Publications by authors named "Debanik Chaudhuri"

27 Publications

  • Page 1 of 1

tricuspid valve infective endocarditis.

Proc (Bayl Univ Med Cent) 2022 7;35(4):522-523. Epub 2022 Apr 7.

Department of Cardiology, State University of New York Upstate Medical University, Syracuse, New York.

is an alpha-hemolytic, gram-positive coccus that is responsible for 54/1,000,000 cases of all urinary tract infections. Risk factors include male gender, advanced age, and genitourinary tract abnormalities. It has often been misidentified as or due to its morphological similarities. Fewer than 50 cases of infective endocarditis have been reported, most affecting the mitral or aortic valve. We present the case of a 61-year-old woman who presented with recurrent fevers and worsening dyspnea on exertion and was found to have bacteremia. A transesophageal echocardiogram showed evidence of moderate tricuspid valve regurgitation and vegetations involving its posterior and septal leaflets. The patient was successfully treated with intravenous penicillin G for 6 weeks. She was not deemed a candidate for cardiac surgery.
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http://dx.doi.org/10.1080/08998280.2022.2054042DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9196797PMC
April 2022

Invasive Lipoma of the Interventricular Septum, a Rare Benign Cardiac Mass With Atypical Presentation and Management.

J Investig Med High Impact Case Rep 2022 Jan-Dec;10:23247096221104469

SUNY Upstate Medical University, Syracuse, NY, USA.

Lipoma of the interventricular septum involving the tricuspid valve is a rare entity. A 50-year-old woman presented with exertional dyspnea. She was found to have a large right interventricular septal mass in the initial transthoracic echocardiography. This mass was further investigated by transesophageal echocardiography, cardiac gated CT, and cardiac magnetic resonance imaging. It was found to be lipomatous and embedded into the septal leaflet of the tricuspid valve. The diagnosis was confirmed by biopsy. Surgical exploration revealed that the mass was deeply embedded in the interventricular septum and septal leaflet of the tricuspid valve. The mass was resected along with sections of the interventricular septum and tricuspid valve. She underwent bioprosthetic tricuspid valve placement and patch reconstruction of the interventricular septum. We also searched case reports from MEDLINE and studied pathological and epidemiological characteristics of the published cases of cardiac masses in the past year. Cardiac lipoma although a benign tumor can cause serious hemodynamic complications. Initial transthoracic echocardiography followed by multimodality imaging is the cornerstone of the diagnosis.
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http://dx.doi.org/10.1177/23247096221104469DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9218626PMC
June 2022

The association of hyponatremia and clinical outcomes in patients with acute myocardial infarction: a cross-sectional study.

BMC Cardiovasc Disord 2022 06 18;22(1):276. Epub 2022 Jun 18.

Division of Cardiology, SUNY Upstate Medical University, Syracuse, NY, 13210, USA.

Introduction: Hyponatremia is a common electrolyte abnormality that has been associated with poor outcomes in several conditions including acute myocardial infarction (AMI). However, those studies were performed in the era before percutaneous coronary intervention (PCI), focused mostly on ST-elevation myocardial infarction (STEMI), and sodium levels up to 72 h of admission. The purpose of this study was to identify the association between hyponatremia and clinical outcomes in patients with acute myocardial infarction.

Methods: We performed a retrospective analysis of patients with a diagnosis of non-ST-elevation myocardial infarction (NSTEMI) and STEMI presenting at our institution from March 2021 to September 2021. Our independent variables were sodium levels on the day of admission and up to 7 days later. Dependent variables were in-hospital mortality, 30-day mortality, length of hospital stay, intensive care admission, new heart failure diagnosis, and ejection fraction.

Results: 50.2% of patients had hyponatremia up to 7 days of admission. Intensive care admission was higher in patients with hyponatremia up to7 days (69.7% vs 54.3%, P 0.019, OR 1.9), they had worse 30-day mortality (12.7% vs to 2.2%, P 0.004, OR 6.5), in hospital mortality (9.9% vs 1.1%, P 0.006, OR 9.9), and new heart failure diagnosis (31.5% vs 17.9%, P < 0.043, OR 2.1). Hyponatremia on admission was associated with in-hopital mortality (16.3% vs 3.8%, P 0.004, OR 4.9), 30-day mortality (18.4% vs 5.9%, P 0.017, OR 3.5).

Conclusions: This study suggests that hyponatremia on admission and at any point during the first seven days of hospitalization are associated with in-hospital and 30-day mortality.
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http://dx.doi.org/10.1186/s12872-022-02700-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9206366PMC
June 2022

Displaced AICD Lead Presenting as Hiccups: A Rare Complication.

J Investig Med High Impact Case Rep 2022 Jan-Dec;10:23247096221103380

State University of New York Upstate Medical University, Syracuse, USA.

Ventricular fibrillation can lead to sudden cardiac death. Automatic implantable cardioverter defibrillator (AICD) devices have shown to be highly successful in the termination of these arrhythmias and are a first-line modality of treatment for the prevention of sudden cardiac death. We present the case of a 69-year-old female with a history of paroxysmal atrial fibrillation on anticoagulation with apixaban and rate controlled with metoprolol who presented from home with a chief complaint of hiccups. She had a prior admission to the hospital after she was found to have monomorphic ventricular tachycardia during a nuclear stress test. A cardiac work-up including cardiac catheterization and cardiac magnetic resonance imaging did not show any evidence of significant coronary artery disease or reversible cardiomyopathy. The patient underwent successful placement of a single chamber ICD and was discharged home. Twelve weeks after placement of the AICD, the patient was lifting furniture and experienced sudden onset of hiccups. A chest X-ray showed displacement of the AICD lead from the right ventricular apex to the superior vena cava. The patient underwent lead repositioning with complete resolution of her hiccups. The etiology hiccups was suspected to be secondary to irritation of the right phrenic nerve which travels along the anterolateral border of the superior vena cava. We present the case of hiccups following ICD lead displacement. This serves to highlight a rare complication of ICD displacement that healthcare providers should consider when patients with recently placed ICD devices complain of hiccups.
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http://dx.doi.org/10.1177/23247096221103380DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9201358PMC
June 2022

Catheter-Directed Thrombectomy: An Alternative in Massive Pulmonary Embolism.

Case Rep Cardiol 2022 11;2022:3562017. Epub 2022 Apr 11.

Division of Cardiology, SUNY Upstate Medical University, Syracuse, NY 13210, USA.

Massive pulmonary embolism (PE) is a life-threatening condition. The mainstay treatment is thrombolysis. Catheter-directed thrombectomy involves a group of new techniques that appear to have relatively low complications and mortality. These techniques have so far been studied mostly in submassive PE. We present a patient with massive PE that was successfully treated with catheter-directed thrombectomy.
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http://dx.doi.org/10.1155/2022/3562017DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9017483PMC
April 2022

Heart Failure as the Initial Presentation of Anomalous Left Coronary Artery From the Pulmonary Artery.

J Investig Med High Impact Case Rep 2022 Jan-Dec;10:23247096221084909

Upstate University Hospital, Syracuse, NY, USA.

Coronary arteries arising from the pulmonary artery have an incidence of 0.002% in the general population. We present a 29-year-old woman who presented to our hospital with acute decompensated heart failure and atrial fibrillation with a rapid ventricular rate. She underwent a cardiac catheterization to rule out ischemic disease, which revealed retrograde contrast flow through the left coronary artery from the right coronary artery. A coronary computed tomography (CT) angiogram was pursued which showed the presence of an anomalous left coronary artery arising from the pulmonary artery (ALCAPA). For the management of her atrial fibrillation, she was electrically cardioverted. She was discharged on guideline-directed medical therapy for her heart failure, with a cardiac surgery referral for the surgical fixation of her ALCAPA.
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http://dx.doi.org/10.1177/23247096221084909DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8943460PMC
May 2022

Asymptomatic Tumor Thrombus in the Left Atrium from Squamous Cell Carcinoma.

Case Rep Med 2021 21;2021:4256471. Epub 2021 Dec 21.

Department of Medicine, SUNY Upstate Medical University, Syracuse, NY, USA.

A 67-year-old female patient presented asymptomatically for further evaluation of a chest mass. Other than significant smoking history, the patient had been healthy with a recently treated case of uncomplicated pneumonia. The mass originated in the aortopulmonary window of the left mediastinum and invaded proximally into the left superior pulmonary vein and subsequently into the left atrium. The mass protrusion into the mitral valve occupied 50% of the left atrium space but showed no clinical symptoms of a valvular blockade. Poorly differentiated squamous cell carcinoma was identified upon biopsy. These findings of a primary lung tumor with atrial extension in an asymptomatic patient point to the importance of age-appropriate screening and standardization treatment modalities.
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http://dx.doi.org/10.1155/2021/4256471DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8714348PMC
December 2021

A Case Report of Cardiac Amyloidosis Highlighting the Importance of Strain Analysis.

Case Rep Cardiol 2021 12;2021:5673364. Epub 2021 Oct 12.

Division of Cardiology, SUNY Upstate Medical University, Syracuse, NY 13210, USA.

Cardiac involvement in light-chain (AL) amyloidosis has a high mortality. Once cardiac symptoms are present, it is important to make a diagnosis as there is an inverse relationship between mortality and time of diagnosis. Echocardiography is usually one of the first tests performed. But strain analysis, which can provide important clues, is not routinely performed. This is a case of AL amyloidosis presenting with heart failure in which echocardiographic strain analysis was vital for its diagnosis.
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http://dx.doi.org/10.1155/2021/5673364DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8526272PMC
October 2021

Management of Life-Threatening Bleeding in Patients With Mechanical Heart Valves.

Cureus 2021 Jun 13;13(6):e15619. Epub 2021 Jun 13.

Interventional Cardiology, State University of New York (SUNY) Upstate Medical University, Syracuse, USA.

Valvular heart disease is common in the United States, with a number of patients undergoing valve replacement procedures every year. The two types of valve prostheses include mechanical and bioprosthetic valves. Mechanical heart valves require lifelong anticoagulation with vitamin K antagonists like warfarin. The clinicians are often faced with the dilemma of major bleeding episodes such as intracranial hemorrhage or gastrointestinal bleeding in these patients. The management includes reversing warfarin-induced coagulopathy with vitamin K supplementation, fresh frozen plasma, or prothrombin complex concentrate (PCC), with PCC being the treatment of choice. With regard to the safe resumption of anticoagulation, guidelines are silent, and data is limited to case reports/series. This article reviews the present literature for the management of bleeding in patients with mechanical heart valves and the safe duration for holding off anticoagulation with minimal risk of valve thrombosis/thromboembolism.
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http://dx.doi.org/10.7759/cureus.15619DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8276624PMC
June 2021

Very Late Stent Thrombosis due to Possible Epinephrine-Induced Transient Vasospasm.

Am J Ther 2021 Jul 13. Epub 2021 Jul 13.

Department of Internal Medicine, SUNY Upstate, Syracuse, NY Department of Cardiology, SUNY Upstate, Syracuse, NY.

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http://dx.doi.org/10.1097/MJT.0000000000001429DOI Listing
July 2021

Traumatic aortic root rupture leading to acute aortic regurgitation and acute type A aortic dissection.

Echocardiography 2021 07 10;38(7):1195-1200. Epub 2021 Jun 10.

Department of Radiology, SUNY Upstate Medical University, Syracuse, NY, USA.

A 17-year-old male sustained a blunt thoracic trauma after he had a dirt bike accident. He was admitted for the management of multiple fractures, was hemodynamically stable, and presented without any cardiac symptoms. The patient underwent transthoracic echocardiography and CT angiogram of the thorax as the workup of possible cardiac injury as he had a new aortic regurgitation murmur, troponin rise, and a new RBBB. Imaging showed aortic root rupture, type A aortic dissection involving aortic root and proximal ascending aorta, and acute severe aortic regurgitation, not typically seen with blunt thoracic trauma. The patient was immediately taken to the operating room, underwent a surgical aortic valve and root replacement with the Bentall procedure, and had a good outcome.
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http://dx.doi.org/10.1111/echo.15091DOI Listing
July 2021

Association of Marijuana Use and Cardiovascular Disease: A Behavioral Risk Factor Surveillance System Data Analysis of 133,706 US Adults.

Am J Med 2021 05 9;134(5):614-620.e1. Epub 2020 Nov 9.

Division of Cardiology, State University of New York Upstate Medical University, Syracuse.

Background: Marijuana is the most commonly used psychoactive drug, while its effects on cardiovascular health are not well known and remain a subject of interest.

Methods: We used the pooled 2016-2018 data from the Behavioral Risk Factor Surveillance System to perform a cross-sectional analysis evaluating the association of marijuana and cardiovascular disease among US adults who never smoked cigarettes.

Results: Among US adults ages 18-74 years, when compared with nonusers, frequent marijuana use was associated with 88% higher odds of myocardial infarction or coronary artery disease (adjusted odds ratio [aOR] 1.88; 95% confidence interval [CI], 1.15-3.08), and 81% higher odds of stroke (aOR 1.81; 95% CI, 1.14-2.89). Among the premature cardiovascular disease group, frequent marijuana users had 2.3 times higher odds of myocardial infarction or coronary artery disease (aOR 2.27; 95% CI, 1.20-4.30), and 1.9 times higher odds of stroke (aOR 1.92; 95% CI, 1.07-3.43). In terms of the modality of marijuana use, frequent marijuana smoking had 2.1 times higher odds of myocardial infarction or coronary artery disease (aOR 2.07; 95% CI, 1.21-3.56), and 1.8 times higher odds of stroke (aOR 1.84; 95% CI, 1.09-3.10). A similar association was observed in the premature cardiovascular disease group who smoked marijuana (aOR [for myocardial infarction or coronary artery disease] 2.64; 95% CI, 1.37-5.09; aOR [for stroke] 2.00; 95% CI, 1.05-3.79). No association was observed between marijuana use in any form other than smoking and cardiovascular disease, across all age groups.

Conclusion: Frequent marijuana smoking is associated with significantly higher odds of stroke and myocardial infarction or coronary artery disease, with a possible role in premature cardiovascular disease.
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http://dx.doi.org/10.1016/j.amjmed.2020.10.019DOI Listing
May 2021

Impact of atrial fibrillation on the outcomes of transcatheter mitral valve repair using MitraClip: a systematic review and meta-analysis.

Heart Fail Rev 2021 05 10;26(3):531-543. Epub 2020 Nov 10.

Department of Medicine, Division of Cardiology, State University of New York Upstate Medical University, 750 E Adams Street, Syracuse, NY, 13210, USA.

Atrial fibrillation (AF) is a common arrhythmia in patients with mitral regurgitation (MR) undergoing transcatheter mitral valve repair (TMVR). In this systematic review, we aimed to investigate the outcomes of TMVR using MitraClip in AF patients. We performed a systematic search using PubMed, SCOPUS, EMBASE, and Google Scholar, from inception to May 10, 2020, for studies that reported outcomes following MitraClip, in patients with AF versus without AF. Seven studies with a total of 7678 patients met the inclusion criteria. The risk of 1-year all-cause mortality following TMVR was higher in AF patients (RR 1.40, 95% CI 1.27-1.54, p ≤ 0.001). Similarly, the risk of heart failure hospitalization was higher in patients with AF (RR 1.17, 95% CI 1.06-1.30, p = 0.002) and the risk of bleeding was elevated in AF patients (RR 1.29, 95% CI 1.15-1.45, p ≤ 0.001). The risk of procedural failure, in-hospital mortality, cardiovascular mortality, and stroke was not significantly different between the two groups. The higher risk of all-cause mortality, HF hospitalization, and risk of bleeding in AF patients undergoing MitraClip warrants attention.
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http://dx.doi.org/10.1007/s10741-020-10051-zDOI Listing
May 2021

Bilateral pulmonary artery thrombectomy with saddle embolism and COVID-19 infection.

Proc (Bayl Univ Med Cent) 2020 Aug 12;33(4):666-667. Epub 2020 Aug 12.

Department of Cardiology, State University of New York Upstate Medical University, Syracuse, New York.

Thrombotic complications such as venous thromboembolism, ischemic stroke, and myocardial infarction have emerged as causes of significant morbidity and mortality in patients infected with COVID-19. We present a 32-year-old man who developed a large saddle pulmonary embolus secondary to COVID-19 infection and underwent successful bilateral percutaneous pulmonary artery mechanical thrombectomy.
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http://dx.doi.org/10.1080/08998280.2020.1799133DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7549976PMC
August 2020

Aortic dissection and multimodality imaging.

Echocardiography 2020 09 8;37(9):1485-1487. Epub 2020 Aug 8.

Division of Cardiology, SUNY Upstate Medical University, Syracuse, New York, USA.

Aortic dissection is a life-threatening emergency warranting expeditious diagnosis. Computed tomographic angiography (CTA) is the established gold standard test but is not always fool proof. We report the case of an 18-year-old male patient with traumatic type A aortic dissection which was not evident on the CTA, suggestive on the transthoracic echocardiogram (TTE) and eventually confirmed with a transesophageal echocardiogram (TEE). When the clinical suspicion for dissection is high and in the presence of complications of type A dissection, such as aortic regurgitation, it would be prudent to obtain further imaging with a TTE/TEE to rule in or rule out the diagnosis.
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http://dx.doi.org/10.1111/echo.14820DOI Listing
September 2020

Prolonged QT Interval in a Patient With Coronavirus Disease-2019: Beyond Hydroxychloroquine and Azithromycin.

J Investig Med High Impact Case Rep 2020 Jan-Dec;8:2324709620948407

SUNY Upstate Medical University, Syracuse, NY, USA.

Recent reports have suggested an increased risk of QT prolongation and subsequent life-threatening ventricular arrhythmias, particularly torsade de pointes, in patients with coronavirus disease-2019 (COVID-19) treated with hydroxychloroquine and azithromycin. In this article, we report the case of a 75-year-old female with a baseline prolonged QT interval in whom the COVID-19 illness resulted in further remarkable QT prolongation (>700 ms), precipitating recurrent self-terminating episodes of torsade de pointes that necessitated temporary cardiac pacing. Despite the correction of hypoxemia and the absence of reversible factors, such as adverse medication effects, electrolyte derangements, and usage of hydroxychloroquine/azithromycin, the QT interval remained persistently prolonged compared with the baseline with subsequent degeneration into ventricular tachycardia and death. Thus, we highlight that COVID-19 illness itself can potentially lead to further prolongation of QT interval and unmask fatal ventricular arrhythmias in patients who have a prolonged QT and low repolarization reserve at baseline.
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http://dx.doi.org/10.1177/2324709620948407DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7418230PMC
August 2020

A Review of Acute Myocardial Injury in Coronavirus Disease 2019.

Cureus 2020 Jun 3;12(6):e8426. Epub 2020 Jun 3.

Interventional Cardiology, State University of New York (SUNY) Upstate Medical University, Syracuse, USA.

In December 2019, an outbreak of pneumonia caused by a novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), occurred in Wuhan, Hubei province, China, and it has spread rapidly across the world, causing the coronavirus disease 2019 (COVID-19) pandemic. Although SARS-CoV-2 infection predominantly results in pulmonary issues, accumulating evidence suggests the increased frequency of a variety of cardiovascular complications in patients with COVID-19. Acute cardiac injury, defined as elevated cardiac troponin levels, is the most reported cardiac abnormality in COVID-19 and strongly associated with mortality. In this article, we summarize the currently available data on the association of SARS-CoV-2 and COVID-19 with acute myocardial injury.
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http://dx.doi.org/10.7759/cureus.8426DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7336683PMC
June 2020

Hughes Stovin Syndrome, a Rare Form of Behcet's Disease Presenting as Recurrent Intracardiac Thrombus.

Cureus 2020 May 1;12(5):e7907. Epub 2020 May 1.

Interventional Cardiology, State University of New York (SUNY) Upstate Medical University, Syracuse, USA.

Hughes Stovin syndrome (HSS) is a particularly rare disease characterized by multiple pulmonary artery and/or bronchial artery aneurysms with concomitant peripheral venous thrombosis and is believed to be a cardiovascular variant of Behcet's disease. Intracardiac thrombus occurring as a thrombotic manifestation of HSS is an unusual presentation and represents a challenge in diagnosis and treatment. Here we report a 25-year-old male presenting with recurrent right-sided intracardiac thrombi, in whom pulmonary artery aneurysm was later detected in the clinical course corroborating the diagnosis of HSS and leading to appropriate initiation of immunosuppressive agents. The patient required multiple cardiac surgeries during the clinical course for cardiovascular complications associated with recurrent cardiac thrombus. Unfortunately, the patient was readmitted a year later for massive hemoptysis secondary to pulmonary arterial aneurysm rupture requiring left lower lobectomy. Our case highlights also the significant morbidity, complications, and treatment challenges associated with this potentially life-threatening syndrome, which is intensified in the presence of cardiac involvement.
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http://dx.doi.org/10.7759/cureus.7907DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7263413PMC
May 2020

Acute Myocardial Infarction Due to Spontaneous Coronary Artery Dissection and Plaque Rupture.

Cureus 2020 May 11;12(5):e8063. Epub 2020 May 11.

Interventional Cardiology, State University of New York (SUNY) Upstate Medical University, Syracuse, USA.

Myocardial infarction (MI) can be secondary to atherosclerotic coronary artery disease (ACAD) and non-atherosclerotic coronary artery disease (NACAD). The common cause of NACAD in young females is spontaneous coronary artery dissection (SCAD). We present a case of SCAD and plaque rupture leading to MI.
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http://dx.doi.org/10.7759/cureus.8063DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7228802PMC
May 2020

The First Case of Native Mitral Valve Endocarditis due to and Review of the Literature.

Case Rep Cardiol 2019 4;2019:5907319. Epub 2019 Dec 4.

State University of New York Upstate University Hospital, USA.

Gram-positive cocci species, notably , , and account for 80 to 90% of infective endocarditis cases. HACEK microorganisms ( spp., , , , and ) account for approximately 3% of cases and species account for 1-2% of cases. is a rare cause of endocarditis. To our knowledge, only 17 cases of prosthetic valve endocarditis have been described due to and a single case of native aortic valve endocarditis has been described. The following case is the only documented case of native mitral valve endocarditis. A review of the literature pertaining to Micrococcus endocarditis was performed to further characterize the entity.
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http://dx.doi.org/10.1155/2019/5907319DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6914890PMC
December 2019

A Large Pericardial Effusion Culminating in Left Lung Collapse.

Cureus 2019 Jul 31;11(7):e5287. Epub 2019 Jul 31.

Interventional Cardiology, State University of New York Upstate Medical University, Syracuse, USA.

Pericardial effusion is characterized by excess fluid accumulation in the pericardium. It can be asymptomatic or silent when the effusion is trivial in size or develops slowly. On the other hand, large rapidly developing effusions may present with hemodynamic instability or tamponade. In rare circumstances when a large effusion develops over a period of time, it may cause compression atelectasis of the surrounding bronchi and lung. We describe the case of a 70-year-old female who presented with acute respiratory insufficiency due to left lung collapse secondary to large pericardial effusion. To our knowledge, this is an extremely rare complication of large pericardial effusion.
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http://dx.doi.org/10.7759/cureus.5287DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6764612PMC
July 2019

Stage IV Non-small Cell Lung Cancer Presenting as Supraventricular Tachycardia.

Cureus 2019 Apr 20;11(4):e4503. Epub 2019 Apr 20.

Interventional Cardiology, State University of New York Upstate Medical University, Syracuse, USA.

Despite numerous advancements in diagnostics and treatment, lung cancer carries a high mortality rate. This is primarily attributable to the fact that the majority of patients present with stage III or IV disease and otherwise non-specific symptoms. In this article, we discuss a rare case of stage IV lung cancer presenting as supraventricular tachycardia secondary to cardiomediastinal involvement. Unfortunately, by the time the tumor had involved the mediastinum, surgical options were limited and treatment was largely palliative.
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http://dx.doi.org/10.7759/cureus.4503DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6584174PMC
April 2019

A 71-Year-Old Woman Presenting With Abdominal Pain and Dyspnea.

Chest 2017 10;152(4):e81-e84

State University of New York, Upstate Medical University, Syracuse, NY.

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http://dx.doi.org/10.1016/j.chest.2017.04.190DOI Listing
October 2017

The misleading electrocardiogram - Midventricular Takotsubo masquerading as anterior wall STEMI.

Am J Emerg Med 2017 Oct 27;35(10):1586.e3-1586.e4. Epub 2017 Jul 27.

Department of Medicine, Division of Cardiology, State University of New York, Upstate Medical University, Syracuse, NY, USA. Electronic address:

Midventricular Takotsubo cardiomyopathy (TC) is a relatively rare variant of stress induced cardiomyopathy, wherein there is akinesis of only the mid-ventricular segment with or without hyperkinesis of apical and basal ventricular segments. The ECG findings of TC typically do not include ST segment elevation in V1-V2 and are unlikely to be associated with reciprocal changes in inferior leads. The presence of these changes argues strongly in favor of anterior wall STEMI. In our patient, the ECG had changes strongly suggestive of STEMI, however had normal coronaries on cardiac catheterization. This case highlights the importance of carefully analyzing the ECG in emergency situations for differences between TC and STEMI and when in doubt, cardiac catheterization should be pursued.
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http://dx.doi.org/10.1016/j.ajem.2017.07.079DOI Listing
October 2017

Anomalous origin of the left main coronary artery arising from the left ventricular outflow tract with a retro-aortic collateral vessel.

J Card Surg 2017 Aug 26;32(8):483-484. Epub 2017 Jun 26.

Department of Cardiac Surgery, SUNY Upstate Medical University, Syracuse, New York.

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http://dx.doi.org/10.1111/jocs.13173DOI Listing
August 2017

Early intravenous beta-blockers in patients with acute coronary syndrome--a meta-analysis of randomized trials.

Int J Cardiol 2013 Sep 17;168(2):915-21. Epub 2012 Nov 17.

Maimonides Medical Center, Brooklyn, NY, USA. Electronic address:

Background: Intravenous (IV) beta-blockade is currently a Class IIa recommendation in early management of patients with acute coronary syndromes (ACS) without obvious contraindications.

Methods: We searched the PubMed, EMBASE and the Cochrane Register for Controlled Clinical Trials for randomized clinical trials from 1965 through December, 2011, comparing intravenous beta-blockers administered within 12 hours of presentation of ACS with standard medical therapy and/or placebo. The primary outcome assessed was the risk of short-term (in-hospital mortality-with maximum follow up duration of 90 days) all-cause mortality in the intervention group versus the comparator group. The secondary outcomes assessed were ventricular tachyarrhythmias, myocardial reinfarction, cardiogenic shock, and stroke. Pooled treatment effects were estimated using relative risk with Mantel-Haenszel risk ratio, using a random-effects model.

Results: Sixteen studies enrolling 73,396 participants met the inclusion ⁄ exclusion criteria. In- hospital mortality was reduced 8% with intravenous beta-blockers, RR=0.92 (95% CI, 0.86-1.00; p=0.04) when compared with controls. Moreover, intravenous beta-blockade reduced the risk of ventricular tachyarrhythmias (RR=0.61; 95 % CI 0.47-0.79; p=0.0003) and myocardial reinfarction (RR=0.73, 95 % CI 0.59-0.91; p=0.004) without increase in the risk of cardiogenic shock, (RR=1.02; 95% CI 0.77-1.35; p=0.91) or stroke (RR=0.58; 95 % CI 0.17-1.98; p=0.38).

Conclusions: Intravenous beta-blockers early in the course of appropriate patients with ACS appears to be associated with significant reduction in the risk of short-term cardiovascular outcomes, including a reduction in the risk of all-cause mortality.
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http://dx.doi.org/10.1016/j.ijcard.2012.10.050DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4104797PMC
September 2013

Discrete subaortic stenosis in a patient with a history of repaired AV canal defect.

Echocardiography 2011 Oct 19;28(9):E196-7. Epub 2011 Sep 19.

Department of Medicine, State University of New York, Upstate Medical University, Syracuse, New York 13202, USA.

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http://dx.doi.org/10.1111/j.1540-8175.2011.01507.xDOI Listing
October 2011
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