Background: Myocardial ischemia occurs in the setting of inadequate or complete cessation of blood supply to the myocardium. While atherosclerosis is the most common cause; other causes have been identified. Rare cases can be caused by extrinsic compression of the coronaries by a dilated pulmonary artery (PA) or by mechanical obstruction from nearby chest tubes or drains.
View Article and Find Full Text PDFIncidental discovery of sinus venosus atrial septal defect (SV-ASD) in the elderly is rare. This defect allows for lead malpositioning during pacemaker placement and can lead to catastrophic cardioembolic events. Post-pacemaker implantation, chest radiography should be obtained to detect malpositioning early, and if detected, lead adjustment is recommended; if identified later, treatment with an anticoagulant is feasible.
View Article and Find Full Text PDFLeadless pacing systems have revolutionized the field of electrophysiology given its low complication rates and almost non-existent rate of infections compared with traditional pacemakers. These devices boast resistance to infections given its unique features; however, as described in this report, device-related infection from these leadless devices is still possible. In patients with leadless pacing system that is persistently bacteremic in the future, evaluation of the device with transesophageal echocardiogram or intracardiac echocardiography should be performed, and if vegetation is noted on the device, device extraction should highly be considered, along with empiric intravenous antibiotics.
View Article and Find Full Text PDFAs cardiac implantable electronic devices (CIED) become more prevalent, it is important to acknowledge potential electromagnetic interference (EMI) from other sources, such as internal and external electronic devices and procedures and its effect on these devices. EMI from other sources can potentially inhibit pacing and trigger shocks in permanent pacemakers (PPM) and implantable cardioverter defibrillators (ICD), respectively. This review analyzes potential EMI amongst CIED and left ventricular assist device, deep brain stimulators, spinal cord stimulators, transcutaneous electrical nerve stimulators, and throughout an array of procedures, such as endoscopy, bronchoscopy, and procedures involving electrocautery.
View Article and Find Full Text PDFTakotsubo cardiomyopathy (TCM), also known as stress cardiomyopathy, occurs in the setting of catecholamine surge from an acute stressor. This cardiomyopathy mimics acute myocardial infarction in the absence of coronary disease. The classic feature of TCM is regional wall motion abnormalities with characteristic ballooning of the left ventricle.
View Article and Find Full Text PDFJ Cardiol Cases
June 2022
Myocardial infarction with non-obstructive coronary artery (MINOCA) accounts for 5-6% of all acute coronary syndrome presentations. Common causes of MINOCA include coronary vasospasm, coronary embolism/thrombosis, myocarditis, and spontaneous coronary artery dissection. Of them all, myocarditis is the most common cause of MINOCA, accounting for up-to 33% of all MINOCA cases.
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