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Mishra AK, George AA, John KJ, Arun Kumar P, Dasari M, Afraz Pasha M, Hadley M. Takotsubo cardiomyopathy following envenomation: An updated review. World J Cardiol 2023; 15:33-44. [PMID: 36714368 PMCID: PMC9850669 DOI: 10.4330/wjc.v15.i1.33] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Revised: 11/15/2022] [Accepted: 01/05/2023] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Takotsubo cardiomyopathy (TTC) can be diagnosed in patients presenting with clinical features of acute coronary syndrome (ACS) by using Mayo clinic criteria. Multiple precipitators have been attributed to causing TTC. Rarely it has been reported to occur following an acute envenomation.
AIM This review describes the various patterns, mechanisms, and outcomes of envenomation induced TTC.
METHODS In this review, we included all studies on “TTC” and “envenomation “published in the various databases before June 2022. To be included in the review articles had to have a distinct diagnosis of TTC and an envenomation
RESULTS A total of 20 patients with envenomation induced TTC were identified. Most episodes of envenomation induced TTC were reported following a bee sting, scorpion sting, and snake envenomation. Fear and anxiety related to the sting, direct catecholamine toxicity and administration of exogenous beta-adrenergic agents have been commonly postulated to precipitate TTC in these patients. 95% of these patients presented with a clinical picture of ACS. Most of these patients also fulfill at least 3 out of 4 criteria of Mayo clinic criteria for TTC. Echocardiographic evidence of Apical TTC was noted in 72% of patients. 94% of these patients had clinical improvement following optimal management and 35% of these patients were treated with guideline directed medications for heart failure.
CONCLUSION Envenomation following multiple insect stings and reptile bites can precipitate TTC. Most reported envenomation related TTC has been due to bee stings and scorpion bites. Common mechanisms causing TTC were fear, anxiety, and stress of envenomation. Most of these patients present with clinical presentation of ACS, ST elevation, and elevated troponin. The most common type of TTC in these patients is Apical, which improved following medical management.
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Affiliation(s)
- Ajay K Mishra
- Division of Cardiology, Saint Vincent Hospital, Worcester, MA 01608, United States
| | - Anu A George
- Department of Medicine, Saint Vincent Hospital, Worcester, MA 01608, United States
| | - Kevin John John
- Department of Medicine, Tufts Medical Center, Boston, MA 02111, United States
| | - Pramukh Arun Kumar
- Department of Medicine, Saint Vincent Hospital, Worcester, MA 01608, United States
| | - Mahati Dasari
- Department of Medicine, Saint Vincent Hospital, Worcester, MA 01608, United States
| | - Mohammed Afraz Pasha
- Department of Medicine, North Alabama Medical Center, Florence, AL 35630, United States
| | - Michelle Hadley
- Division of Cardiology, Saint Vincent Hospital, Worcester, MA 01608, United States
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Pereañez JA, Granados J, Agudelo R. Tako-tsubo cardiomyopathy in clinical toxinology: A systematic review. Toxicon 2022; 219:106929. [PMID: 36162498 DOI: 10.1016/j.toxicon.2022.09.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 09/02/2022] [Accepted: 09/16/2022] [Indexed: 11/25/2022]
Abstract
Tako-tsubo cardiomyopathy (TTC) is a transient left ventricular dysfunction, normally triggered by emotional or physical stress, although it is also associated with to use of drugs, drug abuse, or some intoxications. In addition, TTC has been reported in some case reports derived from the exposure of patients to animal venoms, toxins or poisons, or bacterial infections. However, to date, a systematic assessment of TTC in clinical toxinology is lacking. Therefore the aim of this study was to collect and integrate the available information about TTC in clinical toxinology. After our search strategy, 19 articles were retrieved, resulting in 20 case reports. Most cases occurred in women (75.0%). The venomous species that trigger TTC are bee/wasp, including probable Africanized honey bee and Vespa orientalis (15.0%), scorpions (Tytius serrulatus and Androctonus australis, 15.0%), a spider (Latrodectus tredecimguttatus, 5.0%), snakes (Gloydius blomhofii and Naja nivea, 10.0%), Clostridium sp (C. tetani, C. botulinum and C. difficile, 45.0%) and jellyfish (Pelagia noctiluca and Carukia barnesi, 10.0%). Among the affected people there were two deaths. In all case reports authors diagnosed TTC by using the combination of some of the following strategies: clinical findings, echocardiography, magnetic cardiac resonance, electrocardiogram changes and/or the increased plasma levels of cardiac damage biomarkers. In most cases images were available. We hypothesized the possible mode of action of venoms, toxins or poisons to induce TTC, however other mechanisms may exist, but they have not been described yet. Therefore, further studies are needed. In some cases, venoms, toxins, or poisons might cause catecholamine discharge either directly or indirectly, therefore, this was suggested as the trigger of TTC. Finally, the appearance of TTC should be considered in clinical toxinology.
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Affiliation(s)
- Jaime Andrés Pereañez
- Grupo de Investigación en Toxinología, Alternativas Terapéuticas y Alimentarias, Facultad de Ciencias Farmacéuticas y Alimentarias, Universidad de Antioquia, Medellín, 050010, Colombia; Grupo Promoción y Prevención Farmacéutica, Facultad de Ciencias Farmacéuticas y Alimentarias, Universidad de Antioquia, Medellín, 050010, Colombia.
| | - Johan Granados
- Grupo Promoción y Prevención Farmacéutica, Facultad de Ciencias Farmacéuticas y Alimentarias, Universidad de Antioquia, Medellín, 050010, Colombia
| | - Raquel Agudelo
- Departamento de Farmacia, Facultad de Ciencias Farmacéuticas y Alimentarias, Universidad de Antioquia, Medellín, 050010, Colombia
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3
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Manousek J, Kala P, Lokaj P, Ondrus T, Helanova K, Miklikova M, Brazdil V, Tomandlova M, Parenica J, Pavkova Goldbergova M, Hlasensky J. Oxidative Stress in Takotsubo Syndrome-Is It Essential for an Acute Attack? Indirect Evidences Support Multisite Impact Including the Calcium Overload-Energy Failure Hypothesis. Front Cardiovasc Med 2021; 8:732708. [PMID: 34738019 PMCID: PMC8562109 DOI: 10.3389/fcvm.2021.732708] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 09/16/2021] [Indexed: 12/28/2022] Open
Abstract
Indirect evidences in reviews and case reports on Takotsubo syndrome (TTS) support the fact that the existence of oxidative stress (OS) might be its common feature in the pre-acute stage. The sources of OS are exogenous (environmental factors including pharmacological and toxic influences) and endogenous, the combination of both may be present, and they are being discussed in detail. OS is associated with several pathological conditions representing TTS comorbidities and triggers. The dominant source of OS electrones are mitochondria. Our analysis of drug therapy related to acute TTS shows many interactions, e.g., cytostatics and glucocorticoids with mitochondrial cytochrome P450 and other enzymes important for OS. One of the most frequently discussed mechanisms in TTS is the effect of catecholamines on myocardium. Yet, their metabolic influence is neglected. OS is associated with the oxidation of catecholamines leading to the synthesis of their oxidized forms - aminochromes. Under pathological conditions, this pathway may dominate. There are evidences of interference between OS, catecholamine/aminochrome effects, their metabolism and antioxidant protection. The OS offensive may cause fast depletion of antioxidant protection including the homocystein-methionine system, whose activity decreases with age. The alteration of effector subcellular structures (mitochondria, sarco/endoplasmic reticulum) and subsequent changes in cellular energetics and calcium turnover may also occur and lead to the disruption of cellular function, including neurons and cardiomyocytes. On the organ level (nervous system and heart), neurocardiogenic stunning may occur. The effects of OS correspond to the effect of high doses of catecholamines in the experiment. Intensive OS might represent "conditio sine qua non" for this acute clinical condition. TTS might be significantly more complex pathology than currently perceived so far.
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Affiliation(s)
- Jan Manousek
- Department of Internal Medicine and Cardiology, University Hospital Brno, Brno, Czechia
| | - Petr Kala
- Department of Internal Medicine and Cardiology, University Hospital Brno, Brno, Czechia
- Department of Internal Medicine and Cardiology, Faculty of Medicine, Masaryk University, Brno, Czechia
| | - Petr Lokaj
- Department of Internal Medicine and Cardiology, University Hospital Brno, Brno, Czechia
- Department of Internal Medicine and Cardiology, Faculty of Medicine, Masaryk University, Brno, Czechia
| | - Tomas Ondrus
- Department of Internal Medicine and Cardiology, University Hospital Brno, Brno, Czechia
- Department of Internal Medicine and Cardiology, Faculty of Medicine, Masaryk University, Brno, Czechia
| | - Katerina Helanova
- Department of Internal Medicine and Cardiology, University Hospital Brno, Brno, Czechia
- Department of Internal Medicine and Cardiology, Faculty of Medicine, Masaryk University, Brno, Czechia
| | - Marie Miklikova
- Department of Internal Medicine and Cardiology, University Hospital Brno, Brno, Czechia
| | - Vojtech Brazdil
- Department of Internal Medicine and Cardiology, University Hospital Brno, Brno, Czechia
- Department of Internal Medicine and Cardiology, Faculty of Medicine, Masaryk University, Brno, Czechia
| | - Marie Tomandlova
- Department of Biochemistry, Faculty of Medicine, Masaryk University, Brno, Czechia
| | - Jiri Parenica
- Department of Internal Medicine and Cardiology, University Hospital Brno, Brno, Czechia
- Department of Internal Medicine and Cardiology, Faculty of Medicine, Masaryk University, Brno, Czechia
| | | | - Jiri Hlasensky
- Department of Internal Medicine and Cardiology, University Hospital Brno, Brno, Czechia
- Department of Internal Medicine and Cardiology, Faculty of Medicine, Masaryk University, Brno, Czechia
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Wang X, Wang F, Sun N, Zhang L. Stress cardiomyopathy: Medical studies and extensive review. Saudi J Biol Sci 2021; 28:2598-2601. [PMID: 33911970 PMCID: PMC8071884 DOI: 10.1016/j.sjbs.2021.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 01/21/2021] [Accepted: 02/01/2021] [Indexed: 12/02/2022] Open
Abstract
Stress cardiomyopathy (SC) was first reported in the year 1983. It is narrated as critical but quite commutative left ventricular (LV) malfunction mostly caused by poignant or psychological disorder. Numerous variations of SC have been described as well as reverse stress cardiomyopathy (rSC) which is an adaptation identified by the decreased muscle movement related with hyperkinesis that reconciles impetuously. The signature of rSC is a medical demonstration alike to syndrome by an acute coronary, with no obvious difficult coronary artery disease. The occurrence of SC is approximated to be 4% of all victims conferring with gleaned syndrome by acute coronary. The portion of victims conferring with the rSC transfiguration out of all SC patients has been inconstant, varying from 1 to 24%. Reverse stress cardiomyopathy cases are found to be common with young people, less decrease in left ventricular ejection fraction (LVEF) and more neurological disease compared to the SC. While the correct phenomenon of rSC is undetermined, postulated methods comprises of coronary microvasculature impairment, coronary artery spasm, and estrogen deficiency. Patients with rSC typically suffer with chest pain after an emotional or Psychological stressful event. The rSC can also be happened by general anesthesia, or neurological conditions. The diagnosis of rSC demands the presence of new electrocardiogram (EKG) abnormalities or elevated cardiac troponin, and absence of obstructive coronary disease, pheochromocytoma, or myocarditis. The consideration of rSC is quite analogous to that of SC, which is predominantly supportive with the treatment of complications. The recrudescence rate of rSC is around 12%. The most frequent complications of rSC include pericardial effusions, and development of LV thrombi.
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Affiliation(s)
- Xiang Wang
- Department of Cardiology, Jinan People's Hospital Affiliated to Shandong First Medical University, Jinan, Shandong 271199, China
| | - Fangming Wang
- Department of Cardiology, Jinan People's Hospital Affiliated to Shandong First Medical University, Jinan, Shandong 271199, China
| | - Ningwei Sun
- Department of Cardiology, Jinan People's Hospital Affiliated to Shandong First Medical University, Jinan, Shandong 271199, China
| | - Lijun Zhang
- Department of Cardiology, Jinan People's Hospital Affiliated to Shandong First Medical University, Jinan, Shandong 271199, China
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Fusto G, Bennardo L, Duca ED, Mazzuca D, Tamburi F, Patruno C, Nisticò SP. Spider bites of medical significance in the Mediterranean area: misdiagnosis, clinical features and management. J Venom Anim Toxins Incl Trop Dis 2020; 26:e20190100. [PMID: 33061945 PMCID: PMC7534902 DOI: 10.1590/1678-9199-jvatitd-2019-0100] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Despite the disrepute spiders have had for centuries, their bite is a rare
occurrence. In the Mediterranean area, only two of the numerous known species
are considered of medical significance: Latrodectus
tredecimguttatus and Loxosceles rufescens. Spider
bites have no pathognomonic signs or symptoms, therefore most diagnoses are
presumptive; a spider bite can only be diagnosed when a spider (seen at the time
of the bite) is collected and identified by an expert, since most physicians and
patients are unable to recognize a certain spider species or distinguish spiders
from other arthropods. Skin lesions of uncertain etiology are too often
attributed to spider bites. In most cases, these are actually skin and
soft-tissue infections, allergic reactions, dermatoses etc. Misdiagnosing a
wound as a spider bite can lead to delays in appropriate care, cause adverse or
even fatal outcomes and have medical-legal implications. Concerningly,
misinformation on spider bites also affects the medical literature and it
appears there is lack of awareness on current therapeutic indications for
verified bites.
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Affiliation(s)
- Gabriele Fusto
- Unit of Dermatology, Department of Health Sciences, Magna Graecia University, Catanzaro, Italy
| | - Luigi Bennardo
- Unit of Dermatology, Department of Health Sciences, Magna Graecia University, Catanzaro, Italy
| | - Ester Del Duca
- Unit of Dermatology, Department of Health Sciences, Magna Graecia University, Catanzaro, Italy.,Department of Dermatology, Mount Sinai Medical Center, New York, USA
| | - Daniela Mazzuca
- Unit of Forensic Pathology, Department of Health Sciences, Magna Graecia University, Catanzaro, Italy
| | - Federica Tamburi
- Unit of Dermatology, Department of Health Sciences, Magna Graecia University, Catanzaro, Italy
| | - Cataldo Patruno
- Unit of Dermatology, Department of Health Sciences, Magna Graecia University, Catanzaro, Italy
| | - Steven Paul Nisticò
- Unit of Dermatology, Department of Health Sciences, Magna Graecia University, Catanzaro, Italy
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Ludhwani D, Sheikh B, Patel VK, Jhaveri K, Kizilbash M, Sura P. Atypical Takotsubo Cardiomyopathy with Hypokinetic Left Mid-ventricle and Apical Wall Sparing: A Case Report and Literature Review. Curr Cardiol Rev 2019; 16:241-246. [PMID: 31752657 DOI: 10.2174/1573403x15666191120114442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 11/09/2019] [Accepted: 11/14/2019] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Takotsubo Cardiomyopathy (TTC) is an uncommon cause of acute reversible ventricular systolic dysfunction in the absence of obstructive Coronary Artery Disease (CAD). Typically manifesting as apical wall ballooning, TTC can rarely present atypically with apical wall sparing. CASE REPORT A 62-year-old female presented with complaints of chest pain and features mimicking acute coronary syndrome. Coronary angiogram revealed no obstructive CAD and left ventriculogram showed reduced ejection fraction, normal left ventricular apex and hypokinetic mid-ventricles consistent with atypical TTC. The patient was discharged home on heart failure medications and a follow-up transthoracic echocardiogram demonstrated improved left ventricular function with no wall motion abnormality. CONCLUSION This case report provides an insight into the diagnosis and management of TTC in the absence of pathognomic features.
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Affiliation(s)
- Dipesh Ludhwani
- Department of Internal Medicine, Chicago Medical School, Rosalind Franklin University, Northwestern McHenry Hospital, Illinois, 60050, United States
| | - Belaal Sheikh
- Department of Internal Medicine, Chicago Medical School, Rosalind Franklin University, Northwestern McHenry Hospital, Illinois, 60050, United States
| | - Vasu K Patel
- Department of Internal Medicine, Chicago Medical School, Rosalind Franklin University, Northwestern McHenry Hospital, Illinois, 60050, United States
| | - Khushali Jhaveri
- Department of Internal Medicine, Georgetown University Washington Hospital Center, Washington, D.C., United States
| | - Mohammad Kizilbash
- Department of Cardiology, Chicago Medical School, Rosalind Franklin University, Northwestern McHenry Hospital, Illinois 60050, United States
| | - Prashant Sura
- Department of Internal Medicine, Chicago Medical School, Rosalind Franklin University, Northwestern McHenry Hospital, Illinois, 60050, United States
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Abstract
A 70-year-old woman was admitted to our hospital due to difficulty in moving her limbs. She had trismus and a necrotic and contaminated wound in her left lower leg. A diagnosis of tetanus was confirmed and intensive care was started. On the second day, her blood pressure fell and a ST segment elevation on electrocardiography (ECG) was detected. She was diagnosed with takotsubo cardiomyopathy by echocardiogram and improved undergoing conservative therapy.
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Affiliation(s)
- Taisuke Araki
- Center of Infectious Diseases, Nagano Prefectural Shinshu Medical Center, Japan
| | - Naoya Iwanami
- Center of Infectious Diseases, Nagano Prefectural Shinshu Medical Center, Japan
| | - Yoshitaka Yamazaki
- Center of Infectious Diseases, Nagano Prefectural Shinshu Medical Center, Japan
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8
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Awad HH, McNeal AR, Goyal H. Reverse Takotsubo cardiomyopathy: a comprehensive review. ANNALS OF TRANSLATIONAL MEDICINE 2018; 6:460. [PMID: 30603648 DOI: 10.21037/atm.2018.11.08] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Takotsubo cardiomyopathy (TTC) was first described in Japan in the 1980s. It is described as an acute but often reversible left ventricular (LV) dysfunction mainly triggered by emotional or physical stress. Multiple variants of TTC have been reported including reverse Takotsubo cardiomyopathy (rTTC) which is a variant characterized by the basal akinesis/hypokinesis associated with apical hyperkinesis that resolves spontaneously. The hallmark of rTTC is a clinical presentation similar to an acute coronary syndrome (ACS), with no evident obstructive coronary artery disease. The incidence of TTC is estimated to be 2% of all troponin-positive patients presenting with suspected ACS. The proportion of patients presenting with the rTTC variant out of all TTC patients in published literature has been variable, ranging from 1-23%. Reverse Takotsubo has been associated with younger age, less decrease in left ventricular ejection fraction (LVEF), and more neurological disease compared to the TTC. While the exact mechanism of rTTC is unknown, hypothesized mechanisms include catecholamine cardiotoxicity, coronary artery spasm, coronary microvasculature impairment, and estrogen deficiency. Patients with rTTC typically present with chest pain and/or dyspnea after an emotional or physically stressful event. rTTC can also be triggered by intracranial hemorrhage, general anesthesia, or neurological conditions. Diagnosis of rTTC requires the presence of LV basal hypokinesis/akinesis, new electrocardiogram (EKG) abnormalities or elevated cardiac troponin, and absence of obstructive coronary disease, pheochromocytoma, or myocarditis. Management of rTTC is similar to that of TTC, which is predominantly supportive with the treatment of complications. The recurrence rate of rTTC is around 10%. The most common complications of rTTC include myocarditis, pleural and pericardial effusions, and development of LV thrombi. The best predictors of mortality include decreased LVEF, development of atrial fibrillation, and neurologic disease.
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Affiliation(s)
- Hamza H Awad
- Department of Community Medicine/Internal Medicine, Mercer University School of Medicine, Macon, GA, USA
| | - Ashley R McNeal
- Medical Student, Mercer University School of Medicine, Macon, GA, USA
| | - Hemant Goyal
- Department of Internal Medicine, Mercer University School of Medicine, Macon, GA, USA
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9
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Insekten und Spinnentiere als Auslöser toxischer und allergischer Reaktionen in Deutschland. ALLERGO JOURNAL 2017. [DOI: 10.1007/s15007-017-1368-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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10
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Miocardiopatía de takotsubo desencadenada por la utilización o exposición a drogas de abuso, sustancias químicas o venenos de origen animal. REVISTA COLOMBIANA DE CARDIOLOGÍA 2017. [DOI: 10.1016/j.rccar.2016.05.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Hung MJ, Kao YC, Chen WS, Mao CT, Chen TH, Yang NI, Ko T, Liang CY. Layer-specific quantification of myocardial deformation in sepsis-induced Takotsubo cardiomyopathy: Three case reports of a serial 2-dimensional speckle-tracking echocardiographic study. Medicine (Baltimore) 2016; 95:e5250. [PMID: 27858884 PMCID: PMC5591132 DOI: 10.1097/md.0000000000005250] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
INTRODUCTION Little is known about the time-course changes in left ventricular myocardial deformation in patients with Takotsubo cardiomyopathy (TC) using layer-specific quantification of myocardial deformation assessed by 2-dimensional speckle tracking echocardiography (2DSTE). CASE SUMMARY In this retrospective 2DSTE follow-up study of 3 female patients with sepsis-induced TC, we examined changes in strain among the 3 myocardial layers, and examined the changes in left ventricular diastolic function and right ventricular systolic function. In all 3 patients, there was improvement of at least 15% in left ventricular ejection fractions, and improvement in left ventricular longitudinal and circumferential strains. The absolute differences in left ventricular global strains between the endocardium and epicardium, and between the first and the third 2DSTE studies reflect the following: a decrease in all 3 myocardial layers in patients with acute TC; and a slower improvement in mid-myocardial and epicardial function during recovery of TC. In addition, the right ventricular free wall strains were also impaired in the acute stage of TC with gradual improvement during recovery. CONCLUSIONS Left ventricular strains did not fully recover even 1 month after acute TC. In addition, right ventricular free wall strains were also impaired in all 3 patients initially. In this case series, we found that layer-specific 2DSTE is a more sensitive method for myocardial function assessment than standard echocardiography.
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Affiliation(s)
- Ming-Jui Hung
- Section of Cardiology, Department of Medicine, Chang Gung Memorial Hospital, Keelung, Chang Gung University College of Medicine, Keelung City, Taiwan
- Correspondence: Ming-Jui Hung, Section of Cardiology, Department of Medicine, Chang Gung Memorial Hospital, Keelung, 222 Maijin Road, Keelung City 20401, Taiwan (e-mail: )
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Preda C, Iosif R, Tudoran R, Tuţă LA. Terrestrial Arthropods as a Public Health Issue in South–Eastern Romania. TRAVAUX DU MUSÉUM NATIONAL D’HISTOIRE NATURELLE “GRIGORE ANTIPA” 2016. [DOI: 10.1515/travmu-2016-0005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Abstract
Little is known about the prevalence and severity of allergic reactions caused by terrestrial arthropods in Romania although bites and stings of arthropods represent a widely recognized public health issue. We conducted a retrospective study in Constanța, the largest city at the Romanian Black Sea coast, and documented 207 cases during 2013–2014, representing 0.5% of the total number of records at the Emergency Department of the County Clinical Emergency Hospital. Young men and women presented themselves more often to the hospital to report this type of injuries and most arthropods causing allergic reactions were not identified. Our study brings novel information on the prevalence of injuries inflicted by terrestrial arthropods on the human adult population at the Romanian Black Sea coast, it highlights existing knowledge gaps and provides information on which to base future guidelines.
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