ABSTRACT
Valvular heart disease contributes to a large burden of morbidity and mortality in the United States. During the last decade there has been a paradigm shift in the management of valve disease, primarily driven by the emergence of novel transcatheter technologies. In this article, the latest update of the American College of Cardiology/American Heart Association valve heart disease guidelines is reviewed.
Subject(s)
Cardiology , Heart Valve Diseases , American Heart Association , Heart Valve Diseases/diagnosis , Heart Valve Diseases/surgery , Humans , United States/epidemiologyABSTRACT
Coronary embolism is an uncommon mechanism of myocardial infarction in comparison with atherosclerotic plaque rupture. We present a unique case of an anterior ST elevation myocardial infarction as a result of coronary embolism, the source of which appears to be calcific debris from mitral annular calcification (MAC). Although embolic phenomena in the setting of MAC has been documented previously, particularly in the setting of acute ischemic stroke, to our knowledge this is the first reported case in the literature where MAC alone appears to have resulted in a coronary embolic event.
Subject(s)
Coronary Circulation , Echocardiography, Transesophageal , Mitral Valve Insufficiency/diagnostic imaging , Mitral Valve/diagnostic imaging , Blood Flow Velocity , Echocardiography, Doppler, Color , Female , Hemodynamics , Humans , Middle Aged , Mitral Valve/physiopathology , Mitral Valve Insufficiency/physiopathology , Severity of Illness IndexABSTRACT
Although several risk factors are associated with spontaneous coronary artery dissection, strenuous activity is an uncommon risk factor for women. We report a case of a patient who developed spontaneous coronary artery dissection shortly after starting F45, a highly strenuous fitness program. As high-intensity exercise regimens become more mainstream, clinicians should more readily consider spontaneous coronary artery dissection in young patients with history of recent strenuous activity when presenting with symptoms concerning for acute coronary syndrome.
Subject(s)
Coronary Vessels/injuries , High-Intensity Interval Training/adverse effects , ST Elevation Myocardial Infarction/diagnosis , Coronary Angiography , Coronary Occlusion/diagnostic imaging , Coronary Occlusion/therapy , Coronary Vessels/diagnostic imaging , Electrocardiography , Female , Humans , Middle Aged , ST Elevation Myocardial Infarction/etiology , Troponin/bloodABSTRACT
BACKGROUND: The results of mitral valve repair operations conducted at community hospitals in rural states are not well studied or reported in the literature. METHODS: We retrospectively assessed consecutive patients who underwent isolated mitral valve repair operations performed by a single experienced cardiothoracic surgeon at a large community hospital from May 1, 2006 - April 30, 2010. Patients were monitored for up to three years (average 2.2 years) following surgery for a variety of surgical variables, including morbidity, mortality, and serial two-dimensional transthoracic echocardiographic findings. Comparisons were made with the Society of Thoracic Surgeons Adult Cardiac Surgery Database (ACSD). RESULTS: Sixty-three consecutive patients underwent isolated complex mitral repair operations. Echocardiographic and morbidity data demonstrated successful outcomes, with no operative mortality and a single cardiac-related death within three years postoperatively. Other variables, especially those that relate to post-repair outcomes, showed no significant differences between our patients and comparison data from the ASCD. CONCLUSIONS: Our study demonstrates equivalent risks and outcomes for complex mitral valve repair performed in a community hospital setting as those found in a national database. The appropriate institutional setting for performing highly complex procedures has substantial implications for health policy, especially regarding access and quality issues.
Subject(s)
Databases, Factual , Echocardiography , Mitral Valve Annuloplasty , Mitral Valve , Social Planning , Adult , Aged , Aged, 80 and over , Female , Follow-Up Studies , Humans , Male , Middle Aged , Mitral Valve/diagnostic imaging , Mitral Valve/surgery , Retrospective StudiesABSTRACT
Patients with hepatic hemangiomas have been known to have high-output heart failure as a result of left-to-right arteriovenous shunting. We report a patient with a hepatic hemangioma that presented with high-output heart failure with hypoxia on exertion. After embolization of the hemangioma, the patient's hypoxia resolved and ejection fraction improved. In the absence of cardiopulmonary pathophysiology, we presume that our patient's hemangioma was causing a right-to-left shunt as opposed to an expected left-to-right shunt.
