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Dual potential embolic source detected in left atrium during hyperacute stroke
Clinical introduction A woman in her late 60s with a medical history of hypertension presented to the emergency department with symptoms of a stroke which began 40 min prior. Brain MRI was performed (figure 1A). Hyperacute CT angiography of the head and neck did not find any atherosclerosis. ECG is shown (figure 1B), and subsequent transthoracic echocardiography showed left atrium enlargement and left-to-right flow at the region of the fossa ovalis (figure 1C). Figure 1Brain MRI of diffusion-weighted image sequence (A), ECG (B), and transthoracic echocardiogram (C). Question Which of the following is the most likely mechan...
Source: Heart - September 13, 2023 Category: Cardiology Authors: Fu, Z., Xu, C., Gao, L. Tags: Image challenges Source Type: research

Ischaemic stroke after ST-elevation myocardial infarction
Clinical introduction A 67-year-old Hispanic man presented with 5-h history of typical chest pain and an ECG consistent with inferior ST-elevation myocardial infarction (STEMI). Coronary angiography revealed an occluded proximal right coronary artery, and a percutaneous intervention with drug eluting stent was performed. He was started on aspirin and clopidogrel. Two weeks later, he was admitted with loss of consciousness, tonic-clonic seizure and urinary incontinence. On physical examination, he was unresponsive to tactile stimuli. Cardiac examination revealed a prominent left ventricular heave. Neurological examination s...
Source: Heart - December 11, 2015 Category: Cardiology Authors: Al-Ansari, Y., Otalvaro, L., Damluji, A. A. Tags: Drugs: cardiovascular system, Echocardiography, Image challenges, Acute coronary syndromes, Clinical diagnostic tests Source Type: research

Ticagrelor and aspirin for the prevention of cardiovascular events after coronary artery bypass graft surgery
Conclusions Ticagrelor added to aspirin after CABG reduced the proportion of patients with graft occlusion, and was a significant univariate and multivariable predictor of graft occlusion. These results are hypothesis-generating and should be confirmed in larger studies. Trial registration number NCT01373411: Results.
Source: Heart - April 24, 2016 Category: Cardiology Authors: Saw, J., Wong, G. C., Mayo, J., Bernstein, V., Mancini, G. B. J., Ye, J., Skarsgard, P., Starovoytov, A., Cairns, J. Tags: Drugs: cardiovascular system, Interventional cardiology, Acute coronary syndromes, Clinical diagnostic tests, Epidemiology Coronary artery disease Source Type: research

Clinical outcomes in spontaneous coronary artery dissection
Conclusions In this large prospective cohort of patients with SCAD, prognosis was overall favourable, with events mainly driven by reinfarctions or unplanned revascularisations. History of hypothyroidism, proximal vessel involvement, type 2 IMH and DAPT at discharge were associated with MACCE. Trial registration number NCT03607981.
Source: Heart - September 12, 2022 Category: Cardiology Authors: Garcia-Guimaraes, M., Masotti, M., Sanz-Ruiz, R., Macaya, F., Roura, G., Nogales, J. M., Tizon-Marcos, H., Velazquez-Martin, M., Veiga, G., Flores-Rios, X., Abdul-Jawad Altisent, O., Jimenez-Kockar, M., Camacho-Freire, S., Moreu, J., Ojeda, S., Santos-Mar Tags: Coronary artery disease Source Type: research