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Intern Emerg Med 2021 Jun 11. Epub 2021 Jun 11.

Department of Emergency Medicine, Careggi University Hospital, largo Brambilla 3, 50134, Firenze, Italy.

Am J Emerg Med 2021 Jun 4;49:137-141. Epub 2021 Jun 4.

British Medical Association, Flat 6 Souchay Court, 1 Clothorn Road, Manchester M20 6BR, United Kingdom. Electronic address:

This is a review of the underlying causes of the association of ST segment elevation and gastrointestinal symptoms such as abdominal pain, nausea, vomiting, and anorexia, in patients who do not have chest pain. The review was based on anecdotal reports in Googlescholar and Pubmed using the search terms, abdominal pain, nausea, vomiting, anorexia, ST elevation, myocardial infarction, and Takotsubo cardiomyopathy. Those patients who did not have acute myocardial infarction as the cause of the association of ST segment elevation and gastrointestinal symptoms were compared with counterparts with similar symptoms who had well authenticated acute myocardial infarction or Takotsubo cardiomyopathy as the underlying cause of ST segment elevation. Read More

Eur Heart J Case Rep 2021 May 10;5(5):ytab181. Epub 2021 May 10.

Department of Cardiology, University Hospital of Wales, Heath Park, Cardiff CF14 4XN, U K.

Background: Coronary stent avulsion is a rare, infrequently reported complication of percutaneous coronary intervention (PCI) with no consensus on management options.

Case Summary: This case series presents three descriptions of iatrogenic coronary stent avulsions, and three different bailout management strategies. All patients presented with acute coronary syndrome and required PCI. Read More

J Cardiovasc Med (Hagerstown) 2021 Jun 8. Epub 2021 Jun 8.

Department of Medical & Surgical Sciences, University of Foggia Ospedali Riuniti University Hospital, Foggia, Italy.

Spontaneous coronary artery dissection (SCAD) may be a cause of up to 1-4% of acute coronary syndrome overall, occurring mainly in young women, less than 50 years old, with no classical risk factor for CAD, especially during the postpartum period or associated with inflammatory disease. The clinical presentation varies from no symptoms to typical angina and sudden cardiac death. Multivessel coronary artery dissection is a very uncommon condition. Read More

Surg Case Rep 2021 Jun 9;7(1):140. Epub 2021 Jun 9.

Department of Surgery, Koseiren Takaoka Hospital, Eirakutyou 5-10, Takaoka, Toyama, Japan.

Background: Median arcuate ligament syndrome (MALS), which results from compression of the median arcuate ligament (MAL), is a rare cause of abdominal pain and weight loss. Treatment is dissection of the MAL; however, the laparoscopic procedure is not yet established and it involves the risk of major vascular injury, especially in cases with an anomaly.

Case Presentation: A 47-year-old man was evaluated at the hospital for epigastric pain. Read More

Turk Kardiyol Dern Ars 2021 06;49(4):334-338

Department of Cardiology, Katip Çelebi University School of Medicine, İzmir, Turkey.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is responsible for the global coronavirus disease 2019 (COVID-19) pandemic. Although the virus predominantly causes respiratory system infection, recent reports have shown that it is also associated with many cardiovascular complications. It has been reported that COVID-19 may cause myocarditis, type 1 and 2 acute myocardial infarction, and thrombotic complications. Read More

Eur Heart J Cardiovasc Imaging 2021 Jun 9. Epub 2021 Jun 9.

Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain.

Aims: To assess aortic flow and stiffness in patients with Loeys-Dietz syndrome (LDS) by 4D flow and cine cardiovascular magnetic resonance (CMR) and compare the results with those of healthy volunteers (HV) and Marfan syndrome (MFS) patients.

Methods And Results: Twenty-one LDS and 44 MFS patients with no previous aortic dissection or surgery and 35 HV underwent non-contrast-enhanced 4D flow CMR. In-plane rotational flow (IRF), systolic flow reversal ratio (SFRR), and aortic diameters were obtained at 20 planes from the ascending (AAo) to the proximal descending aorta (DAo). Read More

Ann Pediatr Cardiol 2021 Apr-Jun;14(2):204-207. Epub 2021 May 3.

Department of Cardiology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.

Coarctation of aorta (CoA) is one of the common congenital heart diseases. The two approaches for intervention in CoA include surgical and transcatheter (TC). Out of the two TC interventions available, stenting has been proved better than balloon angioplasty. Read More

Indian J Anaesth 2021 Apr 15;65(4):302-308. Epub 2021 Apr 15.

Department of Gastro Intestinal Surgery, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India.

Background And Aims: Accurate blood pressure measurements are the mainstay for the efficient management of abrupt cardiovascular changes during reperfusion in liver transplant. We sought to compare the femoral and radial pressures during reperfusion and at baseline, 1 h in dissection: portosystemic shunt, reperfusion, at bile duct anastomosis.

Methods: A retrospective study was performed amongst 102 adult patients who underwent R lobe living donor liver transplantation. Read More

Am J Emerg Med 2021 May 21;49:133-136. Epub 2021 May 21.

British Medical Association, Flat 6 Souchay Court, 1 Clothorn Road, Manchester M20 6BR, United Kingdom. Electronic address:

The purpose of this review is to draw attention to the presence and significance of murmurs other than the murmur of aortic regurgitation, in patients with aortic dissection. For that purpose, a literature search was conducted using Pubmed and Googlescholar. The search terms were "dissecting aneurysm of the aorta", "systolic murmurs", "ejection systolic murmurs", "holosystolic" murmurs, "continuous murmurs", and "Austin-Flint" murmur. Read More

Chirurg 2021 Jun 8. Epub 2021 Jun 8.

Chirurgische Klinik, Universitätsmedizin Mannheim, Medizinische Fakultät Mannheim, Universität Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Deutschland.

Background: The superior mesenteric artery (SMA) is exposed and dissected during pancreatic resections (PR) and mesenteric vascular surgery (MVS). The resulting damage of the surrounding extrinsic and intrinsic vegetative nerve plexus can lead to a temporary or treatment refractory diarrhea.

Objective: This study aimed to provide an overview of the current status of SMA revascularization and dissection-associated diarrhea (SMARD syndrome) in Germany. Read More

J Pediatr Orthop 2021 Jul;41(Suppl 1):S33-S38

Department of Orthopaedic Surgery, Vanderbilt University Medical Center, Monroe Carell Jr. Children's Hospital, Nashville, TN.

Introduction: Tibial shaft fractures are common injuries in the adolescent age group. Potential complications from the injury or treatment include infection, implant migration, neurovascular injury, compartment syndrome, malunion, or nonunion.

Methods: Published literature was reviewed to identify studies which describe the management options, complications, and outcome of tibial shaft fractures in adolescents. Read More

J Vasc Surg Cases Innov Tech 2021 Jun 20;7(2):350-353. Epub 2021 Apr 20.

Department of Vascular Surgery, The Chaim Sheba Medical Center, Tel Hashomer, Sackler School of Medicine, Tel Aviv, Israel.

We report the case of a 69-year-old woman with Marfan syndrome and a history of multiple thoracic aortic surgeries and a coexisting dissection of her abdominal aorta. She had presented with a ruptured para-anastomotic thoracic aortic aneurysm due to an infected graft. She was treated with two parallel Nellix endografts that were placed in the true and false lumens. Read More

Cureus 2021 May 3;13(5):e14812. Epub 2021 May 3.

Department of Cardiology, Post Graduate Institute of Medical Education & Research, Chandigarh, IND.

Spontaneous coronary artery dissection (SCAD) is an unusual but important cause of acute coronary syndrome and is often underdiagnosed. The first clue to the diagnosis is the angiographic appearance of the lesion, and, in certain cases, intravascular imaging is needed to confirm it. Conservative management is the preferred treatment strategy for the majority of cases. Read More

J Cardiol Cases 2021 Jun 30;23(6):274-280. Epub 2021 Jan 30.

Department of Cardiovascular Biology and Medicine, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachidori, Chuo-ku, Niigata 951-8510, Japan.

Spontaneous coronary artery dissection (SCAD) is a rare cause of acute coronary syndrome. Treatment for SCAD includes conservative approaches, percutaneous coronary intervention (PCI), and coronary artery bypass graft surgery. Although the success rate of PCI is low, conservative treatment often leads to a good clinical course. Read More

Implement Sci Commun 2021 Jun 4;2(1):60. Epub 2021 Jun 4.

The Department of Emergency Medicine, Health Science North Research Institute, Northern Ontario School of Medicine, 41 Ramsey Lake Rd, Sudbury, ON, P3E 5 J1, Canada.

Background: Acute aortic syndrome (AAS) is an uncommon, life-threatening emergency that is frequently misdiagnosed. The 2020 Canadian clinical practice guidelines for the diagnosis of AAS incorporate all available evidence into four key recommendations. In order to facilitate the implementation of these recommendations, a clinical decision aid was created. Read More

Int J Cardiol 2021 Jun 1. Epub 2021 Jun 1.

San Raffaele Hospital and Vita e Salute University, Milan, Italy.

The role of cardiac magnetic resonance (CMR) in identifying mechanisms for myocardial infarction with non-obstructed coronary arteries (MINOCA) is well established. Recent reports have highlighted the potentially key role of invasive management in this diagnostic process. Intravascular ultrasound (IVUS) and optical coherence tomography (OCT) allow precise evaluation of coronary anatomy, and assessment of coronary physiology in the catheter laboratory provides information on the hemodynamic significance of sub-critical atherosclerosis and on coronary microvascular dysfunction (CMD). Read More

Hered Cancer Clin Pract 2021 Jun 3;19(1):28. Epub 2021 Jun 3.

Department of Obstetrics and Gynecology, Chung-Ang University College of Medicine, 102 Heukseok-ro, Dongjak-gu, Seoul, 06973, South Korea.

Background: Endometrial cancer is often the sentinel cancer in women with Lynch syndrome, among which endometrioid endometrial cancer is the most common. We found a Korean case of uterine carcinosarcoma associated with Lynch syndrome. And we reviewed 27 Korean women with endometrial cancer associated with Lynch syndrome already released in case report so far. Read More

Front Cardiovasc Med 2021 17;8:652527. Epub 2021 May 17.

Department of Critical Care Medicine, Zhongshan Hospital, Fudan University, Shanghai, China.

Acute type A aortic dissection (aTAAD) is usually lethal without emergency surgery. Although veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is widely used in patients with cardiogenic shock following cardiac surgery, VA-ECMO support following aTAAD surgery has not been well-described. Based on our 6-year experience, we aimed to retrospectively analyze risk factors, application and timing of VA-ECMO, and outcomes in aTAAD patients. Read More

Psychol Med 2021 Jun 3:1-10. Epub 2021 Jun 3.

Department of Psychiatry, Amsterdam Public Health Research Institute, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit, The Netherlands.

Background: A recent hypothesis postulates the existence of an 'immune-metabolic depression' (IMD) dimension characterized by metabolic dysregulations. Combining data on metabolomics and depressive symptoms, we aimed to identify depressions associated with an increased risk of adverse metabolic alterations.

Method: Clustering data were from 1094 individuals with major depressive disorder in the last 6 months and measures of 149 metabolites from a 1H-NMR platform and 30 depressive symptoms (IDS-SR30). Read More

Biomedicines 2021 May 31;9(6). Epub 2021 May 31.

Kardiologie I and DZHK Standort Rhein-Main, Universitätsmedizin Mainz, 55131 Mainz, Germany.

The term coronary "artery vasculitis" is used for a diverse group of diseases with a wide spectrum of manifestations and severity. Clinical manifestations may include pericarditis or myocarditis due to involvement of the coronary microvasculature, stenosis, aneurysm, or spontaneous dissection of large coronaries, or vascular thrombosis. As compared to common atherosclerosis, patients with coronary artery vasculitis are younger and often have a more rapid disease progression. Read More

Neurol Sci 2021 May 31. Epub 2021 May 31.

Department of Diagnostic and Interventional Neuroradiology, Galliera Hospital, Via Mura delle Cappuccine 14, 16128, Genoa, Italy.

Introduction: Vascular Eagle syndrome, due to impingement of the extracranial internal carotid artery (ICA) by the styloid process (SP), is an uncommon and not yet widely recognized cause of ICA dissection. Up to now, this diagnosis is still presumptive, based mainly on the length of the SP. However, given the discrepancy between the much higher prevalence of an elongated SP in the population compared to the reported rate of Eagle syndrome, other anatomical factors beyond the length itself of this bony structure seem to be involved. Read More

Orphanet J Rare Dis 2021 May 31;16(1):245. Epub 2021 May 31.

Heart and Vascular Center, Semmelweis University, Városmajor u. 68, Budapest, 1122, Hungary.

Background: Marfan syndrome (MFS) is a genetically determined systemic connective tissue disorder, caused by a mutation in the FBN1 gene. In MFS mainly the cardiovascular, musculoskeletal and ocular systems are affected. The most dangerous manifestation of MFS is aortic dissection, which needs to be prevented by a prophylactic aortic root replacement. Read More

Interv Cardiol Clin 2021 Jul;10(3):323-332

The Heart Center, St Francis Hospital, 100 Port Washington Blvd, Flower Hill, NY 11576, USA; Cardiovascular Research Foundation, 1700 Broadway, 9th Floor, New York, NY 10019, USA; New York-Presbyterian Hospital/Columbia University Irving Medical Center, New York, NY, USA. Electronic address:

Advances in intravascular imaging have enabled assessment of the underlying plaque morphology in acute coronary syndromes, which allows for the initiation of individualized therapy. The atherothrombotic substrates for acute coronary syndromes consist of plaque rupture, erosion, and calcified nodule, whereas spontaneous coronary artery dissection, coronary artery spasm, and coronary embolism constitute rarer nonatherothrombotic etiologies. This review provides a brief overview of the data from clinical studies that have used intravascular optical coherence tomography to assess the culprit plaque morphology. Read More

Cardiovasc Res 2021 May 28. Epub 2021 May 28.

Department of Cardiovascular Sciences and National Institute for Health Research Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, United Kingdom.

Aims: Spontaneous coronary artery dissection (SCAD) is a cause of acute coronary syndromes and in rare cases sudden cardiac death (SCD). Connective tissue abnormalities, coronary inflammation, increased coronary vasa vasorum density and coronary fibromuscular dysplasia have all been implicated in the pathophysiology of SCAD but have not previously been systematically assessed. We designed a study to investigate the coronary histological and dermal collagen ultrastructural findings in SCAD. Read More

World J Clin Cases 2021 May;9(15):3644-3648

Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China.

Background: Since the outbreak of the coronavirus disease 2019 (COVID-19) pandemic, the exclusion of a patient from COVID-19 should be performed before surgery. However, patients with type A acute aortic dissection (AAD) during pregnancy can seriously endanger the health of either the mother or fetus that requires emergency surgical treatment without the test for COVID-19.

Case Summary: A 38-year-old woman without Marfan syndrome was admitted to the hospital because of chest pain in the 34 week of gestation. Read More

Int J Dermatol 2021 May 26. Epub 2021 May 26.

Division of Urogynecology, Department of Obstetrics and Gynecology, UC Irvine Medical Center, Orange, CA, USA.

Background: Vulvovaginal involvement in Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) is common, likely underdiagnosed, and can result in severe sequelae if not managed acutely. There are few studies on acute management of vulvovaginal SJS/TEN. Current recommendations are predominantly based on expert opinion. Read More

CJC Open 2021 May 1;3(5):687-689. Epub 2021 Jan 1.

Regional Cardiac Catheterization Lab, Kaiser Permanente Los Angeles Medical Center, Los Angeles, California, USA.

A 53-year-old woman underwent a cardiac catheterization for evaluation of acute coronary syndrome. The coronary angiogram revealed evidence of spontaneous coronary artery dissection in multiple coronary arteries including the left anterior descending artery, posterior descending artery, and posterior left ventricular artery. Further diagnostic imaging revealed associated bilateral vertebral artery and renal artery fibromuscular dysplasia (FMD). Read More

Am J Cardiol 2021 May 21. Epub 2021 May 21.

Brigham and Women's Hospital Heart & Vascular Center, Harvard Medical School, Boston, Minnesota. Electronic address:

Spontaneous coronary artery dissection (SCAD) can present with various clinical symptoms, including chest pain, syncope, and sudden cardiac death, particularly in those without atherosclerotic risk factors. In this contemporary analysis, we aimed to identify the causes and predictors of 30-day hospital readmission in SCAD patients. We utilized the latest Nationwide Readmissions Database from 2016 - 2017 to identify patients with a primary discharge diagnosis of SCAD. Read More

CJC Open 2021 May 28;3(5):585-594. Epub 2020 Dec 28.

Department of Anesthesiology, Pharmacology and Therapeutics, British Columbia Children's Hospital Child and Family Research Institute, University of British Columbia, Vancouver, British Columbia, Canada.

Background: Aortic dilation, stiffening, and dissection are common and potentially lethal complications of Marfan syndrome (MFS) and Loeys-Dietz syndrome (LDS), which involve abnormal transforming growth factor beta (TGF-β) signalling. The relation of aortic dimensions, stiffness, and biomarker levels is unknown. The objective of this study was to measure aortic dimensions, stiffness, TGF-β and matrix metalloproteinase (MMP) levels, and endothelial function in patients with MFS, and to compare TGF-β levels in patients with MFS receiving different therapeutic regimens. Read More