Publications by authors named "Crystal L Yan"

Article Synopsis
  • The study evaluated a personalized treatment plan for heart failure patients, focusing on improving their medication regimen and overall health outcomes.
  • The results showed significant improvements in both medication scores and heart function, with many patients experiencing better symptoms and fewer hospitalizations.
  • The approach led to lower mortality rates compared to expected figures, suggesting that this aggressive protocol can effectively bridge the gap between existing medical knowledge and practical treatment for heart failure.
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Background: Veno-arterial extracorporeal membrane oxygenation (ECMO) is associated with increased afterload and hindered myocardial recovery. Adding a percutaneous left ventricular assist device (pLVAD) to ECMO is one strategy to unload the left ventricle. We evaluated in-hospital outcomes in cardiogenic shock patients treated with ECMO alone versus ECMO plus pLVAD.

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Hospitalization for acute heart failure (HF) represents an important opportunity for initiation and up-titration of guideline-directed medical therapy. This study aimed to determine whether sodium-glucose co-transporter-2 inhibitor (SGLT2I) use is safe in patients hospitalized for acute HF and whether its use is associated with improved clinical outcomes. We conducted a single-center, retrospective cohort study of adults hospitalized for acute HF with any ejection fraction and separated them into 2 matched groups based on inpatient SGLT2I use.

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Article Synopsis
  • A woman with flu-like symptoms experienced syncope and tested positive for influenza B.
  • She quickly deteriorated into cardiogenic shock over two days, needing intense medication and temporary mechanical support.
  • The case emphasizes the critical need for early intervention and proper medical guidelines for treating severe myocarditis caused by influenza B.
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Article Synopsis
  • A heart transplant recipient in his 60s experienced syncopal episodes due to a complete atrioventricular block seven months post-surgery.
  • To address this, doctors implanted a leadless pacemaker, navigating the challenges of his immunocompromised condition and past cardiac device issues.
  • Five years after the pacemaker was successfully implanted, the patient has remained free of syncopal episodes and device-related complications.
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A 71-year-old female with heart failure who underwent left ventricular assist device (LVAD) placement presented for evaluation of low hemoglobin and dark stools. She also had leg pain, numbness, and weakness for which she was taking ibuprofen. She was found to have a gastrointestinal bleed, INR of 4.

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Randomized controlled trials have demonstrated mortality benefits for several medication classes in patients with heart failure (HF), especially with reduced ejection fraction (EF). However, the benefit of these traditional HF therapies in patients with HF from cardiac amyloidosis is unclear. our study aimed to evaluate the safety and efficacy of traditional HF therapies in patients with cardiac amyloidosis and HF with reduced EF or HF with mid-range EF (HFmrEF).

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A man in his early 20s with heart failure with reduced ejection fraction secondary to non-compaction cardiomyopathy (Titin (TTN) gene mutation positive) was transitioned from left ventricular assist device (LVAD) mechanical support to heart transplantation. Transplantation was successful; however, LVAD explantation resulted in innumerable complications secondary to penetration of the driveline into the peritoneal cavity. He developed an enterocutaneous fistula which led to concurrent malnutrition, poor wound healing, systemic infection, and allograft rejection in a patient less than 1 month after heart transplantation on immunosuppression.

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Background: Cardiac rehabilitation (CR) is an evidence-based comprehensive program that includes exercise training, health education, physical activity promotion, and extensive counseling for the management of cardiovascular risk factors. Wearable devices monitor certain physiological functions, providing biometric data such as heart rate, movement, sleep, ECG analysis, blood pressure, energy expenditure, and numerous other parameters. Recent evidence supports wearable devices as a likely relevant component in cardiovascular risk assessment and disease prevention.

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Article Synopsis
  • A 69-year-old man with ischemic cardiomyopathy experienced complications after receiving a left ventricular assist device (LVAD), including abdominal pain and infections related to the device.
  • Serial cultures revealed various bacteria and imaging suggested possible colonic involvement but no perforation was found.
  • Over 9 months, he developed an enterocutaneous fistula due to driveline erosion of the colon, highlighting the need for careful investigation of gastrointestinal sources when typical infection patterns change in LVAD patients.
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Heart failure is a clinical syndrome caused by structural cardiac abnormalities that lead to increased intracardiac pressures and decreased cardiac output. Following cardiovascular insult or direct myocardial injury, neurohormonal activation triggers hemodynamic changes and cardiac remodeling to preserve cardiac output. While initially adaptive, cardiac remodeling eventually causes pathologic changes in cardiac structure that often compromise cardiac function.

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Article Synopsis
  • Condyloma acuminatum and squamous cell carcinoma in situ (CIS) in the bladder are rare occurrences, especially in developed nations where bladder cancer is generally uncommon.
  • The diagnosis of squamous bladder lesions is complicated by their similar morphological features, making accurate identification challenging.
  • A case is presented involving a 79-year-old man with a kidney transplant and a history of anal SCC, who developed bladder squamous cell CIS linked to condyloma acuminatum.
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• Patients with well-controlled HIV are still at increased risk of PCL. • Multimodal imaging led to the diagnosis prior to histopathologic confirmation. • Surgical resection is indicated in the setting of hemodynamic compromise.

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A 68-year-old female with end-stage heart failure presented to the hospital for heart transplant. She was diagnosed with achalasia 14 months prior and treated with frequent botulinum toxin injections. She underwent orthotopic heart transplant on the day of admission and was extubated a few days later.

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