Andre Ghantous

Endocarditis Complicating Central Venous Catheter Bloodstream Infections: A Unique Form of Health Care Associated Endocarditis

Endocarditis complicating central venous catheter blood stream infection (CVC‐BSI) is a serious complication and is being seen with increasing frequency.

Long-term Outcome of Tako-tsubo Cardiomyopathy

BACKGROUND Current data suggest an excellent outcome for patients with Tako-tsubo cardiomyopathy (TC). The objectives of this study were to evaluate the long-term outcome and the prognostic implication of thrombolysis in myocardial infarction myocardial perfusion grade (TMPG) in patients with TC. METHODS Retrospective analysis of all patients diagnosed with TC at our hospital between 2003 and 2008. RESULTS During the five-year period, we identified 27 patients with TC out of 1374 cases of emergent left heart catheterisation (2%). Mean follow-up was 27 ± 16 months. The majority were Caucasian (81%) female (96%), postmenopausal (96%), with a mean age of 68 ± 14 years. A precipitating stressor event was found in 74% of the patients, 30% being gastrointestinal triggers. Fourteen patients (52%) reached a combined end point of all cause death, cardiogenic shock, sudden cardiac death and rehospitalisation for cardiac reasons. TMPG was abnormal in 37% cases with no correlation with the outcome. CONCLUSIONS The long-term outcome of patients with TC is worse than previously reported. TMPG does not correlate with the outcome in TC.

Coronary artery aneurysms.

Aneurysmal coronary artery disease is frequently encountered in clinical cardiology practice. Although more commonly associated with atherosclerosis, a variety of other acquired (eg, inflammatory, infectious, iatrogenic) or congenital causes have been identified. Recent research on the pathogenesis of coronary aneurysms has yielded interesting results. Advances in imaging have also provided new insights as to the nature of angiographic coronary aneurysms. Critical assessment of the abnormal flow dynamics and pathophysiology of aneurysms has been performed and there is an improved understanding of the associated complications. We present an extensive review of the recent literature highlighting the major advances in the field.

Spontaneous aortic thrombosis and embolization: antithrombin deficiency and the work-up of hypercoagulable states

The Case: A previously healthy 24-year-old man presented to the emergency department with sudden onset of severe periumbilical and right costovertebral pain accompanied by nausea and vomiting. His vital signs, including oxygen saturation, were normal. His physical exam was remarkable for decreased