Treatment of thrombosis of a mechanical aortic valve with fibrinolysis.

We describe the case of a 57-year-old man with a mechanical aortic valve who had discontinued oral anticoagulants for a long period and presented with symptoms of severe congestive heart failure, including pulmonary oedema and hypotension. Clinical and echocardiographic examination revealed a large thrombus obstructing the prosthetic valve. Since his critical clinical condition was not improved by heparin treatment we decided to administer intravenous fibrinolysis with 100 mg rtPA.

Non-high density lipoprotein cholesterol is the best discriminator of myocardial infarction in young individuals.

Background: Several studies have shown that non-high density lipoprotein (HDL) cholesterol is a strong and independent predictor of cardiovascular events. We investigated whether non-HDL cholesterol can discriminate young individuals with myocardial infarction (MI) from age- and sex-matched controls.

Methods: We conducted a case-control study which included 100 consecutive patients who had survived their first MI before the age of 36 years and 100 age- and sex-matched healthy controls without a history of cardiovascular disease.

Relation of elevated C-reactive protein and interleukin-6 levels to left atrial size and duration of episodes in patients with atrial fibrillation.

Previous studies have demonstrated inflammation to be a risk factor in patients with atrial fibrillation (AF). In this prospective study of 90 patients with persistent and permanent AF and 46 controls, we found increased C-reactive protein (CRP) and interleukin-6 levels in patients with AF compared with controls (p <0.001).

Myocardial infarction under the age of 36: prevalence of thrombophilic disorders.

It has been suggested that thrombotic tendency increases the risk of myocardial infarction (MI). To investigate the association between the risk of MI at a young age and genetic thrombogenic disorders (G20210A mutation in the prothrombin gene, G1691A mutation in the factor V gene and deficiencies of protein C, protein S and antithrombin III) we conducted a case-control study among 70 survivors of MI who had experienced the event before the age of 36 and 260 healthy subjects. The G20210A mutation in the prothrombin gene was found more often in young patients with MI than among controls (11.