No abstract available.
Choriocarcinoma* ; Female ; Lung Neoplasms* ; Lung* ; Pregnancy

A variety of clinical conditions are known to result in a giant T wave and a marked QT prolongation. We report a case of a giant T wave and a QT prolongation after the resolution of an acute cardiogenic but nonischemic pulmonary edema.
Heart Failure ; Pulmonary Edema*

No abstract available.
Foreign Bodies* ; Pulmonary Artery*

BACKGROUND: In patients with myocardial infarction (MI) and chronic stable angina, the coronary flow reserve (CFR) is reduced not only in the region of myocardium perfused by the ischemia-related artery but also in the regions supplied by angiographically normal coronary arteries. The effect of myocardial stunning on the remote CFR is unknown, however. METHODS: In ten open-chest anesthetized dogs, left circumflex coronary artery was occluded for 15 minutes (myocardial stunning group, n=5) or for 30 minutes (MI group, n=5) and was followed by a reperfusion for 60 minutes. Before coronary occlusion and at 30 minutes and at 60 minutes after reperfusion, resting coronary blood flow (CBF) and maximal CBF after IV injection of each of adenosine (ADE) and acetylcholine (Ach) was measured with electromagnetic flow probe located in the proximal left anterior descending coronary artery. CFR was calculated as the ratio of maximal and resting CBF. RESULTS: At 30 minutes and 60 minutes after reperfusion, the remote resting CBF were significantly increased in both groups and the remote CFR was significantly decreased in both groups. The CFR of the MI group was lower than myocardial stunning group. The coronary vasodilator response to Ach was significantly lower than the response to ADE in both groups. CONCLUSION: After MI and myocardial stunning, there was severe coronary vasodilator abnormality in the remote myocardium and that was more marked after MI. The coronary vasodilator response to Ach was significantly lower than the response to ADE in both groups, suggesting endothelial dysfunction in remote myocardium.
Acetylcholine ; Adenosine ; Angina, Stable ; Animals ; Arteries ; Coronary Occlusion ; Coronary Vessels ; Dogs ; Humans ; Magnets ; Myocardial Infarction ; Myocardial Stunning* ; Myocardium ; Reperfusion

Background and Objectives: The objective of this study was to estimate the supply and demand for cardiologists in Korea and provide evidence for healthcare policy to ensure a stable and adequate workforce for optimal cardiovascular disease management. Methods: Past trends of inflow and outflow of cardiologists were used to make crude projections, which were then adjusted based on demands of services to obtain final projections. Inflow of cardiologists was estimated using second-order polynomial regression and demand for cardiology care was estimated using linear regression. Results: There were 1,139 active cardiologists who were under the age of 65 in clinical practice in Korea. The estimated number of cardiologists from 2022 to 2040 showed that the number of cardiologists would peak at 1,344 in 2032 and gradually decrease thereafter. We also estimated an increase of 947,811 cases of heart-related procedures annually from 2023 to 2032. The number of heart-related procedures per cardiologist would increase 1.4 times from 12,964 in 2023 to 17,862 in 2032. The estimated number of emergency patients per cardiologist under 50 years old would almost double from 544 in 2022 to 987 in 2032. Conclusions We expect significant shortage of cardiologists in Korea within the next 10 years. The number of emergency patients per cardiologist will increase by nearly 50%, leading to high individual workload for cardiologists. To prevent this imbalance between supply and demand, an organized and collective approach by the specialty of cardiology is imperative to produce a balanced workforce.

One of the authors' names was misprinted.

The Noonan syndrome is a rate clinical syndrome associated with similar congenital abnormalities, that is characteristics of Turner syndrome, such as short stature, webbed neck, low posterior hairline, cubitus valgus, shield chest or funnel chest, congenital features similar to Turner syndrome but with a normal karyotype, and Opitz et al. proposed the name "Noonan syndrome" for this condition in 1965. We experienced a 31-year old man with Noonan syndrome combined with valvular and infundibular pulmonic stenosis who had short stature, webbed neck and normal karyotype. So we report a case Noonan syndrome with a review of literature.
Adult ; Congenital Abnormalities ; Funnel Chest ; Humans ; Karyotype ; Neck ; Noonan Syndrome* ; Pulmonary Valve Stenosis* ; Thorax ; Turner Syndrome

BACKGROUND: Carotid intima-media thickness (CIMT) is associated with several risk factors for atherosclerosis and has been consistently linked to cardiovascular and cerebrovascular disease. The clinical significance of separate measurements of CIMT, which is the sum of the intima (IT) and media thickness (MT), to use as an assessment of risk for atherosclerosis has not yet been fully established. METHODS: Among 3377 patients who underwent B-mode ultrasound of carotid arteries and coronary angiography in the Medical Department of St. Mary's Hospital from September 2003 to March 2009, 1146 subjects (M:F = 616:530; mean age, 57.7 ± 12.1 years) who were diagnosed with normal coronary arteries were enrolled in this study. IT, MT, and CIMT of the enrolled patients were manually measured using high-frequency ultrasonography (15 MHz linear array transducer). RESULTS: In multivariate logistic regression analysis, age (β = 0.063, p < 0.0001), body mass index (BMI) (β = 0.028, p = 0.018), and hypertension (HTN) (β = 0.046, p = 0.0002) were associated with MT (R2 = 0.256) and the IT/MT ratio (R2 = 0.209). Age (β = 0.065, p < 0.0001), BMI (β = 0.025, p = 0.038), hemoglobin A1c (β = 0.045, p = 0.045), and HTN (β = 0.043, p = 0.0006) correlated with mean CIMT (R2 = 0.230). Age (β = -0.071, p < 0.0001) and BMI (β = -0.046, p = 0.002) were associated with the IT/MT ratio (R2 = 0.219) on the left side. Age (β = 0.093, p < 0.0001) was related to MT (R2 = 0.265) and mean CIMT (R2 = 0.243) on the left side. CONCLUSION: We noted different atherosclerotic risk factors were related to measurements of the arterial wall in different ways. Therefore, separate measurements of CIMT might be a useful method to assess the risk for atherosclerosis.
Atherosclerosis* ; Body Mass Index ; Carotid Arteries ; Carotid Intima-Media Thickness ; Coronary Angiography ; Coronary Vessels ; Humans ; Hypertension ; Logistic Models ; Risk Factors* ; Ultrasonography

PURPOSE: The triad of chest pain, normal coronary arteries and a positive stress test has been called microvascular angina. The link between coronary flow reserve(CFR) and Duke treadmill score(DTS) in patients with microvascular angina remains elusive. METHODS: We studied 108 subjects (M:F=8:60, mean age 54+/-9 yrs) with chest pain and normal coronary angiogram. Exercise treadmill test(ETT) was performed by Bruces protocol and the equation for calculating DTS was DTS=xercise time- (5xST deviation)-(4x exercise angina), with 0=one, 1=onlimiting, 2=exercise-limiting. The coronary flow velocity at diastole(PDV) using Transesophageal echocardiography (TEE) was obtained from the proximal left anterior descending coronary artery and coronary flow reserve(CFR) was calculated as the ratio of hyperemic PDV after the intravenous infusion of dipyridamole(0.56 mg/kg) to baseline PDV. RESULTS: 1) CFR was 3.04+/-0.45 in group with negative ETT and 2.19+/-0.62 in group with positive ETT(p<0.001). 2) CFR was 1.51+/-0.31 in high-risk group with a score of <-10, 2.39+/-0.63 in moderate-risk group with scores from -10 to + and 3.04+/-0.43 in low-risk group with a score of > or =+ on DTS(p< 0.001 versus low-risk, respectively). 3) DTS was significantly related to CFR (r=.704, p<0.001). CONCLUSION: The composite DTS is closely related to CFR using TEE and might be a useful tool that can help clinicians determine the severity of ischemia and evaluate the efficacy of treatment in patients with microvascular angina.
Chest Pain ; Coronary Vessels ; Echocardiography, Transesophageal* ; Exercise Test ; Humans ; Infusions, Intravenous ; Ischemia ; Microvascular Angina*

Anomalous origin of left coronary artery from pulmonary artery (ALCAPA) is a rare congenital cardiovascular anomaly. The mortality rate among infants and children without operation has been eighty to ninety-five percents and few patients survive till teen-age or adulthood. This anomaly was detected during elective coronary angiogram in a 32 year-old female patient with atypical chest pain. Reversible ischemia was demonstrated on myocardial 201Tl-SPECT. Coronary angiogram revealed anomalous origin of left coronary artery from pulmonary artery.
Adult* ; Bland White Garland Syndrome ; Chest Pain ; Child ; Coronary Vessels* ; Female ; Humans ; Infant ; Ischemia ; Mortality ; Pulmonary Artery