Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0392680 (shortness of breath)
 5,217 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 65-year-old man had bypass surgery 10 years previously with pulmonary artery catheter monitoring. Shortness of breath and mitral regurgitation necessitated repeat left and right heart catheterization using a pulmonary artery catheter. Before any iodinated contrast media exposure, the pulmonary artery catheter was inserted and within 2 min the patient developed anaphylaxis associated ventricular fibrillation. It was discovered that the pulmonary artery catheter used in the cath lab had a latex balloon and that the patient had been exposed to latex 10 years ago. Latex induced anaphylaxis is rarely considered in the differential diagnosis of patients with hypersensitivity reactions in the cath lab, intensive care unit, and operating room. The principal reason for failure to recognize the latex balloon as a potential allergen is that most health professionals are not aware that almost all pulmonary artery catheters contain a latex balloon. The risk of an allergic response to latex is 0.8% for the general population. Others at high risk include those who have had multiple surgical procedures and interventions with repeated latex exposure. Five to 10% of all U.S. health professionals and those performing household duties wearing latex gloves have an allergic response to latex. Latex hypersensitivity is an IgE dependent reaction, while iodinating contrast medium reaction is an IgE independent reaction. If latex hypersensitivity is suggested by pre-procedural history or if the patient falls into a high-risk group, pre-procedural skin testing and/or latex IgE radioallergosorbent (RAST) should be performed.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Latex versus iodinated contrast media anaphylaxis in the cardiac cath lab. 755 29

Sinus of Valsalva aneurysm (SVA) is a rare cardiac anomaly either presenting as a congenital heart disease or occurring secondary to cardiac surgical interventions. A 19-year-old male patient presented with chest pain and shortness of breath. On auscultation, a grade 4/6 early diastolic murmur was heard over the left lower sternal border and Erb's area with a thrill. Crepitating rales were heard over bilateral basal lung fields. The electrocardiogram showed right bundle branch block and ST depression. Troponin and CK-MB levels were increased. Shortly after admission, he developed ventricular fibrillation and was defibrillated three times. After restoration of hemodynamic stabilization, transthoracic echocardiography was performed, which showed grade 4 aortic regurgitation, patent foramen ovale, and an aneurysm of the sinus of Valsalva arising from the right coronary sinus, with rupture into the right ventricle. The patient underwent surgery under cardiopulmonary bypass, for repair of the ruptured SVA and patent foramen ovale and aortic valve replacement. He was discharged on the fifth postoperative day following an uneventful operation and postoperative course.
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PMID:Ruptured sinus of Valsalva aneurysm associated with aortic regurgitation and severe myocardial ischemia. 2120 Jan 22

We present an unusual case of ventricular fibrillation in a conscious patient symptomatic for chest pain and shortness of breath. Almost 20 years ago he underwent heterotopic cardiac transplantation for the treatment of severe idiopathic cardiomyopathy. In the precyclosporine era, this technique was extremely useful because of the high rate of graft rejection in which the maintenance of the native heart could prevent patient death. To date, with the improvements in immunosuppressive therapy, it is generally reserved to a specific subset of conditions. A coronary angiography and a cardiac MRI confirmed the diagnosis. Six months follow-up ECG was unchanged suggesting the persistence of a double heart rhythm in the same body.
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PMID:Stable ventricular fibrillation in a heterotopic heart transplant recipient. 2285 6

Transmyocardial laser revascularization (TMLR) is a new surgical technique clinically tested in patients with advanced severe coronary arteriosclerosis when classic routine treatment by medicaments, percutaneous transluminal coronary angioplasty (PTCA), or aorto-coronary bypass surgery does not improve symptoms of ischemic heart disease. During the procedure high-energy CO 2 laser performs 35-40 transmyocardial channels via left-sided thoracotomy. Channels are drilled from the epicardial side of the heart through the myocardium into the left ventricle cavity. Impulses are synchronized with EKG (diastole), the channel diameter is about 1 mm. Transmural laser penetration is confirmed by intraoperative transesophageal echocardiography (TEE). This technique is based on a theory that channels allow blood supply from left ventricle directly into the intramyocardial vessels (possibly capillaries) and so improve oxygenation of ischemic myocardium. Presented are gross and microscopic findings in a 75-year-old woman who suffered from classic class IV angina with shortness of breath. She had a history of an inferior myocardial infarct, ventricular tachyarrhythmia, aorto-coronary bypass, and mitral valvuloplasty. Her ejection fraction by echocardiography was 25%. Angiographically, she had multiple occlusions of native coronary arteries and diffuse distal stenosis in the graft of the left internal mammary artery (LIMA) to the left anterior descending coronary artery (LAD). Thirty six of forty laser pulses were confirmed by TEE as transmural. The patient died suddenly of ventricular fibrillation 5 days after TMLR surgery. The autopsy was performed 6 hours after death. After cross-sectioning of the heart all the laser-bored channels were found partially or completely filled by fibrin and cell infiltrate composed mainly of polymorphonuclear leukocytes. Patent channels were found within myocardial scars, channels performed through viable myocardium appeared to be partially collapsed and occluded.
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PMID:Transmyocardial laser revascularization: histopathological findings. 2599 64

Benign multinodular goitre is a common illness. When accompanied by obstructive symptoms, such as dyspnoea, it carries an indication for surgery. Benign multinodular goitres rarely cause acute airway obstruction. We report the case of a 88-year-old woman who presented with acute shortness of breath and stridor. A chest CT revealed marked enlargement of the thyroid gland, with an extensive intrathoracic component. She was proposed for total thyroidectomy. Her intraoperative course was unremarkable, but the patient passed away in postoperative period from ventricular fibrillation. Recognition of these cases is important, as they constitute a preventable cause of mortality if timely diagnosed and treated.
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PMID:Acute airway obstruction due to benign multinodular goitre. 3099 65

A 70-year-old woman was admitted to our hospital complaining of shortness of breath. She was diagnosed with acute decompensated heart failure due to left ventricular dysfunction. Her symptoms began to improve with standard therapy for heart failure with diuretics, noninvasive pressure ventilation, and inotropes, but paroxysmal atrial fibrillation and premature ventricular contractions (PVCs) occurred. After treatment with amiodarone, the number of PVCs decreased, and the left ventricular wall motion gradually improved. However, on day 28, ventricular fibrillation and cardiopulmonary arrest occurred suddenly, and she could not be resuscitated. She was diagnosed with giant cell myocarditis via an autopsy. The autopsy revealed diffuse inflammatory cells that comprised giant cells and eosinophils as well as cellular degeneration and necrosis. <Learning objective: We herein report a case of sudden cardiac death due to giant cell myocarditis diagnosed at an autopsy.>.
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PMID:Sudden cardiac death due to ventricular fibrillation in a case of giant cell myocarditis. 3254 58

Wolff-Parkinson-White syndrome is the most common form of ventricular preexcitation and affects 1-3 per 1,000 persons worldwide. Many patients remain asymptomatic throughout their lives; however, approximately half of the patients with Wolff-Parkinson-White syndrome experience symptoms secondary to tachyarrhythmias, such as paroxysmal supraventricular tachycardia, atrial fibrillation, atrial flutter, and, rarely, ventricular fibrillation and sudden death. Patients with Wolff-Parkinson-White syndrome may present with a multitude of symptoms such as unexplained anxiety, palpitations, fatigue, light-headedness or dizziness, loss of consciousness, and shortness of breath. We report the case of a patient who presented with a plethora of symptoms related to generalized anxiety along with several confounding factors such as psychosocial stressors, chronic fatigue secondary to high physical and mental demands at work, a strong family history of anxiety, and a history of substance abuse. Keeping cardiac dysrhythmia within his differential diagnosis allowed for accurate diagnosis and treatment.
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PMID:Wolff-Parkinson-White Syndrome: A Master of Disguise. 3269 72

A pneumonia outbreak with an unknown microbial etiology was reported in Wuhan, Hubei province of China, on December 31, 2019. This was later attributed to a novel coronavirus, currently called as severe acute respiratory system coronavirus 2 (SARS-CoV-2). Coronavirus disease 2019 (COVID-19) mainly affects the respiratory system and can also cause acute or chronic damage to the cardiovascular system. We present a case of a 64-year-old female with past medical history of diabetes mellitus and hypertension who presented to the Emergency Medicine Department with shortness of breath and worsening chest discomfort, then had a ventricular fibrillation (VF) arrest while in triage, in the context of COVID-19 diagnosis. Cardiovascular complications during the COVID-19 pandemic should be brought to medical attention; it is crucial that physicians be aware of the complications and treat it as an emergency.
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PMID:Sudden Cardiac Arrest at the Triage of Emergency Medicine Department in a Patient With COVID-19. 3330 6