Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0036690 (sepsis)
 59,461 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Thirty-two intracardiac myxoma patients who underwent tumor excision in Srinagarind Hospital between January 1, 1983 and January 30, 1997 were retrospectively reviewed. Clinical presentations, diagnostic method, operative findings, and postoperative course were also analysed. There were 20 female and 12 male patients, age range 10 to 60 years (mean 37.9). Clinical presentations included congestive heart failure (56.2%), atypical chest pain (25.0%), syncope (18.9), and constitutional symptoms (9.3%). In six patients, there was clinical evidence of systemic embolism. One patient was essentially asymptomatic and incidentally detected during clinical check-up. Diagnosis was all made by two dimensional (2-D) echocardiographic study. There were 29 left atrial, 2 right atrial and 1 combined right atrial and right ventricular myxomas. There were 3 postoperative deaths, two due to septicemia and the other due to cerebral embolism. One patient developed postoperative severe mitral regurgitation and complete heart block needed mitral valve replacement and permanent pacemaker insertion. One patient developed localized seizure 6 years after resection and was suspected of brain metastasis. The other was found to have two high echogenic liver masses, 2 years after resection, suggestive of hepatic metastasis. Unfortunately, we could not obtain the histologic confirmation from any of those suspected lesions. Because of the non-specific and various manifestations of atrial myxoma, a high index of suspicion is needed. The diagnostic method of choice is 2D-echocardiography. Clinical follow-up for at least 10 years may be needed to rule out recurrence or metastasis.
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PMID:Atrial myxoma: a review of clinical experience at Srinagarind Hospital. 1008 16

Sixteen years after a long admission for a serious occupational accident, a 38-year-old man presented with intermittent atypical chest pain. Upon investigations a retained fragment of a pulmonary artery catheter was found in the right ventricle. Throughout the years between his accident and the current presentation he did not have any symptoms or signs of complications associated with the retained catheter such as arrhythmia, sepsis or thromboembolism. Upon presenting his case at the medical/surgical multidisciplinary meeting it was decided that the probability of complications occurring at this stage was low as the catheter fragment would have endothelialised and the risk of retrieval would outweigh the benefits. This scenario highlighted the importance of understanding the possible long-term complications of retained catheter fragments, the importance of being aware of the limitation of these devices and the need to be more vigilant in the emergency setting.
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PMID:A retained pulmonary artery catheter fragment incidentally found lodged in the right heart 16 years after its insertion. 2353 21

Elevated troponin and atypical chest pain in the setting of septicemia and Type II Non ST elevation myocardial infarction is frequently encountered. These cases are not necessarily scheduled for emergent cardiac catheterization. High index of clinical suspicion and continuous in-patient cardiac monitoring with serial trending of cardiac enzymes are important in such cases. Subsequent sudden development of electrocardiogram changes requires prompt investigation with emergent coronary catheterization. These types of cases may be missed especially in females who present with atypical chest pain and in patients with Left bundle branch block.
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PMID:Elevated troponin and left bundle branch block in the setting of suspected septicemia and demand ischemia: to treat or not to treat. 3009 Feb 18