• Title/Summary/Keyword: Cardiac event

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Prognostic Implication of Normal Myocardial Perfusion Scintigraphy in Patients with Chest Pain (정상 심근관류신티그라피 소견을 보인 흉통환자의 예후)

  • Song, Ho-Cheon;Min, Jung-Jun;Kim, Ji-Yeul;Bom, Hee-Seung
    • The Korean Journal of Nuclear Medicine
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    • v.31 no.1
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    • pp.67-72
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    • 1997
  • Myocardial scintigraphy is a widely used noninvasive procedure with high sensitivity for the detection of patients with suspected coronary artery disease. The purpose of this study was to determine the prognostic value of a normal myocardial scintigraphy in 292 patients (150 males, 142 females, mean age $53{\pm}12$ years) with chest pain who were followed from 7 to 58 (mean 25) months. Myocardial SPECT was performed with Tc-99m MIBI in 173 patients, with Tc-99m tetrofosmin in 74 patients and with T1-201 in 45 patients. During the follow-up period, there were 2 cardiac deaths and 2 nonfatal myocardial infarctions resulting in cardiac event rate of 1.37% (0.66% Per Year). The cardiac event rate was not different in patients with angiographically normal coronary arteries (1/30, 3.3%) and in those who had significant coronary artery disease (2/27, 7.4%) (p=0.60). In conclusion, patients with chest pain and normal myocardial scintigraphy have a low cardiac event rate, and there was no significant difference of. cardiac event rates between patients with normal and abnormal coronary angiograms.

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Tricuspid Valve Repair for Tricuspid Valve Insufficiency Following a Cardiac Stab Injury - One case report - (심장 자상 후에 발생된 삼첨판막 폐쇄부전의 삼첨판막 성형술 - 1예 보고 -)

  • Kim, Dong-Hyun;Lee, Seong-Jin;Lee, Chol-Sae;Lee, Kihl-Rho;Lee, Seock-Yeol
    • Journal of Chest Surgery
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    • v.40 no.5 s.274
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    • pp.376-379
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    • 2007
  • A 51-year-old male was admitted three month previously with a cardiac stab injury and he underwent direct cardiac repair He had no problem after this event. He complained of dyspnea that stalled 2 months after the original injury. Echocardiography showed severe tricuspid regurgitation and so, chordac replacement and ring annuloplasty was performed. Herein we report on a case of tricuspid valve repair for treating tricuspid insufficiency following a cardiac stab injury.

Penetrating Injury to the Left Ventricle from a Fractured Rib Following Blunt Chest Trauma (흉부 둔상으로 골절된 늑골로 인해 발생한 좌심실 천공)

  • Oh, Tak-Hyuk;Lee, Sang Cjeol;Lee, Deok Heon;Cho, Joon Yong
    • Journal of Trauma and Injury
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    • v.27 no.4
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    • pp.192-195
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    • 2014
  • The perforation of a cardiac chamber by a fractured rib after blunt trauma is a rare event. Here, we report the case of patient who was referred for multiple rib fractures after a fall from a height. The patient was found to have a penetrating cardiac injury which was detected on a computed tomography chest scan. Computed tomography is a useful screening tool for victims of blunt chest trauma. Once cardiac perforation has been confirmed or is highly suspected, it is important to preserve the patient's vital signs until reaching the operating room by minimally manuplating the chest wall and permitting hypotension, which also prevents exsanguinating hemorrhage. For the same reasons, early cardiac tamponade may also improve the patient's survival.

The Simulation of Myocardium Conduction System using DEVCS and Discrete Time CAM (DEVCS 및 Discrete Time CAM을 이용한 심근 전도 시스템의 시뮬레이션)

  • Kim, K.N.;Nam, G.K.;Son, K.S.;Lee, Y.W.;Jun, K.R.
    • Proceedings of the KOSOMBE Conference
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    • v.1997 no.05
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    • pp.150-155
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    • 1997
  • Modelling and Simulation of the activation process for the myocardium is meaningful to understand special excitation conduction system in the heart and to study cardiac functions. In this paper, we propose two dimensional cellular automata model for the activation process of the myocardium and simulated by means of discrete time and discrete event algorithm. In the model, cells are classified into anatomically similar characteristic parts of heart; SA node, internodal tracks, AV node, His bundle, bundle branch and four layers of the ventricular muscle, each of which has a set of cells with preassigned properties, that is, activation time, refractory duration and conduction time between neighbor cell. Each cell in this model has state variables to represent the state of the cell and has some simple state transition rules to change values of state variables executed by state transition function. Simulation results are as follows. First, simulation of the normal and abnormal activation process for the myocardium has been done with discrete time and discrete event formalism. Next, we show that the simulation results of discrete time and discrete event cell space model is the same. Finally, we compare the simulation time of discrete event myocardium model with discrete time myocardium models and show that the discrete event myocardium model spends much less simulation time than discrete time myocardium model and conclude the discrete event simulation method Is excellent in the simulation time aspect if the interval deviation of event time is large.

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Penetrating right ventricular injury following a single gunshot to the left flank in Iraq: a case report

  • Zryan Salar Majeed;Yad N. Othman;Razhan K. Ali
    • Journal of Trauma and Injury
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    • v.36 no.3
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    • pp.253-257
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    • 2023
  • A century ago, cardiac injuries usually resulted in death. However, despite all the advances in medicine, these injuries still have high mortality and morbidity rates. In the present case, we describe a patient with a bullet injury to the right ventricle who survived at our hospital despite the limitations of our center with regard to modalities and equipment. A 30-year-old man was brought to our emergency department with a bullet wound to his left flank. He was hemodynamically unstable. After only 8 minutes in the hospital and without further investigations he was rushed to the operating room. During laparotomy, a clot was visible in the left diaphragm, which dislodged and caused extensive bleeding. The decision was made to perform a sternotomy in the absence of a sternal saw. An oblique 8-cm injury to the right ventricle was discovered following rapid exploration. It was repaired without the need for cardiopulmonary bypass surgery. After a few days in the hospital, the patient was discharged home. In the event of a penetrating cardiac injury, rapid decision-making is crucial for survival. Whenever possible, the patient should be transferred to the operating room, as emergency department thoracotomies are associated with a high mortality rate.

Pearls and Pitfalls of Pulsed Field Ablation

  • Stefan Hartl;Nico Reinsch;Anna Futing;Kars Neven
    • Korean Circulation Journal
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    • v.53 no.5
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    • pp.273-293
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    • 2023
  • Pulsed field ablation (PFA) was recently rediscovered as an emerging treatment modality for the ablation of cardiac arrhythmias. Ultra-short high voltage pulses are leading to irreversible electroporation of cardiac cells subsequently resulting in cell death. Current literature of PFA for pulmonary vein isolation (PVI) consistently reported excellent acute and long-term efficacy along with a very low adverse event rate. The undeniable benefit of the novel ablation technique is that cardiac cells are more susceptible to electrical fields whereas surrounding structures such as the pulmonary veins, the phrenic nerve or the esophagus are not, or if at all, minimally affected, which results in a favorable safety profile that is expected to be superior to the current standard of care without compromising efficacy. Nevertheless, the exact mechanisms of electroporation are not yet entirely understood on a cellular basis and pulsed electrical field protocols of different manufactures are not comparable among one another and require their own validation for each indication. Importantly, randomized controlled trials and comparative data to current standard of care modalities, such as radiofrequency- or cryoballoon ablation, are still missing. This review focuses on the "pearls" and "pitfalls" of PFA, a technology that has the potential to become the future leading energy source for PVI and beyond.

Prognostic Value of Normal Exercise $^{99m}Tc$-MIBI Myocardial Perfusion SPECT: Comparison with Exercise Electrocardiography and Coronary Angiography ($^{99m}Tc$-MIBI 운동부하 심근관류 SPECT에서 정상소견을 보인 환자의 예후: 운동부하 심전도와 관동맥 조영소견과의 비교)

  • Lee, Sang-Woo;Lee, Jae-Tae;Chun, Kyung-Ah;Kang, Do-Young;Kim, Dong-Hwan;Cho, Yong-Keun;Chae, Shung-Chull;Lee, Kyu-Bo
    • The Korean Journal of Nuclear Medicine
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    • v.34 no.3
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    • pp.199-206
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    • 2000
  • Purpose: Myocardial perfusion scintigraphy is a useful technique to diagnose and to predict prognosis in patients with suspected or known coronary artery disease. The purpose of the present study is to evaluate the prognostic value of normal exercise $^{99m}Tc$-MIBI myocardial perfusion single photon emission computed tomography (SPECT) and to analyze results with regard to those of exercise electrocardiography or coronary angiography. Materials and Methods: We evaluated 301 patients (mean age $52{\pm}10$ years, 166 males and 135 females) with normal exercise $^{99m}Tc$-MIBI myocardial perfusion SPECT performed for suspected coronary artery disease. Subject were evaluated for cardiac events and followed for 8-55 months (mean $19{\pm}10$ months) after imaging. Results: During the follow-up period, there was no cardiac death but only one non-fatal myocardial infarction (event rate 0.21% per year). In addition, only one patient underwent coronary revascularization. There was no significant difference in cardiac event rate between patients with positive (n=27) and negative (n=235) exercise electrocardiography (p:NS). There was no cardiac event in 17 patients who underwent coronary angiography (4 patients with >50% luminal narrowing, 2 patients with vasospasm and 11 patients with no significant lesion). Conclusion: Patients with normal exercise $^{99m}Tc$-MIBI myocardial perfusion SPECT has a very low risk for cardiac events regardless of exercise electrocardiographic and coronary angiographic findings.

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Intelligent Pattern Recognition Algorithms based on Dust, Vision and Activity Sensors for User Unusual Event Detection

  • Song, Jung-Eun;Jung, Ju-Ho;Ahn, Jun-Ho
    • Journal of the Korea Society of Computer and Information
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    • v.24 no.8
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    • pp.95-103
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    • 2019
  • According to the Statistics Korea in 2017, the 10 leading causes of death contain a cardiac disorder disease, self-injury. In terms of these diseases, urgent assistance is highly required when people do not move for certain period of time. We propose an unusual event detection algorithm to identify abnormal user behaviors using dust, vision and activity sensors in their houses. Vision sensors can detect personalized activity behaviors within the CCTV range in the house in their lives. The pattern algorithm using the dust sensors classifies user movements or dust-generated daily behaviors in indoor areas. The accelerometer sensor in the smartphone is suitable to identify activity behaviors of the mobile users. We evaluated the proposed pattern algorithms and the fusion method in the scenarios.

Out-of-Hospital Cardiac Arrest Response to a Pregnant Woman by the 119 Emergency Medical Service System: A Case Study (119구급대에 의한 병원 전 임산부 심장정지 소생환자 1례)

  • Lee, Jae-Min;Hong, Soo-Mi;An, Guk-Ki;Yun, Hyeong-Wan
    • Fire Science and Engineering
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    • v.34 no.1
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    • pp.127-134
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    • 2020
  • When a pregnant woman experiences cardiac arrest, resuscitation is of the utmost importance. Cardiac arrest in pregnant women differs from cardiac arrest in the general population since both mother and fetus need to be taken into consideration. In the event of cardiac arrest, determining whether to deliver the baby is significant. Cardiopulmonary resuscitation is not always successful, and the survival rate depends on the speed and precision of the procedure. In this study, we focus on the case of a 30-year-old pregnant woman who experienced cardiac arrest and whose family was quick to perceive her condition and call the hospital. A witness performed initial cardiopulmonary resuscitation, while rescue workers performed the advanced procedure. In this case, the patient and baby received proper treatment and left the hospital after six days. It is extremely rare for a pregnant patient to achieve return of spontaneous circulation (ROSC) or receive advanced cardiac life support before reaching the hospital. However, the woman in question in this study achieved ROSC and received both cardiopulmonary resuscitation before reaching the hospital and advanced cardiac life support at the hospital. The specifics of the case are reported in the context of a literature review.

A Simulation of the Myocardium Activation Process using the Discrete Event Cell Space Model (DEVCS 모델을 사용한 심근 활성화과정의 시뮬레이션)

  • Kim Gwang-Nyeon;Jung Dong-Keun;Kim Gi-Ryon;Choi Byeong-Cheol;Lee Jung-Tae;Jeon Gye-Rok
    • Journal of the Korea Society for Simulation
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    • v.13 no.4
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    • pp.1-16
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    • 2004
  • The modelling and simulation of the activation process for the heart system is meaningful to understand special excitatory and conductive system in the heart and to study cardiac functions because the heart activation conducts through this system. This thesis proposes two dimensional cellular automaton(CA) model for the activation process of the myocardium and conducted simulation by means of discrete time and discrete event algorithm. In the model, cells are classified into anatomically similar characteristic parts of the heart and each of cells has a set of cells with preassigned properties. Each cell in this model has state variables to represent the state of the cell and has some state transition rules to change values of state variables executed by state transition function. The state transition rule is simple as follows. First, the myocardium cell at rest stay in passive state. Second, if any one of neighborhood cell in the myocardium cell is active state then the state is change from passive to active state. Third, if cell's state is an active then automatically go to the refractory state after activation phase. Four, if cell's state is refractory then automatically go to the passive state after refractory phase. These state transition is processed repeatedly in all cells through the termination of simulation.

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