Juniper Publishers Journal of Cardiology and Cardiovascular Therapy

JUNIPER PUBLISHERS - OPEN ACCESS JOURNAL OF CARDIOLOGY & CARDIOVASCULAR THERAPY   Abstract Introduction: We present the case of a man who remained symptomatic for angina despite percutaneous coronary intervention and optimized medical treatment. Description of the problem: A 72-years-old man with overweight, dyslipidaemia, hypertension and previously treated prostate cancer is referred for chest pain. After non-invasive evaluation (mild left ventricular hypertrophy -11mm-, no wall motion abnormalities and normal ejection fraction on the echocardiogram, and non-high-risk treadmill test), medical treatment is started for angina. However there is a poor response so an invasive coronariography is done. Severe stenosis in anterior descendent coronary is found and percutaneously treated. During the follow up, the patient remained moderately symptomatic for chest pain. Questions and problems: Despite that there was little suspicion of a stent restenosis or new obstructio...

JUNIPER PUBLISHERS - OPEN ACCESS JOURNAL OF CARDIOLOGY & CARDIOVASCULAR THERAPY   Abstract Myocardial ischemia/reperfusion injury is a major socioeconomic problem worldwide. Though there are wider advancements, still mortality rate is substantial. This can be overcome by exploring complete pathopysiology of the disease mechanism. High-mobility group box-1 (HMGB1) is recently explored multifunctional protein based on its location. The present short communication gives an idea on multiple biological activities of HMGB1. Introduction Myocardial infarction (MI) is the leading cause of death worldwide. Atherosclerotic plaque formation, blocks the coronary artery and there by leads to MI. Early reperfusion is required to salvage diseased myocardium. Reperfusion in turn damages the myocardium called as reperfusion injury ( Figure 1 ). Myocardial ischemia/reperfusion (I/R) injury aggravates the area of infarction. Though t...

JUNIPER PUBLISHERS - OPEN ACCESS JOURNAL OF CARDIOLOGY & CARDIOVASCULAR THERAPY   Abstract A 70-year-old gentleman presented with 8 months history of low grade fever and dyspnoea on exertion which worsened gradually. It was not associated with history of cough, weight loss and pedal edema. There was no prior significant chronic illness including bronchial asthma. Laboratory work-up revealed raised total leukocyte count with hypereosinophilia. Chest radiograph, lower limb venous Doppler, and computed tomography pulmonary angiogram were normal. Genetic testing for chronic eosinophilic leukemia was negative. However, IgG and IgM antibodies to filaria were raised. Echocardiogram showed right ventricular apical obliteration due to thrombus. Patient was started on Diethylcarbamazine and oral anticoagulants. He responded very favourably to treatment with improvement in symptoms, normalization of eosinophilia, and complete resolution of right ventricular apical throm...

JUNIPER PUBLISHERS - OPEN ACCESS JOURNAL OF CARDIOLOGY & CARDIOVASCULAR THERAPY   Abstract We present a patient with symptomatic multi-vessel ischemic heart disease requiring surgical intervention. The saphenous veins and radial arteries were unsuitable conduits and the ascending aorta was near porcelain. Six off-pump coronary artery bypass (OP-CAB) were performed utilizing five grafts derived from the basilic-cephalic veins and one from the internal mammary artery. Coronary angiography one year later showed complete patency of all the grafts. Introduction The choice of conduits for coronary artery bypass grafting (CABG) includes arterial and venous options with the most common combination being the internal mammary artery (IMA) and greater saphenous vein (GSV). Additional bypass conduits include the radial artery (RA), gastroepiploic artery (GEA), and lesser saphenous vein [ 1 ]. On rare occasions, cadaver vein is used as a last resort ...

JUNIPER PUBLISHERS - OPEN ACCESS JOURNAL OF CARDIOLOGY & CARDIOVASCULAR THERAPY   Abstract Isolated left atrial appendage ostial stenosis has been previously described. The clinical implications of this anomaly are uncertain. The relative stasis behind ostial stenosis may result in systemic embolization, particularly stroke. We report the case of a 55 years old woman who has left atrial appendage ostial stenosis. She was admitted for radiofrequency catheter ablation of atrial flutter. We present this case to discuss whether life-long anticoagulation would be necessary for stroke prevention after successful radiofrequency catheter ablation Keywords: Left atrial appendage ostial stenosis; Transesophageal echocardiogram; Anticoagulation; Stroke prevention Abbreviations: AFL: Atrial Flutter; AF: Atrial Fibrillation; LVOT: Left Ventricular Outflow Tract; RFCA: Radiofrequency Catheter Ablation; TEE: Transesophageal Echocardiogram; LAA: Left Atrial Appendage ...

JUNIPER PUBLISHERS - OPEN ACCESS JOURNAL OF CARDIOLOGY & CARDIOVASCULAR THERAPY   Abstract Chest pain (CP) in children is a common complaint encountered by many health care providers in deferent sittings. The causes of pediatric CP are largely benign in etiology. However, the possibility of a cardiac cause must always be entertained. Certain information gathered during the initial evaluation can help identify patients with increased risk for cardiovascular disease necessitating a more extensive workup. Multiple risk factors and physical exam findings were found to be associated with an increased likelihood of cardiac etiology in children presenting with CP. Knowledge of these “red flags” can help the evaluating physician to risk stratify patients and decide on the appropriate disposition. Keywords: Chest pain; Red flags; Children; Sudden death; HCM Introduction Chest pain (CP) is a relatively common complaint in the pediatric po...

JUNIPER PUBLISHERS - OPEN ACCESS JOURNAL OF CARDIOLOGY & CARDIOVASCULAR THERAPY   Introduction Among US adults aged 18 years or older, the prevalence of metabolic syndrome (MetS) rose by more than 35% from 1988-1994 to 2007-2012, increasing from 25.3% to 34.2% [ 1 ]. Overweight and obesity - major component of MetS are reaching record-high levels. From 2000 to 2013, the global prevalence of overweight and obesity increased by one-quarter among adults and by nearly half among children; by 2013, more than 2 billion people were overweight, and of these, more than 674 million were obese [ 2 ]. In 2010, overweight and obesity were estimated to cause 3.4 million deaths worldwide [ 3 ], a number that is likely to increase in line with rising overweight and obesity rates; the annual health care costs attributable to obesity and overweight are more than $600 billion [ 4 ]. People with the MetS are at increased risk of a cardiovascular disease, such as coronary heart disease o...

JUNIPER PUBLISHERS - OPEN ACCESS JOURNAL OF CARDIOLOGY & CARDIOVASCULAR THERAPY Abstract Reverse cholesterol transport in the arterial wall was first postulated in 1981. In the last 36 years, great strides have been made in identifying the factors which cause impedance and diminished access of cholesterol laden high density lipoprotein (HDL) and foam cells to the lymphatic circulation. Initiating factors are endothelial dysfunction, oxidation of cholesterol, inflammation, monocyte migration and expression of cytokines and chemokines that inhibit cholesterol transfer and lymphatic access. Lymphatic vessels are intimately involved in this inflammatory process and the lymphatic flow is dependent on constriction, spasm, sclerosis, fluidity and external physical compression. Lifestyle changes in stress reaction, exercise and diet can profoundly influence this process. Opinion The lymphatic circulation as the pathway for reverse cholesterol trans...