Isolated left ventricular noncompaction (ILVNC) is a rare form of cardiomyopathy characterized by prominent left ventricular trabeculations and intertrabecular recesses. Most common clinical manifestations are severe systolic and...
moreIsolated left ventricular noncompaction (ILVNC) is a rare form of cardiomyopathy characterized by prominent left ventricular trabeculations and intertrabecular recesses. Most common clinical manifestations are severe systolic and diastolic dysfunction, conduction abnormalities and cardioembolic events. Evidence based recommendations for the prevention of thromboembolic events in ILVNC have not been established. We report the case of a young woman initially diagnosed with hypertrophic cardiomyopathy (HCM) without systolic dysfunction who presented with left hemiparesis due to a large right hemispheric ischemic stroke, later diagnosed with ILVNC. A 30-year-old female with a previous diagnosis of HCM and an implantable cardioverter defibrillator (ICD) for primary prevention presented with complaints of left sided weakness and slurred speech. The patient was diagnosed with an ischemic right caudate/lentiform infarct, compatible with a cardioembolic stroke. A Transthoracic echocardiogram...
We identified all patients with age 21 years and older, without a history of obstructive coronary artery disease, who presented to the emergency department with chest pain, and were admitted for cardiac observation followed by stress...
moreWe identified all patients with age 21 years and older, without a history of obstructive coronary artery disease, who presented to the emergency department with chest pain, and were admitted for cardiac observation followed by stress echocardiography during a 1-year period. The positive predictive value of stress echocardiography and cardiovascular outcomes were compared based on patients' Diamond chest pain classification. In patients with typical chest pain, who accounted for 8.7% (44/503) of the total cohort, the positive predictive value of stress echocardiography was 75% compared with 0% for all other subgroups (P = 0.007). Six patients (14%) with typical chest pain went on to have coronary revascularization compared with 0% for all other subgroups (P < 0.001). No patient in any subgroup died or was readmitted with a myocardial infarction in 30 days. Applying the Diamond criteria could improve utilization of stress echocardiography for patients with low-risk chest pain i...
Isolated left ventricular noncompaction is a rare form of cardiomyopathy characterized by prominent left ventricular trabeculations and intertrabecular recesses. The typical clinical manifestations are severe systolic and diastolic...
moreIsolated left ventricular noncompaction is a rare form of cardiomyopathy characterized by prominent left ventricular trabeculations and intertrabecular recesses. The typical clinical manifestations are severe systolic and diastolic dysfunction, conduction abnormalities, and cardiac embolic events theorized to result from thrombus formation within the intertrabecular recesses. Evidence-based recommendations for preventing thromboembolic events in isolated left ventricular noncompaction have not been established. We report the case of a woman who, at 10 years of age, had been diagnosed with hypertrophic cardiomyopathy without systolic dysfunction. At age 30, she presented with left hemiparesis consequent to a large right-hemispheric ischemic stroke, and she was diagnosed with isolated left ventricular noncompaction. In addition to discussing the patient's case, we review the medical literature that pertains to isolated left ventricular noncompaction.
ABSTRACT The meta‐analysis examines the efficacy of high dose preloading of statin prior to PCI and demonstrate its association with lower PMI and cardiovascular events at short‐term.Results from this analysis should encourage high‐dose...
moreABSTRACT The meta‐analysis examines the efficacy of high dose preloading of statin prior to PCI and demonstrate its association with lower PMI and cardiovascular events at short‐term.Results from this analysis should encourage high‐dose pretreatment with statins prior to PCI, especially in patients with NSTE‐ACS.A large randomize clinical trial would be desirable but not entirely necessary to initiate adoption of this novel strategy.
Cardiac resynchronization therapy (CRT) is an established treatment modality for systolic heart failure. Aimed to produce simultaneous biventricular stimulation and correct the lack of ventricular synchrony in selected patients with...
moreCardiac resynchronization therapy (CRT) is an established treatment modality for systolic heart failure. Aimed to produce simultaneous biventricular stimulation and correct the lack of ventricular synchrony in selected patients with congestive heart failure, CRT ...
Most cardiovascular implantable electronic devices (CIEDs) require a ventricular lead to be placed across the tricuspid valve. Tricuspid regurgitation (TR) is an understudied clinical complication of right ventricular lead implantation...
moreMost cardiovascular implantable electronic devices (CIEDs) require a ventricular lead to be placed across the tricuspid valve. Tricuspid regurgitation (TR) is an understudied clinical complication of right ventricular lead implantation and its clinical significance is unknown. We review the incidence, predictors, and current management of TR as a complication of ventricular lead implantation. Emerging technologies, including leadless pacing devices and subcutaneous systems, offer the benefit of little or none tricuspid valve disruption.
