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Aortic Disease
Published in Paul Schoenhagen, Frank Dong, Cardiac CT Made Easy, 2023
An incidental finding of an intra-aortic balloon pump in the aorta is shown in Figure 10.55. Aortic coarctation is further described in Chapter 13 (Section 13.6, ‘Aortic Disease‘) on congenital disease (Chapter 11).
Deaths Following Cardiac Surgery and Invasive Interventions
Published in Mary N. Sheppard, Practical Cardiovascular Pathology, 2022
Intra-aortic balloon pumps are inserted into the aorta to help with the peripheral circulation in cases of left ventricular failure and there may be thrombosis associated with its insertion (see Fig. 9.6).
Angina pectoris in the elderly
Published in Wilbert S. Aronow, Jerome L. Fleg, Michael W. Rich, Tresch and Aronow’s Cardiovascular Disease in the Elderly, 2019
Wilbert S. Aronow, William H. Frishman
The majority of elderly patients with stable and unstable angina can be stabilized with medical management. Patients who continue to have unstable angina 30 minutes after initiation of therapy or who have recurrent unstable angina during the hospitalization are at increased risk for MI or cardiac death. In addition, patients who demonstrate major ischemic complications, such as pulmonary edema, ventricular arrhythmias, or cardiogenic shock associated with unstable angina, also have a poor prognosis. In these patients, emergency cardiac catheterization should be performed with the consideration of interventional therapy (CABG or PCI). Insertion of an intra-aortic balloon pump may be necessary in some of these elderly patients.
Amplatzer Post-Infarction Ventricular Septal Defect Closure via Retrograde Transarterial Access: Easier and Better
Published in Structural Heart, 2021
David Hildick-Smith, Natalia Briceno, Osama Alsanjari, Gerald J. Clesham, Thomas Keeble, Andrew Hill, Arionilson Gomes, James Cockburn
An 82-year-old female with a background of hypertension and non-insulin-dependent diabetes presented to the Essex Cardiothoracic Center with a four-day history of chest pain and evidence of anterior ST elevation on her ECG with associated Q waves. Due to ongoing chest pain, she was brought directly to the catheterization laboratory. Coronary angiography demonstrated severe disease proximally in the left anterior descending artery with a mid-vessel total occlusion. This was treated but without good restoration of flow. Echocardiography showed a large anteroapical infarct with a ventricular septal defect close to the apex. An intra-aortic balloon pump was inserted. Her renal function deteriorated and arrangements were made for percutaneous VSD closure. This was undertaken 3 days following her presentation to the hospital, via the arterial route. The defect (Figure 3a) was crossed with an AL-1 catheter and an Amplatzer Superstiff wire was positioned in the left pulmonary artery. A 10 F Occlutech sheath was introduced (Figure 3b) and a 20 mm PIVSD device (Figure 3c) was implanted with a very good result.
A rare association of Takotsubo cardiomyopathy with neuroleptic malignant syndrome
Published in Journal of Community Hospital Internal Medicine Perspectives, 2020
Waqas Ullah, Muhammad Arslan Cheema, Ammar Ashfaq, Maryam Mukhtar, Zain Ali, Mamoon Ur Rashid, Vincent Figueredo
NMS management includes dantrolene, which decreases CK levels and body temperature [14]. Bromocriptine has also been found to hasten clinical response [15]. All patients should be given supportive care with intravenous fluids and electrolytes. Renal function should be monitored and managed accordingly. Complete recovery is reduced by 6 days with dantrolene and 5 days with bromocriptine if given in addition to supportive care alone [15]. There is evidence of reduced mortality of about 8.6% with dantrolene and 7.8% with bromocriptine, compared with supportive care (21%) [16]. TCM in NMS is treated just like any other TCM, where the management of the responsible stressor is of paramount importance [8]. Treatment of TCM should be individualized depending upon the TCM related complications such as for LVSD. Anticoagulation is sometimes needed for associated thrombosis in the ventricle [8]. Patients with cardiogenic shock usually recover with transient use of intra-aortic balloon pump as in our case.
Broken Heart Syndrome – An intra operative complication
Published in Alexandria Journal of Medicine, 2018
Her treatment was started with dopamine and dobutamine support to increase the cardiac output, guarded intravenous fluids with diuretics with strict monitoring of central venous pressure (CVP) maintaining it between 8 and 12 mmHg, routine arterial blood gas analysis and serum electrolytes in addition to cardio-protective dual anti-platelet drugs like aspirin and clopidogrel, statin, Low molecular weight Heparin along with broad spectrum antibiotic. Later patient was taken on Intra Aortic Balloon Pump support. After continuous monitoring for 48 h, patient showed improvement as her chest became clear and ionotropic supports came down and beta-blockers were added to treatment regimen. On 3rd day, her 2D-Echo was repeated which raised our eyebrows, as cardiac activity was absolutely normal (No regional wall motion abnormalities-RWMA, Ejection Fraction – 55%). She was shifted to catheterization laboratory for coronary arteriography, which further added to our surprise list as normal coronaries. Patient showed drastic improvement and was discharged on simple beta-blockers on day-7. The team of Cardiologists diagnosed this as ‘Broken Heart Syndrome’.