Hypoplastic coronary artery disease: A rare cause of sudden cardiac death and its treatment with an implantable defibrillator.

A 21-year-old African American male presented to the emergency department after an episode of unexplained syncope. He had no significant past medical history. The initial physical examination was within normal limits, and his 12-lead electrocardiogram showed no signs of ischemia or evidence of chamber enlargement.

Acute myocardial infarction and cardiac arrest due to coronary artery perforation after mitral valve surgery: successful treatment with a covered stent.

We present a case of a gentleman who presented with acute myocardial infarction and cardiac arrest 6 days after undergoing mitral valve replacement surgery. Immediate coronary angiography revealed perforation of the left circumflex artery which was successfully treated with a covered stent. This report details the successful percutaneous treatment of an exceedingly rare complication of mitral valve surgery.

Sudden cardiac death due to large coronary aneurysm successfully treated with a covered stent and ChromaFlo guidance.

We present the case of a gentleman who presented to our hospital with recurrent episodes of sudden cardiac death treated initially with cardioversion. Immediate coronary angiography revealed a 7 mm aneurysm in the proximal left coronary artery. Using intravascular ultrasound and ChromaFlo technology, the aneurysm was successfully treated with a polytetrafluoroethylene-covered stent and the patient had no further episodes of sudden cardiac death.

Wellens syndrome: a life-saving diagnosis.

The diagnosis of acute coronary syndrome relies on clinical history, electrocardiographic (ECG) changes, and cardiac biomarkers; but within the spectrum of acute coronary syndrome, there exist subtle presentations that cannot afford to be overlooked. Wellens syndrome is one such example, in which a patient can present with both ECG changes that are not classic for myocardial ischemia and negative cardiac biomarkers. The characteristic ECG findings associated with Wellens syndrome consist of deep, symmetric T-wave inversions in the anterior precordial leads.

Inaccuracy of Doppler echocardiographic estimates of pulmonary artery pressures in patients with pulmonary hypertension: implications for clinical practice.

Background: Recent studies suggest that Doppler echocardiography (DE)-based estimates of pulmonary artery systolic pressure (PASP) may not be as accurate as previously believed. We sought to determine the accuracy of PASP measurements using DE compared with right-sided heart catheterization (RHC) in patients with pulmonary hypertension (PH).

Methods: We compared DE estimates of PASP to invasively measure PASP during RHC in 160 consecutive patients with PH (part one).

Clinical methods for the detection and management of left ventricular hypertrophy.

Left ventricular hypertrophy (LVH) has been shown to be an independent risk factor for adverse cardiac and cerebrovascular events. Despite this well-known association, the lack of a standardized approach for both the quantification of LVH and the monitoring of LVH regression has limited its use as a primary risk factor that can be clinically targeted. In this State of the Art Paper, we will provide a current appraisal of LVH with a focus on presenting the current methods to accurately detect LVH and management strategies to develop a therapeutic target for clinicians.

Echocardiographic quantification of left ventricular mass: prognostic implications.

Left ventricular hypertrophy (LVH) has been shown to be an independent risk factor for adverse cardiac and cerebrovascular events. Despite this well-known association, the lack of a standardized approach for the quantification and the monitoring of LVH regression has limited its use as a primary risk factor that can be easily clinically targeted. Echocardiography has become the most widespread tool used for the quantification of LVH.

Short duration exercise increases breath hydrogen excretion after lactulose ingestion: description of a new phenomenon.

Objective: There is limited information on the effect of exercise on colonic function. Beneficial effects have been described, including prevention of colon cancer. In the present study, we demonstrate that short duration exercise results in enhancement of breath hydrogen excretion after consumption of lactulose.