Cardiol J
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The heart was very sensitive to fluctuating thyroid hormone levels. To assess intra-left ventricular (LV) systolic asynchrony in patients with subclinical thyroid dysfunction. ⋯ Patients with subclinical hypothyroidism present evidence of LV asynchrony by TSI. LV systolic asynchrony could be a warning sign of the early stage in cardiac systolic dysfunction in subclinical hypothyroid patients.
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Case Reports
Pheochromocytoma-induced reverse tako-tsubo with rapid recovery of left ventricular function.
Pheochromocytoma is a rare, catecholamine-secreting tumor of neuroendocrine cells. It has been documented to present atypically as myocardial ischemia, arrhythmias, or congestive heart failure. We present the case of a patient who had transient cardiomyopathy with hypokinesia of the basal portions of the left ventricle and hyperkinesia of the apex triggered by a pheochromocytoma crisis similar to that of tako-tsubo cardiomyopathy, but with an inverse left ventricular contractile pattern ('inverted tako-tsubo').
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The number of elderly patients that present with an acute coronary syndrome (ACS) is increasing, reflecting the growing number of people in the general population in this age group. The various guidelines do not generally specify a management strategy in this elderly group and the management is often at the discretion of the treating physician. We conducted an audit within our Cardiology Department to compare our practice of management of ACS in the elderly population based on the European Society of Cardiology guidelines. ⋯ Octo and nonagenarians represent a significant proportion of our ACS patients. They have high mortality, greater number of comorbidities, diseased coronary vessels and if intervention was undertaken required more than one stent. Therefore, octo-nonagenarians represent a very complex group of patients. Guidelines and risk stratification are of limited value in this group as clinical trial data is currently lacking. Quality of life and risk to benefit assessments are of paramount importance in this group.
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Case Reports
Anterior mitral leaflet perforation identified by real time three-dimensional transesophageal echocardiography.
With its unique en face view, real time three-dimensional transesophageal echocardiography has been reported to be more precise than conventional two-dimensional studies in evaluating mitral regurgitation etiology, and can locate diseased segments correctly. We present a case with severe mitral regurgitation due to anterior mitral leaflet perforation. Intraoperative real time three-dimensional transesophageal echocardiography demonstrated its value in diagnosis and surgical planning for this perforation, which had not been identified preoperatively. This technique should be applied more widely for dedicated mitral valve assessment in clinical practice.