Embolization of the closure device is a rare but potentially fatal complication of percutaneous atrial septal defect (ASD) closure. We report a case of 45-year-old woman who underwent ASD device closure with 32 mm Amplatzer device, which was embolized to the pulmonary artery without symptom one day after successful device implantation.
Female ; Heart Septal Defects, Atrial ; Humans ; Pulmonary Artery ; Septal Occluder Device

The heart is frequently the site of metastasis of various malignant tumors. Lung cancer is one of the most common primary tumors of cardiac metastasis and usually involves the pericardium or epicardium by direct invasion and/or lymphatic spread. However, metastasis of lung cancer involving the left ventricular endocardium is extremely rare. We report a patient with adenocarcinoma of lung, metastasized to the left ventricular myocardium and endocardium, diagnosed by echocardiography and 18-fludeoxyglucose positron emission tomography-computed tomography.
Adenocarcinoma ; Echocardiography ; Electrons ; Endocardium ; Heart ; Heart Ventricles ; Humans ; Lung ; Lung Neoplasms ; Myocardium ; Neoplasm Metastasis ; Pericardium

Diabetes is associated with increased risk of cardiovascular disease, with atherosclerosis responsible for most associated morbidity and mortality. Atherosclerosis often causes acute thrombotic events through plaque rupture and formation of platelet-rich thrombi. The principal clinical manifestations of atherosclerosis are coronary artery disease, ischemic stroke, and peripheral arterial disease. Endothelial dysfunction, oxidative stress, and low-grade inflammation are key features in the pathophysiology of atherosclerosis.
Atherosclerosis ; Biomarkers ; Cardiovascular Diseases ; Coronary Artery Disease ; Diabetes Mellitus ; Inflammation ; Oxidative Stress ; Peripheral Arterial Disease ; Rupture ; Stroke

No abstract available.
Facial Nerve* ; Paralysis*

Submucosal infiltration and the topical application of epinephrine as a vasoconstrictor produce excellent hemostasis during surgery. The hemodynamic effects of epinephrine have been documented in numerous studies. However, its metabolic effects (especially during surgery) have been seldom recognized clinically. We report two cases of significant metabolic effects (including lactic acidosis and hyperglycemia) as well as hemodynamic effects in healthy patients undergoing orthognathic surgery with general anesthesia. Epinephrine can induce glycolysis and pyruvate generation, which result in lactic acidosis, via β2-adrenergic receptors. Therefore, careful perioperative observation for changes in plasma lactate and glucose levels along with intensive monitoring of vital signs should be carried out when epinephrine is excessively used as a vasoconstrictor during surgery.
Acidosis, Lactic* ; Administration, Topical ; Anesthesia, General ; Anesthesia, Local ; Epinephrine ; Glucose ; Glycolysis ; Hemodynamics ; Hemostasis ; Humans ; Lactic Acid ; Orthognathic Surgery* ; Plasma ; Pyruvic Acid ; Vital Signs

Mid-ventricular obstruction (MVO) rarely occurs in patients without hypertrophic cardiomyopathy. Increased cardiac contractility may play an important role in causing MVO. We experienced a case of severe chest pain and MVO in a 50-year-old female patient. She had hypertension, diabetes, stroke and peripheral artery disease. Her blood pressure was very high (222/122 mmHg) with severe fluctuation. The transthoracic echocardiography revealed MVO accompanied by hyper-dynamic left ventricular systolic function. We regarded her chest pain and MVO as secondary findings related to other diseases. Coronary angiography and several tests for uncontrolled hypertension were performed, and those evaluations revealed that she had coronary artery disease and hyperthyroidism. We considered that the increase in the myocardial oxygen demand in response to the increase in cardiac contractility and workload associated with hyperthyroidism aggravated her symptoms and MVO. She was treated with methimazole and beta blockers and her symptoms dramatically improved.
Blood Pressure ; Cardiomyopathy, Hypertrophic ; Chest Pain* ; Coronary Angiography ; Coronary Artery Disease ; Echocardiography ; Female ; Humans ; Hypertension ; Hyperthyroidism* ; Methimazole ; Middle Aged ; Oxygen ; Peripheral Arterial Disease ; Stroke ; Thorax* ; Ventricular Function

No abstract available.
Arteries ; Cardiac Imaging Techniques ; Heart Defects, Congenital ; Transposition of Great Vessels

No abstract available.
Ectopia Cordis*

Iatrogenic hypoglycemia is a major obstacle to glycemic control in patients with diabetes. Hypoglycemia has been associated with greater risk of cardiovascular disease (CVD) and mortality among patients with diabetes. Recent large randomized clinical trials have shown conflicting results regarding the impact of intensive glycemic control on CVD prevention in patients with diabetes. There is growing consensus that hypoglycemia is a possible cause for the lack of benefit on cardiovascular morbidity and mortality in large-scale diabetes outcomes trials. Acute hypoglycemia causes a cascade of physiologic effects, including hemodynamic changes, pro-thrombotic reactions and cardiac arrhythmias, presenting several potential mechanisms through which hypoglycemic events may increase cardiovascular risk. However, recent studies do not support a temporal or dose-response relationship between hypoglycemia and long-term cardiovascular risk in patients with diabetes. Recently, severe hypoglycemia was suggested as a predictor of adverse outcomes in patients with diabetes. Thus, individualized therapy was recommended in order to avoid severe hypoglycemia and any related adverse cardiovascular outcomes in patients with diabetes.
Arrhythmias, Cardiac ; Cardiovascular Diseases ; Consensus ; Diabetes Mellitus ; Hemodynamics ; Humans ; Hypoglycemia ; Mortality*

Mid-ventricular obstruction (MVO) rarely occurs in patients without hypertrophic cardiomyopathy. Increased cardiac contractility may play an important role in causing MVO. We experienced a case of severe chest pain and MVO in a 50-year-old female patient. She had hypertension, diabetes, stroke and peripheral artery disease. Her blood pressure was very high (222/122 mmHg) with severe fluctuation. The transthoracic echocardiography revealed MVO accompanied by hyper-dynamic left ventricular systolic function. We regarded her chest pain and MVO as secondary findings related to other diseases. Coronary angiography and several tests for uncontrolled hypertension were performed, and those evaluations revealed that she had coronary artery disease and hyperthyroidism. We considered that the increase in the myocardial oxygen demand in response to the increase in cardiac contractility and workload associated with hyperthyroidism aggravated her symptoms and MVO. She was treated with methimazole and beta blockers and her symptoms dramatically improved.
Blood Pressure ; Cardiomyopathy, Hypertrophic ; Chest Pain ; Coronary Angiography ; Coronary Artery Disease ; Echocardiography ; Female ; Humans ; Hypertension ; Hyperthyroidism ; Methimazole ; Middle Aged ; Oxygen ; Peripheral Arterial Disease ; Stroke ; Thorax ; Ventricular Function