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Kunadian Babu - - 2008
BACKGROUND: Rescue angioplasty (rPCI) for failed fibrinolysis is associated with a low mortality if successful, but a high mortality if it fails. The latter may reflect a high-risk group or harm in some patients. Predictors of success or failure of rPCI may aid selection of patients to be treated. METHODS: ...
Khalid L - - 2008
Cardiogenic shock continues to be the most common cause of death in patients hospitalized with acute myocardial infarction. It has also been frequently associated with ST-segment elevation myocardial infarction (STEMI) and patients with co-morbidities. Cardiogenic shock presents with low systolic blood pressure and clinical signs of hypoperfusion. Rapid diagnosis and ...
Fedorov Vadim V VV Department of Biomedical Engineering, Washington University, St. Louis, Missouri 63130-4899. - - 2008
Defibrillation shock is known to induce atrial stunning, which is electrical and mechanical dysfunction. We hypothesized that atrial stunning is caused by higher atrial susceptibility to electroporation vs ventricles. We also hypothesize that electroporation may be responsible for early recurrence of atrial fibrillation. We investigated electroporation induced by 10-ms epicardial ...
Ashihara Takashi T Department of Cardiovascular Medicine, Shiga University of Medical Science, Otsu, - - 2008
Comprehensive understanding of the ventricular response to shocks is the approach most likely to succeed in reducing defibrillation threshold. We propose a new theory of shock-induced arrhythmogenesis that unifies all known aspects of the response of the heart to monophasic (MS) and biphasic (BS) shocks. The central hypothesis is that ...
Khairy Paul - - 2008
BACKGROUND: Tetralogy of Fallot is the most common form of congenital heart disease in implantable cardioverter-defibrillator (ICD) recipients, yet little is known about the value of ICDs in this patient population. METHODS AND RESULTS: We conducted a multicenter cohort study in high-risk patients with Tetralogy of Fallot to determine actuarial ...
Kim, Seok Chan
A strong internal defibrillation shock may damage the heart via disruption of cell membranes (electroporation). The spatial distribution and extent of electroporation were characterized in intact rabbit hearts with and without chronic (>4 weeks) left ventricular myocardial infarction (MI). An implantable defibrillator was inserted in the right ventricle, and one ...
Kooshkabadi Mohammad - - 2008
Cardiogenic shock in the setting of myocardial infarction continues to represent a high proportion of immediate mortality in this patient population, despite ongoing advances in thrombolytics, PCI, and medical management of AMI. We present a case of peri-MI cardiogenic shock necessitating deployment of a percutaneous ventricular assist device (pVAD). TEE ...
Hauser Balázs - - 2008
In patients with hyperdynamic hemodynamics, infusing arginine vasopressin (AVP) in advanced vasodilatory shock is usually accompanied by a decrease in cardiac output and in visceral organ blood flow. Depending on the infusion rate, this vasoconstriction also reduces coronary blood flow despite an increased coronary perfusion pressure. In a porcine model ...
Lee Kaeng W - - 2008
Cardiogenic shock is the commonest cause of death in acute myocardial infarction (AMI). Although the syndrome of cardiogenic shock complicating AMI is common to all, the spectrum of underlying pathology is broad. While thrombolysis can be attempted with inotropic support or augmentation of blood pressure with an intra-aortic balloon pump, ...
Mebazaa Alexandre - - 2008
The mechanism of sepsis-induced cardiac failure was initially thought to be related to the presence of 'myocardial depressant' substances that directly alter heart function. Exosomes released by platelets and identified in the plasma are suggested to, at least partially, explain myocardial depression in sepsis. This hypothesis needs to be evaluated ...
Schmittinger Christian A - - 2008
INTRODUCTION: The multifactorial etiology of septic cardiomyopathy is not fully elucidated. Recently, high catecholamine levels have been suggested to contribute to impaired myocardial function. METHODS: This retrospective analysis summarizes our preliminary clinical experience with the combined use of milrinone and enteral metoprolol therapy in 40 patients with septic shock and ...
Wu Xue-Ming - - 2008
Pheochromocytoma is a rare, catecholamine-secreting tumor. The classic symptoms are headache, diaphoresis, and tachycardia with paroxysmal hypertension. Other less common cardio-vascular manifestations, such as arrhythmias, angina pectoris, acute myocardial infarction, dilated cardiomyopathy, acute heart failure, and cardiogenic shock, have occasionally been reported. Here, we report two middle-aged men with acute ...
Greif Martin - - 2008
Data on the use of levosimendan in patients with myocardial infarction related cardiogenic shock already under combined catecholamine treatment and intra-aortic balloon counterpulsation (IABP) are scarce. Seven consecutive patients with refractory cardiogenic shock after ST-elevation myocardial infarction, multi-organ dysfunction syndrome and under maximal intensive care (combined catecholamine treatment, IABP) were ...
Molina Arturo Martín Peñato - - 2008
BACKGROUND AND OBJECTIVE: Electrical defibrillation is very effective in interrupting atrial fibrillation (AF). However, its mechanism is not completely understood. We report our observations in patients subjected to external electriocardioversion (ECV) of atrial fibrillation and contrast them with recent theories about defibrillation mechanism. METHODS: In 13 consecutive patients transthoracic electrical ...
Fedorov Vadim V - - 2008
Defibrillation shocks are commonly used to terminate life-threatening arrhythmias. According to the excitation theory of defibrillation, such shocks are aimed at depolarizing the membranes of most cardiac cells, resulting in resynchronization of electrical activity in the heart. If shock-induced transmembrane potentials are large enough, they can cause transient tissue damage ...
Topalian Simon - - 2008
Cardiogenic shock is the most common cause of death in patients hospitalized with acute myocardial infarction and is associated with a poor prognosis. More than 75% of cases are due to extensive left ventricular infarction and ventricular failure. Other causes include right ventricular infarction and papillary muscle rupture with acute ...
Montcriol Ambroise - - 2008
A 26-year-old woman was referred to an Emergency Department because of common flu-like syndrome with hemodynamic collapse. In Intensive Care Unit (ICU), she was diagnosed as a probable septic shock. But despite treatment her condition rapidly deteriorated during the subsequent hours. Diagnosis of cardiogenic shock was established. Mechanical circulatory support ...
Garcia-Rubira Juan C - - 2008
BACKGROUND: Although invasive management of ST segment elevation myocardial infarction has improved the clinical outcome, cardiogenic shock (CS) remains an important issue. Our purpose was to asses the utility of the initial electrocardiogram in detecting patients who are at increased risk of CS after percutaneous coronary intervention for acute myocardial ...
Williams Jeffrey L - - 2008
INTRODUCTION: Few attempts have been made to extract information from the ventricular electrogram (EGM) recorded by implantable cardioverter defibrillators (ICD) aside from the discrimination of supraventricular tachycardia and ventricular tachycardia. The current study aims to examine the effect of ischemia in the major coronary artery distributions on the shock EGM ...
Russ Martin A - - 2007
OBJECTIVES: Levosimendan, a novel inodilator, has been shown to improve hemodynamic function in patients with acute exacerbation of congestive heart failure. We wanted to determine the hemodynamic effects of levosimendan following ineffective conventional therapy (with catecholamines) in patients with cardiogenic shock following myocardial infarction. DESIGN: Observational hemodynamic study. SETTING: Tertiary ...
Bédard Elisabeth - - 2007
The case of a patient with pheochromocytoma who presented with an unusual pattern of left ventricular dysfunction not previously described is reported. Although a triad of headaches, sweating attacks and palpitations is generally recognized as the classic mode of presentation of this pathology, this patient first presented with shock and ...
Goland Sorel - - 2007
Spontaneous coronary artery dissection is a rare cause of acute myocardial infarction that occurs particularly in women during the pregnancy and in the postpartum period. We describe a dramatic case of pregnancy-related spontaneous left main coronary artery dissection that resulted in acute myocardial infarction with severe left ventricular dysfunction and ...
Brohi Karim - - 2007
PURPOSE OF REVIEW: Acute coagulopathy of trauma has only been described relatively recently. Developing early in the postinjury phase, it is associated with increased transfusion requirements and poor outcomes. This review examines the possible initiators, mechanism and clinical importance of acute coagulopathy. RECENT FINDINGS: Acute coagulopathy of trauma occurs in ...
Singh Mandeep - - 2007
OBJECTIVES: This study sought to assess long-term outcome and determine its predictors among 30-day survivors of cardiogenic shock. BACKGROUND: Patients with cardiogenic shock have high in-hospital and 30-day mortality, but there are little data about those who survive beyond 30 days. METHODS: We analyzed baseline, in-hospital, and survival data from ...
Nicholls Stephen J SJ Department of Cardiovascular Medicine and Center for Cardiovascular Diagnostics and Prevention, Cleveland Clinic Foundation, 9500 Euclid Ave, NE-10, Cleveland, OH 44195, USA. - - 2007
It is unclear whether abnormalities of arginine and nitric oxide metabolism are related to hemodynamic dysfunction and mortality in patients with cardiogenic shock (CS) after acute myocardial infarction. Plasma metabolites reflecting arginine bioavailability, nitric oxide metabolism, and protein oxidation were analyzed by mass spectrometry in patients with CS (n=79) and ...
Gurm Hitinder S - - 2007
Cardiogenic shock is the primary cause of death among patients hospitalized with acute myocardial infarction. It is defined as tissue hypoperfusion resulting from ventricular pump failure in the presence of adequate intravascular volume. These patients need rapid assessment and appropriate institution of supportive therapies including vasopressor and inotropic agents, ventilatory ...
Lehmann A - - 2008
BACKGROUND AND OBJECTIVE: Levosimendan is a calcium-sensitizing drug that enhances myocardial contractility without increasing intracellular calcium. By activating adenosine triphosphate-dependent potassium channels it exerts cardioprotective and vasodilatory effects. METHODS: A retrospective matched pair analysis was performed in 52 patients undergoing emergency coronary artery bypass grafting for acute myocardial ischaemia with ...
Turgeman Yoav - - 2007
A 44-year-old male was admitted with ST-elevation myocardial infarction and cardiogenic shock. Angiography revealed a left anterior descending artery (LAD) as well as right a coronary artery acute thrombotic occlusion and large mobile thrombi in the circumflex artery. He was treated mainly with multivessel thrombus aspiration and intra-aortic balloon insertion. ...
Parsai Chirine - - 2007
The implantable cardioverter defibrillator (ICD) may be responsible for psychological disorders especially among patients experiencing multiple shocks. An associated hyperadrenergic state (e.g., anger, anxiety) may trigger malignant ventricular arrhythmias repeatedly treated by ICD shocks, entertaining a "vicious circle" often difficult to interrupt. Despite aggressive cardiac and psychological therapeutic efforts, this ...
Almquist Adrian K - - 2008
INTRODUCTION: Implantable defibrillators have proved effective in terminating potentially life-threatening ventricular tachyarrhythmias in hypertrophic cardiomyopathy (HCM), although the timing of appropriate shocks may be exceedingly variable. METHODS AND RESULTS: We report an unusual occurrence in a 48-year-old woman with nonobstructive HCM who experienced an appropriate shock for ventricular fibrillation only ...
Maharaj Thushka T Computing Laboratory, University of Oxford, Oxford, OX1 3PG, UK. - - 2008
Transmural electrophysiological heterogeneities have been shown to contribute to arrhythmia induction in the heart; however, their role in defibrillation failure has never been examined. The goal of this study is to investigate how transmural heterogeneities in ionic currents and gap-junctional coupling contribute to arrhythmia generation following defibrillation strength shocks. This ...
Merx M W - - 2007
Sepsis is generally viewed as a disease aggravated by an inappropriate immune response encountered in the afflicted individual. As an important organ system frequently compromised by sepsis and always affected by septic shock, the cardiovascular system and its dysfunction during sepsis have been studied in clinical and basic research for ...
Richardson Lydia - - 2007
A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was how many cardioversion attempts should be performed for patients who have gone into ventricular fibrillation post-cardiac surgery prior to performing chest reopening. Using the reported search, 1183 papers were identified. Fifteen papers ...
Wilansky Susan - - 2007
Echocardiography is a most useful bedside tool to help in the diagnosis and management of critically ill patients after acute myocardial infarction. In most instances, the mechanism of unexplained shock will be elucidated. Transesophageal echocardiography can further delineate the mechanical complications of myocardial infarction when the transthoracic echocardiogram may not ...
Tang H C - - 2007
A 64-year-old Chinese man presented to the Accident and Emergency Department with chest pain and was found to be in cardiogenic shock. The electrocardiogram (ECG) showed features of acute myocardial infarction due to left main coronary artery occlusion,which had no ST elevation in precordial leads. Emergency coronary angiogram revealed left ...
Russell James A - - 2007
PURPOSE OF REVIEW: The aim of this article is to review mechanisms of action of vasopressin and clinical studies of vasopressin in septic shock. RECENT FINDINGS: Arginine vasopressin is an important stress hormone that has both vasoactive and antidiuretic properties. The vasoactive properties of vasopressin have been more applicable clinically ...
Yang Chang-Sue - - 2007
We report the proper management of a severe adverse reaction of anaphylactic shock during intravenous fluorescein angiography at an outpatient clinic. A 72-year-old male developed the severe, life-threatening complication after intravenous injection of sodium fluorescein dye for retinal angiography. Three minutes after receiving an intravenous injection of fluorescein, the patient ...
Uwatoku Toyokazu - - 2007
OBJECTIVE: We have recently demonstrated that low-energy extracorporeal shock wave therapy improves chronic myocardial ischemia in pigs and humans. In this study, we examined whether our shock wave therapy is also effective at improving left ventricular remodeling after acute myocardial infarction in pigs. METHODS: Acute myocardial infarction was created by ...
Hernandez Adrian F - - 2007
BACKGROUND: Previous studies showed 75% mortality before hospital discharge in patients with a ventricular assist device (VAD) placed for post-cardiac surgery shock. We examined a large national clinical database to assess trends in the incidence of post-cardiac surgery shock requiring VAD implantation, survival rates, and risk factors for mortality. METHODS ...
Dominguez-Rodriguez Alberto - - 2008
BACKGROUND: Levosimendan is a new calcium sensitizer with positive inotropic properties. In previous studies, it has recently been shown that levosimendan improves the Doppler echocardiographic parameters of the left ventricular (LV) diastolic function in patients with anterior acute myocardial infarction. We sought to evaluate the effects of levosimendan compared to ...
Inoue Shigeaki - - 2007
We report here the clinical course of a 31-year-old male who recovered from a fulminant form of mitochondrial myopathy with lactic acidosis. The patient was transferred to our hospital with acute dyspnea and a convulsive seizure. On admission, he was in a state of shock, and presented with severe high-output ...
Iakobishvili Zaza - - 2007
The treatment of cardiogenic shock complicating the acute coronary syndromes consists of medical therapy, percutaneous revascularization procedures, cardiac surgery, and the implantation of devices. Medical therapy is limited to different positive inotropic and vasoactive drugs, without any firm evidence of survival benefit using these drugs. Several new pharmacologic compounds are ...
Serra E - - 2007
Transesophageal echocardiography (TEE) is a semi-invasive monitoring technique increasingly used in cardiac surgery and in major noncardiac surgery for patients with known or supposed cardiac or coronary problems. During lung transplantation (LTx), the close interrelation between heart and lung function makes TEE an invaluable tool for instantly monitoring the physiopathological ...
Aymong Eve D - - 2007
Cardiogenic shock is a rapidly progressive, often fatal complication of acute myocardial infarction. A vicious circle of ischemia, decreased cardiac output and reinfarction progress to left ventricular failure and death. The fundamental pathophysiology of this cascade and other mechanisms beyond the classic paradigm of ischemia and dysfunction are discussed in ...
Li Jin-long - - 2007
BACKGROUND: To evaluate the efficacy of prolonged intra-aortic balloon pumping (IABP) support in patients with cardiogenic shock following acute myocardial infarction (AMI). MATERIAL/METHODS: Thirty-nine patients with cardiogenic shock after AMI were treated with percutaneous coronary intervention which was supported by IABP. After 72 hours of IABP, the patients who attained ...
Wood Alice - - 2007
A 57-year-old woman developed cardiogenic shock secondary to right ventricular failure in the postoperative setting. Because of clinical suspicion of pulmonary embolism, the patient was taken to the operating room for emergency thrombectomy. The patient improved dramatically after sternotomy and pericardiotomy, with no evidence of thrombus being found. Sternotomy followed ...
Rudiger Alain A Bloomsbury Institute of Intensive Care Medicine, Wolfson Institute for Biomedical Research and Department of Medicine, University College London, - - 2007
To review mechanisms underlying sepsis-induced cardiac dysfunction in general and intrinsic myocardial depression in particular. MEDLINE database. Myocardial depression is a well-recognized manifestation of organ dysfunction in sepsis. Due to the lack of a generally accepted definition and the absence of large epidemiologic studies, its frequency is uncertain. Echocardiographic studies ...
Liu Li - - 2007
Oxidative stress and myocyte apoptosis are thought to play an important role in the pathogenesis, progression and prognosis of heart failure (HF). Heat shock protein 27 (Hsp27) has been found to confer resistance to oxidative stress in cultured cells; however, the role of Hsp27 in in-vivo hearts remains to be ...
Brown Simon G A - - 2007
The balance of evidence from human observations and animal studies suggests that the main pathophysiologic features of anaphylactic shock are a profound reduction in venous tone and fluid extravasation causing reduced venous return (mixed hypovolemic-distributive shock) and depressed myocardial function. Aggressive fluid resuscitation is required to ameliorate hypovolemic-distributive shock, and ...
Cohen Joshua - - 2007
BACKGROUND: Enhanced external counterpulsation (EECP) currently is used as an outpatient therapy for patients with refractory chronic angina. HYPOTHESIS: We sought to determine the safety and feasibility of a portable EECP unit to treat patients with acute coronary syndrome and/or cardiogenic shock in the coronary care unit (CCU). METHODS: Ten ...
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