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ABSTRACT: A young woman who presented with chest pain was shown with CT and selective coronary angiography to have spontaneous dissections of her left anterior descending and distal right coronary arteries. She was managed with enoxaparin, aspirin, clopidogrel and metoprolol: she was well with a normal stress echocardiogram fourteen months later. Surgical intervention or angioplasty and stent deployment may be avoided in such patients if they are clinically stable.
Heart Lung & Circulation 11/2010; 19(11):678-80. · 1.20 Impact Factor
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ABSTRACT: Kaposi's sarcoma is a relatively rare but potentially fatal malignancy which affects immunosuppressed individuals. It has been found to occur especially in association with cyclosporine and tacrolimus use and with concurrent cytomegalovirus infection. When detected and treated early, it usually carries a good prognosis and responds well to measures increasing immunocompetence. We report a case of cutneous Kaposi's sarcoma occurring in a cardiac transplant patient treated with tacrolimus.
Heart Lung & Circulation 11/2006; 15(5):340-1. · 1.20 Impact Factor
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ABSTRACT: Portopulmonary hypertension is a poorly understood and uncommon complication of advanced chronic liver disease. Current therapy is based largely on treatment options proven in idiopathic pulmonary hypertension. The severity of the portopulmonary hypertension should best be attenuated medically before attempting combined liver and lung transplantation to avoid increased peri-operative mortality. This case report describes the successful use of sildenafil to decrease the pulmonary vascular resistance in a patient with hepatitis-C cirrhosis who was preparing for liver transplantation.
The Journal of Heart and Lung Transplantation 05/2005; 24(4):498-500. · 4.33 Impact Factor
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ABSTRACT: We present a case study of a truck driver with sinus node dysfunction diagnosed with the help of an implantable loop recorder more than 18 months after implantation. This case emphasizes that cardiogenic syncope may be very infrequent and its diagnosis can be elusive despite extensive testing.
Pacing and Clinical Electrophysiology 05/2005; 28(4):346-7. · 1.35 Impact Factor
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ABSTRACT: Severe refractory angina pectoris can occur in end-stage coronary artery disease despite maximal medical and revascularization therapy. Spinal cord stimulation is an under-utilized but well-established modality for the treatment of intractable angina pain.
To illustrate the practical, beneficial and effective use of spinal cord stimulation as a treatment option for refractory angina in a local context.
A case series clinical audit of 11 patients with refractory angina treated with spinal cord stimulation over a one-year period was carried out. Baseline, three-month, six-month and two-year functional assessment data and subjective patient reports on their symptoms were evaluated.
Spinal cord stimulation improves six-minute walk distance, exercise duration, New York Heart Association functional class, Likert score, and number of angina free days per week for at least one year over two years of follow-up.
Spinal cord stimulation is an effective medium-term treatment option for refractory angina pectoris with significant benefits to functional parameters and patient symptoms. Spinal cord stimulation is an under-utilized but well-established modality for the treatment of intractable angina pain. We report a small case series clinical audit of patients who gained significant functional and symptomatic benefits from this treatment.
Heart Lung & Circulation 04/2005; 14(1):3-7. · 1.20 Impact Factor
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ABSTRACT: A 71-year-old man presented with fever and positive blood cultures for methicillin-sensitive Staphylococcus aureus 4 days after an uncomplicated intra-luminal abdominal aortic aneurysm repair. Investigations looking for a source of sepsis including computerized tomography scans, transoesophageal echocardiography, a bone scan and repeated chest X-rays, did not reveal an infective focus. Gallium(67) scintigraphy, however, showed a focus of tracer uptake in the region of the aorto-cardiac junction consistent with the presence of an abscess. Coronary angiography later opacified an aneurysmal cavity arising from the right sinus of Valsalva which was confirmed to be a mycotic aneurysm on thoracotomy. This is a rare case of early detection of a cardiac mycotic aneurysm by Gallium(67) scintigraphy.
Heart Lung & Circulation 04/2004; 13(1):101-5. · 1.20 Impact Factor
