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Specialized Circulations in Susceptible Tissues
Published in Wilmer W Nichols, Michael F O'Rourke, Elazer R Edelman, Charalambos Vlachopoulos, McDonald's Blood Flow in Arteries, 2022
Typically, patients present as acute ST segment elevation myocardial infarction (STEMI) with typical clinical features including chest pain/discomfort and with dyspnea, and tachycardia attributed to LV failure. They show ST segment elevation on ECG (but no reciprocal ST depression), and troponins are often diagnostically elevated. There is often a recent history of unaccustomed exercise or of a fright or injury. The condition may follow major surgery or be associated in some way with sympathetic nervous excitation. It may be the first evidence of an epinephrine or norepinephrine secreting pheochromocytoma (Loscalzo et al., 2018). The condition typically occurs in older, postmenopausal females with male/female ratio of 1:10—the opposite gender ratio for young persons with STEMI (Arora et al., 2019). It can be complicated by all problems of STEMI, including death, arrhythmia, heart failure, even apical heart rupture (O'Rourke, 1973; Jaguszewski et al., 2012; Loscalzo et al., 2018). The abnormality of contraction affects the whole apex of the heart but with no confinement to the territory of any particular coronary artery.
The patient with acute cardiovascular problems
Published in Peate Ian, Dutton Helen, Acute Nursing Care, 2020
The LCA divides into two main arteries: the left anterior descending artery (LAD) and the Circumflex (CX). The LAD extends down across the surface of the heart supplying the left ventricle. The LAD has a number of branches that supply the interventricular septum (the septal arteries) and the anterior surface of the left ventricle (the diagonal arteries). The LAD terminates at the apex of the heart.
The Isolated, Coronary-Perfused, Right Ventricular Wall Preparation
Published in John H. McNeill, Measurement of Cardiac Function, 2020
Thane G. Maddaford, Hamid Massaeli, Grant N. Pierce
The heart should be first placed on a dissection tray covered with a gauze sponge wet with the HEPES perfusate. The right and left atria are first dissected off, with care not to cut any of the large vessels entering or exiting the heart. The heart should be positioned with the right ventricle up, apex of the heart distal and vessels proximal.
Nesfatin-1 attenuates injury in a rat model of myocardial infarction by targeting autophagy, inflammation, and apoptosis
Published in Archives of Physiology and Biochemistry, 2023
Maryam Naseroleslami, Masuomeh Sharifi, Kamran Rakhshan, Behnaz Mokhtari, Nahid Aboutaleb
To evaluate infarct volume and area at risk (AAR), TTC staining was used. At 24 h after reperfusion, the animals were sacrificed and heart tissues were collected. Then, isolated tissues were cut into slices with 5 µm thickness from the apex of the heart to the bottom of it. Then, sections were stained with 1% solution of TTC in water with a constant temperature of 37 °C for 15 min. In order to increase contrast, samples were fixed in 10% formaldehyde overnight. A percentage of left ventricles (AAR/LV) was defined as an area at risk. Likewise, a percentage of area at risk (IS/AAR) was defined in infarct size. The slices were photographed using a digital camera. The determination of infarct size was performed using the software Image J (National Institutes of Health, Bethesda, MD).
Strategies and pitfalls during minimally invasive total coronary artery revascularization via left anterior minithoracotomy: a promising future
Published in Acta Cardiologica, 2022
Mugisha Kyaruzi, Ergun Demirsoy
Safety of each anastomosis is a key to success and validity of any surgical procedure during coronary artery surgery. To improve exposure of all anastomotic sites both left pulmonary veins and inferior vena cava should be encircled with a thick silk tape. The right coronary artey exposure and its branches is achieved by pulling both tapes around the apex of the heart making the right coronary artery anastomotic site become closer to the surface (Figure 7). This allows the anastomotic field to be perfectly visualised for quality anastomosis. Circumflex artery, left anterior descending artery and their branches exposure is achieved by pulling encircled tapes around both inferior vena cava and left pulmonary veins to the left direction (Figure 8). Failure to encircle the left pulmonary veins and inferior vena cava will make difficulties during distal anastomosis. The tapes acts as secure guards and facilitate proper position and exposure of respective anastomotic regions for desirable, quality distal anastomosis.
Takotsubo cardiomyopathy in a chronic spinal cord injury patient with autonomic dysreflexia: A case report
Published in The Journal of Spinal Cord Medicine, 2021
Maria Pollifrone, Seema Sikka, Rita Hamilton
The exact pathophysiology of TC is not well known, but it is accepted that catecholamines play a primary role. It is suspected that the effects of catecholamines accumulate at the apex of the heart as there are more adrenergic receptors at the apex when compared to the base.9 This accounts for the classic left ventricular ballooning on ECHO demonstrated in TC.9,10 Similarly, this patient's echocardiogram demonstrated EF of 10% with global hypokinesis. EKG findings typically mimic MI or NSTEMI with ST segment elevation or T wave inversion. In this case, the EKG also showed normal sinus rhythm with ST elevation with nonspecific T wave abnormalities in anterior-lateral leads. Other published cases are consistent with the mechanism of increased circulating catecholamines in TC after acute stress, and include that of TC diagnosed in a tetraplegic after acute baclofen withdrawal and after a supratherapeutic dose of epinephrine was administered during anaphylaxis treatment.10,11 One study demonstrated elevated serum catecholamines in a patient with acute central SCI who was diagnosed with TC.12