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Showing posts from January, 2022

Images in Cardiology -Skin Lesions in Native Valve Infective Endocarditis-Juniper Publishers

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JUNIPER PUBLISHERS - OPEN ACCESS JOURNAL OF CARDIOLOGY & CARDIOVASCULAR THERAPY Introduction Janeway’s lesions are non tender small erythematous or hemorrhagic macular or nodular lesions on the palms or soles; they rarely present as a diffuse rash, and are rare in clinical practice [ 1 ]. Possibly the lesions are the result of septic micro emboli that originate from the endocardium, a fact that has been substantiated by histopathological studies in the literature [ 2 ]. Pathologically, the lesion is described to be a micro abscess of the dermis with marked necrosis and inflammatory infiltrate [ 3 ]. However Osler’s nodes are painful, erythematous nodules on the pads of the fingers and toes are more commonly seen in patients with subacute bacterial endocarditis. It is believed that the nodes are caused by an immunologically-mediated vasculitis caused by circulating immune complex deposition in the skin [ 4 ]. A 20 year old man presented with high grade fever w

Targeted Pharmacological Heme-Oxygenase-1 Induction as a Therapy for Diabetes-Juniper Publishers

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JUNIPER PUBLISHERS - OPEN ACCESS JOURNAL OF CARDIOLOGY & CARDIOVASCULAR THERAPY Abstract Diabetes has emerged as a major threat to health worldwide. The exact mechanisms underlying the disease are unknown; however, there is growing evidence that excess generation of reactive oxygen species (ROS), causes oxidative stress in various organs. In diabetic patients, oxidative stress is closely associated with chronic inflammation and plays a key role in the pathogenesis of micro-and macrovascular diabetic complications. Redox reactions associated with carbon monoxide (CO) metabolism play key roles in intra- and inter-cellular signaling. Cells produce significant amounts of CO as a product of cellular metabolism, largely from heme degradation catalyzed by microsomal heme oxygenases (HOs) generating CO, biliverdin, bilirubin and iron. This review focuses on the importance of both HO-1/CO system in the pathophysiology and therapy of inflammation associated with diabetes. Rese

Recurrent Spontaneous Stent Fracture in a Case of Takayasu Arteritis Treated Successfully with Supera Stent System-Juniper Publishers

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JUNIPER PUBLISHERS - OPEN ACCESS JOURNAL OF CARDIOLOGY & CARDIOVASCULAR THERAPY Abstract Purpose: To report a case of recurrent spontaneous left subclavian stent fracture in a patient with Takayasu arteritis (TA). The patient subsequently had recurrent in-stent restenosis (ISR) which was treated successfully with Supera peripheral stent system. Case report: A middle aged female with Takayasu arteritis with symptomatic left subclavian long segment occlusion underwent percutaneous transluminal angioplasty with stenting. Recurrent intraprocedural stent fracture and deformity was noted. Recurrence of symptoms was later treated successfully with Supera peripheral stent system. Conclusion: Takayasu arteritis with long segment occlusions may yield poorly to balloon dilatation and may result in stent deformity. Stents with high radial force, like Supera, may result in better outcomes. Keywords: Takayasu arteritis; Stent fracture; Supera; PTA

Acute Myocardial Infarction Associated with Severe Fatal Ulcerative Colitis-Juniper Publishers

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JUNIPER PUBLISHERS - OPEN ACCESS JOURNAL OF CARDIOLOGY & CARDIOVASCULAR THERAPY Abstract A case of acute myocardial infarction (MI) in a young woman presenting with first episode of ulcerative colitis (UC) is presented. The patient had a rapidly deteriorating clinical course with a fatal outcome. The cardiac manifestations of ulcerative colitis and its association with myocardial infarction is discussed. Introduction Inflammatory bowel diseases (IBD) include Ulcerative colitis (UC) and Crohn’s disease (CD). Both the conditions may present with a variety of extra-intestinal manifestations. Myocarditis and pericarditis are the most common cardiac manifestations of ulcerative colitis (UC). UC also predisposes to arterial and venous thromboembolic complications. A few cases of myocardial infarction (MI) in association with UC have been reported. However, the association between UC and MI is uncertain. We report a case of a

Fibrinolytic Therapy with tPA Failed Because it was Based on a Flawed Concept-Juniper Publishers

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JUNIPER PUBLISHERS - OPEN ACCESS JOURNAL OF CARDIOLOGY & CARDIOVASCULAR THERAPY Abstract Fibrinolytic therapy has become synonymous with tPA based on the belief that tPA alone was responsible for natural fibrinolysis. Although this assumption was belied from the outset by disappointing clinical results, it persisted, eventually causing fibrinolysis to be discredited and replaced by an endovascular procedure. Since time to reperfusion is the critical determinant of outcome, which in acute myocardial infarction (AMI) means within two hours, a time-consuming hospital procedure is ill-suited as first line treatment. For this purpose, fibrinolysis is better suited. The assumption that tPA is responsible for fibrinolysis is contradicted by published findings. Instead, tPA initiates fibrinolysis which is continued by urokinase plasminogen activator (uPA) which has the dominant effect. tPA and uPA gene deletion and clot lysis studies showed the activators to have complementa