1.Inverted stress cardiomyopathy during monitored anesthesia care for endoscopic sinus surgery.
Min Seok KOO ; Jung Won LEE ; Do Hun KIM ; Jung Ju SIR ; Jung Min KIM
Korean Journal of Anesthesiology 2013;65(6 Suppl):S79-S81
No abstract available.
Anesthesia*
;
Takotsubo Cardiomyopathy*
2.Successful Resection of a Giant Left Ventricular Pseudoaneurysm Developed Later after Mitral Valve Replacement.
Sun Kyung MIN ; Jung Ju SIR ; Jong Chun NAH ; Yong In KIM
Journal of Korean Medical Science 2010;25(7):1080-1082
We present a case of successful surgical resection of a giant left ventricular (LV) pseudoaneurysm that developed 5 yr after mitral valve replacement (MVR). A 59-yr-old female was admitted with exertional chest pain radiating to left arm and back. 64-slice multidetector computed tomography (MDCT) revealed significant stenosis on the ostium of the first diagonal branch of the left anterior descending coronary artery and also a huge pseudoaneurysm compressing the right atrium and the inferior vena cava. She underwent resection of the pseudoaneurysm, and the pseudoaneurysm tunnel was repaired from the inside of LV cavity by removing the previously inserted prosthetic valve, followed by redo MVR together with coronary arterial bypass grafting (CABG) for a single-vessel disease. At the 6-month follow-up, the patient continued to do well without any complications.
*Aneurysm, False/etiology/pathology/surgery
;
Female
;
*Heart Aneurysm/etiology/pathology/surgery
;
Heart Valve Prosthesis Implantation/*adverse effects
;
Heart Ventricles/pathology/*surgery
;
Humans
;
Middle Aged
;
Mitral Valve/*surgery
;
Postoperative Complications/*surgery
;
Treatment Outcome
3.Takotsubo Cardiomyopathy Associated with Chronic Psychiatric Stress in Major Depressive Disorder in an Elderly Patient.
Jung A KOH ; Seon Jae KIM ; Hak Cheol LEE ; Seong Taek CHU ; Yong Chul SHIN ; Jung Ju SIR ; Seung Min CHOI ; Shin Bae JOO
Journal of the Korean Geriatrics Society 2015;19(3):181-184
Takotsubo cardiomyopathy (TC) is a transient form of acute heart failure that most often occurs in postmenopausal women, typically triggered by a preceding emotional or physical stressor. A 74-year-old woman who suffered from chronic psychiatric stress visited National Medical Center for dyspnea. Acute emotional or physical stress could not be identified despite careful history taking. An electrocardiogram showed diffuse T-wave inversions with prolonged QT interval, and the echocardiogram showed akinesia of mid and apical segments of the left ventricle with hyperkinesia at the base. There was no significant stenosis on coronary angiography. Differing from the typical case of TC, which follows acute stress triggers, our case indicates that underlying chronic psychiatric illness exacerbation can lead to TC. We suggest that cardiologists and psychiatrists be aware of this predisposition to TC, especially in the circumstances of acute heart failure.
Aged*
;
Cardiomyopathies
;
Constriction, Pathologic
;
Coronary Angiography
;
Depressive Disorder, Major*
;
Dyspnea
;
Electrocardiography
;
Female
;
Heart Failure
;
Heart Ventricles
;
Humans
;
Hyperkinesis
;
Psychiatry
;
Takotsubo Cardiomyopathy*
4.Partial Anomalous Pulmonary Venous Return into Coronary Sinus with Intact Atrial Septum.
Il Young OH ; Sung A CHANG ; Sung Hwan KIM ; Jung Im SHIN ; Jung Ju SIR ; Yong Sang HONG ; Hyo Soo KIM ; Dae Won SOHN
Journal of the Korean Society of Echocardiography 2004;12(2):94-96
We report a case of partial anomalous pulmonary venous return where the right upper and lower pulmonary veins drain into the coronary sinus with right-to-left shunt via patent foramen ovale. To our knowledge, this is the uncommon case where the interatrial septum is intact. The diagnosis was initially made by transthoracic echocardiography and transesophageal echocardiography with the infusion of agitated saline and confirmed by pulmonary artery angiography. Curative operation could not be performed because of the irreversible pulmonary hypertension.
Angiography
;
Atrial Septum*
;
Coronary Sinus*
;
Diagnosis
;
Dihydroergotamine
;
Echocardiography
;
Echocardiography, Transesophageal
;
Foramen Ovale, Patent
;
Hypertension, Pulmonary
;
Pulmonary Artery
;
Pulmonary Veins
;
Scimitar Syndrome*
5.Atypical Stress Induced Cardiomyopathy During Endoscopic Sinus Surgery With Septoplasty in an Elderly Male Patient.
Hee Sook LEE ; Jae Ryung YI ; Yu Na JUNG ; Gi Ho JO ; Jung Ju SIR ; Seung Min CHOI
Journal of the Korean Geriatrics Society 2013;17(4):219-222
Stress-induced cardiomyopathy, also known as Takotsubo cardiomyopathy, is caused by emotional or physical stressors and mimics acute myocardial infarction. Stress-induced cardiomyopathy is characterized by acute, reversible left ventricular apical ballooning without significant coronary artery stenosis. New variants of stress-induced cardiomyo pathy with localized wall motion abnormalities or an inverted pattern with a hyperdynamic apex have been reported. We present a rare case of a sudden cardiac arrest due to atypical stress-induced cardiomyopathy (mucosal packing and the injection of epinephrine) in an elderly male patient during elective endoscopic sinus surgery with septoplasty under local anesthesia. In this case, only the basal and midportions of the left ventricle were affected, whereas the apex was completely spared. The patient rapidly and completely recovered without sequelae.
Aged*
;
Anesthesia, Local
;
Cardiomyopathies*
;
Coronary Stenosis
;
Death, Sudden, Cardiac
;
Epinephrine
;
Heart Ventricles
;
Humans
;
Male*
;
Myocardial Infarction
;
Takotsubo Cardiomyopathy
6.A Case of Klippel-Trenaunay Syndrome with Acute Submassive Pulmonary Thromboembolism Treated with Thrombolytic Therapy.
Seong Taek CHU ; Yung Hee HAN ; Jung A KOH ; Seon Jae KIM ; Hak Cheol LEE ; Si Eun KIM ; Yong Chul SHIN ; Jung Ju SIR ; Seung Min CHOI ; Shin Bae JOO
Journal of Cardiovascular Ultrasound 2015;23(4):266-270
Klippel-Trenaunay syndrome is a rare congenital mesodermal abnormality characterized by varicose veins, cutaneous hemangiomas, soft tissue and bony hypertrophy of limb. Potential complications such as deep venous thrombosis and pulmonary thromboembolism have not been reported in Korea to date. We demonstrate the case of a 48-year-old woman with Klippel-Trenaunay syndrome with extensive varicose veins on right lower limb, hypertrophy of left big toe and basilar artery tip aneurysm, complicated with acute submassive pulmonary thromboembolism treated successfully with intravenous thrombolytic therapy.
Aneurysm
;
Basilar Artery
;
Extremities
;
Female
;
Heart Failure
;
Hemangioma
;
Humans
;
Hypertrophy
;
Intracranial Aneurysm
;
Klippel-Trenaunay-Weber Syndrome*
;
Korea
;
Lower Extremity
;
Mesoderm
;
Middle Aged
;
Pulmonary Embolism*
;
Thrombolytic Therapy*
;
Toes
;
Varicose Veins
;
Venous Thromboembolism
;
Venous Thrombosis
7.A Case of Idiopathic Acute Myocarditis with Isolated Right Ventricular Failure.
Jung Ju SIR ; Il Young OH ; Yong Jin KIM ; Bon Kwon KOO ; Dae Won SOHN ; Byung Hee OH ; Young Bae PARK ; Yun Shik CHOI
Journal of the Korean Society of Echocardiography 2004;12(2):104-106
A 68 year-old woman was admitted due to chest pain with dyspnea. Transthoracic echocardiography showed isolated right ventricular dysfunction. Coronary angiogram was normal. Cardiac enzyme was elevated persistently. Under the supposed diagnosis of acute idiopathic myocarditis, she was treated with supportive care but symptom and cardiac enzyme was not improved. After steroid pulse therapy, symptom was improved and cardiac enzyme was normalized. She was discharged with improvement of symptoms.
Aged
;
Chest Pain
;
Diagnosis
;
Dyspnea
;
Echocardiography
;
Female
;
Humans
;
Myocarditis*
;
Ventricular Dysfunction, Right
8.Acute Idiopathic Hemorrhagic Pericarditis with Cardiac Tamponade as the Initial Presentation of Acquired Immune Deficiency Syndrome.
Young Il PARK ; Jung Ju SIR ; Sung Won PARK ; Hyun Tae KIM ; Bora LEE ; Ye Kyung KWAK ; Wook Hyun CHO ; Suk Koo CHOI
Yonsei Medical Journal 2010;51(2):273-275
This paper presents a case of cardiac tamponade with idiopathic hemorrhagic pericarditis as the initial symptom of human immunodeficiency virus (HIV) infection. A 29-year-old male came to the emergency room with a sudden onset of dizziness. Upon arrival, he was hypotensive although not tachycardic, and his jugular venous pressure was not elevated. His chest X-rays revealed a mild cardiomegaly. Transthoracic echocardiography revealed a large amount of pericardial effusion with a diastolic collapse of the right ventricle, a dilated inferior vena cava with little change in respiration, and exaggerated respiratory variation of mitral inflow velocities, representing echocardiographic evidence of cardiac tamponade. After pericardiocentesis, his blood pressure improved to 110/70 mmHg without inotropics support. Serial 12-lead electrocardiograms during hospitalization revealed upwardly concave diffuse ST-segment elevation followed by a T-wave inversion suggestive of acute pericarditis. Pericardial fluid cytology and cultures for bacteria, mycobacteria, adenovirus, and fungus were all negative. HIV enzyme-linked immunosorbent assay (ELISA) was positive and confirmed by Western blot. The CD4 cell count was 168/mm3. Finally, the diagnosis of cardiac tamponade due to HIV-associated hemorrhagic pericarditis was made. It was concluded that HIV infection should be considered in the diagnosis of unexplained pericardial effusion or cardiac tamponade in Korea.
Acquired Immunodeficiency Syndrome/*diagnosis/*pathology
;
Acute Disease
;
Adult
;
Cardiac Tamponade/*complications/*diagnosis
;
Enzyme-Linked Immunosorbent Assay
;
Humans
;
Male
;
Pericarditis/*complications/*diagnosis
9.A Case of Severe Coronary Spasm Associated with 5-Fluorouracil Chemotherapy.
Sang Min KIM ; Cheol Hoon KWAK ; Bora LEE ; Seong Beom KIM ; Jung Ju SIR ; Wook Hyun CHO ; Suk Koo CHOI
The Korean Journal of Internal Medicine 2012;27(3):342-345
Cardiotoxicity associated with 5-fluorouracil (FU) is an uncommon, but potentially lethal, condition. The case of an 83-year-old man with colon cancer who developed chest pain during 5-FU infusion is presented. The electrocardiogram (ECG) showed pronounced ST elevation in the lateral leads, and the chest pain was resolved after infusion of nitroglycerin. A coronary angiogram (CAG) revealed that the patient had significant atherosclerosis in the proximal left circumflex artery. Coronary artery spasm with fixed stenosis was considered, and a drug-eluting stent was implanted. After 8 hours, the patient complained of recurring chest pain, paralleled by ST elevation on the ECG. The chest pain subsided after administration of intravenous nitroglycerin followed by sublingual nifedipine. Repeated CAG showed patency of the previous stent. This case supports the vasospastic hypothesis of 5-FU cardiac toxicity, indicating that a calcium channel blocker may be effective in the prevention or treatment of 5-FU cardiotoxicity.
Aged, 80 and over
;
Angina Pectoris/chemically induced
;
Antineoplastic Combined Chemotherapy Protocols/administration & dosage/*adverse effects
;
Calcium Channel Blockers/administration & dosage
;
Colonic Neoplasms/*drug therapy
;
Coronary Angiography
;
Coronary Vasospasm/*chemically induced/diagnosis/therapy
;
Drug-Eluting Stents
;
Electrocardiography
;
Fluorouracil/administration & dosage/*adverse effects
;
Humans
;
Leucovorin/administration & dosage/adverse effects
;
Male
;
Nifedipine/administration & dosage
;
Nitroglycerin/administration & dosage
;
Organoplatinum Compounds/administration & dosage/adverse effects
;
Percutaneous Coronary Intervention/instrumentation
;
Recurrence
;
Severity of Illness Index
;
Treatment Outcome
;
Vasodilator Agents/administration & dosage
10.Severe Resistant Hypertension Induced by Carbamazepine in an Elderly Patient.
Seon Jae KIM ; Jung A KOH ; Hak Chul LEE ; Si Eun KIM ; Seong Taek CHU ; Seung Hun LEE ; Jung Ju SIR ; Seung Min CHOI ; Shin Bae JOO ; Hong Soon LEE ; Dae Hee HAN
Journal of the Korean Geriatrics Society 2013;17(2):99-102
We report a case of a 73-year-old patient with a 17 year-history of well-controlled primary hypertension with a single antihypertensive drug, which became uncontrolled since 9 months ago when he started on oral carbamazepine (CBZ) therapy for syringomyelia. On admission, the patient had a blood pressure of 200-215/95-104mmHg despite an antihypertensive combination therapy with five different drugs. Further investigations ruled out secondary hypertension such as primary aldosteronism, pheochromocytoma and renal artery stenosis. After the discontinuation of CBZ, the blood pressure profile became significantly improved. The rechallenge with CBZ aggravated his blood pressure profile. Therefore, we considered that resistant hypertension was induced by the oral CBZ therapy.
Aged
;
Antidepressive Agents, Tricyclic
;
Blood Pressure
;
Carbamazepine
;
Humans
;
Hyperaldosteronism
;
Hypertension
;
Pheochromocytoma
;
Quaternary Ammonium Compounds
;
Renal Artery Obstruction
;
Syringomyelia