Stress-induced cardiomyopathy is described as an acute cardiomyopathy that occurs under the influence of an excessive level of catecholamine related to intense emotional stress. A 64-year-old woman presented with symptoms of acute myocardial infarction after emotional upset, but her coronary angiographic findings were revealed to be normal. Diffuse T wave inversions were observed in her electrocardiograms with akinetic wall motions sparing the basal segments in her left ventriculography. After four months, her electrocardiogram and echocardiogram findings had completely returned to normal. The precise diagnosis of this acute cardiomyopathy must be emphasized because it can initially be misdiagnosed as acute coronary syndromes. However in complete contrast to acute myocardial infarction, it has a rapid and favorable recovery with hardly any sequelae after a few months.
Case Report ; Electrocardiography ; Female ; Human ; Middle Age ; Myocardial Diseases/*complications ; Myocardial Infarction/*etiology ; Stress, Psychological/*complications

Humans ; Cardiovascular Diseases ; Risk Factors ; Myocardial Infarction/complications* ; Coronary Disease/etiology* ; Heart Disease Risk Factors

Aged, 80 and over ; Atrial Fibrillation ; complications ; Embolism ; complications ; Female ; Heart Atria ; pathology ; Heart Diseases ; complications ; Humans ; Myocardial Infarction ; etiology ; Thrombosis ; complications

Pheochromocytoma in pregnancy is very rare but it is associated with very high maternal and fetal mortality. Therefore, it is important to include pheochromocytoma in the differential diagnosis of hypertension associated with pregnancy. It is difficult to make a diagnosis of pheochromocytoma in pregnancy before delivery. The characteristic symptoms of pheochromocytoma could be initiated during delivery because the process of delivery, general anesthesia, fetal movement, induce acute surge of catecholamine release, which could also induce cardiomyopathy. Early diagnosis and intensive care can affect the prognosis of cardiomyopathy induced by pheochromocytoma. Proper management with alpha-blockade, beta-blockade and angiotension converting enzyme inhibitor could acutely reverse the course of cardiomyopathy.
Adrenal Gland Neoplasms/surgery ; Adrenal Gland Neoplasms/diagnosis* ; Adrenal Gland Neoplasms/complications ; Adult ; Cardiovascular Agents/therapeutic use ; Disease-Free Survival ; Echocardiography ; Electrocardiography ; Female ; Human ; Myocardial Diseases/ultrasonography ; Myocardial Diseases/etiology* ; Myocardial Diseases/drug therapy ; Pheochromocytoma/surgery ; Pheochromocytoma/diagnosis* ; Pheochromocytoma/complications ; Pregnancy ; Pregnancy Complications, Cardiovascular/etiology* ; Pregnancy Complications, Neoplastic/surgery ; Pregnancy Complications, Neoplastic/diagnosis* ; Pregnancy Outcome* ; Puerperium ; Tomography, X-Ray Computed ; Substances: Cardiovascular Agents

BACKGROUNDPatients with atherosclerotic renal artery stenosis (ARAS) are in substantial risk of cardiovascular adverse events. We investigated whether myocardial infarction patients with ARAS are in additional risk of cardiovascular events.

METHODSIn this retrospective study, 257 patients with type 1 myocardial infarction were enrolled. Median follow-up was 42 months. Composite endpoint events are analyzed by definitions of ARAS as ≥ 50% or ≥ 70% diameter stenosis.

RESULTSDefining ARAS as ≥ 70% diameter stenosis, ARAS was a significant predictor for composite endpoint events including death, non-fatal myocardial infarction, ischaemic stroke and intracranial haemorrhage, rehospitalisation for cardiac failure (HR: 4.381; 95% CI: 1.770-10.842) by Cox regression analysis, but not for death. Diabetes mellitus was also a significant predictor for composite endpoint events (HR: 2.756; 95% CI: 1.295-5.863). However, defining ARAS ≥ 50% diameter stenosis, ARAS was no longer a significant predictor for composite endpoint events or death.

CONCLUSIONSAlthough not associated with mortality, ARAS ≥ 70% is associated with major adverse cardiac events after acute myocardial infarction. For prognosis, ≥ 70% diameter stenosis is a more appropriate criteria for ARAS definition than ≥ 50% diameter stenosis.

Atherosclerosis ; pathology ; Cardiovascular Diseases ; etiology ; Diabetes Complications ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; complications ; Renal Artery Obstruction ; complications ; pathology ; Retrospective Studies

BACKGROUND AND OBJECTIVES: The role of preoperative transthoracic echocardiography (TTE) for the risk stratification has not been well investigated yet. We compared the predictive power of TTE with N-terminal pro-brain natriuretic peptide (NT-proBNP), a representative biomarker that predicts perioperative cardiovascular risk, and investigated whether these tests have incremental value to the clinically determined risk. SUBJECTS AND METHODS: We evaluated the Revised Cardiac Risk Index (RCRI), TTE, and NT-proBNP in 1,923 noncardiac surgery cases. The primary endpoint was a perioperative major cardiovascular event (PMCE), which was defined by any single or combined event of secondary endpoints including myocardial infarction, development of pulmonary edema, or primary cardiovascular death within 30 days after surgery. RESULTS: All echocardiographic parameters including left ventricular ejection fraction, regional wall motion score index, and transmitral early diastolic velocity/tissue Doppler mitral annular early diastolic velocity (E/E') were predictive of PMCE (c-statistics=0.579+/-0.019 to 0.589+/-0.015), but none of these parameters were better than the clinically determined RCRI (c-statistics=0.594+/-0.019) and were inferior to NT-proBNP (c-statistics=0.748+/-0.019, p<0.001). The predictive power of RCRI {adjusted relative risk (RR)=1.4} could be improved by addition of echocardiographic parameters (adjusted RR=1.8, p<0.001), but not to that extent as by addition of NT-proBNP to RCRI (adjusted RR=3.7, p<0.001). CONCLUSION: TTE was modestly predictive of perioperative cardiovascular events but was not superior to NT-proBNP. Moreover, it did not have incremental value to the clinically determined risk. The results of our study did not support the use of routine echocardiography before noncardiac surgery.
Cardiovascular Diseases ; Echocardiography ; Humans ; Myocardial Infarction ; Natriuretic Peptide, Brain ; Natriuretic Peptides ; Peptide Fragments ; Postoperative Complications ; Pulmonary Edema ; Stroke Volume

OBJECTIVE: To analyses the causes and prevention of systemic complications of functional endoscopic sinus surgery (FESS) in patients with chronic rhinosinusitis. METHOD: Three typical cases were reported including their medical history, preoperative diagnosis, medications during preoperational period, complications and treatment. The causes and preventive measures of systemic complications were analyzed. RESULT: Three patients were all suffered from chronic rhinosinusitis with nasal polyps (CRSwNP). After FESS, 1 case was complicated with coma and hyponatremia, 1 case with acute myocardial infarction, and 1 case with lower extremity deep venous thrombosis. The patient with coma and hyponatremia was soon waked after intravenous infusion of 10% sodium chloride. Two patients with acute myocardial infarction and lower extremity deep venous thrombosis were soon completely rehabilitated after emergency thrombolytic therapy and endovascular intervention. Three patients were completed recovered from their systemic complications without any severe sequela. CONCLUSION Systemic hemostatic drugs should be banned in patients with hypercoagulable state in perioperation period of FESS in order to avoid severe systemic complications. Timely vascular interventional treatment can prevent severe sequels.
Cardiovascular Diseases ; Chronic Disease ; Endoscopy ; Humans ; Myocardial Infarction ; Nasal Polyps ; Postoperative Complications ; Rhinitis ; surgery ; Sinusitis ; Venous Thrombosis

OBJECTIVEThe effects of primary percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (AMI) induced by left main (LM) artery occlusion were analyzed retrospectively in this study.

METHODSA total of 1343 consecutive AMI patients who underwent primary PCI between January 1995 and December 2004 were retrospectively studied.

RESULTSLM occlusion or severe stenosis were found in 11 patients [all male, mean age (56.4 +/- 9.2) years (range 43-70 years)], cardiogenic shock was overt in 6 patients. Primary PCI were performed under the assistance of intra-aortic balloon pump (IABP) in these patients [8 stent implantation, 3 balloon dilation and 2 necessitating emergency CABG after balloon dilation]. In-hospital mortality was 45.5% (5/11). Three-month follow-up were made in all survivals (6/11). Analysis showed good collateral circulation flow from right coronary artery to left coronary artery was existed in all survival cases before PCI.

CONCLUSIONPrognosis of AMI patients with LM artery obstruction or severe stenosis was poor. Patients with pre-existed collateral circulation before primary PCI and IABP had a better clinical outcomes.

Adult ; Aged ; Angioplasty, Balloon, Coronary ; Arterial Occlusive Diseases ; complications ; Coronary Stenosis ; complications ; Emergency Treatment ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; etiology ; therapy ; Prognosis ; Retrospective Studies

OBJECTIVETo study the difference in prognosis for children with acute viral myocarditis induced ventricular premature beats (VPB) originating from different positions, and to study the role of 99Mtc-MIBI myocardial perfusion ECT in the prognostic evaluation of VPB.

METHODSThe clinical data of 83 children with viral myocarditis induced VPB were retrospectively studied. They were divided into four groups according to the original site of VPB, as shown by the ECG: right ventricular (RV) outflow tract, RV anterior wall and apex, left ventricular (LV) outflow tract, LV anterior wall and apex. All patients were treated with anti-viral drugs and myocardial nutritional medicine. Short-term and long term outcomes in the four groups were compared. The relationship between the results of 99Mtc-MIBI myocardial perfusion ECT and prognosis in 40 patients was observed.

RESULTSThere were no significant differences in short-term and long-term effective rates among the four groups (P>0.05). There were no differences in the ECT positive rates between the patients with VPB originating from RV and those with VPB originating from LV (P>0.05). The treatment effective rates of ECT-positive patients were higher than the treatment effective rates of ECT-negative ones (P<0.05).

CONCLUSIONSThe short-term and long-term prognosis of children with VPB originating from different positions are not significantly different. In children with viral myocarditis induced VPB, positive ECT results suggest a better prognosis.

Acute Disease ; Humans ; Myocardial Perfusion Imaging ; methods ; Myocarditis ; complications ; Prognosis ; Retrospective Studies ; Technetium Tc 99m Sestamibi ; Ventricular Premature Complexes ; diagnostic imaging ; etiology ; Virus Diseases ; complications

We present an unusual case of a patient with bilateral-lung transplantation due to severe coronavirus disease 2019 (COVID-19), who subsequently suffered complications with acute myocardial infarction and underwent primary percutaneous coronary intervention (PCI).
Aged ; Betacoronavirus ; China ; Coronavirus Infections ; complications ; Humans ; Lung Diseases ; surgery ; virology ; Lung Transplantation ; Male ; Pandemics ; Percutaneous Coronary Intervention ; Pneumonia, Viral ; complications ; ST Elevation Myocardial Infarction ; surgery ; virology