Gender, racial and ethnic disparities in acute coronary syndromes with coronary in-stent restenosis.

Background: Coronary in-stent restenosis (ISR) is a major clinical challenge of contemporary percutaneous revascularization and portends adverse cardiovascular outcomes.

Objectives: We aimed to evaluate gender, race, and ethnicity related outcomes in acute coronary syndromes (ACS) with ISR.

Methods: Primary hospitalizations for ACS and ISR in the National Inpatient Sample database from 2016 to 2019 were included.

Distal myocardial protection with intracoronary beta blocker when added to a Gp IIb/IIIa platelet receptor blocker during percutaneous coronary intervention improves clinical outcome.

Objective: The present study tested the hypothesis that intracoronary (IC) propranolol improves clinical outcomes with percutaneous coronary intervention (PCI) when used with background Gp IIb/IIIa receptor blockade.

Background: We have previously shown that administration of a relatively large weight-based IC dose of the beta blocker propranolol before PCI decreases the incidence of post-PCI myocardial infarction (MI) and improves short- and long-term outcome. It has previously been shown that administration of a Gp IIb/IIIa receptor blocker decreases post-PCI MI and improves short- and long-term clinical outcome.

Color M-mode flow propagation velocity and conventional doppler indices in the assessment of diastolic left ventricular function during isometric exercise.

Background And Objective: Color M-mode flow propagation velocity (Vp) was shown to be a preload-independent measure of diastolic function. To study the effects of an increase in afterload induced by isometric handgrip exercise on diastolic function assessment in patients with cardiomyopathy, we measured Vp and conventional Doppler indices at baseline and at 30% of predetermined maximum handgrip strength.

Methods: Twenty-four patients with systolic dysfunction were divided into two groups: Group I comprising 12 patients with E/A < 1 (early filling velocity/atrial contraction velocity) and Group II comprising 12 patients with E/A > 1.

Acute coronary syndrome induced by intravenous ephedrine in pregnant woman with normal coronaries.

Intravenous ephedrine administered during a C-section was observed to cause an acute coronary syndrome in a pregnant woman with normal coronaries. The patient developed sub-sternal chest pain, was noted to have 10 beats of non-sustained ventricular tachycardia, ST abnormalities were observed on her ECG and cardiac enzymes were elevated. The patient had normal coronary arteries by angiogram and during a one-year period of follow up no further cardiac events occurred.

Unusual evolution of ST elevation acute myocardial infarction.

We report a case of acute ST-segment elevation myocardial infarction with an unusual evolution of ST-segment elevation. Several possible explanations of this progression are discussed with supportive evidence for each explaination. The clinical, electrocardiographic, and angiographic features of this case are also illustrated.

Rapid screening of cardiac patients with a miniaturized hand-held ultrasound imager--comparisons with physical examination and conventional two-dimensional echocardiography.

Background: Rapid screening of cardiac patients with a hand-held ultrasound imager (SonoHeart [SH]) could provide valuable clinical information.

Hypothesis: Whether the use of this device yields additional information to a carefully conducted physical examination and comparable findings to those of conventional two-dimensional echocardiography (2-D) during inpatient rounds is not well established and is the subject of this study.

Methods: In all, 100 consecutive telemetry patients underwent rapid screening with 2-D and color Doppler SH during inpatient rounds.

Real-time three-dimensional echocardiography versus two-dimensional echocardiography in the diagnosis of left ventricular apical thrombi: preliminary findings.

Purpose: Real-time 3-dimensional transthoracic echocardiography (RT-3D-TE) with real-time volume rendering (RTVR) offers multiple simultaneous views and spatial definition of intracardiac structures superior to that attainable by 2-dimensional transthoracic echocardiography (2D-TE). We hypothesized that RT-3D-TE would therefore improve identification of left ventricular apical thrombi (LVT).

Methods: Patients were referred to our echocardiography laboratory over an 8-month period.

Ventricular free wall rupture following acute myocardial infarction.

Ventricular free wall rupture remains a dreaded complication of acute myocardial infarction. A dramatic fatal presentation is not universal and if recognized early, especially in its sub-acute form, a therapeutic intervention may be lifesaving. Changing trends in its natural history and the previously described pathological subtypes have emerged since the advent of thrombolysis.

Mitral regurgitation following acute myocardial infarction.

Mitral valve regurgitation (MR) is a frequent Doppler echocardiographic finding in patients after acute myocardial infarction (AMI) and an independent predictor of long-term cardiovascular mortality. Reported risk factors include advanced age, prior myocardial infarction, infarct extension, and recurrent ischemia. During the early phase of AMI, transient ischemic MR is common and rarely causes hemodynamic compromise.

Color M-mode flow propagation velocity versus conventional Doppler indices in the assessment of diastolic left ventricular function in patients on chronic hemodialysis.

Background And Objective: Color M-mode flow propagation velocity (Vp) has been reported as a preload-independent measure of diastolic function. To study the effects of loading conditions on diastolic function assessment in patients on chronic hemodialysis, we measured Vp and conventional Doppler indices pre- and posthemodialysis.

Methods: Twenty hemodialysis patients with normal systolic function underwent measurement of Vp, early filling velocity (E), its deceleration time (DT), atrial contraction velocity (A), isovolumic relaxation time (IVRT), and pulmonary atrial flow reversal velocity (PFR) pre- and posthemodialysis.