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Penetrating Trauma Resulting in Ventricular Septal Defect

World Journal of Cardiovascular Surgery 2014年第5期4卷 77-80页

作者： daniel juneau daniel Hermann Gretchen L. Wells Wake Forest School of Medicine Department of Internal Medicine Section on Cardiology Winston-Salem USA

Most ventricular septal defects (VSDs) are congenital. Acquired VSDs are generally due to myocardial infarction. An unusual case of VSD from penetrating trauma is described. In this case, the lack of a hemopericardium at presentation led the treatment team not to pursue cardiac pathology. Once the patient developed heart failure, the diagnosis of a VSD was made. Patients with penetrating chest wounds should undergo echocardiography, as such lesions may not be detected by physical examination or chest exploration.

关键词： Ventricular Septal Defect Penetrating Trauma Echocardiography

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Apical Ballooning Syndrome: Recent Insights from a Consecutive Series of 104 Patients

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Health 2015年第1期7卷 9-13页

作者： Sandhya Shresthra daniel juneau daniel Hermann Gretchen L. Wells Section on Pulmonary/Critical Care Medicine Department of Internal Medicine Wake Forest School of Medicine Winston-Salem USA Section on Cardiovascular Medicine Department of Internal Medicine Wake Forest School of Medicine Winston-Salem USA

Apical ballooning syndrome (Takotsubo cardiomyopathy) is an increasingly recognized form of acute systolic dysfunction which is usually reversible. It typically occurs in post-menopausal women following a major psychological stressor. We conducted a single center, retrospective analysis of all hospitalized patients from 2001-2012 and found 104 patients who met the diagnostic criteria for apical ballooning. In this current largest series of its kind, 83% of the patients were women. Among both men and women, an antecedent stressor was not always identified. The exact pathophysiologic mechanism resulting in apical ballooning remains poorly understood. These findings challenge the paradigm that catecholamine cardiotoxicity in the setting of relative estrogen deficiency results in the cardiomyopathy.

关键词： Apical Ballooning Takotsubo Catecholamines Estrogen

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