BACKGROUND Endoscopic retrograde cholangiopancreatography(ERCP)is a key procedure for diagnosing and treating biliary and pancreatic disorders.Although effective,it carries risks,including rare but severe complication...BACKGROUND Endoscopic retrograde cholangiopancreatography(ERCP)is a key procedure for diagnosing and treating biliary and pancreatic disorders.Although effective,it carries risks,including rare but severe complications such as air embolism.CASE SUMMARY We report a case of a 58-year-old man who developed extensive air embolism during ERCP.He previously underwent a Whipple procedure and experienced a sudden drop in vital signs and loss of consciousness.Immediate intervention with hyperbaric oxygen therapy and supportive care led to gradual recovery.Imaging confirmed widespread air embolism,which resolved with continued treatment.CONCLUSION Air embolism is a rare,critical complication of ERCP,especially in patients with prior surgery such as pancreaticoduodenectomy.Early detection and prompt treatment,including hyperbaric oxygen therapy,are crucial for favorable out-comes.展开更多
BACKGROUND The incidental detection of a right atrial mass during routine cardioncological workup is a rare condition. The correct differential diagnosis between cancer and thrombi is challenging. A biopsy may not be ...BACKGROUND The incidental detection of a right atrial mass during routine cardioncological workup is a rare condition. The correct differential diagnosis between cancer and thrombi is challenging. A biopsy may not be feasible while diagnostic techniques and tools may not be available.CASE SUMMARY We report the case of a 59-year-old female patient with a history of breast cancer and current secondary metastatic pancreatic cancer. She developed deep vein thrombosis and pulmonary embolism and was admitted to the Outpatient Clinic of our Cardio-Oncology Unit for follow-up. Transthoracic echocardiogram incidentally found a right atrial mass. Clinical management was difficult due to the abrupt worsening of the patient’s clinical condition and the progressive severe thrombocytopenia. We suspected a thrombus, according to its echocardiographic appearance, the patient’s cancer history and recent venous thromboembolism. The patient was unable to adhere to low molecular weight heparin treatment. Due to worsening prognosis, palliative care was recommended. We also highlighted the distinguishing features between thrombi and tumors. We proposed a diagnostic flowchart to aid diagnostic decision making in the case of an incidental atrial mass.CONCLUSION This case report highlights the importance of cardioncological surveillance during anticancer treatments to detect cardiac masses.展开更多
Aim: To evaluate the benefits of counseling intervention related to dietary habits changes on patients following percutaneous coronary intervention (PCI). Materials and Methods: A randomized counseling intervention st...Aim: To evaluate the benefits of counseling intervention related to dietary habits changes on patients following percutaneous coronary intervention (PCI). Materials and Methods: A randomized counseling intervention study, with a 3- and 6-month follow-up was performed on 230 patients who underwent PCI. They were randomly allocated to the intervention (n = 93) or the control group (n = 137). A 3- and 6-month telephone follow-up was performed for dietary habits evaluation. Data analysis was performed by using the statistical package SPSS, ver. 20.?Results: Compared with control group, intervention group had higher prevalence of hypertension, history of diabetes and dyslipidemias and history of acute myocardial infraction, with no statistical difference. Moreover, patients in control group were more likely to be ex-smokers (p = 0.01). Post hoc tests using the Bonferroni correction revealed that mean TCHOL concentration while patients admitted to hospital differed statistically significantly between the time points of 3 and 6 months (209 ± 67 mg/dl vs 174 ± 34 mg/dl vs 176 ± 36 mg/dl), p= 0.005 and p = 0.042 respectively. However, there was no statistical significant difference between 3 months and 6 months measurements. Mean glucose concentration while patients admitted to hospital differed statistically significantly between the time points of 3 and 6 months (108 ± 40 mg/dl vs 95 ± 21 mg/dl vs 95 ± 23 mg/dl), p =0.009 and p = 0.012 respectively. However, there was no significant statistical difference between 3 months and 6 months measurements, (p = 1.000). Conclusion: A nurse-led program regarding dietary habits modifications on patients undergoing PCI should be performed along with a long-term follow up after hospital discharge.展开更多
The Tako-Tsubo syndrome is a rare yet recognized condition characterized by acute but rapidly reversible left ventricular dysfunction in absence of obstructive coronary artery stenosis. Although several factors have b...The Tako-Tsubo syndrome is a rare yet recognized condition characterized by acute but rapidly reversible left ventricular dysfunction in absence of obstructive coronary artery stenosis. Although several factors have been associated with the development of this syndrome, still its etiology remains undefined. We report the case of a 51-years-old woman presenting with dyspnea in whom the diagnosis of Tako-Tsubo syndrome was posed. We describe the diagnostic modalities and the clinical outcome of the patient. Secondly, the present paper is aimed at providing a review of the current evidence over this topic and at proposing future research directions.展开更多
文摘BACKGROUND Endoscopic retrograde cholangiopancreatography(ERCP)is a key procedure for diagnosing and treating biliary and pancreatic disorders.Although effective,it carries risks,including rare but severe complications such as air embolism.CASE SUMMARY We report a case of a 58-year-old man who developed extensive air embolism during ERCP.He previously underwent a Whipple procedure and experienced a sudden drop in vital signs and loss of consciousness.Immediate intervention with hyperbaric oxygen therapy and supportive care led to gradual recovery.Imaging confirmed widespread air embolism,which resolved with continued treatment.CONCLUSION Air embolism is a rare,critical complication of ERCP,especially in patients with prior surgery such as pancreaticoduodenectomy.Early detection and prompt treatment,including hyperbaric oxygen therapy,are crucial for favorable out-comes.
文摘BACKGROUND The incidental detection of a right atrial mass during routine cardioncological workup is a rare condition. The correct differential diagnosis between cancer and thrombi is challenging. A biopsy may not be feasible while diagnostic techniques and tools may not be available.CASE SUMMARY We report the case of a 59-year-old female patient with a history of breast cancer and current secondary metastatic pancreatic cancer. She developed deep vein thrombosis and pulmonary embolism and was admitted to the Outpatient Clinic of our Cardio-Oncology Unit for follow-up. Transthoracic echocardiogram incidentally found a right atrial mass. Clinical management was difficult due to the abrupt worsening of the patient’s clinical condition and the progressive severe thrombocytopenia. We suspected a thrombus, according to its echocardiographic appearance, the patient’s cancer history and recent venous thromboembolism. The patient was unable to adhere to low molecular weight heparin treatment. Due to worsening prognosis, palliative care was recommended. We also highlighted the distinguishing features between thrombi and tumors. We proposed a diagnostic flowchart to aid diagnostic decision making in the case of an incidental atrial mass.CONCLUSION This case report highlights the importance of cardioncological surveillance during anticancer treatments to detect cardiac masses.
文摘Aim: To evaluate the benefits of counseling intervention related to dietary habits changes on patients following percutaneous coronary intervention (PCI). Materials and Methods: A randomized counseling intervention study, with a 3- and 6-month follow-up was performed on 230 patients who underwent PCI. They were randomly allocated to the intervention (n = 93) or the control group (n = 137). A 3- and 6-month telephone follow-up was performed for dietary habits evaluation. Data analysis was performed by using the statistical package SPSS, ver. 20.?Results: Compared with control group, intervention group had higher prevalence of hypertension, history of diabetes and dyslipidemias and history of acute myocardial infraction, with no statistical difference. Moreover, patients in control group were more likely to be ex-smokers (p = 0.01). Post hoc tests using the Bonferroni correction revealed that mean TCHOL concentration while patients admitted to hospital differed statistically significantly between the time points of 3 and 6 months (209 ± 67 mg/dl vs 174 ± 34 mg/dl vs 176 ± 36 mg/dl), p= 0.005 and p = 0.042 respectively. However, there was no statistical significant difference between 3 months and 6 months measurements. Mean glucose concentration while patients admitted to hospital differed statistically significantly between the time points of 3 and 6 months (108 ± 40 mg/dl vs 95 ± 21 mg/dl vs 95 ± 23 mg/dl), p =0.009 and p = 0.012 respectively. However, there was no significant statistical difference between 3 months and 6 months measurements, (p = 1.000). Conclusion: A nurse-led program regarding dietary habits modifications on patients undergoing PCI should be performed along with a long-term follow up after hospital discharge.
文摘The Tako-Tsubo syndrome is a rare yet recognized condition characterized by acute but rapidly reversible left ventricular dysfunction in absence of obstructive coronary artery stenosis. Although several factors have been associated with the development of this syndrome, still its etiology remains undefined. We report the case of a 51-years-old woman presenting with dyspnea in whom the diagnosis of Tako-Tsubo syndrome was posed. We describe the diagnostic modalities and the clinical outcome of the patient. Secondly, the present paper is aimed at providing a review of the current evidence over this topic and at proposing future research directions.
