1/11. Giant negative T waves in guillain-barre syndrome.A guillain-barre syndrome patient showed giant negative T waves on electrocardiography at the height of the disease, with large left ventricular hypokinesis on echocardiography and extensive defects on 123I-meta-iodobenzylguanidine myocardial scintigraphy. Gamma-globulin improved the neurological symptoms, and the above abnormalities resolved. We speculate that cardiac sympathetic nerve endings were transiently damaged, with consequent myocardial injury, due to norepinephrine toxicity.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
2/11. Giant cell myocarditis responding to immunosuppressive therapy.An unusual case of giant cell myocarditis presenting with cardiogenic shock that dramatically responded to conventional dose of steroids and azathioprine is reported. Cardiac recovery was rapid, complete (left ventricular ejection fraction rose to 55% from 10%), and was accompanied by the disappearance of the inflammatory infiltrates including giant cells in the control endomyocardial biopsy. maintenance of the recovery at 16 months of follow-up on a low dose of azathioprine suggests that giant cell myocarditis might be a heterogeneous disease having either a negative untreatable trend necessitating cardiac transplantation, or a curable substrate responding to immunosuppressive drugs.- - - - - - - - - - ranking = 3keywords = giant (Clic here for more details about this article) |
3/11. mitral valve replacement and endocavitary patch repair for a giant left ventricular pseudoaneurysm.We present a case of a giant inferior left ventricular (LV) wall pseudoaneurysm. The patient had new york Heart association class IV heart failure due to severe mitral valve regurgitation and poor LV function. Our operative approach included right thoracotomy, excision of the mitral valve, and patch repair of the pseudoaneurysm neck from inside of the dilated LV cavity followed by mitral valve replacement. Surgery was performed without aortic cross-clamping on a normothermic perfused beating heart. The patient had an uncomplicated cardiac recovery and is doing well 15 months after surgery.- - - - - - - - - - ranking = 5keywords = giant (Clic here for more details about this article) |
4/11. Dor's endoaneurysmorrhaphy in severe heart failure due to giant cell myocarditis.Giant cell myocarditis is an unusual and frequently fatal form of myocarditis. A 37-year-old woman presented with resistant cardiac failure and left ventricular aneurysm. She underwent Dor's endoaneurymorrhaphy and was histopathologically proved to have giant cell myocarditis. She had significant improvement of symptoms and was alive 13 months after surgery. Dor's endoaneurysmorrhaphy may be a useful therapeutic modality in selected cases of giant cell myocarditis.- - - - - - - - - - ranking = 6keywords = giant (Clic here for more details about this article) |
5/11. Reversible left ventricular dysfunction "takotsubo" cardiomyopathy related to catecholamine cardiotoxicity.An 80-year-old female was admitted for a persistent consciousness disturbance. electrocardiography revealed ST-segment elevation in leads II, III, aVf, and V3-V6. coronary angiography demonstrated normal arteries, while left ventriculography revealed asynergy of apical akinesis and basal hyperkinesis. The creatinine kinase and creatinine kinase MB levels were not elevated after the initial measurement on admission. The diffuse ST-segment elevation reached a maximum level 24 hours after admission. In leads V3-V6, ST-segment elevation continued for 48 hours, and was followed-up by deep inverted T waves. Within 24 days, the asynergy improved without any specific treatment, but the giant negative T waves were present on the electrocardiogram. The plasma norepinephrine and brain natriuretic peptide levels on the first hospital day were 2.9ng/mL and 906pg/mL, respectively. The left ventricular dysfunction appeared to be induced by the exposure to high-level plasma catecholamines. (123)I-metaiodobenzyl guanidine scintigraphy also revealed transient dysfunction of the cardiac catecholamine dynamics.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
6/11. A massive left-to-right shunt due to a ruptured giant aneurysm of the sinus of valsalva.We describe a patient with a giant ruptured sinus of valsalva aneurysm causing a massive left-to-right shunt. The diagnosis was made by transoesophageal echocardiography and confirmed by angiography. We outline briefly a diagnostic and therapeutic work-up.- - - - - - - - - - ranking = 5keywords = giant (Clic here for more details about this article) |
7/11. Complete lysis of left ventricular giant thrombus with fibrinolytic therapy in clopidogrel resistant patient.Sixty-year-old woman admitted with dyspnea and cough. Three weeks ago she underwent primary stenting for acute anterior myocardial infarction and received antiplatelet therapy (clopidogrel). echocardiography and left ventriculography revealed left ventricular segmental dysfunction at anterolateral-apical region but no thrombus. On last admission, despite the clopidogrel therapy, echocardiography showed giant-partly mobil thrombus obliterated half of the left ventricle. Slow infusion of thrombolytic therapy was given and complete lysis occurred with uneventful course. disclosure of such a rapidly evolving giant left ventricular thrombus in the clopidogrel non-responder is a rare clinical problem with potentially catastrophic consequences. Slow infusion of thrombolytic therapy may be effective and life saving.- - - - - - - - - - ranking = 6keywords = giant (Clic here for more details about this article) |
8/11. Two adults requiring implantable defibrillators because of ventricular tachycardia and left ventricular dysfunction caused by presumed Kawasaki disease.There is an adult patient population in japan with undiagnosed coronary artery lesions caused by Kawasaki disease (KD) occurring before 1967, the time at which KD was first described. Two adult patients presented with a low left ventricular (LV) ejection fraction and ventricular tachycardia (VT) caused by presumed KD. A 43-year-old man with rapid VT had a history of an acute febrile illness with desquamation of the fingertips at the age of 10 months. coronary angiography (CAG) showed segmental stenosis of the right coronary artery (RCA) and occlusion of the left anterior descending artery with a giant aneurysm. The other patient was a 48-year-old man with a history of ischemic cardiomyopathy diagnosed after a previous myocardial infarction when he was 32 years old. He had segmental stenosis of the RCA on CAG. Non-sustained VT with transient unconsciousness was observed during 24-h Holter electrocardiography. Rapid VT with syncope was induced in both patients in the electrophysiologic studies and an implantable defibrillator was required to prevent sudden death. physicians must be aware that VT can occur in older patients with LV dysfunction many years after KD.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
9/11. Twenty-five-year-old man with a giant left ventricular mass.We report a rare case of a massive 7- x 3.25-cm thrombus in the left ventricle of a 25-year-old man. He presented with a subacute febrile illness for 1 month with a sudden worsening respiratory distress and chest pain. His initial evaluation in the emergency department diagnosed an interstitial lung process. Two-dimensional echocardiography demonstrated a previously undiagnosed cardiomyopathy and a massive left ventricular thrombus.- - - - - - - - - - ranking = 4keywords = giant (Clic here for more details about this article) |
10/11. Transient left ventricular apical ballooning developing after the Central Niigata Prefecture Earthquake: two case reports.Two patients presented with transient left ventricular apical ballooning (takotsubo cardiomyopathy) induced by emotional stress caused by the Central Niigata Prefecture Earthquake in 2004. These patients complained of chest pain immediately after the earthquake. In patient 1, electrocardiography (ECG) showed slight ST elevation in leads V5 to V6 and 1 mm ST depression in lead III. Serial ECG revealed inverted giant T waves in leads V3 to V6 and inverted T waves in leads I, II, aVL and aVF 13 days after the earthquake occurred. Patient 2 also complained of chest pain right after the earthquake, but consulted a doctor 15 days after the earthquake occurred. ECG showed inverted giant T wave in leads V1 to V6 and inverted T waves in leads I, II and aVL. Transthoracic echocardiography showed hypokinesis of the apical area of the left ventricle with normokinesis in the basal area in both patients. coronary angiography showed no stenotic segments and coronary spasms were not induced by provocative testing. Serial cardiac radionuclide single photon emission computed tomography of myocardial functional sympathetic innervation using iodine-123-metaiodobenzyl-guanidine (MIBG) and thiallium-201 (201Tl) showed an MIBG uptake defect and increased wash-out in the apical area, but only mild decrease of apical 201Tl uptake. Due to strong emotional stress, earthquakes may induce transient left ventricular apical ballooning (takotsubo cardiomyopathy).- - - - - - - - - - ranking = 2keywords = giant (Clic here for more details about this article) |
| | Next -> |