Severity: Warning
Message: file_get_contents(https://...@pubfacts.com&api_key=b8daa3ad693db53b1410957c26c9a51b4908&a=1): Failed to open stream: HTTP request failed! HTTP/1.1 429 Too Many Requests
Filename: helpers/my_audit_helper.php
Line Number: 176
Backtrace:
File: /var/www/html/application/helpers/my_audit_helper.php
Line: 176
Function: file_get_contents
File: /var/www/html/application/helpers/my_audit_helper.php
Line: 250
Function: simplexml_load_file_from_url
File: /var/www/html/application/helpers/my_audit_helper.php
Line: 1034
Function: getPubMedXML
File: /var/www/html/application/helpers/my_audit_helper.php
Line: 3152
Function: GetPubMedArticleOutput_2016
File: /var/www/html/application/controllers/Detail.php
Line: 575
Function: pubMedSearch_Global
File: /var/www/html/application/controllers/Detail.php
Line: 489
Function: pubMedGetRelatedKeyword
File: /var/www/html/index.php
Line: 316
Function: require_once
A 73-year-old woman with cardiac tumor arising from aortic valve was scheduled for extirpation surgery. She has a symptom of chest discomfort during her walk. Contrasted CT scan around the aortic valve demonstrated a 1 cm-size tumor close to the left coronary inlet. Coronary blood flow was preserved. On the day of admission she became unconscious during preoperative interview with the surgeon. Cardiopulmonary resuscitation was immediately initiated and she regained her consciousness. Emergency operation was scheduled and started about two hours after the event of syncope. Cardiac tumor attached to the left cusp of the aortic valve was found and later identified as papillary fibroelastoma by pathological diagnosis. She was discharged on the 13th day from admission without neurological deficit. Occlusion of the left coronary artery inlet was strongly suspected from preoperative event of her syncope. Cardiac tumor around aortic value may cause significant derangement of circulation, and we should closely monitor the patient's status and prompt operation was indicated especially when tumor is impeding coronary artery inlet.
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