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Biomedical subjects

T J Sacchi

Publications and source records attributed to T J Sacchi.

32 records · Page 2Linked to original sources
PubMed1996

Uncommon etiologies of atrial fibrillation.

A newly diagnosed atrial fibrillation warrants a full investigation of the etiopathogenesis of this common arrhythmia. In the adult population, the most frequently associated conditions are systemic hypertension, coronary artery disease, mitral valvulopathy, congestive heart failure, and hyperthyroidism. Nevertheless, more infrequent and even rare, yet correctable, etiologies should not be overlooked. We describe three patients who presented to our hospital with a first episode of atrial fibrillation and who subsequently were demonstrated to have very unusual cardiovascular pathologies subtending this common arrhythmia. In all three cases, trans-esophageal echocardiography was instrumental in reaching an accurate diagnosis that was later confirmed at surgery.

Adult↗
PubMed1995

Doppler echocardiographic methods to estimate severity of aortic stenosis.

The continuity equation should be regarded as the Doppler echocardiographic gold standard for estimation of valve area in patients with aortic stenosis, but a quick, easy, and inexpensive screening test may be desirable in an era of medical cost containment. Aortic valve leaflet separation could be used as such a test. In fact, it could prove especially useful in cases where calculations using the continuity equation or the fractional shortening-velocity ratio are problematic.

Aged↗
PubMed1995

Transient severe myocardial ischemia during septic shock in a young woman with AIDS.

A 29-year-old woman with acquired immunodeficiency syndrome (AIDS) was admitted to the intensive care unit with a diagnosis of septic shock. During intensive hemodynamic support with intravenous dopamine, she developed electrocardiographic ischemic changes compatible with an acute injury pattern. The pattern disappeared readily and was not followed by any subsequent enzymatic evidence of myocardial necrosis. Intensive hemodynamic support with intravenous catecholamines may induce myocardial ischemia even in young AIDS patients with no apparent risk for coronary artery disease.

Acquired Immunodeficiency Syndrome↗
PubMed1994

Multicentric granular cell tumor of the heart presenting with aortic dissection.

A 43-year-old woman with a history of cutaneous granular cell tumor presented with severe aortic regurgitation due to a type A aortic dissection. During repair, multiple masses were found on the surface of the heart, which later were identified to be granular cell tumor. We present an extremely rare case of multicentric granular cell tumor of the skin and heart, manifested over a 23-year period.

Adult↗
PubMed1994

Headache, thrombolytic therapy, and chronic subdural hemorrhage--a case report.

Subdural hematomas are well known but infrequent complications of thrombolytic therapy. Although these are usually associated with head trauma, the authors describe a case of a patient who received a particularly aggressive thrombolytic regimen and presented six months later with complaints of nothing more than a headache resistant to medical therapy, without associated neurologic manifestations, which was finally diagnosed as a chronic subdural hematoma by computerized tomography. In the era of thrombolysis, physicians should maintain a heightened index of suspicion for subdural hematoma in patients complaining of headache.

Aged↗
PubMed1993

Accelerated idioventricular rhythm in pregnancy: a case report.

A seventeen-year-old primigravida, without structural heart disease or abnormalities of serum chemistry, presented with complaints of palpitations during the twenty-fourth week of gestation. Holter monitoring revealed long episodes of accelerated idioventricular rhythm. The authors are not aware of similar reports, but this entity may be more common than realized because of the relative infrequency of rhythm monitoring in this particular group.

Adolescent↗
PubMedDate not supplied

Age-related differences in the use of cardiac medications in patients with coronary artery disease.

BACKGROUND: Benefits of aspirin and beta-blocker use in patients with coronary artery disease and angiotensin-converting enzyme (ACE) inhibitors in those with left ventricular systolic dysfunction are well documented in all age groups. OBJECTIVE: To investigate whether aspirin, beta-blockers, and ACE inhibitors are equally used in geriatric (> or =65 years) versus younger (<65 years) patients with coronary artery disease. SETTING: University-affiliated major academic hospital. METHODS: Records of 402 patients with coronary artery disease were analyzed for use of aspirin, beta-blockers, and ACE inhibitors. One hundred thirty patients with contraindications to use of these agents were excluded. RESULTS: Of 272 study patients, 85% were using aspirin and 71% beta-blockers. Among the patients with left ventricular systolic dysfunction, 79% were using ACE inhibitors. One hundred forty-seven patients were of geriatric age, whereas 125 were of younger age. No significant difference in the use of aspirin (82% versus 89%, P = 0.10), beta-blockers (71% versus 70%, P = 0.85), or ACE inhibitors (86% versus 69%, P = 0.13) was found between geriatric and younger patients. This lack of difference in use of cardiac medications between geriatric and younger patients persisted on gender-based subgroup analysis. On decade-of-age-based analysis, aspirin use was not equally distributed among all the decades of age (P < 0.005), but beta-blocker use was. CONCLUSION: Results of this study demonstrate equal use of aspirin, beta-blockers, and ACE inhibitors in geriatric versus younger patients with coronary artery disease. Aspirin use was not equally distributed among all the decades of age.

Adrenergic beta-Antagonists↗
PubMedDate not supplied

Atrial fibrillation associated with systemic lupus erythematosus and use of methylprednisolone.

Systemic lupus erythematosus is known to have cardiac manifestations consisting of pericarditis, myocarditis, endocarditis, and coronary vasculitis. Pericarditis is the most common cardiac manifestation of systemic lupus erythematosus. Myocarditis may be suspected in patients presenting with unexplained tachycardia, conduction disturbances, unexplained systolic dysfunction with or without heart failure, or arrhythmias. The development of arrhythmias in systemic lupus erythematosus could be secondary to pericarditis, myocarditis, or ischemia caused by coronary vasculitis. The development of atrial fibrillation in systemic lupus erythematosus is not commonly reported. There have been few reports on the patients developing atrial fibrillation after being started on methylprednisolone therapy. Described here is a case of the development of atrial fibrillation in a newly diagnosed 37-year-old patient with systemic lupus erythematosus who was started on intravenous methylprednisolone therapy.

Adult↗