scholarly journals Left Ventricular Thrombus as a Complication of Clozapine-Induced Cardiomyopathy: A Case Report and Brief Literature Review

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Shahbaz A. Malik ◽  
Sarah Malik ◽  
Taylor F. Dowsley ◽  
Balwinder Singh
Keyword(s):  
Heart Failure ◽  
Case Report ◽  
Chest Pain ◽  
New Left ◽  
Left Ventricular ◽  
Heart Failure Therapy ◽  
Bundle Branch Block ◽  
Ventricular Thrombus ◽  
First Case ◽  
History Of

A 48-year-old male with history of schizoaffective disorder on clozapine presented with chest pain, dyspnea, and new left bundle branch block. He underwent coronary angiography, which revealed no atherosclerosis. The patient’s workup was unrevealing for a cause for the cardiomyopathy and thus it was thought that clozapine was the offending agent. The patient was taken off clozapine and started on guideline directed heart failure therapy. During the course of hospitalization, he was also discovered to have a left ventricular (LV) thrombus for which he received anticoagulation. To our knowledge, this is the first case report of clozapine-induced cardiomyopathy complicated by a LV thrombus.

scholarly journals Point-of-care Echocardiogram as the Key to Rapid Diagnosis of a Unique Presentation of Dyspnea: A Case Report

2020 ◽  
Vol 4 (3) ◽  
pp. 424-427
Author(s):  
Michael Moore ◽  
Brian Dilcher ◽  
Joseph MInardi ◽  
Kimberly Quedado ◽  
Erica Shaver
Keyword(s):  
Heart Failure ◽  
Case Report ◽  
Respiratory Symptoms ◽  
Point Of Care ◽  
Diagnostic Error ◽  
Left Ventricular ◽  
Rapid Diagnosis ◽  
Point Of Care Ultrasound ◽  
Emergency Physicians ◽  
Ventricular Thrombus

Introduction: Dyspnea is commonly evaluated in the emergency department (ED).The differential diagnosis is broad. Due to the large volume of dyspneic patients evaluated, emergency physicians (EP) will encounter uncommon diagnoses. Early, liberal application of point-of-care ultrasound (POCUS) may decrease diagnostic error and improve care for these patients. Case Report: We report a 48-year-old male presenting to the ED with cough and progressively worsening dyspnea for 11 months after multiple healthcare visits. Using POCUS, the EP was immediately able to diagnose a severe dilated cardiomyopathy (DCM) with left ventricular thrombus. Conclusion: Given that non-ischemic DCM is one of the most common etiologies of heart failure, often presenting with respiratory symptoms, POCUS is key to rapid diagnosis and, along with modalities such as electrocardiography and chest radiograph, should be standard practice in the workup of dyspnea, regardless of age or comorbidities.

scholarly journals Male with Long Standing Heart Failure and Left Bundle Branch Block with Acute Chest Pain: Is It Needed for Urgent Revascularization?

2020 ◽  
Vol 1 (4) ◽  
pp. 34-38
Author(s):  
Fahmy Rusnanta ◽  
Mohammad Saifur Rohman ◽  
Setyasih Anjarwani ◽  
Ardian Rizal
Keyword(s):  
Heart Failure ◽  
Case Report ◽  
Chest Pain ◽  
Acute Heart Failure ◽  
Left Bundle Branch Block ◽  
Acute Chest Pain ◽  
Current Evidence ◽  
Bundle Branch Block ◽  
Early Reperfusion ◽  
Early Revascularization

Background : Patients with acute heart failure and left bundle branch block (LBBB) presenting acute chest pain have many clinical challenges to perform the diagnostic and therapeutic process. Recent recommendations revealed that the patients with LBBB (new or presumably new) should be performed early revascularization. However, several clinical controversies occurred due to scientific gaps between current evidence and recommen- dations. Therefore, the review of other approaches to assess this setting might be required. Objective : This case report aims to describe factors related to early revascularization strategy in patients with long standing heart failure and left bundle branch block. Case : A 46-year-old man with the previous history of dyspnea (long-standing heart failure) was admitted to our hospital with recurrent chest pain and acute heart failure. Electrocardiogram (ECG) showed LBBB suggesting acute myocardial infarction (excessive discordance in the precordial lead). He had normal serial cardiac enzymes with ongoing ischemia symptoms. He had been decided not to perform urgent reperfusion therapy. After five days of hospitalization, he discharged home with medicines. Our case report provided an example of applying the existing algorithm to assess acute chest pain in congestive heart failure, regardless of ST-segment deviation in LBBB. Conclusion : Clinical judgement and the use of objective findings offer the best way to determine the need for early reperfusion in our case.

scholarly journals Case Report: Swallowed toothbrush in the stomach of a 56 year female at St Mary’s Hospital Lacor, Uganda

2018 ◽  
Vol 1 ◽  
pp. 5
Author(s):  
Derrick Amone ◽  
Christopher Okot ◽  
Patrick Mugabi ◽  
Tom Richard Okello ◽  
David Martin Ogwang
Keyword(s):  
Case Report ◽  
Chest Pain ◽  
Foreign Bodies ◽  
Traditional Healer ◽  
Exploratory Laparotomy ◽  
Rare Occurrence ◽  
First Case ◽  
History Of ◽  
Psychiatric Conditions ◽  
Accessory Muscles

Toothbrush swallowing is a rare occurrence. Toothbrush swallowing presents a risk of impaction and perforation along the gastrointestinal tract. This case report describes a 56 year old female that presented to the emergency unit of St Mary’s Hospital Lacor with a 1 day history of chest pain after a toothbrush was pushed down her throat by a traditional healer who was managing her for pharyngitis. The chest pain was associated with difficulty in breathing. She also reported dull abdominal pain. There was no history of vomiting or drooling of saliva. On examination, we found that she was in pain and had respiratory distress with a respiratory rate of 32 breath/ min and was using accessory muscles. There was no oedema, aneamia or jaundice. Blood pressure of 120/80 mmHg and pulse rate of 87 beats/ min. The abdominal findings were normal, but ultrasound scan suggested that the toothbrush was in the stomach. The plain erect abdominal x-ray was inconclusive. She was admitted to the ward for conservative management. After 2 weeks we decided to do exploratory laparotomy and we found the toothbrush in the stomach, that we removed and closed the abdomen in layers. Post-operatively the patient recovered uneventfully on the ward. Toothbrush swallowing is a rare occurrence. The commonest foreign bodies ingested by adults are bones, spoons and dentures. Toothbrush ingestion occurs commonly among patients with psychiatric conditions like bulimia or anorexia nervosa, schizophrenia and bezoar. Most swallowed toothbrushes have been found in the esophagus or the stomach of affected patients. Most people who swallowed their toothbrushes did so entirely without erotic intent, as with this case where the patient had the brush pushed down her throat by a traditional healer. This is the first case of toothbrush swallowing in this hospital.

A left ventricular lipoma presenting as heart failure in a septuagenarian: A first case report

2007 ◽  
Vol 114 (3) ◽  
pp. 386-387 ◽  
Author(s):  
Kamran Akram ◽  
Clark Hill ◽  
Narasimhulu Neelagaru ◽  
Miriam Parker
Keyword(s):  
Heart Failure ◽  
Case Report ◽  
Left Ventricular ◽  
First Case

scholarly journals A young patient with heart failure – picture Quiz Question

2012 ◽  
Vol 11 (1) ◽  
pp. 28-28
Author(s):  
H Patel ◽  
◽  
G Dhillon ◽  
A Bandali ◽  
Neil Patel ◽  
...  
Keyword(s):  
Heart Failure ◽  
Case Report ◽  
Chest Pain ◽  
Young Patient ◽  
Loss Of Consciousness ◽  
Productive Cough ◽  
Shortness Of Breath ◽  
Pleuritic Chest Pain ◽  
History Of

Case report A 28 year old gentleman presented after an episode of collapse with loss of consciousness. He gave a history of non-specific malaise and myalgia over the previous 7 days, with fever, a generalised rash and a non productive cough. He developed progressive shortness of breath with sharp, pleuritic chest pain that was unresponsive to antibiotics in the community.

Clinical characteristics and outcomes after pulmonary vein isolation in atrial fibrillation patients with complete right bundle branch block

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
M Yano ◽  
M Nishino ◽  
K Yanagawa ◽  
H Nakamura ◽  
Y Matsuhiro ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Late Recurrence ◽  
Left Ventricular ◽  
Bundle Branch Block ◽  
Intraventricular Conduction ◽  
Echocardiographic Parameters ◽  
History Of ◽  
Qrs Duration ◽  
Cox Analysis

Abstract Background Complete right bundle branch block (CRBBB) is one of the most frequent alterations of the electrocardiogram (ECG). Several studies have shown that CRBBB was a risk factor for cardiovascular diseases and the appearance of CRBBB in patients hospitalized for exacerbated heart failure (HF) was associated with a worse prognosis. Various alternations of ECG such as early repolarization pattern and intraventricular conduction disturbance were associated with high recurrence ratio of atrial fibrillation (AF) after pulmonary vein isolation (PVI). However clinical outcome after PVI in patients with CRBBB remains unclear. Methods We enrolled consecutive AF patients who underwent PVI from September 2014 to November 2018 rom Osaka Rosai Atrial Fibrillation (ORAF) registry. We excluded patients with other wide QRS (left bundle branch block, ventricular pacing and unclassified intraventricular conduction disturbance) and divided into 2 groups; CRBBB (QRS duration ≥120msec) group and no-CRBBB (QRS duration <120) group. We compared the clinical characteristics including age, gender, hypertension, diabetes mellitus, history of heart failure, history of stroke, CHADS2Vasc score, paroxysmal AF (PAF), renal function, plasma brain natriuretic peptide (BNP) level and echocardiographic parameters including left ventricular end-diastolic diameter (LVDd), left ventricular end-systolic diameter (LVDs), left atrial diameter (LAD) and left ventricular ejection fraction (LVEF) between the 2 groups. We also compared the incidence of late recurrence of AF/atrial tachycardia (AT) between the 2 groups. We investigated whether CRBBB was an independent predictor of late recurrence of AF/AT after PVI by multivariate Cox analysis. Results We enrolled 736 consecutive AF patients who underwent PVI. CRBBB patients comprised 55 patients (7.5%). There were no significant differences of age, gender, hypertension, diabetes mellitus, history of heart failure, history of stroke, CHADS2Vasc score, PAF, renal function, plasma BNP level and echocardiographic parameters (LVDd, LVDs, LVEF and LAD) between the 2 groups. Incidence of AF/AT recurrence after PVI was significantly higher in CRBBB group than no-CRBBB group (Figure). CRBBB was an independently and significantly associated with late recurrence of AF/AT after PVI by multivariate Cox analysis (hazard ratio: 1.923, 95% CI: 1.190–2.961, p=0.009) in addition to female (p<0.001), no-PAF (p=0.005) and left atrial diameter (p=0.042). Conclusion CRBBB may be a strong predictor of AF/AT late recurrence after PVI. AF/Ar recurrence after PVI Funding Acknowledgement Type of funding source: None

scholarly journals A case report of a 40-year-old woman with endomyocardial fibrosis in a non-tropical area: from initial presentation to high urgent heart transplantation

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Gernot Wagner ◽  
Markus Haumer ◽  
Gerhard Poelzl ◽  
Dominik Wiedemann ◽  
Andreas Kliegel ◽  
...  
Keyword(s):  
Heart Failure ◽  
Case Report ◽  
Chest Pain ◽  
Heart Transplantation ◽  
Restrictive Cardiomyopathy ◽  
Left Ventricular ◽  
Diagnostic Workup ◽  
Lv Function ◽  
Endomyocardial Fibrosis ◽  
Tropical Regions

Abstract Background Endomyocardial fibrosis (EMF) represents the most common cause of restrictive cardiomyopathy worldwide. Despite a high prevalence in tropical regions, it occasionally occurs in patients who have never visited these areas. While researches have proposed various possible triggers for EMF, etiology and pathogenesis remain largely unknown. Diagnosis is based on patient history, heart failure symptoms, and echocardiographic signs of restrictive ventricular filling, atrioventricular valve regurgitation and frequently apical thrombus. Following is a case report of an Austrian patient with EMF who eventually had to undergo a heart transplant. This case report strives to promote awareness for this in non-tropical areas uncommon but nevertheless detrimental disease. Case presentation A 40-year-old woman was presented at our emergency department with chest pain and fever up to 38.1° Celsius. Plasma troponin-T levels and inflammatory markers were slightly elevated, but the echocardiogram was without pathological findings. The patient was hospitalized on the suspicion of acute myocarditis and discharged soon after improvement. Eight months later, she was presented again with chest pain and symptoms of heart failure. The echocardiogram showed normal systolic left ventricular (LV) function with LV wall thickening and severe restrictive mitral regurgitation as well as aortic and tricuspid regurgitation. Coronary angiogram was normal but right heart catheterization showed pulmonary hypertension due to left heart disease. Further diagnostic workup with cardiac magnetic resonance imaging revealed subendocardial late enhancement and apical thrombus formation in the left ventricle compatible with the diagnosis of EMF. A comprehensive diagnostic workup showed no evidence of infection, systemic immunologic or hematological disease, in particular hypereosinophilic syndrome. After a multidisciplinary consideration of several therapeutic options, the patient was listed for heart transplantation. On the waiting list, she deteriorated rapidly due to progressive heart failure and finally underwent a heart transplantation. Histological examination confirmed the diagnosis of EMF. Six years after her heart transplantation, the patient was presented in an excellent clinical condition. Conclusions Even in non-tropical regions, the diagnosis of EMF should always be considered in restrictive cardiomyopathy. Knowledge of the distinct phenotype of EMF facilitates diagnosis, but comprehensive workup and therapeutic management remain challenging and require a multidisciplinary approach.

scholarly journals Endomyocardial Fibrosis in non-tropical patient with no obvious eosinophilia presented with chest pain mimicking ACS and left ventricular thrombus

2021 ◽  
Author(s):  
ahmad matarneh ◽  
Yousef Hailan ◽  
Sabir Abdulkarim ◽  
Maryam Alkuwari ◽  
Wafer dabdoob
Keyword(s):  
Heart Failure ◽  
Chest Pain ◽  
Restrictive Cardiomyopathy ◽  
Left Ventricular ◽  
Left Ventricular Thrombus ◽  
Endomyocardial Fibrosis ◽  
Ventricular Thrombus

Endomyocardial fibrosis is a disease that causes restrictive cardiomyopathy, it varies in presentation ranging from asymptomatic to full-blown heart failure. its pathogenesis is poorly understood and it poses a diagnostic and treatment challenge due to its infrequent occurrence.

scholarly journals Recurrent pheochromocytoma with catecholamine cardiomyopathy and left ventricular thrombus: a case report

2021 ◽  
Vol 49 (4) ◽  
pp. 030006052110077
Author(s):  
Renzheng Chen ◽  
Yong Wang ◽  
Jie Yang ◽  
Xiaofeng Cheng ◽  
Jiang Wang ◽  
...  
Keyword(s):  
Case Report ◽  
Connective Tissue ◽  
Clinical Outcome ◽  
Rare Case ◽  
Adrenal Glands ◽  
Benign Tumor ◽  
Anticoagulation Therapy ◽  
Left Ventricular ◽  
Ventricular Thrombus ◽  
History Of

Pheochromocytoma is a rare and usually benign tumor of the adrenal glands. We report a case of a 40-year-old woman with recurrent pheochromocytoma and catecholamine cardiomyopathy. She had no history of other types of tumors or connective tissue disease. She had already undergone surgery twice to remove the pheochromocytoma, which had now recurred for the second time. A thrombus in the left ventricle was also noted upon imaging examination, which dissipated after anticoagulation therapy using dabigatran, allowing the patient to opt for an elective third surgery. This paper describes the clinical outcome of using the anticoagulant dabigatran to treat left ventricular thrombosis in this rare case of recurrent pheochromocytoma, and thus further contributing to the knowledge of the clinical management of this rare and complicated disease.

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