Takotsubo cardiomyopathy: An under-recognized myocardial syndrome
ABSTRACT Takotsubo cardiomyopathy is characterized by reversible left ventricular dysfunction with apical ballooning and is triggered by marked psychological or physiological stress in the absence of significant epicardial coronary artery disease. Clinically, this unique myocardial syndrome mimics acute myocardial infarction, and it has been considered to be a rare entity with a good prognosis. The literature on takotsubo cardiomyopathy is limited by selection bias and patient heterogeneity, but recent data suggest the syndrome is more prevalent, e.g., in critically ill, non-cardiac patients. Prompt diagnosis and aggressive therapy are essential for a rapid recovery. Clinicians should increase their awareness of this syndrome and more research should be carried out on the epidemiology, pathophysiology, and treatment of takotsubo cardiomyopathy.
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ABSTRACT: Chest pain is one of the chief presenting complaints among patients attending Emergency department. The diagnosis of acute myocardial infarction may be a challenge. Various tools such as anamnesis, blood sample (with evaluation of markers of myocardial necrosis), ultrasound techniques and coronary computed tomography could be useful. However, the interpretation of electrocardiograms of these patients may be a real concern. The earliest manifestations of myocardial ischemia typically interest T waves and ST segment. Despite the high sensitivity, ST segment deviation has however poor specificity since it may be observed in many other cardiac and non-cardiac conditions. Therefore, when ST-T abnormalities are detected the physicians should take into account many other parameters (such as risk factors, symptoms and anamnesis) and all the other differential diagnoses. The aim of our review is to overview of the main conditions that may mimic a ST segment Elevation Myocardial Infarction (STEMI).Indian Heart Journal 07/2013; 65(4):412-423. DOI:10.1016/j.ihj.2013.06.013 · 0.17 Impact Factor
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ABSTRACT: Summary form only given, as follows. Electron trajectories from the field emitters in the field emitter displays are very important. The trajectories effect the design of pixel size, the phosphor voltage, the gap between the field emitter arrays and the phosphor, color purity, etc. The electron trajectories are effected not only by the local potentials around each emitter, but the global field of each pixel. Two dimensional simulations would not be adequate. We are using a three-dimensional computer code EO-3D by Munro's Electron Beam Software, Ltd. To find the electric potential and the electron trajectories. First, the results of this code will be bench marked with experimental data of simplified field emitter array geometry not that of a display. Later, it will be applied to hypothetical display pixel geometry. We will discuss the properties of this software for these applications as well as the simulation resultsIEEE International Conference on Plasma Science 01/1997; DOI:10.1109/PLASMA.1997.605149
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ABSTRACT: Emotional, physiological and physical stress is associated with increased rates of cerebrovascular events and sudden deaths. The pathophysiology of stress-induced cardiomyopathy is not well understood. Proposed mechanisms for catecholamine-mediated stunning in stress cardiomyopathy include epicardial vasospasm, microvascular dysfunction, hyperdynamic contractility with midventricular or outflow tract obstruction, and direct effects of catecholamines on cardiomyocytes. Studies show evidence of significant heritable influences on individual responses to adrenergic stimulation. Data from such studies may be of help for a more accurate comprehension of clinical and morphological alterations of the heart. Irrespective of the cause, patients with the classic stress-induced cardiomyopathy morphology deserve special attention because this extensive distribution of wall motion abnormalities has implications for potential associated complications. Cardiac response may be significantly coupled to genetic differences at candidate loci that encode components of catecholamine biosynthesis, storage, and metabolic pathway. Given the role of the sympathetic nervous system in responses to acute stress, it is reasonable to explore whether genetically determined alterations in catecholamine system functions contribute to acute and chronic cardiovascular disorders such as stress-induced cardiomyopathy.Forensic science international 11/2009; 194(1-3):1-8. DOI:10.1016/j.forsciint.2009.10.025 · 2.12 Impact Factor