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ABSTRACT: No-reflow is a serious condition, and is associated with substantial morbidity and mortality after percutaneous coronary intervention. The most feared complication of no-reflow is a case of no-reflow that is resistant to multiple drug therapy. This condition usually occurs in patients with distal coronary disease or high thrombus burden. In the present case, a patient with resistant no-reflow that could be reversed by distal intracoronary administration of very high doses of adenosine (1 mg) is described. Administration of very high doses of adenosine via a balloon catheter was safe and did not cause any changes in the heart rate or blood pressure. The present case is the first to be reported in the literature.
Experimental and clinical cardiology 02/2008; 13(3):141-3. · 0.58 Impact Factor
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ABSTRACT: Changes due to biventricular pacing have been documented by shortening of QRS duration and echocardiography. Compared to normal ventricular activation, the presence of left bundle branch block (LBBB) results in a significant change in cardiac cycle time intervals. Some of these have been used to quantify the underlying cardiac dyssynchrony, assess the effects of biventricular pacing, and guide programming of ventricular pacing devices. This study evaluates a simple noninvasive method using accelerometers attached to the skin to measure cardiac time intervals in biventricularly paced patients.
Ten patients with biventricular pacemakers previously implanted for congestive heart failure were paced in the AAI mode, then in atrioventricular (AV) sequential mode from the right and left ventricles followed by biventricular pacing. Simultaneous recordings were obtained by 2D, Doppler echocardiography as well as by accelerometers. Similar recordings were obtained from 10 gender, aged matched, normal controls during sinus rhythm.
Compared to normals, heart failure patients paced in AAI mode had prolonged isovolumetric contraction time (IVCT), shorter ventricular ejection time (LVET), and prolonged isovolumetric relaxation (IVRT). With biventricular pacing the IVCT decreased, but the LVET and IVRT did not change significantly. There was excellent correlation between the echo and accelerometer-measured intervals.
Shortening of the IVCT measured by an accelerometer is a consistent time interval change due to biventricular pacing that probably reflects more rapid acceleration of left ventricular ejection. The accelerometer may be useful to assess immediate efficacy of biventricular pacing during device implantation and optimize programmable time intervals such as AV and interventricular (VV) delays.
Pacing and Clinical Electrophysiology 01/2008; 30(12):1476-81. · 1.35 Impact Factor
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ABSTRACT: Congenital quadricuspid aortic valves (QAVs) are rare phenomena. They are often associated with aortic insufficiency and significant morbidity. A QAV with an associated ascending aortic aneurysm is extremely rare, and these conditions might have a shared embryonic etiology. We describe the case of a patient with a QAV associated with aortic aneurysm. Pertinent literature on the QAV is reviewed, and embryological factors that may contribute to its pathogenesis are discussed.
Cardiovascular pathology: the official journal of the Society for Cardiovascular Pathology 11/2007; 18(1):49-52. · 1.63 Impact Factor
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The Journal of invasive cardiology 03/2005; 17(2):94-5. · 1.84 Impact Factor
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ABSTRACT: This study examined the changes in brachial artery diameter and flow velocity in response to intravenous adenosine and compared the results to cuff occlusion and single-photon emission computed tomographic (SPECT) images. The change in diameter was less with adenosine than with cuff occlusion. There was no correlation between the presence of abnormal SPECT images and the responses to adenosine or cuff occlusion in either diameter or flow velocity.
The American Journal of Cardiology 02/2005; 95(2):304-7. · 3.37 Impact Factor
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ABSTRACT: This study is the first attempt to evaluate the prevalence of diabetes mellitus and related conditions in Asian Indians living in the United States. A community-based survey of 1,046 Asian Indian immigrants living in and around the Atlanta metro area of Georgia was conducted and found an overall prevalence of diabetes mellitus of 18.3% (22.5% in men and 13.6% in women). This prevalence of diabetes mellitus in Asian Indians is much higher than in whites, blacks, and Hispanics living in the United States.
The American Journal of Cardiology 11/2004; 94(7):977-80. · 3.37 Impact Factor
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ABSTRACT: We describe an adult patient, in whom three-dimensional transesophageal echocardiography was able to make a definitive diagnosis of cor triatriatum associated with common atrium. The lesion mimicked a classical partial atrio-ventricular septal defect on both transthoracic and transesophageal two-dimensional echocardiography. We found only two cases in the literature describing the existence of cor triatriatum with common atrium, none diagnosed by echocardiography.
Echocardiography 05/2004; 21(3):303-6. · 1.24 Impact Factor
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ABSTRACT: Right coronary artery to coronary sinus fistula is a rare anomaly. We present a unique case of an adult patient with multiple fistulae from the right coronary artery draining into the coronary sinus near the posterior left atrium-left ventricle junction, first suspected by transthoracic two-dimensional echocardiography. The multiple openings were not seen by any invasive or noninvasive techniques and were noted only at the time of surgery. To our knowledge, this is the first case of multiple fistulae connecting the right coronary artery to the coronary sinus that has been reported in the English literature.
Echocardiography 03/2004; 21(2):199-202. · 1.24 Impact Factor
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ABSTRACT: We report three-dimensional echocardiographic delineation of a congenital aneurysm of the membranous interventricular septum causing right ventricular outflow tract obstruction in an adult patient. To our knowledge, these findings have not been described before.
Echocardiography 02/2004; 21(1):95-7. · 1.24 Impact Factor
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ABSTRACT: This study is the first attempt to assess the prevalence of stroke and associated risk factors in Asian Indians living in the United States. The overall prevalence of stroke is 2.77% (men 3.72% and women 1.77%). Stroke was significantly associated with systemic hypertension, diabetes mellitus, coronary artery disease, end-stage renal disease, and family history of stroke and myocardial infarction.
The American Journal of Cardiology 02/2004; 93(2):267-9. · 3.37 Impact Factor
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ABSTRACT: We describe two patients in whom mitral valve prosthetic inflow mimicked severe aortic regurgitation. Repeat transthoracic echocardiography using multiple transducer angulations and a narrow color Doppler sector angle in one patient and a color Doppler M-Mode study in the second patient proved useful in excluding the presence of severe aortic regurgitation.
Echocardiography 02/2004; 21(1):99-102. · 1.24 Impact Factor
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The American Journal of Geriatric Cardiology 12(1):60-2. · 1.04 Impact Factor
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The American Journal of Geriatric Cardiology 11(6):410-1. · 1.04 Impact Factor
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The American Journal of Geriatric Cardiology 12(5):329-32. · 1.04 Impact Factor
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The American Journal of Geriatric Cardiology 12(2):113-6. · 1.04 Impact Factor
