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1.
J Investig Med High Impact Case Rep ; 9: 23247096211024027, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34121486

RESUMEN

Ventricular noncompaction is a rare, heterogeneous cardiomyopathy characterized by marked trabeculations and deep intertrabecular spaces with clinical sequelae of heart failure, arrhythmias, and cardioembolic events. In this article, we describe a patient with isolated right ventricular noncompaction who presented with submassive pulmonary embolism, which was managed with long-term direct oral anticoagulation.


Asunto(s)
Cardiomiopatías , Insuficiencia Cardíaca , Embolia Pulmonar , Cardiomiopatías/complicaciones , Cardiomiopatías/diagnóstico por imagen , Insuficiencia Cardíaca/etiología , Ventrículos Cardíacos/diagnóstico por imagen , Humanos , Embolia Pulmonar/complicaciones , Embolia Pulmonar/diagnóstico por imagen
2.
Int Med Case Rep J ; 13: 623-629, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33209063

RESUMEN

Coronary artery disease (CAD) is amongst the leading causes of death in human immunodeficiency virus (HIV)-infected persons. Severe left main disease (LMD) occurs in approximately five percent of HIV-infected patients, with chronic total occlusion (CTO) of this vessel being an even rarer phenomenon. We describe a non-adherent HIV-infected patient with a left main coronary artery (LMCA) CTO that presented with heart failure with mildly reduced ejection fraction (HFrEF) and ventricular tachycardia (VT).

3.
J Investig Med High Impact Case Rep ; 8: 2324709620951652, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32815420

RESUMEN

Penetrative cardiac injury can often result in life-threatening sequelae such as myocardial contusion or rupture, coronary vessel and valvular damage, pericardial effusion with tamponade, and arrhythmias of which gunshot injury is a chief culprit. We report a case of a suspected acute coronary syndrome after a cardiac gunshot injury that was conservatively managed.


Asunto(s)
Síndrome Coronario Agudo/etiología , Cuerpos Extraños/complicaciones , Derrame Pericárdico/etiología , Heridas por Arma de Fuego/complicaciones , Síndrome Coronario Agudo/diagnóstico , Taponamiento Cardíaco/etiología , Cuerpos Extraños/diagnóstico , Humanos , Masculino , Persona de Mediana Edad , Derrame Pericárdico/diagnóstico , Radiografía Torácica , Tomografía Computarizada por Rayos X
4.
SAGE Open Med Case Rep ; 8: 2050313X20933484, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32685152

RESUMEN

Cardiac myxomas are the most frequently encountered tumors of the heart. However, they are unusual to be newly diagnosed in the geriatric population. Myxomas are among the great mimickers, with a myriad of clinical presentations related to heart failure, embolic events, and constitutional symptoms. We describe a rare case of a giant atrial myxoma in a nonagenarian presenting with heart failure, which was medically managed.

5.
SAGE Open Med Case Rep ; 8: 2050313X20927596, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32551115

RESUMEN

Thymic carcinoma typically exhibits more clinically aggressive behavior and portends a worse prognosis as compared to thymoma. Venous thromboembolism is a significant cause of morbidity and mortality in oncologic patients. Traditionally, the standard-of-care management of cancer-associated venous thromboembolism has been therapeutic anticoagulation with low molecular weight heparins; however, with the advent of direct oral anticoagulants, there is an ongoing paradigm shift to transition to these novel agents in an attempt to attenuate cancer-associated venous thromboembolism events. We describe an exceedingly rare case of metastatic thymic carcinoma-associated right atrial thrombus with high-risk embolic features, which subsequently underwent near-complete dissolution with rivaroxaban after 3 months.

6.
J Investig Med High Impact Case Rep ; 8: 2324709620933425, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32525425

RESUMEN

In isolated partial anomalous pulmonary venous connections (PAPVCs), an abnormal vein connects venous blood from the pulmonary circulation to the systemic circulation, resulting in an extracardiac shunt. A single aberrant pulmonary vein (PV) is usually hemodynamically insignificant, and affected patients are generally asymptomatic. We describe a young Caribbean-Black woman with an isolated, singular PAPVC from the left inferior PV to the left innominate (brachiocephalic) vein that was hemodynamically significant, obfuscated by recurrent pleural effusions from catamenial pleural endometriosis.


Asunto(s)
Venas Braquiocefálicas/anomalías , Cardiopatías Congénitas/diagnóstico por imagen , Venas Pulmonares/anomalías , Síndrome de Cimitarra/diagnóstico por imagen , Adulto , Angiografía por Tomografía Computarizada , Ecocardiografía Transesofágica , Electrocardiografía , Femenino , Cardiopatías Congénitas/cirugía , Hemodinámica , Humanos , Imagen por Resonancia Magnética , Radiografía Torácica , Síndrome de Cimitarra/cirugía
7.
J Investig Med High Impact Case Rep ; 8: 2324709620925571, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32370558

RESUMEN

The coronavirus disease-2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) that has significant potential cardiovascular implications for patients. These include myocarditis, acute coronary syndromes, cardiac arrhythmias, cardiomyopathies with heart failure and cardiogenic shock, and venous thromboembolic events. We describe a Caribbean-Black gentleman with COVID-19 infection presenting with atrial arrhythmias, namely, atrial flutter and atrial fibrillation, which resolved with rate and rhythm control strategies, and supportive care.


Asunto(s)
Fibrilación Atrial/diagnóstico , Infecciones por Coronavirus/diagnóstico , Neumonía Viral/diagnóstico , Fibrilación Atrial/diagnóstico por imagen , Fibrilación Atrial/etiología , Fibrilación Atrial/terapia , Betacoronavirus , COVID-19 , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/diagnóstico por imagen , Infecciones por Coronavirus/terapia , Humanos , Masculino , Persona de Mediana Edad , Pandemias , Neumonía Viral/complicaciones , Neumonía Viral/diagnóstico por imagen , Neumonía Viral/terapia , SARS-CoV-2 , Tórax/diagnóstico por imagen
8.
J Investig Med High Impact Case Rep ; 8: 2324709620921626, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32389028

RESUMEN

The quadricuspid aortic valve is an exceedingly rare congenital valvular anomaly, characterized by a tetrad of leaflets that typically presents with aortic regurgitation. Almost one third of cases are associated with coexisting cardiac defects with one fifth warranting surgical intervention. In this article, we describe the first documented-in-Caribbean case and present a brief clinical review of its pathophysiology, diagnosis, and management.


Asunto(s)
Insuficiencia de la Válvula Aórtica/etiología , Válvula Aórtica/anomalías , Válvula Aórtica Cuadricúspide/diagnóstico , Adulto , Válvula Aórtica/cirugía , Ecocardiografía , Electrocardiografía , Humanos , Masculino , Válvula Aórtica Cuadricúspide/cirugía , Tomografía Computarizada por Rayos X , Trinidad y Tobago
9.
Case Rep Cardiol ; 2019: 9027029, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31885934

RESUMEN

Brugada syndrome (BrS) is a genetic condition that accentuates the risk of potentially lethal ventricular arrhythmias and sudden cardiac death (SCD) in a structurally normal heart. The Brugada electrocardiographic pattern may manifest separately from the syndrome-this clinical scenario has been described as Brugada phenocopy (BrP). Many etiologies of BrP have been reported, but it has not yet been reported as a result of coronary slow flow (CSF) phenomenon. This case report highlights a suspected coronary slow flow-associated Brugada type 1 electrocardiographic pattern, which subsequently normalized following the institution of guideline-directed medical therapy for acute coronary syndrome.

10.
J Investig Med High Impact Case Rep ; 7: 2324709619874624, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31509019

RESUMEN

Pregnancy-associated spontaneous coronary artery dissection (PASCAD) accounts for less than 5% of spontaneous coronary artery dissection cases and is comparatively more fulminant or clinically aggressive. Several factors associated with PASCAD include black ethnicity, multiparity, hypertension, advanced maternal age, and age at first childbirth. This atypical case highlights a preeclamptic patient presenting with an ST-segment elevation myocardial infarction in which multivessel dissection of both the left anterior descending and right coronary arteries were deemed co-culprit lesions for the index event.


Asunto(s)
Anomalías de los Vasos Coronarios/etiología , Preeclampsia/diagnóstico , Enfermedades Vasculares/congénito , Adulto , Cineangiografía , Anomalías de los Vasos Coronarios/diagnóstico , Anomalías de los Vasos Coronarios/diagnóstico por imagen , Electrocardiografía , Femenino , Humanos , Masculino , Preeclampsia/patología , Embarazo , Infarto del Miocardio con Elevación del ST/complicaciones , Infarto del Miocardio con Elevación del ST/diagnóstico , Enfermedades Vasculares/diagnóstico , Enfermedades Vasculares/diagnóstico por imagen , Enfermedades Vasculares/etiología
11.
Case Rep Vasc Med ; 2019: 6020393, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31285934

RESUMEN

Carotid artery pseudoaneurysms are infrequently encountered in clinical practice. Major contributory etiologies include blunt trauma, infections, cystic medial necrosis, fibromuscular dysplasia, arteriosclerosis, and congenital abnormalities. The authors report an exceedingly rare case of a dissected external carotid artery pseudoaneurysm in a 26-year-old female patient with neurofibromatosis complicated by preeclampsia at 28-week period of gestation, safely and successfully treated by coil embolization.

12.
Int Med Case Rep J ; 12: 179-183, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31354366

RESUMEN

Cardiac myxomas are the most common benign tumors of the heart. We describe the rare phenomenon of myxomatous embolization, resulting in a non-ST-elevation myocardial infarction treated successfully with surgical excision. The routine early use of both transthoracic and transesophageal echocardiography is pivotal in selecting an optimal management strategy for these patients.

13.
Open Heart ; 6(1): e000841, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-30997117

RESUMEN

Objectives: This novel, pilot study aimed to assess the estimated prevalence of high on-treatment platelet reactivity (HPR) in Trinidad and Tobago. Methods: Patients (n=40) who were awaiting elective percutaneous coronary intervention on maintenance dual antiplatelet therapy (DAPT) with aspirin 81 mg daily and clopidogrel 75 mg or loaded at least 48 hours prior were recruited. Platelet reactivity with the VerifyNow P2Y12 assay (Accriva Diagnostics, San Diego, California, USA) was assessed prior to cardiac catheterisation. Results: 60.7% (17/28) of the South Asian (Indo-Trinidadians) patients had HPR, whereas 14.3% (1/7) of Africans and 40% (2/5) of mixed ethnicity had HPR. There was a significant association between HPR (P2Y12 reaction units >208) and ethnicity with South Asians (Indo-Trinidadians) (OR 5.4; 95% CI 1.18 to 24.66, p=0.029). Conclusions: This pilot study serves to introduce the preliminary observation that the estimated prevalence of HPR is considerably higher within the heterogeneous population in Trinidad at 50% as compared with predominantly Caucasian studies. Furthermore, the HPR is significantly higher in South Asians (Indo-Trinidadians) (>60% of patients) which has severe clinical repercussions considering the cardiovascular disease pandemic. Clopidogrel may not be a satisfactory or optimal antiplatelet agent in this subgroup, and therefore, another more potent antiplatelet such as ticagrelor should be used instead. Further large-scale studies are imperative to confirm these findings. (Funded by the University of the West Indies, St. Augustine; POINT ClinicalTrials.gov number, NCT03667066.).

14.
Int Med Case Rep J ; 12: 61-65, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-30881148

RESUMEN

Brugada syndrome is a genetic condition that predisposes to an increased risk of ventricular fibrillation and sudden cardiac death in a structurally normal heart. The Brugada type 1 electrocardiogram (ECG) pattern may occur independently of the actual syndrome, and this clinical phenomenon is often referred to as Brugada phenocopy. There are several other factors which have been known to induce this electrocardiographic pattern, and currently, there is a paucity of literature with respect to the pattern that is observed in patients with electrolyte disturbances, specifically hyponatremia. This case report highlights a suspected hyponatremia-induced Brugada type 1 ECG pattern, which subsequently normalized following resolution of the electrolyte derangement.

15.
J Investig Med High Impact Case Rep ; 6: 2324709618792028, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-30057925

RESUMEN

Kawasaki disease is an acute multisystemic vasculitis occurring predominantly in children and rarely in adults, with sequelae of potentially life-threatening coronary artery aneurysms. "Incomplete" Kawasaki disease is a novel concept and considered a diagnosis of exclusion as it alludes to patients with fever lasting ⩾5 days and 2 or 3 clinical criteria without another reasonable explanation for the illness. The multidisciplinary team should be vigilant for this oligosymptomatic clinical presentation, specifically within this subgroup despite age and ethnicity, and the syndrome should be considered as a differential diagnosis in challenging cases presenting as infectious or autoimmune disease.

16.
Int Med Case Rep J ; 11: 139-143, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-29950906

RESUMEN

Coronary artery disease is currently one of the leading causes of mortality in patients with HIV. Severe left main disease (LMD) occurs in ~6% of the HIV-infected patients. We describe a case report of an atypical presentation of silent critical LMD in an HIV-infected patient who underwent a low-risk exercise stress test. The cardiovascular disease team should be vigilant for this latent phenomenon, specifically within this subpopulation despite the high Duke treadmill score.

17.
J Investig Med High Impact Case Rep ; 5(2): 2324709617712735, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-28607937

RESUMEN

Anaphylaxis is a sudden-onset, severe hypersensitivity reaction that can be potentially fatal. It can often transition to refractory hemodynamic instability, eventually resulting in death. Stress-related cardiomyopathies (SRCs) have multifactorial etiologies, including being linked to excessive catecholamine release in periods of intense stress. This novel case report recounts a SRC caused by contrast-induced anaphylaxis within 1 hour post percutaneous coronary intervention. Both acutely life-threatening conditions may occur simultaneously and are implicated with devastating complications. Further research is required to understand this cardiac-neuroaxis interplay in SRC to identify risk factors and develop management strategies.

18.
J Investig Med High Impact Case Rep ; 5(1): 2324709617697991, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-28540312

RESUMEN

The incidence of left ventricular (LV) thrombi in the setting of an anterior myocardial infarction has declined significantly since the advent of primary percutaneous coronary intervention coupled with contemporary antithrombotic strategies in ST-segment elevation myocardial infarctions (STE-ACS). Despite oral anticoagulation with the currently accepted, standard-of-care vitamin K antagonist, warfarin, major bleeding complications still arise. Rivaroxaban is a novel, direct oral factor X anticoagulant that has several advantageous properties, which can attenuate bleeding risk. We present a case in which a patient successfully underwent a 3-month course of rivaroxaban in addition to his dual antiplatelet regimen of aspirin and ticagrelor for his STE-ACS and LV thrombus with resultant complete dissolution.

19.
Case Rep Cardiol ; 2017: 7612713, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-29391955

RESUMEN

Angioedema can cause potentially life-threatening airway obstruction. This case report describes an exceedingly rare episode of ticagrelor-induced hypersensitivity reaction, manifesting as angioedema with periorbital and likely respiratory involvement. The heart team should be vigilant for this precarious condition which may require emergent airway management. Desensitization protocols and alternative regimens (e.g., clopidogrel, prasugrel, and addition of an adjunctive anticoagulant) should be considered when there is an absolute indication for antiplatelet therapy.

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