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Bahouh C, Arhoun El Haddad I, Elmouhib A, Laaribi I, El Adak H, Hattab O, El Ouafi N, Bkiyar H, Housni B. Acute neurogenic stunned myocardium in a patient with Guillain-Barré syndrome: case report. Ann Med Surg (Lond) 2023; 85:2186-2189. [PMID: 37229079 PMCID: PMC10205362 DOI: 10.1097/ms9.0000000000000636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 04/02/2023] [Indexed: 05/27/2023] Open
Abstract
Autonomic dysfunction is a prevalent symptom of Guillain-Barré syndrome (GBS); cardiovascular involvement in this scenario has been mentioned infrequently in the literature. Case Presentation A 65-year-old man with GBS presented with reversible left ventricular systolic failure. On first presentation, our patient had no history or indications of heart malfunction. During the clinical manifestation of his autonomic dysfunction, he had electrocardiographic alterations, modestly increased cardiac enzymes, significant left ventricular systolic dysfunction, and segmental wall motion irregularity. Once the initial episode was over, these anomalies and his symptoms resolved quickly. Discussion We believe the reversible left ventricular dysfunction was caused by the toxic impact of elevated catecholamines as well as transiently injured sympathetic nerve endings in the myocardium, which was apparently caused by GBS. We recommend that echocardiography be performed in patients who exhibit clinical signs of autonomic dysfunction, particularly if they are associated with abnormal electrocardiographic findings, cardiac enzyme elevation, or hemodynamic instability, so that appropriate medical therapy can be instituted as soon as possible. Conclusion GBS is a not a very rare situation in our context. Thus, doctors are supposed to know the life-threatening complications such as neurogenic stunned myocardium and be prepared to dodge it.
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Affiliation(s)
- Choukri Bahouh
- Department of Intensive Care Unit, Mohammed VI University Hospital
- Faculty of Medicine and Pharmacy, Mohammed First University
| | - Inass Arhoun El Haddad
- Department of Intensive Care Unit, Mohammed VI University Hospital
- Faculty of Medicine and Pharmacy, Mohammed First University
| | - Amine Elmouhib
- Department of Intensive Care Unit, Mohammed VI University Hospital
- Faculty of Medicine and Pharmacy, Mohammed First University
| | - Ilyass Laaribi
- Department of Intensive Care Unit, Mohammed VI University Hospital
- Faculty of Medicine and Pharmacy, Mohammed First University
| | - Hanane El Adak
- Burns and Reconstructive Surgery Department, Mohammed VI University Hospital, Faculty of Medicine and Pharmacy
| | - Oumaima Hattab
- Department of Intensive Care Unit, Mohammed VI University Hospital
- Cardiology Department, Mohammed VI University Hospital, Faculty of Medicine and Pharmacy
| | - Nouha El Ouafi
- Faculty of Medicine and Pharmacy, Mohammed First University
- Cardiology Department, Mohammed VI University Hospital, Faculty of Medicine and Pharmacy
- Mohammed First University, FMP Oujda, LAMCESM, Oujda, Morocco
| | - Houssam Bkiyar
- Department of Intensive Care Unit, Mohammed VI University Hospital
- Faculty of Medicine and Pharmacy, Mohammed First University
- Mohammed First University, FMP Oujda, LAMCESM, Oujda, Morocco
| | - Brahim Housni
- Department of Intensive Care Unit, Mohammed VI University Hospital
- Faculty of Medicine and Pharmacy, Mohammed First University
- Mohammed First University, FMP Oujda, LAMCESM, Oujda, Morocco
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Agoumy Z, Berrag K, Soufiani A, Bendagha N, Fellat R. Double the Trouble - One Infarction After Another: A Case Report of Two Consecutive ST-Segment Elevation Myocardial Infarctions in Two Different Coronary Arteries. Cureus 2023; 15:e36616. [PMID: 37155456 PMCID: PMC10122754 DOI: 10.7759/cureus.36616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/23/2023] [Indexed: 05/10/2023] Open
Abstract
In multi-vessel coronary artery disease, concomitant ST-segment elevation myocardial infarction (STEMI) in simultaneous two culprit lesions have been rarely reported. In this regard, the recurrence in a short period of time of a STEMI in a different coronary artery is also rare. We describe the case of a 56-year-old male smoker, who was presented with an anterior STEMI. The coronary angiography demonstrated a significant lesion in the left main coronary (LMC) and an occlusion of the left anterior descending artery (LAD), and was referred for surgery. Four days later, he experienced symptoms of acute ischemia of the inferior territory. A newly formed culprit lesion of the circumflex artery (Cx) was detected and benefited from angioplasty. The patient expired the next day from sudden arrythmia. This case report shows two consecutive STEMI situations in separate coronary arteries, which commonly can occur in atherosclerotic patients with very poor prognosis.
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Dimitrova IN, Gaydarski L, Landzhov B, Olewnik Ł, Zielinska N, Tubbs RS, Georgiev GP. Variant origin of three main coronary ostia from the right sinus of Valsalva: report of a rare case. Folia Morphol (Warsz) 2022; 82:932-935. [PMID: 36385427 DOI: 10.5603/fm.a2022.0092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 10/12/2022] [Accepted: 10/14/2022] [Indexed: 11/18/2022]
Abstract
Observing anomalies in the origin of the coronary arteries is a rare but recognised scenario during coronarography. All the major coronary arteries originating from the right sinus of Valsalva is an extremely rare anomaly, its reported incidence being 0.008% in angiographic studies. Most coronary artery variations are benign and are therefore found accidentally or postmortem. However, some anomalies in the origin of the coronary arteries are associated with myocardial ischaemia and a higher risk of sudden cardiac death. Herein, we report a sporadic case of anomalous origin of the coronary arteries, in which the right coronary artery, anterior interventricular artery and left circumflex artery arise separately from the right sinus of Valsalva, each originating from a separate ostium. Regardless of their low incidence rate, coronary artery anomalies can cause serious technical challenges during coronary angiography and percutaneous interventions because of the unusual location and course of the artery. Echocardiography, computed tomography, and magnetic resonance imaging can be useful in such cases.
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Affiliation(s)
- I N Dimitrova
- Department of Cardiology, University Hospital "Al. Tschirkov", Medical University of Sofia, Bulgaria
| | - L Gaydarski
- Department of Anatomy, Histology and Embryology, Medical University of Sofia, Bulgaria
| | - B Landzhov
- Department of Anatomy, Histology and Embryology, Medical University of Sofia, Bulgaria
| | - Ł Olewnik
- Department of Anatomical Dissection and Donation, Chair of Anatomy and Histology, Medical University of Lodz, Poland
| | - N Zielinska
- Department of Anatomical Dissection and Donation, Chair of Anatomy and Histology, Medical University of Lodz, Poland
| | - R S Tubbs
- Department of Anatomical Sciences, St. George's University, Grenada, West Indies
- Department of Neurosurgery, Tulane University School of Medicine, New Orleans, Louisiana, United States
- Department of Neurology, Tulane University School of Medicine, New Orleans, Louisiana, United States
- Department of Structural and Cellular Biology, Tulane University School of Medicine, New Orleans, Louisiana, United States
- Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana, United States
| | - G P Georgiev
- Department of Orthopaedics and Traumatology, University Hospital Queen Giovanna - ISUL, Medical University of Sofia, Bulgaria.
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Ivanov LN, Maksimov AL, Mukhin SA, Chebotar' EV, Naumov SV, Nagaev RI, Mironov EA, Chukrin DI. [Surgical treatment of patients with abdominal aortic aneurysm and ischaemic heart disease]. Angiol Sosud Khir 2021; 27:85-93. [PMID: 34528592 DOI: 10.33529/angio2021316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Presented herein are the results of treatment of 137 patients with infrarenal aneurysms of the abdominal portion of the aorta in a combination with ischaemic heart disease. Severity of lesions to the coronary bed and the risk of cardiac complications were assessed according to the SYNTAX score. Depending on severity of angina pectoris and the clinical course of infrarenal aortic aneurysms, we used different tactical approaches to operative treatment of patients. In a low risk of coronary complications, we performed isolated prosthetic repair or endoprosthetic reconstruction of the abdominal aorta. In patients with haemodynamically significant lesions of the coronary bed and positive non-invasive tests, the first stage consisted in coronary artery bypass grafting or stenting of coronary arteries taking into account the risk of cardiac complications according to the SYNTAX Score. The second stage consisted in prosthetic repair or endoprosthetic reconstruction of the abdominal aorta. The terms of the second stage differed and were determined by the course of abdominal aortic aneurysms. In symptomatic large aneurysms (more than 8 cm), prosthetic repair of the abdominal aorta was carried out within 2 weeks after previous stenting of coronary arteries. Simultaneous myocardial revascularization and abdominal aortic reconstruction were performed only in patients with severe angina pectoris, lesions of the trunk of the left coronary artery, three-vessel lesions of the coronary bed, high risk of cardiac complications according to the SYNTAX Score and a complicated or symptomatic course of an infrarenal aortic aneurysm. During implantation of stent grafts into the abdominal aorta there were neither lethal outcomes nor cardiac complications. In open operations, the 30-day mortality rate amounted to 2.2%, with the 5-year survival rate of 92%.
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Affiliation(s)
- L N Ivanov
- Department of Hospital Surgery named after B.A. Korolev, Volga Research Medical University of the RF Ministry of Public Health, Nizhny Novgorod, Russia; Department of Vascular Surgery, Specialized Cardiosurgical Clinical Hospital named after Academician B.A. Korolev, Nizhny Novgorod, Russia
| | - A L Maksimov
- Department of Vascular Surgery, Specialized Cardiosurgical Clinical Hospital named after Academician B.A. Korolev, Nizhny Novgorod, Russia
| | - S A Mukhin
- Department of Hospital Surgery named after B.A. Korolev, Volga Research Medical University of the RF Ministry of Public Health, Nizhny Novgorod, Russia
| | - E V Chebotar'
- Department of Vascular Surgery, Specialized Cardiosurgical Clinical Hospital named after Academician B.A. Korolev, Nizhny Novgorod, Russia
| | - S V Naumov
- Department of Vascular Surgery, Specialized Cardiosurgical Clinical Hospital named after Academician B.A. Korolev, Nizhny Novgorod, Russia
| | - R Iu Nagaev
- Department of Vascular Surgery, Specialized Cardiosurgical Clinical Hospital named after Academician B.A. Korolev, Nizhny Novgorod, Russia
| | - E A Mironov
- Department of Vascular Surgery, Specialized Cardiosurgical Clinical Hospital named after Academician B.A. Korolev, Nizhny Novgorod, Russia
| | - D Iu Chukrin
- Department of Vascular Surgery, Specialized Cardiosurgical Clinical Hospital named after Academician B.A. Korolev, Nizhny Novgorod, Russia
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Van De Bruaene L, Dujardin K, Gryspeerdt S. When the artefact becomes fact. Acta Cardiol 2021; 77:660-661. [PMID: 34085596 DOI: 10.1080/00015385.2021.1933795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
| | - Karl Dujardin
- Department of Cardiology, AZ Delta, Roeselare, Belgium
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Bajraktari G, Rexhaj Z, Elezi S, Zhubi-Bakija F, Bajraktari A, Bytyçi I, Batalli A, Henein MY. Radial Access for Coronary Angiography Carries Fewer Complications Compared with Femoral Access: A Meta-Analysis of Randomized Controlled Trials. J Clin Med 2021; 10:jcm10102163. [PMID: 34067672 PMCID: PMC8156941 DOI: 10.3390/jcm10102163] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 05/04/2021] [Accepted: 05/06/2021] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND AND AIM In patients undergoing diagnostic coronary angiography (CA) and percutaneous coronary interventions (PCI), the benefits associated with radial access compared with the femoral access approach remain controversial. The aim of this meta-analysis was to compare the short-term evidence-based clinical outcome of the two approaches. METHODS The PubMed, Embase, Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov databases were searched for randomized controlled trials (RCTs) comparing radial versus femoral access for CA and PCI. We identified 34 RCTs with 29,352 patients who underwent CA and/or PCI and compared 14,819 patients randomized for radial access with 14,533 who underwent procedures using femoral access. The follow-up period for clinical outcome was 30 days in all studies. Data were pooled by meta-analysis using a fixed-effect or a random-effect model, as appropriate. Risk ratios (RRs) were used for efficacy and safety outcomes. RESULTS Compared with femoral access, the radial access was associated with significantly lower risk for all-cause mortality (RR: 0.74; 95% confidence interval (CI): 0.61 to 0.88; p = 0.001), major bleeding (RR: 0.53; 95% CI:0.43 to 0.65; p ˂ 0.00001), major adverse cardiovascular events (MACE)(RR: 0.82; 95% CI: 0.74 to 0.91; p = 0.0002), and major vascular complications (RR: 0.37; 95% CI: 0.29 to 0.48; p ˂ 0.00001). These results were consistent irrespective of the clinical presentation of ACS or STEMI. CONCLUSIONS Radial access in patients undergoing CA with or without PCI is associated with lower mortality, MACE, major bleeding and vascular complications, irrespective of clinical presentation, ACS or STEMI, compared with femoral access.
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Affiliation(s)
- Gani Bajraktari
- Department of Public Health and Clinical Medicine, Umeå University, 90187 Umeå, Sweden; (A.B.); (I.B.); (M.Y.H.)
- Clinic of Cardiology, University Clinical Centre of Kosova, 10000 Prishtina, Kosovo; (Z.R.); (S.E.); (F.Z.-B.); (A.B.)
- Medical Faculty, University of Prishtina “Hasan Prishtina”, 10000 Prishtina, Kosovo
- UBT College, 10000 Prishtina, Kosovo
- Correspondence:
| | - Zarife Rexhaj
- Clinic of Cardiology, University Clinical Centre of Kosova, 10000 Prishtina, Kosovo; (Z.R.); (S.E.); (F.Z.-B.); (A.B.)
| | - Shpend Elezi
- Clinic of Cardiology, University Clinical Centre of Kosova, 10000 Prishtina, Kosovo; (Z.R.); (S.E.); (F.Z.-B.); (A.B.)
- Medical Faculty, University of Prishtina “Hasan Prishtina”, 10000 Prishtina, Kosovo
| | - Fjolla Zhubi-Bakija
- Clinic of Cardiology, University Clinical Centre of Kosova, 10000 Prishtina, Kosovo; (Z.R.); (S.E.); (F.Z.-B.); (A.B.)
| | - Artan Bajraktari
- Department of Public Health and Clinical Medicine, Umeå University, 90187 Umeå, Sweden; (A.B.); (I.B.); (M.Y.H.)
- Clinic of Cardiology, University Clinical Centre of Kosova, 10000 Prishtina, Kosovo; (Z.R.); (S.E.); (F.Z.-B.); (A.B.)
| | - Ibadete Bytyçi
- Department of Public Health and Clinical Medicine, Umeå University, 90187 Umeå, Sweden; (A.B.); (I.B.); (M.Y.H.)
- Clinic of Cardiology, University Clinical Centre of Kosova, 10000 Prishtina, Kosovo; (Z.R.); (S.E.); (F.Z.-B.); (A.B.)
| | - Arlind Batalli
- Clinic of Cardiology, University Clinical Centre of Kosova, 10000 Prishtina, Kosovo; (Z.R.); (S.E.); (F.Z.-B.); (A.B.)
- Medical Faculty, University of Prishtina “Hasan Prishtina”, 10000 Prishtina, Kosovo
| | - Michael Y. Henein
- Department of Public Health and Clinical Medicine, Umeå University, 90187 Umeå, Sweden; (A.B.); (I.B.); (M.Y.H.)
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Mujicic E, Kevric E, Rasic S, Selimovic A, Granov N, Music D. Contrast Media Injector Technology - Renal Safety During Coronarography. Acta Inform Med 2015; 23:273-5. [PMID: 26635433 PMCID: PMC4639354 DOI: 10.5455/aim.2015.23.273-275] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Accepted: 10/05/2015] [Indexed: 11/12/2022] Open
Abstract
Aim: This study sought to assess whether the volume and osmolarity of contrast media (CM) influences the occurrence of contrast induced nephropathy (CIN) following coronarography procedure. CIN can be defined as an increase in the serum concentration of creatinine greater than a 25% from baseline during the period of 12 to 48 hours after the administration of radiocontrast media. Material and methods: We examined 100 patients without diabetes with serum creatinine concentration from 45 mmol/l to 141 mmol/l and 100 patients with diabetes with serum creatinine concentration from 46 mmol/l to 161 mmol/l who underwent coronary angiography. During procedure they received iso-osmolar contrast medium, Visipaque 320 (iodixanol-320), for group without diabetes from 40 to 340 ml and for group with diabetes from 49 to 310 ml. Results: CIN occurred in 27 (13,5%) of the 200 study patients. There was a trend toward higher prevalence of CIN (16% vs.11%, p = 0.086) in the diabetic group compared with the non-diabetic group. Patient with diabetes received less contrast media, they are younger but number patients with CIN are higher.
Conclusion: Increasing contrast media dose is associated with the occurrence of CIN following coronarography. But, another risk factors like diabetes mellitus, old age, male sex and preexisting kidney disease have influence of developing CIN after coronarography.
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Affiliation(s)
- Ermina Mujicic
- Institute for Heart, Clinical Center of University of Sarajevo, Sarajevo Bosnia and Herzegovina
| | - Ekrem Kevric
- Institute for Heart, Clinical Center of University of Sarajevo, Sarajevo Bosnia and Herzegovina
| | - Senija Rasic
- Nephrology Clinic, Clinical Center of University of Sarajevo, Sarajevo Bosnia and Herzegovina
| | - Amina Selimovic
- Paediatric Clinic, Clinical Center of University of Sarajevo, Sarajevo Bosnia and Herzegovina
| | - Nermir Granov
- Institute for Heart, Clinical Center of University of Sarajevo, Sarajevo Bosnia and Herzegovina
| | - Dinka Music
- Institute for Heart, Clinical Center of University of Sarajevo, Sarajevo Bosnia and Herzegovina
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Kania M, Zaczek R, Zavala-Fernandez H, Janusek D, Kobylecka M, Królicki L, Opolski G, Maniewski R. ST-segment changes in high-resolution body surface potential maps measured during exercise to assess myocardial ischemia: a pilot study. Arch Med Sci 2014; 10:1086-90. [PMID: 25624843 PMCID: PMC4296061 DOI: 10.5114/aoms.2013.39938] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2013] [Revised: 11/27/2013] [Accepted: 12/06/2013] [Indexed: 12/15/2022] Open
Abstract
INTRODUCTION The aim of the study was to assess myocardial ischemia by analysis of ST-segment changes in high-resolution body surface potential maps (HR-BSPM) measured at rest and during an exercise stress test. MATERIAL AND METHODS The study was carried out on a group of 28 patients with stable coronary artery disease and 15 healthy volunteers. The HR-BSPM were measured at rest and during the exercise stress test on a supine ergometer. The workload was increased in stages by 25 W every 2 min, beginning at 50 W. The maps of ST-segment depression (ST60) were calculated from time averaged recordings at rest and at maximal workload. RESULTS The efficiency in detection of myocardial ischemia was higher for HR-BSPM than for standard 12-lead electrocardiography (ECG) when both methods were evaluated by outcomes of coronarography. The sensitivity of HR-BSPM was 82.4% while for the standard 12-lead ECG exercise stress test it was 58.8%. For some patients significant changes in the ST segment were observed at stress HR-BSPM but were not visible in standard 12-lead ECG recorded under the same conditions. CONCLUSIONS Obtained high values of sensitivity and specificity in myocardial ischemia detection suggest that maps of ST60 calculated from HR-BSPM can improve detection of patients with ischemic heart disease in comparison to the standard electrocardiographic exercise stress test examinations.
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Affiliation(s)
- Michał Kania
- Nalecz Institute of Biocybernetics and Biomedical Engineering, Polish Academy of Sciences, Warsaw, Poland
| | - Rajmund Zaczek
- I Chair Department of Cardiology, Medical University of Warsaw, Warsaw, Poland
| | - Heriberto Zavala-Fernandez
- Nalecz Institute of Biocybernetics and Biomedical Engineering, Polish Academy of Sciences, Warsaw, Poland
| | - Dariusz Janusek
- Nalecz Institute of Biocybernetics and Biomedical Engineering, Polish Academy of Sciences, Warsaw, Poland
| | | | - Leszek Królicki
- Department of Nuclear Medicine, Medical University of Warsaw, Warsaw, Poland
| | - Grzegorz Opolski
- I Chair Department of Cardiology, Medical University of Warsaw, Warsaw, Poland
| | - Roman Maniewski
- Nalecz Institute of Biocybernetics and Biomedical Engineering, Polish Academy of Sciences, Warsaw, Poland
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Chodór P, Morawski S, Sulik-Gajda S, Ramus N, Kowalczyk J, Honisz G, Wilczek K, Sredniawa B, Kalarus Z. Evaluation of the usefulness of coronary catheters and 4 Fr insertion sets for transradial access coronarography in comparison with catheters and 5 Fr sets. Postepy Kardiol Interwencyjnej 2013; 9:332-6. [PMID: 24570748 DOI: 10.5114/pwki.2013.38860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2013] [Revised: 10/08/2013] [Accepted: 10/10/2013] [Indexed: 11/17/2022] Open
Abstract
Introduction Application of transradial arterial access during coronarography, besides pain, means faster patient mobilization and fewer complications. During those procedures, vascular sheaths and 5/6 Fr catheters, and lately 4 Fr catheters, are used. Aim To assess the usefulness of 4 Fr catheters and sheaths in comparison to 5 Fr in diagnostic coronarography. Material and methods In the period from 5.12.2010 to 27.02.2012, a group of patients who had coronarography with a 4 Fr catheter (n = 20) and a 5 Fr catheter (n = 20) were studied. Technical issues and potential problems related to the use of each catheter were analyzed. Morphology, biochemical parameters, and local complications were analyzed. The assessment included pain intensification during catheter removal and insertion in the VAS/numerical (0–10)/verbal scales and the quality of image obtained during the coronarography. Results All the angiograms obtained during all the interventions were of diagnostic value and in invasive cardiologists’ opinions, they did not differ statistically in clarity. Moreover, there were no statistically significant differences in radiation/fluoroscopy time, amount of contrast medium, or morphological and biochemical parameters. The size of hematomas in the 4 Fr group was 17.55 ±14.6 cm2, and in the 5 Fr group 31.07 ±32.11 cm2, p = 0.12. The average intensity of pain felt during the intervention/at the time of its removal and insertion in the numerical scale was in the 4 Fr group 0.65 ±0.93/0.55 ±0.94 and in the 5 Fr group 1.88 ±1.64/1.42 ±1.61, p < 0.05. Conclusions Application of 4 Fr catheters allows one to perform a diagnostic procedure with a small number of local and hemorrhagic complications comparable with 5 Fr catheters. Due to reduced pain, it is appropriate to continue studies with the use of 4 Fr catheters and sheaths.
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Abid L, Frikha F, Bahloul Z, Kammoun S. Acute myocardial infarction in young adults with antiphospholipid syndrome: report of two cases and literature review. Pan Afr Med J 2011; 8:13. [PMID: 22121422 PMCID: PMC3201580 DOI: 10.4314/pamj.v8i1.71062] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2010] [Accepted: 02/12/2011] [Indexed: 11/22/2022] Open
Abstract
Abstract Acute myocardial infarction (AMI) is rarely associated with antiphospholipid syndrome. The treatment of these patients is a clinical challenge. We report the observations of 2 young adults (1 woman and 1 man), admitted in our acute care unit for acute myocardial infarction (AMI). A coagulopathy work-up concludes the existence of antiphospholipid syndrome (APS) in the 2 cases. APS syndrome was considered primary in 2 cases. All patients presented an intense inflammatory syndrome (high level of CRP). Anticardiolipine was present in the 2 cases. However, anti B2 glycoprotein I antibodies were detected in only one case. Emergency percutaneous transluminal coronary angioplasty (PTCA) with direct stenting had been performed successfully only in the first case, and the follow-up was uncomplicated. Thereafter, long-term oral anticoagulant appeared to be effective. The last patient was admitted because of peripheral acute ischemia of legs. Standard electrocardiogram showed signs of previous silent anteroseptal wall myocardial infarction confirmed by echocardiography. The latter revealed an apical thrombus and a very low left ventricular ejection fraction. Amputation of the right leg was necessary because of consultation occurred too late. However, he died four weeks later. Primary antiphospholipid syndrome should be considered as a cause of acute myocardial infarction in young adults, and PTCA with anticoagulant treatment is effective for initial treatment of this complication.
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Affiliation(s)
- Leila Abid
- Cardiology department, Hedi chaker hospital Sfax, Tunisia
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