arteries of patients with stable angina also contain many more non-obstructive plaques, which are prone to rupture resulting in acute coronary syndrome (unstable angina, myocardial infarction, sudden ischemic death). Therefore, the medical management must use strategies which not only relieve symptoms and prolong angina free walking but also reduce the incidence of adverse clinical outcomes. ⋯ Newer medical therapies such as metabolic modulators and sinus rate lowering drugs also hold promise but need further evaluation. Patients who have refractory angina despite optimal medical therapy and are not candidates for revascularization procedures may be candidates for some new techniques of enhanced external Counterpulsation, Spinal Cord Stimulation, sympathectomy or direct transmyocardial revascularization. The usefulness of these techniques, however, needs to be confirmed in large randomized trials.
-
J. Cardiovasc. Pharmacol. Ther. · Sep 2004
Case ReportsAortic dissection: a dreaded disease with many faces.
Aortic dissection is a relatively uncommon but catastrophic illness classically thought to present with acute, sharp, chest pain with radiation to the back. However, aortic dissection can manifest in a number of different ways that include congestive heart failure, inferior myocardial infarction, stroke, focal pulse and neurologic deficits, abdominal pain, or acute renal failure. ⋯ Many patients later found to have aortic dissection are initially suspected to have other conditions such as acute coronary syndrome, pericarditis, pulmonary embolism, or even cholecystitis. In this article we present a case of an unusual presentation of aortic dissection and a review of this condition.