Frequency of elevated troponin I and diagnosis of acute myocardial infarction.

This study evaluated the incidence and type of acute myocardial infarction (AMI) in a consecutive population with increased troponin I (TnI). AMI has recently been redefined and subclassified. Incidence, demographic data, angiographic findings, and hospital mortality of patients with various AMI subtypes or an increased TnI in the absence of AMI have not been previously reported in a prospective study.

Spectrum of electrocardiographic and angiographic coronary artery disease findings in patients with cocaine-associated myocardial infarction.

Background: Cocaine is the most common abused drug in patients presenting to the emergency room with chest pain and frequently leads to cardiac catheterization procedure. The extent of severity underlying coronary artery disease (CAD) in this subgroup of patients has not been well defined. This study set out to define the coronary anatomy as well as the extent of CAD in patients with cocaine-associated myocardial infarction (MI) and correlate that to the presenting electrocardiogram (ECG).

Cocaine-induced chest pain and beta-blockade: an inner city experience.

Background: Cocaine is the most common illicit drug used in patients presenting with chest pain to emergency departments. Data on beta-blockers in cocaine-related chest pain syndrome are sparse. We sought out to study the causal and detrimental effects of beta-blockers in cocaine-related chest pain in a large inner city cohort of patients.

QT dispersion at rest and during adenosine stress myocardial perfusion imaging correlation with Myocardial Jeopardy Score.

Background: The usefulness of QT dispersion (QTd) during adenosine myocardial perfusion imaging (MPI) to predict severity of coronary artery disease (CAD) has not been studied.

Methods: Eighty-eight patients referred for diagnostic cardiac catheterization after abnormal MPI were included. Thirty-four patients with no stenosis (Duke Score = 0) were included in Group 1, and 54 patients with significant CAD (Duke Score > or = 2) formed Group 2.

Cardiac troponin-I: a predictor of prognosis in subarachnoid hemorrhage.

Background: Release of cardiac biomarkers is reported in patients with subarachnoid hemorrhage (SAH). Data addressing the impact of cardiac injury on outcome in these patients is sparse. This study was conducted to ascertain the association of elevation of serum cardiac Troponin-I (cTnI) with mortality and neurological outcome in patients with SAH.

Crack whips the heart: a review of the cardiovascular toxicity of cocaine.

Cocaine is an extremely powerful reinforcing psychostimulant with highly addictive properties. Over the last few decades, cocaine addiction has attained epidemic proportions in North America, imposing a tremendous burden on society and the health care system. The cardiovascular complications of cocaine abuse are adrenergic mediated and range from cocaine-associated acute coronary syndromes to aortic dissection and sudden cardiac death.

Multivessel coronary vasospasm mimicking triple-vessel obstructive coronary artery disease.

Spontaneous coronary artery spasm is an important cause of morbidity both in patients with atherosclerotic coronary artery disease and in those with Prinzmetal's angina. Coronary vasospasm tends to occur in focal areas in the coronary tree and can be readily induced by the use of various agents. Spontaneous severe multivessel spasm, mimicking severe obstructive coronary artery disease, has been infrequently described.

Coronary artery ectasia--is it time for a reappraisal?

Coronary artery ectasia (CAE) is a well recognized clinical entity encountered during diagnostic cardiac catheterization. The etiopathogenesis of this condition is poorly understood. Due to the frequent presence of associated obstructive coronary artery disease it is considered to be a maladaptive process of atherosclerosis.

Thromboembolic complications of left ventricular noncompaction: case report and brief review of the literature.

Left ventricular noncompaction (LVNC) is a rare condition that is believed to represent an arrest in endomyocardial morphogenesis. This entity may be complicated by the development of mural thrombi and embolic events, however data on the associated thromboembolic risk is variable and poorly defined. We describe 2 cases of LVNC in African American patients presenting with thromboembolic manifestations and briefly review the available literature relevant to this complication.

Apical hypertrophic cardiomyopathy: potential utility of Strain imaging.

Hypertrophic cardiomyopathy (HCM) is a frequently recognized condition on echocardiography. The apical variant, also known as 'Japanese variant', is rare and often poses a diagnostic challenge. There has been a resurgence of interest in the diagnosis of HCM especially with the advent of novel imaging modalities such as strain imaging.

Acquired coronary cameral fistula--a report of two cases.

Background: Coronary cameral fistulas (CCF) are an uncommon clinical entity; encountered occasionally during cardiac catheterization. These fistulas most commonly result from congenital abnormalities leading to neovascularization. Other possible etiologies include trauma during surgery or coronary intervention.

Role of the renin-angiotensin-aldosterone system in diastolic heart failure: potential for pharmacologic intervention.

Congestive heart failure (CHF) is a major public health problem that results in tremendous economic burden. Diastolic heart failure (DHF) forms an important subset with increasing incidence and prevalence. There are widely variable estimates of the prevalence, ranging from 13% to 74% of all CHF presentations, and this is predominantly a result of a lack of uniform criteria for establishing a diagnosis.

Pharmacological prevention of thromboembolism in patients with left ventricular dysfunction.

Chronic left ventricular systolic dysfunction is a well recognized problem with an increasingly significant impact on healthcare in the form of congestive heart failure (CHF). Advances in medicine have led to improved survival after myocardial infarction (MI) and as a result, an increased prevalence of left ventricular systolic dysfunction. An increased incidence of thromboembolism, especially stroke, in patients with left ventricular systolic dysfunction is also well recognized.

Common errors in computer electrocardiogram interpretation.

Objective: The aim of the study was to determine the frequency and nature of errors in computer electrocardiogram (ECG) reading.

Methods: The ECGs were collected in the tertiary care VA Hospital from both inpatients and outpatients. They were read by the electrocardiograph built-in computer software, and then reread by two cardiologists.

Clinico-pathological evaluation of restrictive cardiomyopathy (endomyocardial fibrosis and idiopathic restrictive cardiomyopathy) in India.

Background: Restrictive heart disease is characterized by impairment of ventricular filling during diastole with preserved systolic function. The clinical and histopathological profile on endomyocardial biopsy of a cohort of patients with restrictive cardiomyopathy (RCM) is presented.

Methodology: The medical records of patients presenting with heart failure with systemic congestion, subsequently diagnosed as restrictive heart disease after evaluation including cardiac catheterisation, were studied retrospectively to determine the clinical spectrum of restrictive cardiomyopathy.

Current guidelines for the treatment of patients with rheumatic fever.

Rheumatic fever is a multisystem inflammatory disease that occurs as a delayed sequelae to group A streptococcal pharyngitis. The important clinical manifestations are migratory polyarthritis, carditis, chorea, subcutaneous nodules and erythema marginatum occurring in varying combinations. The pathogenesis of this disorder remains elusive: an antigenic mimicry hypothesis best explains the affliction of various organ systems after a lag period following pharyngeal infection.

Critical appraisal of left ventricular function assessment by the automated border detection method on echocardiography. Is it good enough?

Many studies have attempted to validate the echocardiographic automated border detection (ABD) method for assessing left ventricular ejection fraction (LVEF) by comparing it with various echocardiographic and non-echocardiographic standards. The main basis of assessing its accuracy has been the coefficient of correlation. The fallacy of using coefficient of correlation for assessing agreement between two methods of measurement has been well emphasized in the literature.

Balloon mitral valvotomy: comparison between antegrade Inoue and retrograde non-transseptal techniques.

Aims: The results of percutaneous mitral valvotomy performed by the antegrade transseptal method using the Inoue balloon (n = 1000; group 1) and by the retrograde non-transseptal technique using a polyethylene balloon (n = 100; group 2) were compared in a retrospective, non-randomized study.

Methods And Results: Both the groups were similar with respect to baseline characteristics. The success rate was 95% in group 1 and 93% in group 2.

Serial echocardiography in transplanted heart: an initial report of five cases.

Role of echocardiography including Doppler is established in selection of donor and in the care of patients after cardiac transplantation. Its value for recognition of transplant rejection is however still evolving. We present here, serial echocardiographic findings in five male patients, aged 22 to 46 years who underwent cardiac transplantation at our institution.

Percutaneous transvenous mitral commissurotomy for rheumatic mitral stenosis with impaired left ventricular function: an echocardiographic follow-up study.

Sixty consecutive patients of rheumatic mitral stenosis who underwent percutaneous transvenous mitral commissurotomy were evaluated and followed up for 3 months in order to study the effect of the procedure on left ventricular ejection fraction and to elucidate the pathophysiology of impaired left ventricular function. The response in 16 patients (26.7%) with left ventricular dysfunction (ejection fraction less than 50%) was compared to that in 44 patients with normal left ventricular ejection fraction.

Renovascular hypertension resulting from nonspecific aortoarteritis in children: midterm results of percutaneous transluminal renal angioplasty and predictors of restenosis.

Objective: Nonspecific aortoarteritis is a major cause of renovascular hypertension in children. Stenosis of the renal artery is usually long and begins at the origin of that artery. We retrospectively studied the midterm results of angioplasty during treatment and defined the predictors of restenosis in 40 stenoses in 24 children.

Retrograde nontransseptal balloon mitral valvuloplasty for rheumatic mitral stenosis.

Retrograde nontransseptal balloon mitral valvuloplasty is a relatively new technique for dilating stenosed mitral valves, wherein a specially designed steerable catheter is used to enter the left atrium retrogradely. Over a 1-yr period, 52 patients (34 M, 18 F; mean age 26.4 +/- 6.