Acute myocardial infarction associated with severe Plasmodium vivax malaria.

Malaria is still a major public health problem, even after many preventive strategies. Plasmodium vivax is also a major health concern now due to the addition of new unusual manifestations day by day in its clinical profile. Herewith, we report a case of a 15-yr-old male of severe P. vivax malaria (complicated with thrombocytopenia, hepatitis, acute lung injury, and shock), who developed chest pain. Later, he was confirmed to have acute myocardial infarction based on electrocardiography, cardiac enzymes, and echocardiography. PubMed and Google-based literature search found that it was the first confirmed case of this type. Fortunately, timely diagnosis and appropriate management saved his life.

Use of a multiplex polymerase chain reaction to rapidly differentiate Neospora caninum from Toxoplasma gondii in an adult dog with necrotizing myocarditis and myocardial infarct.

This report describes a 3-year-old male castrated Mastiff dog that died unexpectedly with locally extensive, acute, necrotizing myocarditis and myocardial infarction. Intralesional protozoal tachyzoites in the affected myocardium were confirmed to be Neospora caninum by a novel multiplex polymerase chain reaction (PCR) and immunohistochemistry. Protozoal organisms were not identified in other tissues by histology, immunohistochemistry, or PCR. The multiplex PCR assay was used to quickly provide preliminary results on fresh myocardium to differentiate N. caninum and Toxoplasma gondii. Neosporosis is an uncommon cause of myocarditis in adult dogs and differential diagnoses for myocarditis in this population of dogs are reviewed.

Monitorização hemodinâmica em emergência. Visão do fisioterapeuta: fisiologia aos efeitos da ventilação mecânica / Hemodynamic monitoring in emergency, the physiotherapist's perspectives: physiology for the effects of mechanical ventilation

Em diversas situações de emergência cardiológica, a tomada de decisão rápida a beira leito deve estar bem fundamentada para melhor eficácia terapêutica e baseada no conhecimento fisiológico e fisiopatológico da disfunção cardíaca que associada com a adequada monitorização hemodinâmica do paciente possibilitam indicar ou contraindicar o uso da ventilação mecânica invasiva e não-invasiva. Portanto, o presente artigo de opinião reitera alguns aspectos hemodinâmicos a serem lembrados e aplicados no dia a dia do fisioterapeuta

In various cardiac emergency situations, rapid decision-making at the patient's bedside should be well-founded, to ensure better therapeutic efficacy that is based on a physiological and pathophysiological knowledge of the cardiac dysfunction and adequate hemodynamic monitoring of the patient, enabling the indication or non-indication of invasive/non-invasive mechanical ventilation. This opinion article therefore reiterates some hemodynamic aspects to be remembered and applied in the physical therapist's daily routine

Electrocardiographic changes and myocarditis in trichinellosis: a retrospective study of 154 patients.

The frequencies of electrocardiographic (ECG) abnormalities and myocarditis were determined, retrospectively, among 154 cases of trichinellosis [101 males and 53 females, with a mean (S.D.) age of 35.60 (14.64) years] who were hospitalized at the University Hospital for Infectious Diseases in Zagreb, Croatia, over a 5-year period. Eighty-seven (56%) of the patients, most of them in the invasive phase of infection with Trichinella spiralis, were found to have abnormalities when examined by 12-lead, resting electrocardiography. The ECG disorder most frequently observed was a non-specific ventricular repolarization disturbance (with ST-T wave changes), followed by bundle-branch conduction disturbances, and sinus tachycardia. The other ECG disorders recorded, during various phases of the infection, were sinus bradycardia, right bundle-branch block, supraventricular and ventricular extrasystoles, low-voltage QRS complexes in standard limb leads, first-degree atrio-ventricular block, and atrial fibrillation. Eighteen (12%) of the patients were identified as cases of myocarditis (13 in the invasive phase and five in the convalescent) and two (1.3%) as cases of myopericarditis. One patient developed acute myocardial infarction 28 days after the onset of disease and died soon thereafter; an autopsy revealed multiple necroses and fibroses of the myocardium and thrombus of a coronary artery. Although ECG abnormalities appear to be a common feature of trichinellosis, especially during the invasive phase of the disease, they are rarely associated with a poor prognosis. A transient, non-specific, ventricular-repolarization disturbance is the abnormality most commonly observed.