Cases reported "Coronary Disease"

Filter by keywords:



Filtering documents. Please wait...

11/206. Hepatic failure in a patient taking rosiglitazone.

    BACKGROUND: Rosiglitazone maleate is the second approved oral hypoglycemic agent of the thiazolidinedione class. The first, troglitazone, has been associated with liver failure, occasionally resulting in liver transplantation or death. There have been no reports to date of rosiglitazone-associated elevations in the alanine aminotransferase level or hepatotoxicity. OBJECTIVE: To report the clinical characteristics of liver failure developing in a patient receiving rosiglitazone. DESIGN: Case report. SETTING: University hospital. PATIENT: 69-year-old man taking rosiglitazone, 4 mg/d. INTERVENTION: Discontinuation of rosiglitazone therapy and treatment with lactulose, vitamin k, fresh frozen plasma, ventilatory assistance, and intensive care unit support. MEASUREMENTS: blood test monitoring, including toxicology screening, liver function tests, coagulation studies, serum chemistries, and complete blood counts. RESULTS: After 21 days of rosiglitazone therapy, hepatic failure developed. Other causes of hepatic failure, such as viruses and toxins, were excluded, although it is possible that congestive heart failure was also a causative factor. The patient recovered fully with supportive care. CONCLUSION: Rosiglitazone may be associated with hepatic failure.
- - - - - - - - - -
ranking = 1
keywords = death
(Clic here for more details about this article)

12/206. Catastrophic outcomes of noncardiac surgery soon after coronary stenting.

    OBJECTIVES: To assess the clinical course of patients who have undergone coronary stent placement less than six weeks before noncardiac surgery. BACKGROUND: Surgical and percutaneous transluminal coronary angioplasty revascularization performed before high-risk noncardiac surgery is expected to reduce perioperative cardiac morbidity and mortality. Perioperative and postoperative complications in patients who have undergone coronary stenting before a noncardiac surgery have not been studied. methods: Forty patients who underwent coronary stent placement less than six weeks before noncardiac surgery requiring a general anesthesia were included in the study (1-39 days, average: 13 days). The records were screened for the occurrence of adverse clinical events, including myocardial infarction, stent thrombosis, peri- and postoperative bleeding and death. RESULTS: In 40 consecutive patients meeting the study criteria, there were seven myocardial infarctions (MIs), 11 major bleeding episodes and eight deaths. All deaths and MIs, as well as 8/11 bleeding episodes, occurred in patients subjected to surgery fewer than 14 days from stenting. Four patients expired after undergoing surgery one day after stenting. Based on electrocardiogram, enzymatic and angiographic evidence, stent thrombosis accounted for most of the fatal events. The time between stenting and surgery appeared to be the main determinant of outcome. CONCLUSIONS: Postponing elective noncardiac surgery for two to four weeks after coronary stenting should permit completion of the mandatory antiplatelet regimen, thereby reducing the risk of stent thrombosis and bleeding complications.
- - - - - - - - - -
ranking = 3
keywords = death
(Clic here for more details about this article)

13/206. Gender differences in acute coronary events.

    The most frequent cause of death among women in the united states is coronary heart disease, which claims 200,000 lives a year. The prognosis with either medical or surgical therapy is worse in females than in males. The following significant gender differences have been observed and reported: (1) the rate of early death following acute myocardial infarction is greater in women, (2) the difference between sexes remains whether or not thrombolytic therapy is used, and (3) the hospital mortality rate following coronary angioplasty, atherectomy, or bypass surgery is greater in females. The reasons for these gender differences are not clearly understood. Nevertheless, awareness of the higher morbidity and mortality in women dictates the need for early detection and more aggressive therapy of the risk factors. However, diabetes mellitus and essential hypertension are 2 well-established major risk factors for coronary disease and stroke that are more prevalent in the female gender. These 2 risk factors are cumulative and require more intensive and aggressive therapy to prevent acute vascular events, and therefore early detection is mandatory.
- - - - - - - - - -
ranking = 2
keywords = death
(Clic here for more details about this article)

14/206. heterografts as aortocoronary bypass conduits in human beings.

    Clinical and necropsy observations are described in a man in whom two sheep carotid arterial heterografts were inserted as aortocoronary bypass conduits 30 months before death, and in whom a canine saphenous vein heterograft was inserted several hours before death. All three grafts failed. The lumens of the sheep carotid arterial heterografts had closed by the time of catheterization 6 months after operation; at necropsy both grafts were totally occluded at their coronary and aortic ends and their media and adventitia were infiltrated by granulomatous inflammatory cells. Little information is available regarding the use of heterografts as coronary bypass conduits. Examination of previous reports describing heterografts for vascular reconstruction or bypass in both man and experimental animals and observations in our patient suggest that heterografts are unsatisfactory as aortocoronary bypass conduits.
- - - - - - - - - -
ranking = 2
keywords = death
(Clic here for more details about this article)

15/206. Coronary ostial stenosis complicating coronary arteriography.

    Coronary ostial stenosis is a cause of angina pectoris and sudden death. It is due mainly to atherosclerosis, syphilis, and iatrogenic disease. The last is of growing importance because of the frequency of coronary arteriography and surgical procedures on the aortic valve. Since both may cause stenosis of the coronary ostia, these procedures raise the topic from an obscure morphologic entity to an important consideration in the treatment of cardiac disease. We describe a case of ostial stenosis that was complicated by coronary arteriography.
- - - - - - - - - -
ranking = 1
keywords = death
(Clic here for more details about this article)

16/206. Emergency coronary surgery: Evolving indications.

    Between December 1970 and October 1973, 74 patients underwent emergency myocardial revascularization for the relief of acute coronary insufficiency. Through our experience in this area, we have established three categories for which we perform emergency surgery. The first of these is cardiogenic shock complicating acute myocardial infarction for which 14 patients underwent emergency saphenous vein grafting. Seven of these patients expired during operation and one died three months after operation. The second category is acute unstable myocardial infarction for which 25 patients received surgery. There were no operative deaths in this group, but two patients died at six weeks and four months after operation. Thrity-five patients were classified as pre-infarctional angina, the third category for which we perform surgery on an emergency basis. There was one operative death and two late deaths at four and ten months in this group of patients. Our experience suggests that immediate coronary angiography and revascularization will improve survival in the three above-named categories.
- - - - - - - - - -
ranking = 3
keywords = death
(Clic here for more details about this article)

17/206. pathology of hearts after aortocoronary saphenous vein bypass grafting for coronary artery disease, studied by post-mortem coronary angiography.

    A detailed pathological study was made in 10 patients dying up to 13 months after aortocoronary saphenous vein bypass grafting for coronary atherosclerosis. The coronary arteries and vein grafts were investigated by injection with a radio-opaque mass, radiography, dissection, and histology. The report is to some extent historical since the patients died during a period when the operation was first being introduced into two cardiothoracic hospitals. About 80 operations were performed during the time the 10 deaths occurred, a mortality of 12-5 per cent (including cases followed up to 13 months after operation). Seven of the patients were operated on for intractable angina and 3 with a view to aneurysmectomy. All the patients selected for operation were severely disabled despite medical treatment. The main cause of death was extremely severe coronary artery disease and its effects on the left ventricle; in one case, over two-thirds of the left ventricle had been destroyed by infarction before operation. Other causes or contributing causes of death were pulmonary embolism, myocardial infarction complicating angiography (ostial stenosis), and cerebral damage. Ten of the 14 vein grafts (71%) were patent at necropsy. A free flow of injection medium usually occurred between patent grafts and coronary arteries. thrombosis of a graft was thought to have contributed to death in 3 patients, but not in a fourth who died of pulmonary embolism. Since thrombosis of grafts was usually secondary to poor run-off blood into severely atheromatous coronary arteries, this was also an indirect effect of the advanced coronary arterial disease. In one case, thrombosis followed severe chronic intimal thickening of a graft in place for 13 months. The study of these deaths emphasizes that in some patients the pathological changes in the coronary arteries and left ventricle are too severe for them to benefit from surgery. Vein grafts cannot be expected to distribute blood effectively through grossly narrowed coronary arteries. In addition, when a large part of the left ventricle is infarcted or scarred, it is almost certain that improving the blood supply by grafting will not result in significant regeneration of cardiac muscle. Since the time when this study was made, there have been few deaths among the many vein graft operations subsequently carried out in the hospitals involved. The two most important factors thought responsible for the improvement are the selection of cases more suitable for surgery by continued improvement of diagnostic techniques, and also the employment of more radical surgical procedures in the form of coronary endarterectomy and the insertion of more grafts per patient.
- - - - - - - - - -
ranking = 6
keywords = death
(Clic here for more details about this article)

18/206. Can heart rate variability predict sudden death? A case of sudden death in a child with severe coronary sequelae of Kawasaki disease.

    We report the heart rate variability (HRV) of a child aged 11 years. Arrhythmia was the suspected cause of sudden death after 10 years of therapy for Kawasaki disease. The linear methods failed to show any features of the HRV that could have predicted the patient's sudden death, but the fractal scaling as a nonlinear method had suddenly decreased from 5.3 to 4.1 1 year before his death.
- - - - - - - - - -
ranking = 11
keywords = death
(Clic here for more details about this article)

19/206. Fatal air embolism during thoracotomy for gunshot injury to the lung. Report of a case.

    Fatal coronary air embolism occurred during thoracotomy in a patient with a gunshot wound involving the hilum of the right lung. Embolism was observed during a second period of failure of heart action. Evidently, air entered the pulmonary veins from the bronchus, which was receiving positive-pressure ventilation. The literature contains reports of only 3 similar cases, but we suspect that air embolism may be responsible for death and morbidity in additional cases in which accidental or iatrogenic lung trauma has produced a pathway between the bronchial tree and the pulmonary veins.
- - - - - - - - - -
ranking = 1
keywords = death
(Clic here for more details about this article)

20/206. myocardial bridging of left circumflex coronary artery associated with acute myocardial infarction.

    myocardial bridging of coronary arteries has been associated with myocardial infarction (MI), conduction disturbances, and sudden cardiac death. There are several reports on MI in association with myocardial bridging of the left anterior descending coronary artery. Here we present a case report of acute MI associated with myocardial bridging of the left circumflex coronary artery.
- - - - - - - - - -
ranking = 1
keywords = death
(Clic here for more details about this article)
<- Previous || Next ->


Leave a message about 'Coronary Disease'


We do not evaluate or guarantee the accuracy of any content in this site. Click here for the full disclaimer.