The use of Impella Recover in the treatment of post-infarction ventricular septal defect: a new case report.

Ventricular septal defect (VSD) can occur as part of more congenital cardiac malformations or as an isolated finding. VSD can be also a serious complication of acute myocardial infarction. It seems that its prognosis improves if the operation can be deferred for 3-4 weeks.

Exercise-induced ST-segment depression in inferior leads during treadmill exercise testing and coronary artery disease.

The exercise electrocardiogram is a commonly used non-invasive and inexpensive method for detection of electrocardiogram (ECG) changes secondary to myocardial ischemia. Reversible ST-segment depression is the characteristic finding associated with exercise-induced, demand-driven ischemia in patients with significant coronary obstruction but no flow limitation at rest. The exercise-induced ST-segment depression in inferior leads has been questioned and it has been reported that lead V5 alone consistently outperforms the inferior leads and the combination of lead V5 with II, because lead II has a high false-positive rate.

Significant coronary artery disease associated with coronary artery aneurysm and elevation of prostate-specific antigen during acute myocardial infarction.

Coronary artery aneurysms are defined as coronary dilatations which exceed the diameter of normal adjacent segments by 1.5 times. Although more commonly associated with atherosclerosis, a variety of other acquired (eg, inflammatory, infectious, iatrogenic) or congenital causes have been identified that lead to impaired vessel media.

Correction of discrete subaortic stenosis with abnormal chordae tendineae.

The case of a 52-year-old woman with subvalvular aortic stenosis and aortic regurgitation is presented. Mitral regurgitation was associated, due to insertion of two abnormal chordae tendineae at the apex of the anterior papillary muscle and at the free border of the subvalvular membranous annulus. This abnormality displaced the anterior papillary muscle, thus applying a traction at the mitral leaflet.

[Potential impact of drug-eluting stents in Sicily: results from a multicenter survey and cost-benefit analysis of drug-eluting stents versus bare metal stents].

Background: The recent introduction of drug-eluting stents (DES) has shown, in randomized controlled trials, to reduce the incidence of restenosis as compared to bare metal stents (BMS). Since their cost is considerably higher than that of BMS, the study assessed the economic impact of the adoption of this new therapy in the Sicilian clinical practice.

Methods: An economic evaluation was carried out by means of a linear decision model developed in Excel that simulated and compared costs and clinical pathway, within 1 year of the intervention, of hypothetical groups of patients with de novo lesions undergoing angioplasty with DES or BMS.

Diastolic paradoxic jet flow in patients with hypertrophic cardiomyopathy: report of two patients with different morphologic aspects.

Background: In non-Asiatic population, apical hypertrophic cardiomyopathy represents 1% to 2% of hypertrophic cardiomyopathies. The presence of an apical ventricular aneurysm occurs in 1% of patients with the apical variant of hypertrophic cardiomyopathy.

Methods And Results: We present two patients with hypertrophic cardiomyopathy, both illustrating an early diastolic paradoxic jet flow between the apex and the middle area of ventricle.

[Salvage angioplasty in a patient with antiphospholipid antibody syndrome and cardiogenic shock].

Antiphospholipid syndrome is a thrombotic disorder in which the clinical features are venous and/or arterial thrombosis, thrombocytopenia, and recurrent fetal loss. We describe the case of a 39-year-old woman affected by antiphospholipid syndrome and acute anterior myocardial infarction complicated by cardiogenic shock. The patient, after the failure of thrombolysis, was successfully treated by rescue angioplasty.

Concealed ventricular extrasystoles. A family of premature ventricular complexes with high spontaneous variability.

Background: The term concealed ventricular extrasystoles defines a phenomenon in which premature beats have a cyclical distribution and manifest after a predictable number of intervening sinus beats. The extent of its spontaneous variability as well as the stability of its orderly distribution, however, have not been defined yet. The aim of this study was to assess whether there is any difference between the variability of concealed ventricular extrasystoles and their allorhythmic patterns.