A case of cardiogenic shock due to ventricular dyssynchrony resolved by atrial pacing.

Unlabelled: We present a case of a man with ischemic cardiomyopathy and single chamber implantable cardioverter-defibrillator who developed sinus arrest creating sudden dependence on right ventricular (RV) pacing. He presented with cardiogenic shock secondary to abrupt onset ventricular dyssynchrony from RV pacing, which required emergent stabilization and completely resolved with atrial pacing.

Learning Objective: To establish a basic understanding of cardiogenic shock management.

Venous thromboembolic outcomes in patients with lymphedema and lipedema: An analysis from the National Inpatient Sample.

Background: Patients with lymphedema and lipedema share physical exam findings that may lead to misdiagnosis. Poor mobility is common in patients with obesity and patients with lymphedema and lipedema. This may constitute a risk factor for venous thromboembolism (VTE).

Severe cardiogenic shock and cardiac arrest due to fulminant cardiac sarcoidosis: a case report.

Background: Cardiac sarcoidosis is found to occur in approximately 5% of patients with sarcoidosis. Its presentation can typically range from complete heart block to ventricular arrhythmias. This condition can rarely present with severe heart failure and cardiogenic shock requiring aggressive and timely management strategies.

Are formal explanations mere placeholders or pointers?

Formal explanations - explanations that explain properties of a thing by reference to what the thing is, for example, Fido has four legs because he is a dog, appear to be tautological and have led researchers to ask why they are produced. One proposal is that they function as placeholders or pointers to explanations. According to the Placeholders and Pointers as Additional Functions (PPAF) hypothesis, formal explanations are explanatory in and of themselves, and the placeholder and pointer functions are additional functions of formal explanations.

Subclinical Leaflet Thrombosis After Balloon versus Self-Expandable Transcatheter Aortic Valve Implantation.

Hypoattenuated leaflet thickening (HALT) has been recognized as one of the complications after transcatheter aortic valve implantation and may promote structural valve degeneration and increase the risk of cerebrovascular events. The 2 main types of available transcatheter heart valves (THVs), the balloon-expandable (BE) and the self-expanding (SE), are interchangeably used in clinical practice despite substantial design differences. There is unclear evidence on whether these 2 different THV models are achieving similar or different rates of subclinical leaflet thrombosis/HALT.

Outcomes Following Acute Coronary Syndrome in Patients With and Without Rheumatic Immune-Mediated Inflammatory Diseases.

Background Rheumatic immune mediated inflammatory diseases (IMIDs) are associated with high risk of acute coronary syndrome. The long-term prognosis of acute coronary syndrome in patients with rheumatic IMIDs is not well studied. Methods and Results We identified Medicare beneficiaries admitted with a primary diagnosis of myocardial infarction (MI) from 2014 to 2019.

Preoperative Atrial Fibrillation and Cardiovascular Outcomes After Noncardiac Surgery.

Background: The impact of pre-existing atrial fibrillation (AF) on outcomes after noncardiac surgery is not clear.

Objectives: We aimed to study the impact of AF on the risk of adverse outcomes after noncardiac surgery in a nationwide cohort.

Methods: We identified Medicare beneficiaries admitted for noncardiac surgery from 2015 to 2019 and divided the study cohort into 2 groups: with and without AF.

Spontaneous Coronary Artery Dissection-Induced Takotsubo Syndrome.

A case of an anxious 59-year-old woman, who presented with chest pressure, nausea, and vomiting, is described. After hours of symptoms that worsened despite medical management, cardiac catheterization was performed. Angiography revealed diffuse, long, tubular disease of multiple coronary vessels.

Mucopolysaccharidosis Type I Diagnosed by Aortic and Mitral Valve Replacement.

A 32-year-old developmentally delayed man presenting with dyspnea was found to have severe aortic and mitral valve stenosis. After double valve replacement, unique histologic findings prompted a genetics evaluation, ultimately leading to the diagnosis of mucopolysaccharidosis type I, a rare lysosomal storage disorder with high rates of cardiac manifestations. ().

Comparative Risk of Incident Coronary Heart Disease Across Chronic Inflammatory Diseases.

Chronic inflammatory diseases (CIDs) are considered risk enhancing factors for coronary heart disease (CHD). However, sparse data exist regarding relative CHD risks across CIDs. Determine relative differences in CHD risk across multiple CIDs: psoriasis, rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), human immunodeficiency virus (HIV), systemic sclerosis (SSc), and inflammatory bowel disease (IBD).

The Formal Structure of Kind Representations.

Kind representations, concepts like table, triangle, dog, and planet, underlie generic language. Here, we investigate the formal structure of kind representations-the structure that distinguishes kind representations from other types of representations. The present studies confirm that participants distinguish generic-supporting properties of individuals (e.

The physical basis of conceptual representation - An addendum to.

Gallistel (2020) argues that current research on the physical basis of memory assumes an associationistic approach and thus fails to provide an account of quantitative facts because quantitative facts cannot be sensed and have no qualia. But are these approaches any better suited for investigating how we store concepts of concrete things such as dogs, tables and sand, which clearly have qualia? Seven examples of the abstract quantitative and non-quantitative formal structure found in the conceptual representation of concrete things are used to show that Gallistel's critique clearly extends to the conceptual representations stored in semantic memory. Gallistel (2020) presents compelling arguments that the physical basis for quantitative facts will not be the synapse or cell assemblies, but the information-bearing molecules inside the neuron.

A case report of an STEMI mimicker in a patient presenting with haemoptysis and chest pain with metastatic myocardial infiltration and left ventricular mural thrombi.

Background: ST-elevation myocardial infarction (STEMI) requires timely coronary reperfusion but localizing ST-segment elevation (STE) can develop in clinical settings other than STEMI.

Case Summary: We report a case of a 66-year-old man, with a history of diabetes mellitus and arthritis presenting with haemoptysis and chest pain. The electrocardiogram (ECG) at presentation showed marked localizing STE but emergent cardiac catheterization showed no significant coronary artery obstruction and the serial serum cardiac troponin levels were within normal limits.

Left Atrial Dilation and Risk of One-Year Readmission after Embolic Stroke of Undetermined Source.

Background: Structural left atrial and ventricular abnormalities on the electrocardiogram (ECG) and transthoracic echocardiogram (TTE) at the time of ischemic stroke have been associated with morbidity and mortality. Yet, the prognostic impact of the same in embolic stroke of undetermined source (ESUS), a relevant subtype of ischemic stroke with a unique pathophysiology, has not been well studied to date. Our aim was to assess the predictive impact of left atrio-ventricular ECG and TTE abnormalities on one-year hospital readmission after ESUS from an ongoing single center prospective stroke registry in the U.

Differential Associations of Chronic Inflammatory Diseases With Incident Heart Failure.

Objectives: The purpose of this study was to compare the risks of incident heart failure (HF) among a variety of chronic inflammatory diseases (CIDs) and to determine whether risks varied by severity of inflammation within each CID.

Background: Individuals with CIDs are at elevated risk for cardiovascular diseases, but data are limited regarding risk for HF.

Methods: An electronic health records database from a large urban medical system was examined, comparing individuals with CIDs with frequency-matched controls without CIDs, all of whom were receiving regular outpatient care.

Axillary Artery Hemostasis Post-Intra-Aortic Balloon Pump Failure.

Intra-aortic balloon pump via the axillary approach has been increasingly utilized to facilitate physical rehabilitation prior to definitive heart failure therapy. There is a high risk of device fracture with loss of arterial accessibility. Three cases are presented that demonstrate innovative arteriotomy hemostasis techniques for malfunctioning axillary intra-aortic balloon pumps.

Implementation and Impact of Home-Based Cardiac Rehabilitation in a Veterans Affair Medical Center.

Introduction: In patients with prior myocardial infarction (MI), cardiac rehabilitation (CR) has been shown to reduce all-cause mortality, cardiac mortality, and risk of recurrent MI. Medically supervised cardiac rehab has challenges such as increased patient and center cost, patient transportation issues, patient time commitment, and increased need for resources. Home-based cardiac rehabilitation (HBCR) is an innovative alternative to medically supervised CR which can help to address some of the aforementioned issues.

Ankle-brachial index and incident heart failure with reduced versus preserved ejection fraction: The Multi-Ethnic Study of Atherosclerosis.

This study investigated the relationship between ankle-brachial index (ABI) and risk for heart failure with reduced ejection fraction (HFrEF) and preserved ejection fraction (HFpEF). ABI has previously been associated with mortality, cardiovascular disease (CVD), and overall HF but the relationship between ABI and risk of HF stratified by EF has not been well characterized. We analyzed data from 6553 participants (53% female; mean age 62 ± 10 years) enrolled in the Multi-Ethnic Study of Atherosclerosis (MESA) who were free of known clinical CVD/HF at baseline (2000-2002) and had baseline ABI measured.

Changing antibiotic susceptibility pattern in uropathogenic over a period of 5 years in a tertiary care center.

To assess the changing antibiotic sensitivity pattern in Uropathogenic over a period of time (2013-2017) with a special emphasis on ESBL-producing This retrospective study was carried out in the Department of Microbiology, Kasturba Medical College, Ambedkar Circle, Mangalore. A retrospective time bound analysis of 500 samples/year was performed. The urine samples received from the suspected cases of urinary tract infection (UTI) were processed.

Instance-of-object-kind representations.

We naturally think and talk about the objects we encounter as instances of one or another kind of object (e.g. as a dog).