Publications by authors named "Kelechukwu Okoro"

8 Publications

  • Page 1 of 1

Brugada Phenocopy Type 1 Secondary to Synthetic Cannabinoids.

Case Rep Cardiol 2020 23;2020:9425860. Epub 2020 Jun 23.

Marshall University School of Medicine, Huntington, WV, USA.

Brugada phenocopies (BrP) are clinical entities that have EKG tracings similar to the congenital Brugada syndrome (BrS) but without ventricular tachyarrhythmias or sudden cardiac death. BrP is caused by various factors such as metabolic disturbances (electrolyte imbalance), drugs, mechanical compression of the mediastinum, and inflammatory conditions such as myocarditis or pericarditis. We present a very rare case of a young patient who had a Brugada phenocopy Type 1 suspected to be secondary to synthetic cannabinoids.
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http://dx.doi.org/10.1155/2020/9425860DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7330635PMC
June 2020

A Comprehensive Systemic Literature Review of Pericardial Decompression Syndrome: Often Unrecognized and Potentially Fatal Syndrome.

Curr Cardiol Rev 2021 ;17(1):101-110

Department of Internal Medicine, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV 25755, United States.

Background: Pericardial Decompression Syndrome (PDS) is defined as paradoxical hemodynamic deterioration and/or pulmonary edema, commonly associated with ventricular dysfunction. This phenomenon was first described by Vandyke in 1983. PDS is a rare but formidable complication of pericardiocentesis, which, if not managed appropriately, is fatal. PDS, as an entity, has discrete literature; this review is to understand its epidemiology, presentation, and management.

Methodology: Medline, Science Direct and Google Scholar databases were utilized to do a systemic literature search. PRISMA protocol was employed. Abstracts, case reports, case series and clinical studies were identified from 1983 to 2019. A total of 6508 articles were reviewed, out of which, 210 were short-listed, and after removal of duplicates, 49 manuscripts were included in this review. For statistical analysis, patient data was tabulated in SPSS version 20. Cases were divided into two categories surgical and percutaneous groups. t-test was conducted for continuous variable and chi-square test was conducted for categorical data used for analysis.

Results: A total of 42 full-length case reports, 2 poster abstracts, 3 case series of 2 patients, 1 case series of 4 patients and 1 case series of 5 patients were included in the study. A total of 59 cases were included in this manuscript. Our data had 45.8% (n=27) males and 54.2% (n=32) females. The mean age of patients was 48.04 ± 17 years. Pericardiocentesis was performed in 52.5% (n=31) cases, and pericardiostomy was performed in 45.8% (n=27). The most common identifiable cause of pericardial effusion was found to be malignancy in 35.6% (n=21). Twenty-three 23 cases reported pre-procedural ejection fraction, which ranged from 20%-75% with a mean of 55.8 ± 14.6%, while 26 cases reported post-procedural ejection fraction which ranged from 10%-65% with a mean of 30% ± 15.1%. Data was further divided into two categories, namely, pericardiocentesis and pericardiostomy. The outcome as death was significant in the pericardiostomy arm with a p-value of < 0.00. The use of inotropic agents for the treatment of PDS was more common in needle pericardiocentesis with a p-value of 0.04. Lastly, the computed recovery time did not yield any significance with a p-value of 0.275.

Conclusion: Pericardial decompression syndrome is a rare condition with high mortality. Operators performing pericardial drainage should be aware of this complication following drainage of cardiac tamponade, since early recognition and expeditious supportive care are the only therapeutic modalities available for adequate management of this complication.
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http://dx.doi.org/10.2174/1573403X16666200607184501DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8142365PMC
April 2021

Low risk TAVR: Long- term considerations and appropriate patient selection.

Prog Cardiovasc Dis 2020 May - Jun;63(3):377-382. Epub 2020 Apr 8.

John Ochsner Heart and Vascular Center, New Orleans, LA, USA.

Recent trials have shown impressive results in low-risk patients undergoing Transcatheter Aortic Valve Replacement (TAVR) with low procedural complication rates, short hospital length of stay, zero mortality, and zero disabling stroke at 30 days and have led to a Food and Drug Administration indication for TAVR in these patients. The long-term data on subclinical leaflet thrombosis, valve durability, effects of pacemaker implantation, right ventricular pacing, and progressive paravalvular leak is unclear. We describe clinical and procedural considerations for patient selection and introduce future potential procedural challenges. Finally, we discuss the importance of considering life expectancy and durability prior to TAVR in this low risk relatively young cohort and emphasize the importance of a heart team approach.
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http://dx.doi.org/10.1016/j.pcad.2020.04.002DOI Listing
August 2020

Kounis Syndrome Induced by Protamine Sulfate.

Cureus 2020 Feb 12;12(2):e6972. Epub 2020 Feb 12.

Cardiology, Marshall University Joan C. Edwards School of Medicine, Huntington, USA.

Protamine sulfate is considered a "life-saving" antidote for heparinized patients with major bleeds. Although the beneficial attributes and application of protamine sulfate in various clinical settings cannot be argued, it also has an impressive side-effect profile. Kounis syndrome (KS) is an acute coronary syndrome in the setting of an allergic reaction, which can be induced by numerous allergens. Herein, we report a case of KS secondary to the use of protamine sulfate after cryoablation for atrial fibrillation.
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http://dx.doi.org/10.7759/cureus.6972DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7067578PMC
February 2020

Myocarditis Secondary to Mesalamine-Induced Cardiotoxicity in a Patient with Ulcerative Colitis.

Case Rep Med 2018 15;2018:9813893. Epub 2018 Mar 15.

Department of Internal Medicine, Section of Rheumatology, Virginia Tech Carilion School of Medicine and Research Institute, Raonoke, VA, USA.

Development of cardiac manifestations in patients diagnosed with inflammatory bowel disease undergoing treatment with mesalamine is a rare. When this occurs, it can be difficult to tease out the primary etiology, as both IBD and mesalamine can cause cardiac manifestations independently of each other. The exact mechanism of mesalamine-induced cardiotoxicity is yet to be determined although several mechanisms have been described. We present the case of a gentleman with nonexertional chest pain in the setting of ulcerative colitis exacerbation believed to have occurred secondary to mesalamine.
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http://dx.doi.org/10.1155/2018/9813893DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5875043PMC
March 2018

Tuberculous Enteritis Presenting as Acute Appendicitis and Perirectal Abscess.

Case Rep Med 2018 25;2018:6068258. Epub 2018 Feb 25.

Department of Internal Medicine, Section of Infectious Diseases, Virginia Tech Carilion-School of Medicine and Research Institute, Roanoke, VA, USA.

has a wide variety of presentations. A rare occurrence is gastrointestinal tuberculosis. It may occur anywhere along the alimentary canal but usually occurs in the ileocecum with rare involvement of the appendix.
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http://dx.doi.org/10.1155/2018/6068258DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5845528PMC
February 2018

Infiltrating Cardiac Synovial Sarcoma Presenting as Acute Cerebrovascular Accident.

Case Rep Med 2017 3;2017:8539606. Epub 2017 Dec 3.

Department of Pathology, Virginia Tech Carilion-School of Medicine and Research Institute, Roanoke, VA, USA.

Primary cardiac sarcoma is a rare malignant myocardial neoplasm that does not exhibit gender predominance or age predilection. The classification of these tumors includes several subtypes, of which synovial sarcoma is a rare manifestation. When present, these tumors portend a poor prognosis with high morbidity and mortality that is attributable to their inherent infiltrative capacity, especially in the absence of treatment. The general consensus for treatment is surgical excision and neoadjuvant chemotherapy and radiotherapy. In this report, a case of synovial sarcoma involving the left ventricular outflow tract and aortic valve is presented.
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http://dx.doi.org/10.1155/2017/8539606DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5733218PMC
December 2017

Systemic Embolization from an Unusual Intracardiac Mass in the Left Ventricular Outflow Tract.

Case Rep Med 2017 1;2017:4513623. Epub 2017 Jun 1.

Virginia Tech Carilion School of Medicine and Carilion Medical Center, Roanoke, VA, USA.

Endocarditis can affect any endocardial surface; in the vast majority of cases, the cardiac valves are involved. It is exceedingly rare to develop infective endocarditis on the endocardium of the left ventricular outflow tract due to the high velocity of blood that traverses this area. Herein, we present a rare case of left ventricular outflow tract endocarditis that likely occurred secondary to damage to the aortic valve leaflets (from healed prior aortic valve endocarditis) causing a high velocity aortic valve regurgitant jet that impinged upon the interventricular septum which damaged the endocardium and resulted in a fibrotic "jet lesion." This fibrous jet lesion served as a nidus for bacterial proliferation and vegetation formation. The high shear stress (due to high blood flow velocity through the left ventricular outflow tract) likely promoted the multiple embolic events observed in this case. Our patient was successfully treated with aortic valve replacement, vegetation resection, and antibiotics.
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http://dx.doi.org/10.1155/2017/4513623DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5471576PMC
June 2017
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