Extracorporeal membrane oxygenation(ECMO)is a last resort life support in several patients with cardiogenic shock.However,appropriate candidates and optimal timing of ECMO initiation need to be established.The present...Extracorporeal membrane oxygenation(ECMO)is a last resort life support in several patients with cardiogenic shock.However,appropriate candidates and optimal timing of ECMO initiation need to be established.The present report reviewed relevant literatures to refine the allocation of ECMO in patients with cardiogenic shock.The PubMed database was searched from inception to October 5,2020,using the following search terms:"extracorporeal membrane oxygenation"or"mechanical circulatory support"AND"cardiogenic shock"or"cardiac arrest"or"myocardial infarction"or"fulminant myocarditis."The etiology of cardiogenic shock,widened QRS duration,QTc interval prolongation,cardiac arrest,dynamic narrowing of pulse pressure,and speed of lactate accumulation per unit time can be associated with the course of cardiogenic shock,and typically warn that advanced medical circulatory support is required.In the critical moment when the circulatory status deteriorates sharply,an immediate physical examination combined with ready-to-use tools such as monitoring data or blood gas analysis results is crucial for assessing the appropriateness and timing of ECMO initiation.展开更多
Coronary artery involvement in cardiovascular syphilis is infrequent and often overlooked,especially in patients with latent syphilis.Herein,we present the case of myocardial infarction largely related to cardiovascul...Coronary artery involvement in cardiovascular syphilis is infrequent and often overlooked,especially in patients with latent syphilis.Herein,we present the case of myocardial infarction largely related to cardiovascular syphilis in a 63-year-old man.Invasive coronary angiography and contrast-enhanced computed tomography scan revealed a critical ostial narrowing of the left main trunk,an occlusive right coronary artery,and moderate-to-severe ostial stenosis of multiple major branches of the abdominal aorta.Syphilis screening and confirmatory tests were positive.Cardiovascular syphilis was considered.Percutaneous coronary intervention(PCI)was performed uneventfully,and a coronary stent was implanted in the ostium of the left main coronary artery.However,on day 3 after PCI,the patient died suddenly,likely because of stent thrombosis.In conclusion,severe coronary lesions confined to the ostia suggest rheumatologic large-vessel vasculitis or infectious aortitis.展开更多
基金Key Research and Development Projects of Science&Technology Department of Sichuan Province(grant number 2019YFS0351).
文摘Extracorporeal membrane oxygenation(ECMO)is a last resort life support in several patients with cardiogenic shock.However,appropriate candidates and optimal timing of ECMO initiation need to be established.The present report reviewed relevant literatures to refine the allocation of ECMO in patients with cardiogenic shock.The PubMed database was searched from inception to October 5,2020,using the following search terms:"extracorporeal membrane oxygenation"or"mechanical circulatory support"AND"cardiogenic shock"or"cardiac arrest"or"myocardial infarction"or"fulminant myocarditis."The etiology of cardiogenic shock,widened QRS duration,QTc interval prolongation,cardiac arrest,dynamic narrowing of pulse pressure,and speed of lactate accumulation per unit time can be associated with the course of cardiogenic shock,and typically warn that advanced medical circulatory support is required.In the critical moment when the circulatory status deteriorates sharply,an immediate physical examination combined with ready-to-use tools such as monitoring data or blood gas analysis results is crucial for assessing the appropriateness and timing of ECMO initiation.
基金supported by Sichuan Science and Technology Program(2019YFS0351).
文摘Coronary artery involvement in cardiovascular syphilis is infrequent and often overlooked,especially in patients with latent syphilis.Herein,we present the case of myocardial infarction largely related to cardiovascular syphilis in a 63-year-old man.Invasive coronary angiography and contrast-enhanced computed tomography scan revealed a critical ostial narrowing of the left main trunk,an occlusive right coronary artery,and moderate-to-severe ostial stenosis of multiple major branches of the abdominal aorta.Syphilis screening and confirmatory tests were positive.Cardiovascular syphilis was considered.Percutaneous coronary intervention(PCI)was performed uneventfully,and a coronary stent was implanted in the ostium of the left main coronary artery.However,on day 3 after PCI,the patient died suddenly,likely because of stent thrombosis.In conclusion,severe coronary lesions confined to the ostia suggest rheumatologic large-vessel vasculitis or infectious aortitis.
