scholarly journals Sibutramine as a Cause of Sudden Cardiac Death

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Miguel Rodriguez-Guerra ◽  
Mayank Yadav ◽  
Manoj Bhandari ◽  
Archna Sinha ◽  
Jonathan N. Bella ◽  
...  
Keyword(s):  
Weight Loss ◽  
Sudden Cardiac Death ◽  
Cardiac Death ◽  
Public Health Issue ◽  
Herbal Supplements ◽  
Over The Counter ◽  
Coronary Catheterization ◽  
Coronary Syndrome ◽  
First Case ◽  
The Us

Importance. Sibutramine was withdrawn from the US market due to association with adverse cardiovascular outcomes especially with patients having preexisting cardiac disease. However, continued presence of sibutramine in herbal medications is a concern to public safety. Results. We report a case of a patient with no evidence of previous coronary heart disease, who presented with non-ST elevation acute coronary syndrome (NSTE-ACS). Urgent coronary catheterization showed nonobstructive coronaries. However, patient died unexpectedly within 24 hours of admission. The patient denied toxic habits but was taking over-the-counter weight loss herbal supplements. Complete autopsy was performed which showed sibutramine in the toxicology. Patient died due to complications of acute inadvertent intoxication of sibutramine. Conclusion and Relevance. This is the first case report in literature showing association of sibutramine to sudden cardiac death in patients with no prior cardiac history. The continued presence of sibutramine in some over-the-counter weight loss formulations is a very concerning public health issue.

scholarly journals P859 Can we connect intraventricular exercise induced gradients to sudden cardiac death?

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
C Cotrim ◽  
F Costa ◽  
D Severino ◽  
L Baquero ◽  
J Guardado
Keyword(s):  
Sudden Cardiac Death ◽  
Cardiac Death ◽  
Heart Diseases ◽  
Young Male ◽  
Exercise Stress ◽  
Male Athlete ◽  
First Case ◽  
History Of ◽  
Intense Training ◽  
Exercise Induced

Abstract Background Some publications, on exercise induced intraventricular gradients, admit the possibility they can be related to some cases of unexplained sudden cardiac death (SCD). Clinical case We present the case of a young male athlete (16 years) that after winning a triathlon competition has sudden cardiac death. No cardiovascular risk factors. No family history of SCD A previous episode of dizziness, accompanied by nausea and vomiting related to intense training happens 6 months before. In September 2018 about 30 minutes after winning a triathlon competition has SCD episode having been resuscitated on site by the competition physician having been defibrillated and transported to intensive care unit. After discharge, cardiac MRI, Coronary AngioTC, complete genetic study for heart diseases, flecainid test, transthoracic echocardiogram, stress echocardiogram with hyperventilation and ergometrine. All have normal results (Figure) During 24 hours Holter ECG isolated premature ventricular complexes were detected and during exercise stress echocardiography a significant intraventricular gradient without systolic anterior movement of mitral valve was detected (Figure). The athlete was disqualified for sports practice, refuses CDI implantation and started bisoprolol 2,5 mg daily. To the best of our knowledge this is the first case of association between SCD and exercise induced intraventricular gradient. This possible association should be studied in the future. Abstract P859 Figure. Intraventricular gradient in SCD athlete

scholarly journals Severe Metabolic Acidosis: A Case of Triple Hit with Ketogenic Diet, Vinegar, and Metformin in an Obese Patient

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Abdul Mughees Rana ◽  
Kannan Mansoor ◽  
Salman Assad ◽  
Mahmoud Abouzid ◽  
Iheanyichukwu Ogu ◽  
...  
Keyword(s):  
Weight Loss ◽  
Acetic Acid ◽  
Adverse Effects ◽  
Ketogenic Diet ◽  
Herbal Supplements ◽  
Dietary Practices ◽  
Over The Counter ◽  
Mainstream Media ◽  
Ketogenic Diets ◽  
Increased Risk

Obesity is an epidemic with high burden of disease. It is directly proportional to increased risk of morbidity and mortality. Ketogenic diet and herbal supplements have recently gained popularity amongst patients struggling with weight loss. There are limited data available for most of these supplements contrary to the claims laid by the mainstream media. Due to lack of awareness, this patient population is at high risk of adverse effects. We present a case of severe acidosis secondary to ketogenic diet and acetic acid (vinegar) ingestion. The use of dietary acetic acid is usually well tolerated; however, in this case, the large quantities and presence of acute renal injury and metformin use may have worsened the acidosis. Severe ketosis in setting of ketogenic diets is a serious complication, which is infrequently reported in literature. Many of these diets and supplements may seem harmless, but as our case illustrates, when combined with other risk factors, patients can face serious adverse effects and even require hospitalization. It is imperative that such dietary practices are physician supervised to avoid complications. With the recent surge of over-the-counter weight loss supplements and ketogenic diets, physicians also need to engage in dietary discussion with patients when attempting to lose weight.

Impact of Acute Coronary Syndrome Complicated by Ventricular Fibrillation on Long-term Incidence of Sudden Cardiac Death

2015 ◽  
Vol 68 (10) ◽  
pp. 878-884
Author(s):  
Belén Álvarez-Álvarez ◽  
Noelia Bouzas-Cruz ◽  
Emad Abu-Assi ◽  
Sergio Raposeiras-Roubin ◽  
Andrea López-López ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Sudden Cardiac Death ◽  
Ventricular Fibrillation ◽  
Cardiac Death ◽  
Coronary Syndrome

Abstract 17575: Looking Beyond Left Ventricular Ejection Fraction: Investigating the Utility of Multi-factorial Computational Modeling to Predict Sudden Cardiac Death Following Acute Coronary Syndrome in the MERLIN-TIMI36 Trial

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Alex Van Esbroeck ◽  
Mohammed Saeed ◽  
Benjamin M Scirica ◽  
Collin M Stultz ◽  
John V Guttag ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Sudden Cardiac Death ◽  
Left Ventricular Ejection Fraction ◽  
Cardiac Death ◽  
Ventricular Dysfunction ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Clinical Parameters ◽  
Ventricular Ejection Fraction ◽  
Coronary Syndrome

Introduction: Guidelines to prevent sudden cardiac death (SCD) following acute coronary syndrome (ACS) are widely based on cutoffs defined on left ventricular ejection fraction (LVEF) with limited use of other available data. Methods: We investigated the improvement in predicting post-ACS SCD using a multi-factorial model that integrates an assessment of left ventricular dysfunction through echocardiography with a broader set of other parameters collected routinely during hospitalization for ACS. Patients in the MERLIN-TIMI36 trial were admitted within 48 hours of ischemic symptoms for non-ST-elevation ACS and followed for a median of 348 days. SCD was adjudicated by a blinded clinical events committee. Data from 4,404 patients with LVEF and other clinical parameters routinely collected during index hospitalization (demographic, comorbidity, history, laboratory, electrocardiographic, and medication variables) were used to train and validate a logistic regression model to predict SCD using stepwise backward elimination and leave-one-out cross-validation. Results: The stepwise elimination process retained age, history of congestive heart failure, ST depression, beta blocker use, BNP, LVEF, and ischemia and ventricular tachycardia on continuous ECG as variables in the model. The model achieved significant improvements in discrimination, calibration and reclassification relative to LVEF, and demonstrated further utility in stratifying patients with mild/moderate left ventricular dysfunction or normal systolic function (Table 1). The model also resulted in higher sensitivity without increasing false positives relative to the LVEF<=30% rule (38% increase in correct predictions of SCD). Conclusions: Risk stratification for post-ACS SCD is significantly improved using multi-factorial models to integrate information in LVEF with other clinical parameters routinely collected during hospitalization.

Sudden cardiac death in multiple sclerosis caused by active demyelination of the medulla oblongata

2011 ◽  
Vol 17 (9) ◽  
pp. 1146-1148 ◽  
Author(s):  
GJD Hengstman ◽  
B Kusters
Keyword(s):  
Multiple Sclerosis ◽  
Case Report ◽  
Sudden Cardiac Death ◽  
Medulla Oblongata ◽  
Cardiac Death ◽  
Sudden Onset ◽  
Cardiac Arrythmias ◽  
First Case ◽  
Relapsing Remitting ◽  
Demyelinating Lesions

Cardiovascular autonomic dysfunction is not uncommon in multiple sclerosis (MS) and is related to the involvement of the vegetative areas of cardiac innervations in the medulla oblongata. It has been suggested that this may contribute to the occurrence of sudden death in MS. In this case report, we present a patient with active relapsing–remitting MS who died unexpectedly due to the sudden onset of cardiac arrythmias. Post-mortem examination showed the presence of active demyelinating lesions in the medulla oblongata. As far as we know, this is the first case report clearly linking sudden cardiac death to active MS on the histopathological level.

scholarly journals Extreme sacrifice: sudden cardiac death in the US Fire Service

2013 ◽  
Vol 2 (1) ◽  
Author(s):  
Denise L Smith ◽  
David A Barr ◽  
Stefanos N Kales
Keyword(s):  
Sudden Cardiac Death ◽  
Cardiac Death ◽  
Fire Service ◽  
The Us
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