Disulfiram overdose: Cardiogenic shock: case report
(Source: Reactions)...
POSTED 06/29/2009 at 10:13 AM --
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[CASE REPORTS] Successful Treatment of Heart Failure due to Acute Transplant Rejection With the Impella LP 5.0
We present a 52-year-old patient with multiorgan failure secondary to acute graft rejection after orthotopic heart transplantation. Maximal medical therapy was not successful, and the patient was bridged to recovery with an Impella LP 5.0 (Abiomed Inc, Danvers, MA) left ventricular assist device (LVAD). The relative merits of this therapeutic approach are outlined and discussed. The patient was discharged 3 weeks after LVAD removal and remains clinically stable. (Source: The Annals of Thoracic Surgery)...
POSTED 06/28/2009 at 06:00 PM --
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[Surgical treatment of acute type A aortic dissection]
CONCLUSION: The main risk factor for acute aortic dissection is the diameter of the aorta exceeding 4 cm (diagnosed in 73.7% of cases). The main postoperative complications are bleeding (42.1%), injuries of central nervous system (23.7%), and cardiogenic shock (18.4%).
PMID: 19357448 [PubMed - indexed for MEDLINE] (Source: Medicina (Kaunas))...
POSTED 06/27/2009 at 06:39 PM --
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Evaluation of the sublingual microcirculation in cardiogenic shock.
CONCLUSIONS: A consequence of cardiogenic shock is the impairment of microcirculation with organ hypoperfusion. We observed that cardiac output is correlated to disturbance in microflow in the smallest vessels. On-line evaluation of microcirculation in vivo may be a valid tool for optimizing therapeutic measures in high risk patients. Additional online material may be found at: http://www.kim1.uniklinik-jena.de/Microcirculation.html.
PMID: 19433887 [PubMed - in process] (Source: Clinical Hemorheology and Microcirculation)...
POSTED 06/27/2009 at 11:59 AM --
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Creatinine clearance is independently associated with one year mortality in a primary PCI cohort with cardiogenic shock.
Conclusion: Creatinine clearance on admission is strongly associated with one year mortality in STEMI patients with CS on admission and treated with PCI.
PMID: 19449237 [PubMed - in process] (Source: Acute Cardiac Care)...
POSTED 06/27/2009 at 09:18 AM --
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Reperfusion therapy for acute ST-elevation and non ST-elevation myocardial infarction: What can be achieved in daily clinical practice in unselected patients at an interventional center?
Conclusions: In clinical practice STEMI and NSTEMI seem to occur with similar frequency. Invasive strategies were applied in a high percentage in both groups, however with different therapeutic consequences. In-hospital mortality was twice as high in STEMI compared to NSTEMI patients.
PMID: 19391052 [PubMed - in process] (Source: Acute Cardiac Care)...
POSTED 06/27/2009 at 09:18 AM --
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Hemodynamic effects of levosimendan in acute myocardial infarction complicated by cardiogenic shock and high systemic vascular resistance.
Conclusion: The hemodynamic benefit conferred by LEVO added to catecholamines in patients with CS after acute MI was limited to patients with high SVR.
PMID: 19353405 [PubMed - in process] (Source: Acute Cardiac Care)...
POSTED 06/27/2009 at 09:18 AM --
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Disulfiram overdose: Cardiogenic shock: case report.
Page: 14 (Source: Reactions Weekly)...
POSTED 06/27/2009 at 05:42 AM --
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Partial Mechanical Cardiac Support: Part of the Solution or Part of the Problem?⁎
Intuitively it makes sense that providing a significant portion of the cardiac output while unloading the ventricle will improve the patient's hemodynamic status, clinical condition, and quality of life. This is particularly true for patients with milder forms of heart failure. But for those with truly advanced end-stage disease and cardiogenic shock, total cardiac support is typically required. The pragmatic issue is: how does one provide partial cardiac support that is effective, safe, and ideally performed with a minimally invasive procedure? (Source: Journal of the American College of Cardiology)...
POSTED 06/25/2009 at 02:29 AM --
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Clinical characteristics, management, and prognosis of octogenarians with acute heart failure admitted to cardiology wards: Results from the Italian Survey on Acute Heart Failure
Conclusions: Octogenarians represent more than one fourth of the admissions for AHF and have a more severe clinical presentation. Their management is less aggressive, and treatments recommended by guidelines are underused. In-hospital mortality is high in the OLD group independently of left ventricular ejection fraction. (Source: American Heart Journal)...
POSTED 06/25/2009 at 02:27 AM --
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Left ventricular outflow tract obstruction in Tako-Tsubo syndrome: Stress cardiomyopathy or hypertrophic cardiomyopathy?
We thank Dr Núñez-Gil, Dr García-Rubira, and Dr Luaces for their interest in our article. We are very glad to see that these authors have found in part the same results from our study. Tako-Tsubo syndrome is now classified as a cardiomyopathy. Left ventricular outflow tract (LVOT) obstruction may occur in Tako-Tsubo cardiomyopathy. Its prevalence was 25% in our study (vs 16% in the first reports), and its detection is of importance because the use of inotropic agents may increase the intraventricular pressure gradient and induce cardiogenic shock. We found that a septal bulge (localized hypertrophy of the proximal interventricular septum) was systematically present in patients with LVOT obstruction and Tako-Tsubo cardiomyopathy, whereas in patients without LVOT obstruction, a septal bud......
POSTED 06/25/2009 at 02:27 AM --
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Cardiogenic shock caused by disulfiram
We report the case of a female patient with refractory shock after deliberate self-poisoning with disulfiram. Clinical, biochemical and echocardiographic assessment, as well as invasive monitoring confirmed cardiogenic shock associated with this drug. The known mechanisms of action of disulfiram are discussed, and the major collateral effects, especially cardiovascular effects, are described. We underscore the importance of suspecting this diagnosis and of adopting prompt and the most adequate therapeutic approach in this context.La intoxicación medicamentosa por disulfiram es una situación rara, aunque puede presentarse con manifestaciones cardiovasculares graves y potencialmente fatales, como el shock cardiogénico. Este relato presenta el caso de una paciente con shock refractario, tr......
POSTED 06/25/2009 at 02:26 AM --
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Temporary (short-term) percutaneous left ventricular assist device (Tandem Heart) in a patient with STEMI, multivessel coronary artery disease, cardiogenic shock and severe peripheral artery disease.
Authors: Neuzil P, Kmonicek P, Skoda J, Reddy VY
Cardiogenic shock remains the leading cause of mortality among patients admitted for acute myocardial infarction (AMI). Percutaneous left ventricular assist devices (pVAD) represent one possible means of supporting these critically ill patients during interventional procedures. Tandem Heart is one such pVAD, which uses transseptal cannulation and a paracorporal centrifugal pump to maintain active circulation to the descending aorta. Despite its overall effectiveness in clinical use, the use of the Tandem Heart has several potential limitations, including a contraindication for patients with peripheral artery disease. This case report describes the successful use of the Tandem Heart in one such patient requiring a high-risk coronary inter......
POSTED 06/21/2009 at 06:00 PM --
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ACC/AHA guideline update for the management of ST-segment elevation myocardial infarction.
Authors: Campbell-Scherer DL, Green LA
The American College of Cardiology and American Heart Association, in collaboration with the Canadian Cardiovascular Society, have issued an update of the 2004 guideline for the management of patients with ST-segment elevation myocardial infarction. The American Academy of Family Physicians endorses and accepts this guideline as its policy. Early recognition and prompt initiation of reperfusion therapy remains the cornerstone of management of ST-segment elevation myocardial infarction. Aspirin should be given to symptomatic patients. Beta blockers should be used cautiously in the acute setting because they may increase the risk of cardiogenic shock and death. The combination of clopidogrel and aspirin is indicated in patients who have had ST-segme......
POSTED 06/14/2009 at 06:00 PM --
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[Original articles] Efficacy and safety of pioglitazone in patients with ST elevation myocardial infarction treated with primary stent implantation
Conclusions:
Treatment of pioglitazone reduced neointimal hyperplasia in patients with STEMI treated with primary stent implantation without placing the patient at increased risk of complications. Additional larger trials will be necessary to establish the clinical benefit of pioglitazone. (Source: Heart)...
POSTED 06/11/2009 at 11:00 PM --
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Reversible cardiogenic shock following 5-Fluorouracil infusion
We report the case of reversible cardiogenic
shock following 5-FU administration and discuss the different pitfalls of such toxicity. Oncologist should be aware of that
rare but potentially lethal adverse event.
Content Type Journal ArticleCategory SHORT REPORTDOI 10.1007/s10637-009-9271-3Authors
Charles Ferté, Institut Gustave Roussy Phase I unit (SITEP), Department of Medicine 94805 Villejuif FranceCarlos Gomez Roca, Institut Gustave Roussy Phase I unit (SITEP), Department of Medicine 94805 Villejuif FranceYohann Loriot, Institut Gustave Roussy Phase I unit (SITEP), Department of Medicine 94805 Villejuif FranceRastislav Bahleda, Institut Gustave Roussy Phase I unit (SITEP), Department of Medicine 94805 Villejuif FranceCristian Moldovan, Institut Gustave Roussy Phase I unit (SITEP......
POSTED 06/05/2009 at 03:58 AM --
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Management of venous thromboembolism in the intensive care unit
Abstract: Venous thromboembolism, manifested as either deep venous thrombosis or pulmonary embolism (PE), is a major cause of morbidity and mortality in patients admitted to the intensive care unit. Clinically, PE may present as massive thromboembolism associated with cardiogenic shock or may be asymptomatic, as may occur with anatomically small emboli without hemodynamic or respiratory compromise. The management of venous thromboembolism in the critically ill patient can be exceedingly complex. The main treatment objectives are the prevention of recurrent PE and, in case of hemodynamic compromise, definitive therapy for deep venous thrombosis or PE involving removal of thrombus. Prevention of recurrent PE is accomplished with anticoagulation and/or placement of an inferior vena cava filte......
POSTED 05/31/2009 at 11:00 PM --
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Postshunt Hemochromatosis Leading to Cardiogenic Shock in a Patient Presenting for Orthotopic Liver Transplant: A Case Report
Conclusion: Dilated cardiomyopathy, congestive heart failure, and other unexpected disease processes resulting from hemochromatosis can greatly influence the care of postshunt liver failure patients. (Source: Transplantation Proceedings)...
POSTED 05/31/2009 at 06:00 PM --
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Vascular Ehlers-Danlos syndrome -All three coronary artery spontaneous dissections.
In this report, we describe a 33-year-old woman with all three coronary artery spontaneous dissections, resulting in cardiogenic shock and therapy-resistant ventricular fibrillation. We could successfully complete revascularization of all three coronary arteries and terminate the life-threatening arrhythmia. Biochemical findings finally revealed a point mutation in the COL3A1 gene, consistent with a diagnosis of vascular Ehlers-Danlos syndrome. To the best of our knowledge, this is the first case of vascular Ehlers-Danlos syndrome causing all three coronary artery spontaneous dissections. Our case also suggests that, from vascular fragility even if it is spontaneous coronary dissection, physicians always consider connective-tissue disorders as a differential diagnosis at an early stage eve......
POSTED 05/31/2009 at 06:00 PM --
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Outcomes of a system-wide protocol for elective and nonelective coronary angioplasty at sites without on-site surgery: the Mayo Clinic experience.
CONCLUSION: Optimal outcomes with PCI have been observed at community hospitals without on-site cardiac surgical programs with application of a prospective, standardized quality assurance protocol.
PMID: 19483166 [PubMed - in process] (Source: Mayo Clinic Proceedings)...
POSTED 05/31/2009 at 06:00 PM --
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