Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 1.392
Filtrar
1.
BMJ Case Rep ; 14(1)2021 Jan 11.
Artigo em Inglês | MEDLINE | ID: mdl-33431448

RESUMO

Embolised needles causing injury to the right heart and cardiac tamponade has been reported before in intravenous drug users, but to our knowledge, this is the first reported case of a needle migrating via the pulmonary arterial system to cause perforation of the left ventricle. Appropriate utilisation of imaging modalities such as plain X-ray and point-of-care focused cardiac ultrasound can be vital and life-saving in the emergency setting, and the value of gated multidetector CT as a powerful tool for imaging moving structures is highlighted.


Assuntos
Migração de Corpo Estranho/diagnóstico , Traumatismos Cardíacos/diagnóstico , Ventrículos do Coração/lesões , Agulhas/efeitos adversos , Abuso de Substâncias por Via Intravenosa/complicações , Adulto , Ponte Cardiopulmonar , Ecocardiografia , Migração de Corpo Estranho/complicações , Migração de Corpo Estranho/cirurgia , Traumatismos Cardíacos/etiologia , Traumatismos Cardíacos/cirurgia , Ventrículos do Coração/diagnóstico por imagem , Ventrículos do Coração/cirurgia , Humanos , Pulmão/irrigação sanguínea , Pulmão/diagnóstico por imagem , Pulmão/cirurgia , Masculino , Pericardiocentese , Artéria Pulmonar/diagnóstico por imagem , Cirurgia Torácica Vídeoassistida , Resultado do Tratamento
3.
Saudi Med J ; 41(11): 1204-1210, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33130840

RESUMO

OBJECTIVES: To evaluate acute cardiac injury in COVID-19 patients and its association with adverse outcomes including mortality in the United Arab Emirates (UAE) population. METHODS: A retrospective study conducted between February and June 2020 in Dubai, UAE, for all laboratory-confirmed Coronavirus disease-19 patients. Demographic, clinical, laboratory, radiological, and clinical outcomes were compared between patients with and without acute cardiac injury. RESULTS: During the study period, 203 patients were included, of which, 44 (21.7%) had evidence of acute cardiac injury. Compared with patients without acute cardiac injury, patients with acute cardiac injury were: older, had more shortness of breath, diabetes, hypertension, and more bilateral airspace shadowing on admission chest radiography. These patients also had a higher neutrophil count, C-reactive protein, procalcitonin, ferritin, D-dimers and lactate dehydrogenase but lower lymphocyte count. Regarding outcomes, these patients had higher intensive care admissions; a higher rate of complications including acute kidney and liver injury, acidosis, septic shock, acute respiratory distress syndrome, needed more mechanical ventilation, and had a significantly higher risk of death. CONCLUSION: Acute cardiac injury is common among Coronavirus disease-19 patients. These patients present with higher comorbidities, have high inflammatory markers and have greater risk for in-hospital multi-organ damage, need for mechanical ventilation, and death. Prompt full assessment and intervention are recommended.


Assuntos
Causas de Morte , Infecções por Coronavirus/epidemiologia , Traumatismos Cardíacos/epidemiologia , Mortalidade Hospitalar/tendências , Pandemias/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Doença Aguda , Adulto , Idoso , Estudos de Coortes , Comorbidade , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/terapia , Feminino , Traumatismos Cardíacos/diagnóstico , Hospitalização/estatística & dados numéricos , Hospitais Urbanos , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias/prevenção & controle , Pneumonia Viral/diagnóstico , Pneumonia Viral/terapia , Estudos Retrospectivos , Arábia Saudita/epidemiologia , Índice de Gravidade de Doença , Taxa de Sobrevida
4.
J Mol Cell Cardiol ; 147: 74-87, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32827510

RESUMO

BACKGROUND: Cardiac injury, as measured by troponin elevation, has been reported among hospitalized coronavirus disease 2019 (COVID-19) patients and portends a poor prognosis. However, how the dynamics of troponin elevation interplay with inflammation and coagulation biomarkers over time is unknown. We assessed longitudinal follow-up of cardiac injury, inflammation and coagulation markers in relation to disease severity and outcome. METHODS: We retrospectively assessed 2068 patients with laboratory-confirmed COVID-19 between January 29 and April 1, 2020 at Tongji Hospital in Wuhan, China. We defined cardiac injury as an increase in high sensitivity cardiac troponin-I (hs-cTnI) above the 99th of the upper reference limit. We explored the dynamics of elevation in hs-cTnI and the relationship with inflammation (interleukin [IL]-6, IL-8, IL-10, IL-2 receptor, tumor necrosis factor-α, C-reactive protein) and coagulation (d-dimer, fibrinogen, international normalized ratio) markers in non-critically ill versus critically ill patients longitudinally and further correlated these markers to survivors and non-survivors. RESULTS: Median age was 63 years (first to third quartile 51-70 years), 51.4% of whom were women. When compared to non-critically ill patients (N = 1592, 77.0%), critically ill (defined as requiring mechanical ventilation, in shock or multiorgan failure) patients (N = 476, 23.0%), had more frequent cardiac injury on admission (30.3% vs. 2.3%, p < 0.001), with increased mortality during hospitalization (38.4% vs. 0%, p < 0.001). Among critically ill patients, non-survivors (N = 183) had a continuous increase in hs-cTnI levels during hospitalization, while survivors (N = 293) showed a decrease in hs-cTnI level between day 4 and 7 after admission. Specifically, cardiac injury is an independent marker of mortality among critically ill patients at admission, day 4-7 and 8-14. Consistent positive correlations between hs-cTnI and interleukin (IL)-6 on admission (r = 0.59), day 4-7 (r = 0.66) and day 8-14 (r = 0.61; all p < 0.001) and d-dimer (at the same timepoints r = 0.54; 0.65; 0.61, all p < 0.001) were observed. A similar behavior was observed between hs-cTnI and most of other biomarkers of inflammation and coagulation. CONCLUSIONS: Cardiac injury commonly occurs in critically ill COVID-19 patients, with increased levels of hs-cTnI beyond day 3 since admission portending a poor prognosis. A consistent positive correlation of hs-cTnI with IL-6 and d-dimer at several timepoints along hospitalization could suggest nonspecific cytokine-mediated cardiotoxicity.


Assuntos
Infecções por Coronavirus/patologia , Citocinas/sangue , Traumatismos Cardíacos/patologia , Pneumonia Viral/patologia , Troponina I/sangue , Idoso , Betacoronavirus , Biomarcadores/sangue , Coagulação Sanguínea/fisiologia , Infecções por Coronavirus/sangue , Estado Terminal , Feminino , Traumatismos Cardíacos/sangue , Traumatismos Cardíacos/diagnóstico , Humanos , Inflamação , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/sangue , Prognóstico , Estudos Retrospectivos
5.
Am Surg ; 86(4): 354-361, 2020 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-32391760

RESUMO

In recent years, the incidence of blunt cardiac injury (BCI) has increased rapidly and is an important cause of death in trauma patients. This study aimed to explore early diagnosis and therapy to increase survival. All patients with BCI during the past 15 years were analyzed retrospectively regarding the mechanism of injury, diagnostic and therapeutic methods, and outcome. The patients were divided into two groups according to the needs of their condition-nonoperative (Group A) and operative (Group B). Comparisons of the groups were performed. A total of 348 patients with BCI accounted for 18.3 per cent of 1903 patients with blunt thoracic injury. The main cause of injury was traffic accidents, with an incidence of 48.3 per cent. In Group A (n = 305), most patients sustained myocardial contusion, and the mortality was 6.9 per cent. In Group B (n = 43), including those with cardiac rupture and pericardial hernia, the mortality was 32.6 per cent. Comparisons of the groups regarding the shock rate and mortality were significant (P < 0.01). Deaths directly resulting from BCI in Group B were greater than those in Group A (P < 0.05). In all 348 patients, the mortality rate was 10.1 per cent. When facing a patient with blunt thoracic injury, a high index of suspicion for BCI must be maintained. To manage myocardial contusion, it is necessary to protect the heart, alleviate edema of the myocardium, and control arrhythmia with drugs. To deal with those requiring operation, early recognition and expeditious thoracotomy are essential.


Assuntos
Procedimentos Cirúrgicos Cardíacos/métodos , Traumatismos Cardíacos , Ferimentos não Penetrantes , Acidentes de Trânsito , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Arritmias Cardíacas/tratamento farmacológico , Arritmias Cardíacas/etiologia , Ecocardiografia , Eletrocardiografia , Feminino , Coração/diagnóstico por imagem , Traumatismos Cardíacos/diagnóstico , Traumatismos Cardíacos/mortalidade , Traumatismos Cardíacos/terapia , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Traumatismos Torácicos/complicações , Tomografia Computadorizada por Raios X , Ferimentos não Penetrantes/diagnóstico , Ferimentos não Penetrantes/mortalidade , Ferimentos não Penetrantes/terapia , Adulto Jovem
7.
J Med Virol ; 92(7): 819-823, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32232979

RESUMO

An outbreak of severe acute respiratory syndrome novel coronavirus (SARS-CoV-2) epidemic spreads rapidly worldwide. SARS-CoV-2 infection caused mildly to seriously and fatally respiratory, enteric, cardiovascular, and neurological diseases. In this study, we detected and analyzed the main laboratory indicators related to heart injury, creatine kinase isoenzyme-MB (CK-MB), myohemoglobin (MYO), cardiac troponin I (ultra-TnI), and N-terminal pro-brain natriuretic peptide (NT-proBNP), in 273 patients with COVID-19 and investigated the correlation between heart injury and severity of the disease. It was found that higher concentration in venous blood of CK-MB, MYO, ultra-TnI, and NT-proBNP were associated with the severity and case fatality rate of COVID-19. Careful monitoring of the myocardiac enzyme profiles is of great importance in reducing the complications and mortality in patients with COVID-19.


Assuntos
Betacoronavirus/patogenicidade , Infecções por Coronavirus/diagnóstico , Creatina Quinase Forma MB/sangue , Traumatismos Cardíacos/diagnóstico , Mioglobina/sangue , Peptídeo Natriurético Encefálico/sangue , Fragmentos de Peptídeos/sangue , Pneumonia Viral/diagnóstico , Troponina I/sangue , Adulto , Idoso , Biomarcadores/sangue , China , Infecções por Coronavirus/sangue , Infecções por Coronavirus/complicações , Infecções por Coronavirus/mortalidade , Feminino , Traumatismos Cardíacos/sangue , Traumatismos Cardíacos/complicações , Traumatismos Cardíacos/mortalidade , Hospitais , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/sangue , Pneumonia Viral/complicações , Pneumonia Viral/mortalidade , Estudos Retrospectivos , Índice de Gravidade de Doença , Análise de Sobrevida
8.
Herz ; 45(7): 696-702, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32170340

RESUMO

BACKGROUND: Postcardiac injury syndrome (PCIS) is an inflammatory complication that derives from injury to the epicardium, myocardium, or endocardium. It occurs after trauma, myocardial infarction, percutaneous coronary intervention, cardiac surgery, intracardiac ablation, and implantation of cardiac implantable electronic device (CIED). In this study we assessed the incidence of PCIS after CIED implantation and its possible risk factors. MATERIAL AND METHODS: All patients who received CIED implantation at Heidelberg University Hospital between 2000 and 2014 were evaluated (n = 4989 patients). Clinical data including age, sex, underlying cardiac disease, type of implanted CIED, location of electrode implantation, clinical symptoms, time of symptom onset of PCIS, therapy, and outcome were extracted and analyzed. RESULTS: We identified 19 cases of PCIS in 4989 patients, yielding an incidence of 0.38%. The age of patients with PCIS ranged from 39 to 86 years. Dilated cardiomyopathy (DCM) as underlying cardiac disease and right atrial (RA) lead implantation had a significant association with occurrence of PCIS (p = 0.045 in DCM and p < 0.001 in RA lead implantation). Dyspnea, chest pain, dry cough, and fever were the most frequently reported symptoms in patients with PCIS. Pericardial and pleura effusion as well as elevated C­reactive protein (CRP), increased erythrocyte sedimentation rate (ESR), and leukocytosis were the most common findings. CONCLUSION: To the best of our knowledge, this is the largest cohort evaluating the incidence of PCIS after CIED implantation. The data show that PCIS is a rare complication after CIED implantation and occurs more frequently in patients with DCM and those with RA lead implantation. Although rare and mostly benign, PCIS can lead to potentially lethal complications and physicians must be aware of its symptoms.


Assuntos
Procedimentos Cirúrgicos Cardíacos , Desfibriladores Implantáveis , Cardiopatias , Traumatismos Cardíacos , Desfibriladores Implantáveis/efeitos adversos , Traumatismos Cardíacos/diagnóstico , Traumatismos Cardíacos/epidemiologia , Traumatismos Cardíacos/etiologia , Humanos , Incidência , Fatores de Risco
9.
BMC Cardiovasc Disord ; 20(1): 18, 2020 01 17.
Artigo em Inglês | MEDLINE | ID: mdl-31952491

RESUMO

BACKGROUND: Radiofrequency catheter ablation is an established procedure with a high success rate for treating Wolff-Parkinson-White (WPW) syndrome. Rare complications post-ablation may nonetheless occur particularly associated with coronary sinus. Identifying and avoiding these complications remains a challenge. CASE PRESENTATION: A 66-year-old woman with WPW syndrome was admitted to the hospital due to frequent attacks of paroxysmal tachycardia. During electrophysiological study, an accessory pathway was thought to connect the posterior wall of the left ventricle. The patient underwent Radiofrequency (RF) catheter ablation. The procedure was time-consuming because of combined left atrial and coronary sinus ablation. The total amount of radiofrequency application energy in the coronary sinus was 6800 J. After the operation, widespread concave ST-segment elevation, significantly increased value of serum troponin I and mild pericardial effusion were identified, but the patient did not show any symptoms. Therefore, the patient was suspected to have myocardial injury and pericarditis caused by ablation-related injury. The patient was uneventfully discharged five days after the procedure with a significantly decreased value of troponin I. The reexamined electrocardiogram was normal after three weeks. CONCLUSIONS: To the best of our knowledge, this is the first study to report on myocardial injury and pericarditis after combined left atrial and coronary sinus ablation in WPW syndrome. Our findings underscore the need for detailed mapping and careful ablation with low energy, as well as the merits of identifying myocardial infarction after coronary sinus ablation.


Assuntos
Ablação por Cateter/efeitos adversos , Seio Coronário/cirurgia , Átrios do Coração/cirurgia , Traumatismos Cardíacos/etiologia , Pericardite/etiologia , Síndrome de Wolff-Parkinson-White/cirurgia , Idoso , Biomarcadores/sangue , Seio Coronário/fisiopatologia , Feminino , Átrios do Coração/fisiopatologia , Traumatismos Cardíacos/sangue , Traumatismos Cardíacos/diagnóstico , Humanos , Pericardite/sangue , Pericardite/diagnóstico , Fatores de Tempo , Resultado do Tratamento , Troponina I/sangue , Síndrome de Wolff-Parkinson-White/diagnóstico , Síndrome de Wolff-Parkinson-White/fisiopatologia
10.
J Card Surg ; 35(2): 488-491, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31778592

RESUMO

BACKGROUND: Electric shock-induced cardiac injuries, such as myocardial infarction, thrombosis, and dissection, are rare. Few cases have been previously reported. The right coronary artery is most often affected because of its proximity to the chest wall. AIMS: To study the extend of electrical injuries on cardiac tissues and its surgical management. MATERIALS AND METHODS: We conducted a retrospective study on our patients in the last five years, looking for cardiac electrical injuries treated surgically in our department, we identified three cases. RESULT: Our three-case series, reported herein, showed that multiple cardiac tissues are susceptible to electrical injuries, specifically the left coronary artery, inferior vena cava, and right ventricular free wall. In our series, the first patient was a 32-year-old man with triple vessel thrombosis and dissection who survived the electric shock. The second patient was a 23-year-old man who had an inferior vena cava burn and bruising; his heart was used for transplantation. After the transplant, the recipient had a left coronary artery dissection and underwent coronary artery bypass grafting. The third patient was a 30-year-old man (potential heart donor) who had a hematoma of the right ventricular free wall, possible coronary artery dissection, inferior vena cava bruising, and tissue damage. His heart was not used for transplant because of quality concerns. CONCLUSION: We recommend that any person who sustains high voltage (500 V or more) electric shock should be evaluated carefully in the emergency department, including with echocardiography and cardiac catheterization, if indicated, to determine the extent of the injury and the viability of the heart, for patients who do not survive as a donor organ.


Assuntos
Eletricidade/efeitos adversos , Traumatismos Cardíacos/etiologia , Traumatismos Cardíacos/cirurgia , Adulto , Cateterismo Cardíaco , Ponte de Artéria Coronária , Ecocardiografia , Evolução Fatal , Traumatismos Cardíacos/diagnóstico , Transplante de Coração , Humanos , Masculino , Estudos Retrospectivos , Doadores de Tecidos , Adulto Jovem
11.
Ann Vasc Surg ; 64: 292-302, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31629852

RESUMO

BACKGROUND: NT-Pro BNP levels provide incremental value in perioperative risk assessment prior to major noncardiac surgery. Whether they can be pharmacologically modified in patients prior to an elective vascular operation is uncertain. METHODS: A double-blind, randomized controlled trial was implemented at a single institution. Patients were screened during their preoperative vascular clinic appointment and randomly assigned to CoQ10 (400 mg per day) versus Placebo for 3 days prior to surgery. Biomarkers, including NT-Pro BNP, troponin I and C-reactive protein were obtained prior to and following surgery for up to 48 hours. The primary endpoint was postoperative NT-Pro BNP levels, and secondary endpoint measures included myocardial injury, defined by an elevated cardiac troponin level and length of stay. RESULTS: One hundred and twenty-three patients were randomized to receive either CoQ10 (N = 62) versus Placebo (N = 61) for 3 days before vascular surgery. Preoperative cardiac risks included ischemic heart disease (N = 52), CHF (N = 12), stroke (N = 23), and diabetes mellitus (N = 48) and the planned vascular procedures were infrainguinal (N = 78), carotid (N = 36), and intraabdominal (N = 9). There were no intergroup differences in these clinical variables. NT-Pro BNP levels (median; IQs) in the CoQ10 and Placebo groups were 179 (75-347) and 217 (109-585) pg/ml, respectively, (P = 0.08) preoperatively, and 397 (211-686) and 591 (288-1,433) pg/ml respectively, (P = 0.01) at 24 hours following surgery. Patients with an elevated NT-Pro BNP had a higher incidence of myocardial injury, (58% vs. 20%; P < 0.01) and a longer hospital stay (4.4 ± 3.8 vs. 2.8 ± 3.2 days; P < 0.02) compared with individuals without an elevated NT-Pro BNP level. CONCLUSIONS: NT-Pro BNP levels predict adverse events post-vascular surgery and are lowered in those patients assigned to preoperative administration of CoQ10. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT03956017. Among patients undergoing elective vascular surgery, 123 patients were randomized to either CoQ10 (400 mg/day) versus placebo for three days preoperatively. NT-Pro BNP levels (median; IQs) in the CoQ10 and Placebo groups were 179 (75-347) and 217 (109-585) pg/ml, respectively, (P = 0.08) preoperatively, and 397 (211-686) and 591 (288-1,433) pg/ml, respectively, (P = 0.01) post-surgery. Patients with an elevated NT-Pro BNP had a higher incidence of myocardial injury (58% vs. 20%; P < 0.01) and a longer hospital stay (4.4 ± 3.8 vs. 2.8 ± 3.2 days; P < 0.02) compared with individuals without an NT-Pro BNP elevation. In conclusion, BNP predicts adverse outcomes and can be reduced with preoperative CoQ10.


Assuntos
Procedimentos Cirúrgicos Cardíacos , Traumatismos Cardíacos/prevenção & controle , Peptídeo Natriurético Encefálico/sangue , Fragmentos de Peptídeos/sangue , Ubiquinona/análogos & derivados , Idoso , Biomarcadores/sangue , Procedimentos Cirúrgicos Cardíacos/efeitos adversos , Método Duplo-Cego , Esquema de Medicação , Feminino , Traumatismos Cardíacos/sangue , Traumatismos Cardíacos/diagnóstico , Traumatismos Cardíacos/etiologia , Humanos , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Minnesota , Valor Preditivo dos Testes , Fatores de Proteção , Medição de Risco , Fatores de Risco , Fatores de Tempo , Resultado do Tratamento , Troponina T/sangue , Ubiquinona/administração & dosagem , Ubiquinona/efeitos adversos
12.
Ann Thorac Surg ; 109(1): e29-e31, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31233721

RESUMO

Pectus excavatum repair using a Nuss bar is a widely performed procedure and generally regarded to be quite safe. Rare catastrophic cardiovascular complications have been previously reported, by even the most experienced surgeons. These cases typically present with fulminant cardiogenic shock and have an associated high mortality rate. We present a delayed and atypical presentation for a patient with a cardiac perforation after repair of pectus excavatum who underwent successful repair.


Assuntos
Tórax em Funil/cirurgia , Traumatismos Cardíacos/cirurgia , Complicações Intraoperatórias/cirurgia , Adulto , Traumatismos Cardíacos/diagnóstico , Humanos , Complicações Intraoperatórias/diagnóstico , Masculino , Procedimentos Ortopédicos/métodos , Fatores de Tempo
13.
Int J Cardiol ; 299: 37-42, 2020 01 15.
Artigo em Inglês | MEDLINE | ID: mdl-31253528

RESUMO

BACKGROUND: The evidence base for coronary perforation occurring during percutaneous coronary intervention in patients presenting with an acute coronary syndrome (ACS-PCI) is limited and the specific role of acute pharmacology in its clinical presentation unclear. METHODS AND RESULTS: Using the BCIS PCI database, data were analysed on all ACS-PCI procedures performed in England and Wales between 2007 and 2014. Multiple regressions were used to identify predictors of coronary perforation and its association with outcomes. Propensity score matching was used to evaluate the association between differing P2Y12 inhibitors or glycoprotein inhibitors (GPI) and CP. During 270,329 ACS-PCI procedures, 1013 coronary perforations were recorded (0.37%) with a stable annual incidence. In multiple regression analysis, covariates associated with increased frequency of coronary perforation included age, female gender, CTO intervention, number and length of stents used, and rotational atherectomy use, whilst differing P2Y12 inhibitors were not predictive. Using propensity score matching, use of a GPI was independently associated with tamponade (OR 1.50, [1.08-2.06], p = 0.014). The adjusted odds ratios for all clinical outcomes were adversely affected by coronary perforation. CONCLUSIONS: Coronary perforation is an infrequent event during ACS-PCI but is closely associated with adverse clinical outcomes. GPI use was associated with higher rates of tamponade.


Assuntos
Síndrome Coronariana Aguda/epidemiologia , Síndrome Coronariana Aguda/cirurgia , Vasos Coronários/lesões , Traumatismos Cardíacos/epidemiologia , Intervenção Coronária Percutânea/efeitos adversos , Sociedades Médicas/tendências , Síndrome Coronariana Aguda/diagnóstico , Bases de Dados Factuais/tendências , Inglaterra/epidemiologia , Feminino , Traumatismos Cardíacos/diagnóstico , Humanos , Masculino , Inibidores da Agregação de Plaquetas/efeitos adversos , Inibidores da Agregação de Plaquetas/uso terapêutico , Estudos Retrospectivos , País de Gales/epidemiologia
14.
Ann Thorac Surg ; 109(2): e107-e108, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31276648

RESUMO

Patients undergoing sternotomy routinely undergo sternal closure with stainless steel wires. Occasionally these wires can fracture, although normally this presents no concern as the broken wire remains fixed and is not problematic. We report a case of a segment of a broken sternal wire that migrated through the pericardium onto the right ventricular. It was removed with a minimally invasive approach with endoscopic assistance.


Assuntos
Fios Ortopédicos/efeitos adversos , Remoção de Dispositivo/métodos , Endoscopia/métodos , Migração de Corpo Estranho/cirurgia , Traumatismos Cardíacos/cirurgia , Ventrículos do Coração/lesões , Pericárdio/lesões , Idoso , Falha de Equipamento , Feminino , Fluoroscopia , Migração de Corpo Estranho/diagnóstico , Traumatismos Cardíacos/diagnóstico , Traumatismos Cardíacos/etiologia , Ventrículos do Coração/diagnóstico por imagem , Humanos , Pericárdio/diagnóstico por imagem , Radiografia Torácica , Esternotomia/efeitos adversos
15.
Int Heart J ; 61(1): 138-144, 2020 Jan 31.
Artigo em Inglês | MEDLINE | ID: mdl-31875620

RESUMO

Exercise preconditioning may protect against cardiac injury induced by lipopolysaccharide (LPS), but the mechanism is unresolved. The aim of this study is to explore whether the general control nonderepressible 2 (GCN2) kinase gene is associated with the protective effect of exercise preconditioning. Eight-week-old male C57BL/6J (n = 40) and GCN2 knockout (KO) (n = 40) mice were divided into four groups: control, LPS (L), exercise preconditioning (E), and exercise preconditioning LPS (EL). Mice in the exercise groups performed exercise for eight weeks. After exercise, all mice were given an equal volume of LPS or saline (10 µg/g). We measured the cardiac function using echocardiography and then collected heart tissue. Exercise preconditioning improved cardiac inflammation (interleukin-6, tumor necrosis factor α) and cardiac dysfunction (ejection fraction, fraction shortening) in C57 mice induced by LPS and also decreased the expression levels of GCN2, phosphorylation of eukaryotic translation initiation factor 2α (p-eIF2α), and activating transcription factor 4 (ATF4). Moreover, GCN2 KO decreased inflammation and cardiac dysfunction induced by LPS in sedentary mice. The inflammation and cardiac dysfunction in the GCN2 KO EL group were lower than in the C57 EL group, and the expression of GCN2, p-eIF2α, and ATF4 in the GCN2 KO EL group was lower than in the C57 EL group. Exercise preconditioning alleviated cardiac injury induced by LPS. GCN2 KO also improved cardiac injury. Exercise preconditioning promoted the effect of GCN2 KO in alleviating cardiac injury, and the GCN2 and eIF2α/ATF4 pathways play an important role in the process.


Assuntos
Traumatismos Cardíacos/prevenção & controle , Lipopolissacarídeos/efeitos adversos , Condicionamento Físico Animal/métodos , Proteínas Serina-Treonina Quinases/genética , Fator 4 Ativador da Transcrição/metabolismo , Animais , Modelos Animais de Doenças , Ecocardiografia , Fator de Iniciação 2 em Eucariotos/metabolismo , Técnicas de Inativação de Genes , Traumatismos Cardíacos/induzido quimicamente , Traumatismos Cardíacos/diagnóstico , Traumatismos Cardíacos/metabolismo , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Fosforilação , Proteínas Serina-Treonina Quinases/metabolismo
17.
J Cardiothorac Surg ; 14(1): 185, 2019 Nov 04.
Artigo em Inglês | MEDLINE | ID: mdl-31684992

RESUMO

BACKGROUND: Cardiac radiofrequency ablation is a popular treatment for arrhythmias. However, it does have some complications, some of which are severe, even fatally. And there were limited reports on cardiac internal perforation after radiofrequency catheter ablation (RFCA) that required a surgical repair. CASE PRESENTATION: A 47-year-old male was admitted to our hospital due to chest congestion for 4 months. He received a radiofrequency catheter ablation (RFCA) 9 months prior to admission. On admission, an echocardiogram showed an abnormal perforation between the left ventricle and the left atrium with moderate mitral valve regurgitation. We therefore performed a mitral valve replacement (MVR) and fixed the abnormal atrial-ventricular breakage via median sternotomy. CONCLUSIONS: Cardiac perforation is a severe complication of cardiac RFCA, operators should be extremely cautious to minimize radiofrequency associated perforations. Such a challenging and complex procedure should be deliberately considered by doctors and patients before implementation.


Assuntos
Fibrilação Atrial/cirurgia , Ablação por Cateter/efeitos adversos , Traumatismos Cardíacos/diagnóstico , Ecocardiografia , Átrios do Coração/lesões , Traumatismos Cardíacos/diagnóstico por imagem , Traumatismos Cardíacos/cirurgia , Implante de Prótese de Valva Cardíaca , Ventrículos do Coração/lesões , Humanos , Masculino , Pessoa de Meia-Idade , Valva Mitral , Complicações Pós-Operatórias
18.
Vet Ital ; 55(3): 275-278, 2019 Sep 30.
Artigo em Inglês | MEDLINE | ID: mdl-31599553

RESUMO

An adult male Eurasian otter, found dead on the roadside, was submitted for post-mortem examination in April 2014 at the Veterinary Pathology Unit of the Faculty of Veterinary Medicine of Teramo, as part of the RECAL [RECovery and post mortem Analysis of Eurasian otters (Lutra lutra) in the National Park of Cilento, Vallo di Diano and Alburni (Salerno, Italy), and surrounding areas] project. Necropsy revealed an abundant hemothorax associated with multifocal, bilateral pulmonary contusions and lacerations, and a severe hemopericardium characterised by the presence of a wide blood clot in the intact pericardial sac. Two small laceration wounds of the left auricle were found at the base, along the atrioventricular groove, and on the outer free wall. Since myocardial and endocardial tissues showed no other gross and histopathological abnormalities, a left atrial appendage rupture resulting from a blunt chest trauma was diagnosed. Blunt traumatic cardiac rupture is a rarely reported, life-threatening condition in humans. To the best of our knowledge, this is the first report on a left atrial appendage rupture due to blunt chest trauma in veterinary literature. The possible occurrence of a cardiac rupture following a blunt thoracic injury should be taken into consideration in veterinary emergency care.


Assuntos
Apêndice Atrial/patologia , Traumatismos Cardíacos/veterinária , Lontras , Traumatismos Torácicos/veterinária , Ferimentos não Penetrantes/veterinária , Animais , Evolução Fatal , Traumatismos Cardíacos/diagnóstico , Traumatismos Cardíacos/patologia , Itália , Masculino , Traumatismos Torácicos/diagnóstico , Traumatismos Torácicos/patologia , Ferimentos não Penetrantes/diagnóstico , Ferimentos não Penetrantes/patologia
20.
Rev. pediatr. electrón ; 16(3): 12-20, oct. 2019. tab, ilus
Artigo em Espanhol | LILACS | ID: biblio-1046279

RESUMO

El trauma cardiaco constituye una entidad infrecuente en pediatría que requiere de toma de decisiones rápidas y oportunas, además de un manejo óptimo para obtener una mejor sobrevida de los pacientes. En esta revisión en base a un caso clínico, se actualiza el tema de trauma cardiaco, se describen los tipos más frecuentes, las diferentes formas clínicas de presentación y el enfrentamiento terapéutico. Palabras clave: Trauma cardiaco, penetrante cardiaca, cirugía cardiaca.


Cardiac trauma is an uncommon entity in pediatrics that requires quick and timely decision making, as well as optimal management to obtain a better survival of patients. In this review based on a case report, the issue of cardiac trauma is updated, the most frequent types, the different clinical forms of presentation and the therapeutic confrontation are described.


Assuntos
Humanos , Masculino , Criança , Traumatismos Cardíacos/cirurgia , Complicações Pós-Operatórias , Prognóstico , Emergências , Traumatismos Cardíacos/diagnóstico , Traumatismos Cardíacos/fisiopatologia , Traumatismos Cardíacos/terapia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...