Indian heart journal
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Indian heart journal · Jul 2013
Review Case ReportsStreptobacillus moniliformis endocarditis: case report and review of literature.
Rat bite fever is a rare infection and sometimes results in complications. This case report describes native mitral valve endocarditis in a 44-year-old male patient caused by Streptobacillus moniliformis. ⋯ The patient was treated with IV crystalline penicillin (6 weeks) and gentamicin (2 weeks). The fundamental importance of a high index of suspicion, interpreting investigations and appropriateness of therapy are highlighted.
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Indian heart journal · Jul 2013
ReviewST segment elevations: always a marker of acute myocardial infarction?
Chest pain is one of the chief presenting complaints among patients attending Emergency department. The diagnosis of acute myocardial infarction may be a challenge. Various tools such as anamnesis, blood sample (with evaluation of markers of myocardial necrosis), ultrasound techniques and coronary computed tomography could be useful. ⋯ Despite the high sensitivity, ST segment deviation has however poor specificity since it may be observed in many other cardiac and non-cardiac conditions. Therefore, when ST-T abnormalities are detected the physicians should take into account many other parameters (such as risk factors, symptoms and anamnesis) and all the other differential diagnoses. The aim of our review is to overview of the main conditions that may mimic a ST segment Elevation Myocardial Infarction (STEMI).
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Indian heart journal · Jul 2013
ReviewSmokeless tobacco and cardiovascular disease in low and middle income countries.
Smoking is an important cardiovascular risk factor, however, use of smokeless tobacco has not been well studied. Smokeless tobacco use is high in countries of South and Southeast Asia, Africa and Northern Europe. Meta-analyses of prospective studies of smokeless tobacco users in Europe reported a relative risk for fatal coronary heart disease of 1.13 (confidence intervals 1.06-1.21) and fatal stroke of 1.40 (1.28-1.54) while in Asian countries it was 1.26 (1.12-1.40). ⋯ There is a greater prevalence of hypertension and metabolic syndrome in users of smokeless tobacco. Smokeless tobacco use leads to accelerated atherothrombosis similar to smoking. There is an urgent need for public health and clinical interventions to reduce smokeless tobacco addiction.
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Indian heart journal · Jul 2013
Case ReportsFree floating right atrial thrombus with massive pulmonary embolism:near catastrophic course following thrombolytic therapy.
A 28-year-old policeman presented with left lower limb deep vein thrombus, pulmonary embolism and a highly mobile right atrial clot. Thrombolytic therapy with IV Tenecteplase was administered. Within a few minutes after the Tenecteplase bolus, the patient's condition worsened dramatically with severe hypotension and hypoxemia. ⋯ With intensive supportive measures the patient's condition was stabilized and he made a complete recovery. Prior to discharge, the echocardiogram revealed normal right ventricular function and a CT pulmonary angiogram performed after 2 months revealed near complete resolution of pulmonary thrombi. Thrombolytic therapy for right heart thrombus with pulmonary embolism can be a reasonable first line therapy but may be associated with hemodynamic worsening due to clot migration.
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Indian heart journal · Jul 2013
Case ReportsAcute pancreatitis complicated by acute myocardial infarction - a rare association.
Acute pancreatitis complicated by acute myocardial infarction has been reported very rarely. The exact mechanism of the cause of myocardial injury is not known. ⋯ The administration of thrombolytic therapy in such patients can have deleterious effects. We report successful performance of primary angioplasty in this complicated patient.