scholarly journals Bradycardia during Transradial Cardiac Catheterization due to Catheter Manipulation: Resolved by Catheter Removal

2017 ◽  
Vol 2017 ◽  
pp. 1-3
Author(s):  
Maheedhar Gedela ◽  
Vishesh Kumar ◽  
Kashif Abbas Shaikh ◽  
Adam Stys ◽  
Tomasz Stys
Keyword(s):  
Heart Rate ◽  
Cardiac Catheterization ◽  
Carotid Sinus ◽  
Stress Test ◽  
Ascending Aorta ◽  
Coronary Angiogram ◽  
First Case ◽  
Brachiocephalic Trunk ◽  
Artery Disease ◽  
The Right

Purpose. To report the resolution of bradycardia encountered during transradial cardiac catheterization through the catheter pullback technique in two cases. Case Report. A 62-year-old male and an 81-year-old male underwent coronary angiogram to evaluate for coronary artery disease and as a result of positive stress test, respectively. Upon engagement of the FL 3.5 catheter into the ascending aorta through the transradial approach, the first case developed bradycardia with a heart rate of 39 beats per minute. The second case developed profound bradycardia with a heart rate of 25 beats per minute upon insertion of the 5 Fr FL 3.5 catheter near the right brachiocephalic trunk through the right radial access. Conclusion. Bradycardia can be subsided by removal of the catheter during catheter manipulation in patients undergoing transradial coronary angiogram if there is a suspicion of excessive stretching of aortic arch receptors and/or carotid sinus receptors.

Interaction of right and left carotid sinus baroreflexes in the dog

1986 ◽  
Vol 250 (1) ◽  
pp. H96-H107 ◽  
Author(s):  
A. S. Greene ◽  
M. J. Brunner ◽  
A. A. Shoukas
Keyword(s):  
Heart Rate ◽  
Tidal Volume ◽  
Carotid Sinus ◽  
The Other ◽  
Reflex Response ◽  
Pentobarbital Sodium ◽  
Simultaneous Excitation ◽  
Carotid Sinus Baroreflex ◽  
The Right ◽  
Sinus Pressure

Carotid sinus reflex interactions were studied in 10 dogs anesthetized with pentobarbital sodium. The right and left carotid sinus regions were isolated and perfused at controlled pressures. Pressure in the right and left carotid sinuses were independently varied, and the resulting steady-state reflex changes in arterial pressure, heart rate, respiratory frequency, tidal volume, and total ventilation were measured. Reflex changes when carotid sinus pressure was changed on one side were strongly influenced by pressure in the contralateral carotid sinus (P less than 0.05). Right carotid sinus gain was found to be 0.628 +/- 0.058 at a left carotid sinus pressure of 50 mmHg and 0.148 +/- 0.027 when left carotid sinus pressure was 200 mmHg. Similar results were found for left carotid sinus gain. Suppression was also found for heart rate, respiratory rate, tidal volume, and total ventilation. The hypothesis that rapid resetting of one carotid sinus baroreflex might influence responses from the other side was also tested. Although ipsilateral resetting was consistently observed, no contralateral component of the resetting was detected. An additional inhibitory summation between the right and left carotid sinuses was found such that simultaneous excitation of both receptors resulted in a smaller reflex response than did the sum of individual responses. Sympathetic denervation of the carotid sinus region had no effect.

Chronic isolation of carotid sinus baroreceptor region in conscious normotensive and hypertensive rats

1998 ◽  
Vol 275 (1) ◽  
pp. H322-H329 ◽  
Author(s):  
Kelly P. McKeown ◽  
Artin A. Shoukas
Keyword(s):  
Heart Rate ◽  
Cardiac Output ◽  
Arterial Pressure ◽  
Carotid Sinus ◽  
Baroreceptor Reflex ◽  
Hypertensive Rats ◽  
Conscious Rat ◽  
Sd Rats ◽  
The Right ◽  
Reflex System

We have developed a chronic technique to isolate the carotid sinus baroreceptor region in the conscious rat model. Our technique, when used in conjunction with other methods, allows for the study of the control of arterial pressure, heart rate, and cardiac output by the carotid sinus baroreceptor reflex in conscious, unrestrained rats. The performance of our technique was evaluated in two strains: normotensive Sprague-Dawley (SD) rats and spontaneously hypertensive rats (SHR). Each rat was instrumented with an aortic flow probe and a catheter placed in the right femoral artery to monitor cardiac output and arterial pressure, respectively. The cervical sympathetic trunk and aortic depressor nerve were ligated and cut bilaterally, leaving vagus nerves intact. The right and left carotid sinuses were isolated using our new technique. We tested the open-loop function of the carotid sinus baroreceptor reflex system in the conscious rat after recovery from the isolation surgery. We found that changes in nonpulsatile carotid sinus pressure caused significant changes in arterial pressure, heart rate, and total peripheral resistance in both rat strains. However, the cardiac output responses differed dramatically between strains. Significant changes were seen in the cardiac output response of SHR, whereas no significant changes were observed in normotensive SD rats. We have found this technique to be a highly reliable tool for the study of the carotid sinus baroreceptor reflex system in the conscious rat.

scholarly journals A Rare Cause of Supraventricular Ectopic Beats and Angina in a Young Patient

2018 ◽  
Vol 4 (2) ◽  
pp. 106-109
Author(s):  
Monica Jurcău ◽  
Mariana Floria ◽  
Bogdan Mazilu ◽  
Anca Ouatu ◽  
Daniela Maria Tanase
Keyword(s):  
Coronary Artery ◽  
Stress Test ◽  
Young Patients ◽  
Physical Exertion ◽  
Diagnostic Techniques ◽  
History Of ◽  
Ectopic Beats ◽  
Artery Disease ◽  
One Year ◽  
The Right

Abstract Introduction: We present the case of a young man with multiple atherosclerotic risk factors and a rare cause of angina and supraventricular ectopic beats. Case presentation: A 35-year-old man with one-year history of stable angina pectoris and supraventricular ectopic beats, without any medication, presented to the emergency room complaining of anterior chest pain that occurs at moderate physical exertion. The rest electrocardiogram, transthoracic echocardiography, and chest X-ray were normal; the exertion stress test was also normal, except for supraventricular ectopic beats (trigeminal rhythm). Due to the intermediate pre-test probability of coronary artery disease, he was evaluated using coronary computed tomography angiography. An anomalous origin of the right coronary artery from the left coronary sinus, with an inter-arterial course and without any atheroma plaques, was observed. During hospitalization the evolution was stable, without complications. The patient was further referred to a cardiac surgery clinic to evaluate the possibility of surgical treatment of this anomaly. Conclusions: Coronary artery anomalies are very rare; however, they present multiple implications in current practice. The most severe complication of this condition is represented by sudden death in young patients due to malignant ventricular arrhythmias. Imaging diagnostic techniques allow for a rapid, noninvasive diagnosis of this rare cause of angina.

scholarly journals Morphometry of the aortic arch and its branches

2013 ◽  
Vol 19 (3) ◽  
pp. 154-159 ◽  
Author(s):  
A.M. Manole ◽  
D.M. Iliescu ◽  
A. Rusali ◽  
P. Bordei
Keyword(s):  
Carotid Artery ◽  
Aortic Arch ◽  
Subclavian Artery ◽  
Common Carotid Artery ◽  
Left Subclavian Artery ◽  
Ascending Aorta ◽  
Ct Scanner ◽  
Arterial Trunk ◽  
Brachiocephalic Trunk ◽  
The Right

Abstract Our study was conducted by the evaluation of angioCT’s performed on a GE LightSpeed VCT64 Slice CT Scanner. The measurements were performed on the aortic arch at the following levels: at the origin of the aorta, the middle part of the ascending aorta, prior to the origin of the brachiocephalic arterial trunk and after the origin of the left subclavian artery. We measured the caliber of the aortic arch arteries and the data are correlated and reported by gender. The diameter of the ascending aorta was between 27 to 28.9 mm in females and in males from 25.8 to 37.6 mm. The diameter of the aorta within the middle segment of the ascending part was between 28-30.2 mm in females and in males from 26.1 to 34.6. The diameter of the aortic arch prior to the origin of the brachiocephalic arterial trunk was between 26.4 to 29.4 mm in females and in males from 25.8 to 37.5 mm. The diameter of the aortic arch after the origin of the left subclavian artery was in a range of 20.4 to 28.4 mm, which corresponds to the limits found in males while in females the aortic diameter was between 21.3 to 24.1 mm. The brachiocephalic trunk diameters were 8.3 to 15.5 mm in females and in males was 9.1 to 14.5 mm. The right common carotid artery had a diameter of 4-8 mm diameter in males and in females ranged from 4.7 to 5.5 mm. The right subclavian artery showed a caliber of 5.7 to 7.5 mm in females and in males from 5.9 to 10.1. The left common carotid artery diameter was 4.6 to 5.7 mm in females and males the diameter was between 5.2 to 7.4 mm. The left subclavian artery had a diameter of 6-10 mm in females and in males ranged from 7.7 to 12.8 mm. We found that the distance between the ascending part of the aorta and the descending segment ranged from 33.3 to 38.5 mm in females and in males from 40 to 68.6 mm. We measured the distance that exists at the crossing of the aortic arch with the left branch of the pulmonary trunk, finding that in females this distance is 3 to 10.3 mm and in males from 3 to 12.5 mm.

Percutaneous Closure of Acquired Hole- First Case Report from Bangladesh

2021 ◽  
Vol 35 (2) ◽  
pp. 155-158
Author(s):  
Tawfiq Shahriar Haq ◽  
Naharuma Aive Hyder Chowdhury ◽  
Abdul Mazid Khan ◽  
Jesmin Hossain ◽  
Fazila Tun Nesa Malik
Keyword(s):  
Cardiac Death ◽  
Wide Spectrum ◽  
Right Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Coronary Angiogram ◽  
Sinus Of Valsalva ◽  
First Case ◽  
Uncommon Condition ◽  
Artery Disease

Rupture sinus of Valsalva (RSOV) is an uncommon condition with a wide spectrum of presentation, ranging from an asymptomatic murmur to cardiogenic shock or even sudden cardiac death. Our case presented at 62 yrs with progressive onset of dyspnea, palpitation with deterioration of exercise capacity. Diagnosis of ruptured sinus of Valsalva was made by echocardiography, it was aneurysmal and opened into right ventricular outflow tract. Coronary artery disease was excluded by coronary angiogram. Probable cause of rupture was atherosclerosis.We closed percutaneously with ADO I device. The procedure was completed uneventfully. Patient discharged with duel antiplatelet and is on follow up. Bangladesh Heart Journal 2020; 35(2) : 155-158

Abstract 16451: The Temporal Trend in the Utilization of Noninvasive Cardiac Test for Chest Pain Evaluation and Its Impact on Cardiac Catheterization Trends

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Stephanie Hong ◽  
Getu Teressa
Keyword(s):  
Chest Pain ◽  
Cardiac Catheterization ◽  
Stress Testing ◽  
Temporal Trend ◽  
Medical Center ◽  
Stress Test ◽  
Academic Medical Center ◽  
Diagnostic Testing ◽  
High Sensitivity ◽  
Artery Disease

Introduction: Noninvasive diagnostic testing serves as gatekeepers to invasive cardiac catheterization. Computed tomography coronary angiogram (CTCA) has been shown to have high sensitivity and negative predictive value in the diagnosis of coronary artery disease (CAD). However, the temporal trend of CTCA compared to functional tests and the differential downstream impact on cardiac catheterization is unknown. Objective: This study aimed to investigate the temporal trend of the use in CTCA for the evaluation of patients with chest pain and how it compares to the temporal trend of stress testing. The secondary aim was to investigate the temporal pattern in the cardiac catheterization rate and how it varies between CTCA and stress testing. Methods: We performed a retrospective review of 65,686 patients who presented to a large academic medical center with chest pain between 2012 and 2019. We identified those who received CTCA testing or stress testing as the initial diagnostic testing for diagnosing suspected CAD and collected data on downstream cardiac catheterization. We calculated the testing rate per 1000 for each year. Results: Of the patient who received noninvasive imaging (n=18,843), more CTCA was performed (18.6%) compared to stress test (10.1%). After an initial upward trend in CCTA use and a downward trend in stress test use between 2012 and 2014, the trend reversed for both modalities after 2015. The rate of cardiac catheterization increased after 2014, mirroring an increase in stress test utilization. Patients who had stress test first have increased odds of undergoing catheterization compared to those who had CTCA first, even after adjusting for risk factors. However, compared to CTCA, stress test shows a relative decline in the odds of catheterization (Relative adjusted Odd Ratio: 5.6 in 2012 down to 2.8 in 2019) Conclusion: In this large single-center study of chest pain patients, stress-testing leads to increased odds of cardiac catheterization compared to CCTA. However, the relative odds of undergoing catheterization following stress testing show a declining trend.

scholarly journals Triple-Vessel Percutaneous Coronary Revascularization In Situs Inversus Dextrocardia

2010 ◽  
Vol 2010 ◽  
pp. 1-4 ◽  
Author(s):  
Nikolaos Kakouros ◽  
Sundip J. Patel ◽  
Simon Redwood ◽  
Balvinder S. Wasan
Keyword(s):  
Situs Inversus ◽  
Coronary Revascularization ◽  
Recessive Trait ◽  
First Case ◽  
Counter Rotation ◽  
Percutaneous Coronary Revascularization ◽  
Congenital Cardiac Disease ◽  
Percutaneous Coronary ◽  
Artery Disease ◽  
The Right

Dextrocardia with situs inversus occurs in approximately one in 10,000 individuals of whom 20% have primary ciliary dyskinesia inherited as an autosomal recessive trait. These patients have a high incidence of congenital cardiac disease but their risk of coronary artery disease is similar to that of the general population. We report what is, to our knowledge, the first case of total triple-vessel coronary revascularization by percutaneous stent implantation in a 79-year-old woman with situs inversus dextrocardia. We describe the successful use of standard diagnostic and interventional guide catheters with counter rotation and transversely inversed image acquisition techniques. The case also highlights that the right precordial pain may represent cardiac ischemia in this population.

scholarly journals ‘Broken heart’ in acute-on-chronic liver failure

2016 ◽  
Vol 26 (2) ◽  
pp. 131-132
Author(s):  
Ennaliza Salazar ◽  
Chee Kiat Tan ◽  
George Boon Bee Goh
Keyword(s):  
Coronary Artery Disease ◽  
Liver Failure ◽  
Takotsubo Cardiomyopathy ◽  
Myocardial Stunning ◽  
Apical Ballooning ◽  
Chronic Liver ◽  
Coronary Angiogram ◽  
Chronic Liver Failure ◽  
First Case ◽  
Artery Disease

Takotsubo cardiomyopathy usually occurs as a result of catecholamine release causing myocardial ‘stunning’ during physical or emotional stress. Typically coronary angiogram shows normal or minor coronary artery disease and echocardiogram shows apical ballooning with basal wall hyperkinesia. The prognosis is excellent with good cardiac functional recovery within days to weeks. We report the first case of takotsubo cardiomyopathy in a patient with acute-on-chronic liver failure.

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