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5 "cardiogenic shock"
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Review Article
Cardiology
Left ventricle unloading during veno-arterial extracorporeal membrane oxygenation: review with updated evidence
Yongwhan Lim, Min Chul Kim, In-Seok Jeong
Acute Crit Care. 2024;39(4):473-487.   Published online November 18, 2024
DOI: https://doi.org/10.4266/acc.2024.00801
  • 222 View
  • 27 Download
AbstractAbstract PDF
Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is widely used to treat medically refractory cardiogenic shock and cardiac arrest, and its usage has increased exponentially over time. Although VA-ECMO has many advantages over other mechanical circulatory supports, it has the unavoidable disadvantage of increasing retrograde arterial flow in the afterload, which causes left ventricular (LV) overload and can lead to undesirable consequences during VA-ECMO treatment. Weak or no antegrade flow without sufficient opening of the aortic valve increases the LV end-diastolic pressure, and that can cause refractory pulmonary edema, blood stagnation, thrombosis, and refractory ventricular arrhythmia. This hemodynamic change is also related to an increase in myocardial energy consumption and poor recovery, making LV unloading an essential management issue during VA-ECMO treatment. The principal factors in effective LV unloading are its timing, indications, and modalities. In this article, we review why LV unloading is required, when it is indicated, and how it can be achieved.
Case Reports
Cardiology
Successful extracorporeal membrane oxygenation treatment of catecholamine-induced cardiomyopathy-associated pheochromocytoma: a case report
Sangshin Park, Min Kim, Dae In Lee, Ju-Hee Lee, Sangmin Kim, Sang Yeub Lee, Jang-Whan Bae, Kyung-Kuk Hwang, Dong-Woon Kim, Myeong-Chan Cho, Dae-Hwan Bae
Acute Crit Care. 2024;39(1):194-198.   Published online May 11, 2022
DOI: https://doi.org/10.4266/acc.2021.01158
  • 4,541 View
  • 171 Download
  • 1 Crossref
AbstractAbstract PDFSupplementary Material
The main mechanism of Takotsubo cardiomyopathy (TCM) is catecholamine-induced acute myocardial stunning. Pheochromocytoma, a catecholamine-secreting tumor, can cause several cardiovascular complications, including hypertensive crisis, myocardial infarction, toxic myocarditis, and TCM. A 29-year-old woman presented to our hospital with general weakness, vomiting, dyspnea, and chest pain. The patient was nullipara, 28 weeks’ gestation, and had a cachexic morphology. Her cardiac enzyme levels were elevated and bedside echocardiography showed apical akinesia, suggesting TCM. The next day, she could not feel the fetal movement, and an emergency cesarean section was performed. After delivery, the patient experienced cardiac arrest and was transferred to the intensive care unit for cardiopulmonary resuscitation (CPR). Spontaneous circulation returned after 28 minutes of CPR, but cardiogenic shock continued, and extracorporeal membrane oxygenation (ECMO) was initiated. On the third day of ECMO maintenance, left ventricular ejection fraction improved and blood pressure stabilized. On the eighth day after ECMO insertion, it was removed. However, complications of the left leg vessels occurred, and several surgeries and interventions were performed. A left adrenal gland mass was found on computed tomography and was removed while repairing the leg vessels. Pheochromocytoma was diagnosed and left adrenalectomy was performed.

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Citations to this article as recorded by  
  • Mechanical Circulatory Support Strategies in Takotsubo Syndrome with Cardiogenic Shock: A Systematic Review
    Johanna K. R. von Mackensen, Vanessa I. T. Zwaans, Ahmed El Shazly, Karel M. Van Praet, Roland Heck, Christoph T. Starck, Felix Schoenrath, Evgenij V. Potapov, Joerg Kempfert, Stephan Jacobs, Volkmar Falk, Leonhard Wert
    Journal of Clinical Medicine.2024; 13(2): 473.     CrossRef
Cardiology
Acute fulminant myocarditis following influenza vaccination requiring extracorporeal membrane oxygenation
Youn-Jung Kim, Jun-Il Bae, Seung Mok Ryoo, Won Young Kim
Acute Crit Care. 2019;34(2):165-169.   Published online November 7, 2018
DOI: https://doi.org/10.4266/acc.2017.00045
  • 11,313 View
  • 199 Download
  • 27 Web of Science
  • 29 Crossref
AbstractAbstract PDF
The inactivated influenza vaccination is generally safe with mostly mild side effects. We report a rare but fatal adverse event following influenza vaccination. A previously healthy 27-yearold woman who received the influenza vaccination 3 days before presenting to the emergency department had rapidly aggravating dyspnea and mental deterioration. She was diagnosed as having acute fulminant myocarditis with refractory cardiogenic shock, which was successfully managed with veno-arterial extracorporeal membrane oxygenation. The cardiac function of the patient recovered in 3 weeks.

Citations

Citations to this article as recorded by  
  • Clinical Characteristics and Mechanisms of Acute Myocarditis
    Stephane Heymans, Sophie Van Linthout, Sarah Mignon Kraus, Leslie T. Cooper, Ntobeko A.B. Ntusi
    Circulation Research.2024; 135(2): 397.     CrossRef
  • Endosomal Toll-Like Receptors intermediate negative impacts of viral diseases, autoimmune diseases, and inflammatory immune responses on the cardiovascular system
    Fatemeh Sadat Tabatabaei, Melika Shafeghat, Amirali Azimi, Ashley Akrami, Nima Rezaei
    Expert Review of Clinical Immunology.2024; : 1.     CrossRef
  • Clinical Manifestations and Adverse Cardiovascular Events in Patients with Cardiovascular Symptoms after mRNA Coronavirus Disease 2019 Vaccines
    William D. Kim, Min Jae Cha, Subin Kim, Dong-Gil Kim, Jae-Jin Kwak, Sung Woo Cho, Joon Hyung Doh, Sung Uk Kwon, June Namgung, Sung Yun Lee, Jiwon Seo, Geu-ru Hong, Ji-won Hwang, Iksung Cho
    Yonsei Medical Journal.2024; 65(11): 629.     CrossRef
  • Active surveillance for adverse events of influenza vaccine safety in elderly cancer patients using self-controlled tree-temporal scan statistic analysis
    Na-Young Jeong, Chung-Jong Kim, Sang Min Park, Ye-Jee Kim, Joongyub Lee, Nam-Kyong Choi
    Scientific Reports.2023;[Epub]     CrossRef
  • The Incidence of Myocarditis Following an Influenza Vaccination: A Population-Based Observational Study
    Wen-Hwa Wang, Kai-Che Wei, Yu-Tung Huang, Kuang-Hua Huang, Tung-Han Tsai, Yu-Chia Chang
    Drugs & Aging.2023; 40(2): 145.     CrossRef
  • Comparison of COVID-19 Vaccine-Associated Myocarditis and Viral Myocarditis Pathology
    Kamron Reza Hamedi, Gannett Loftus, Lawson Traylor, Richard Goodwin, Sergio Arce
    Vaccines.2023; 11(2): 362.     CrossRef
  • Myocarditis and autoimmunity
    Akira Matsumori
    Expert Review of Cardiovascular Therapy.2023; 21(6): 437.     CrossRef
  • Cardiovascular magnetic resonance (CMR) and positron emission tomography (PET) imaging in the diagnosis and follow-up of patients with acute myocarditis and chronic inflammatory cardiomyopathy
    Federico Caobelli, Jordi Broncano Cabrero, Nicola Galea, Philip Haaf, Christian Loewe, Julian A. Luetkens, Giuseppe Muscogiuri, Marco Francone
    The International Journal of Cardiovascular Imaging.2023; 39(11): 2221.     CrossRef
  • Clinical Syndromes Related to SARS-CoV-2 Infection and Vaccination in Pediatric Age: A Narrative Review
    Maria Vincenza Mastrolia, Camilla De Cillia, Michela Orlandi, Sarah Abu-Rumeileh, Ilaria Maccora, Valerio Maniscalco, Edoardo Marrani, Ilaria Pagnini, Gabriele Simonini
    Medicina.2023; 59(11): 2027.     CrossRef
  • Acute Lymphocyte Myocarditis Associated with Influenza Vaccination
    Ryo Nakamura, Shin-ichi Ando, Seiya Kato, Toshiaki Kadokami
    Internal Medicine.2022; 61(15): 2307.     CrossRef
  • Clinically Suspected Myocarditis Temporally Related to COVID-19 Vaccination in Adolescents and Young Adults: Suspected Myocarditis After COVID-19 Vaccination
    Dongngan T. Truong, Audrey Dionne, Juan Carlos Muniz, Kimberly E. McHugh, Michael A. Portman, Linda M. Lambert, Deepika Thacker, Matthew D. Elias, Jennifer S. Li, Olga H. Toro-Salazar, Brett R. Anderson, Andrew M. Atz, C. Monique Bohun, M. Jay Campbell, M
    Circulation.2022; 145(5): 345.     CrossRef
  • Myocarditis following rAd26 and rAd5 vector‐based COVID‐19 vaccine: case report
    Farah Naghashzadeh, Shadi Shafaghi, Atosa Dorudinia, Seyed Alireza Naji, Majid Marjani, Ahmad Amin, Arezoo Mohamadifar, Sima Noorali, Babak Sharif Kashani
    ESC Heart Failure.2022; 9(2): 1483.     CrossRef
  • Myocarditis following COVID-19 vaccination in adolescents and adults: a cumulative experience of 2021
    Onyedika J. Ilonze, Maya E. Guglin
    Heart Failure Reviews.2022; 27(6): 2033.     CrossRef
  • Chest Pain and Suspected Myocarditis Related to COVID-19 Vaccination in Adolescents—A Case Series
    Da-Eun Roh, Hyejin Na, Jung-Eun Kwon, Insu Choi, Yeo-Hyang Kim, Hwa-Jin Cho
    Children.2022; 9(5): 693.     CrossRef
  • Cardiac Adverse Events after Vaccination—A Systematic Review
    Kanak Parmar, Sai Subramanyam, Gaspar Del Rio-Pertuz, Pooja Sethi, Erwin Argueta-Sosa
    Vaccines.2022; 10(5): 700.     CrossRef
  • A case of myocarditis after COVID-19 vaccination: incidental or consequential?
    Leona S. Alizadeh, Vitali Koch, Ibrahim Yel, Leon D. Grünewald, Daniel Mathies, Simon Martin, Thomas J. Vogl, Dominic Rauschning, Christian Booz
    Heliyon.2022; 8(6): e09537.     CrossRef
  • COVID-19 Vaccination and the Rate of Immune and Autoimmune Adverse Events Following Immunization: Insights From a Narrative Literature Review
    Naim Mahroum, Noy Lavine, Aviran Ohayon, Ravend Seida, Abdulkarim Alwani, Mahmoud Alrais, Magdi Zoubi, Nicola Luigi Bragazzi
    Frontiers in Immunology.2022;[Epub]     CrossRef
  • COVID-19 vaccination and carditis in children and adolescents: a systematic review and meta-analysis
    Oscar Hou In Chou, Jonathan Mui, Cheuk To Chung, Danny Radford, Simon Ranjithkumar, Endurance Evbayekha, Ronald Nam, Levent Pay, Danish Iltaf Satti, Sebastian Garcia-Zamora, George Bazoukis, Göksel Çinier, Sharen Lee, Vassilios S. Vassiliou, Tong Liu, Gar
    Clinical Research in Cardiology.2022; 111(10): 1161.     CrossRef
  • Myopericarditis after vaccination, Vaccine Adverse Event Reporting System (VAERS), 1990–2018
    John R. Su, Michael M. McNeil, Kerry J. Welsh, Paige L. Marquez, Carmen Ng, Ming Yan, Maria V. Cano
    Vaccine.2021; 39(5): 839.     CrossRef
  • Sipuleucel‐T associated inflammatory cardiomyopathy: a case report and observations from a large pharmacovigilance database
    Melissa Y.Y. Moey, Rahim A. Jiwani, Kotaro Takeda, Karyn Prenshaw, R. Wayne Kreeger, John Inzerillo, Darla K. Liles, C. Bogdan Marcu, Bénédicte Lebrun‐Vignes, D. Lynn Morris, Sivakumar Ardhanari, Joe‐Elie Salem
    ESC Heart Failure.2021; 8(4): 3360.     CrossRef
  • Myocarditis following COVID-19 vaccination
    Elisabeth Albert, Gerard Aurigemma, Jason Saucedo, David S. Gerson
    Radiology Case Reports.2021; 16(8): 2142.     CrossRef
  • Myocarditis and Other Cardiovascular Complications of the mRNA-Based COVID-19 Vaccines
    Mahesh K Vidula, Marietta Ambrose, Helene Glassberg, Neel Chokshi, Tiffany Chen, Victor A Ferrari, Yuchi Han
    Cureus.2021;[Epub]     CrossRef
  • Patients With Acute Myocarditis Following mRNA COVID-19 Vaccination
    Han W. Kim, Elizabeth R. Jenista, David C. Wendell, Clerio F. Azevedo, Michael J. Campbell, Stephen N. Darty, Michele A. Parker, Raymond J. Kim
    JAMA Cardiology.2021; 6(10): 1196.     CrossRef
  • Acute myocarditis following Comirnaty vaccination in a healthy man with previous SARS-CoV-2 infection
    Anna Patrignani, Nicolò Schicchi, Francesca Calcagnoli, Elena Falchetti, Nino Ciampani, Giulio Argalia, Antonio Mariani
    Radiology Case Reports.2021; 16(11): 3321.     CrossRef
  • Myocarditis and pericarditis after vaccination for COVID‐19
    Blake Hudson, Ryan Mantooth, Matthew DeLaney
    Journal of the American College of Emergency Physicians Open.2021;[Epub]     CrossRef
  • Myocarditis, Pericarditis and Cardiomyopathy After COVID-19 Vaccination
    Salvatore Pepe, Ann T. Gregory, A. Robert Denniss
    Heart, Lung and Circulation.2021; 30(10): 1425.     CrossRef
  • Cardiac Manifestations of Multisystem Inflammatory Syndrome in Children (MIS-C) Following COVID-19
    Eveline Y. Wu, M. Jay Campbell
    Current Cardiology Reports.2021;[Epub]     CrossRef
  • Hemodynamic Collapse After Influenza Vaccination: A Vaccine-Induced Fulminant Myocarditis?
    Nobutaka Nagano, Toshiyuki Yano, Yugo Fujita, Masayuki Koyama, Ryo Hasegawa, Jun Nakata, Ryo Nishikawa, Naoto Murakami, Takefumi Fujito, Atsushi Mochizuki, Hidemichi Kouzu, Atsuko Muranaka, Nobuaki Kokubu, Tetsuji Miura
    Canadian Journal of Cardiology.2020; 36(9): 1554.e5.     CrossRef
  • Fatal influenza myocarditis with incessant ventricular tachycardia
    Nidhi Saraiya, Supriya Singh, Marilou Corpuz
    BMJ Case Reports.2019; 12(7): e228201.     CrossRef
A Case of Fatal Mechanical Mitral Valve Leaflet Fracture Embolization: A Case Report
Won Yik Lee, Jong Myeon Hong, Jang Whan Bae
Korean J Crit Care Med. 2011;26(2):101-104.
DOI: https://doi.org/10.4266/kjccm.2011.26.2.101
  • 2,799 View
  • 27 Download
  • 2 Crossref
AbstractAbstract PDF
The fracture embolization of a mechanical valve is a very rare but potentially fatal event that can cause acute severe valve regurgitation and subsequent decompensated heart failure. Generally, the mechanical valve is durable and semi-permanent. If this is not the case, bacterial endocarditis can occur. However, leaflet fracture embolizations related to mechanical failure may occur in the specific mechanical valve brands associated with the subjects own structural fragilities. In this case, we dealt with a case of fatal Edward-Duromedics mechanical mitral valve leaflet fracture embolization that had been implanted 20 years ago. The patient presented with severe acute heart failure and shock. Severe transvalvular mitral regurgitation and only one valve leaflet was observed in echocardiography. Although the emergency mitral valve replacement was performed under the diagnosis with valve leaflet fracture embolization, the patient was not resuscitated from systolic pump failure and died.

Citations

Citations to this article as recorded by  
  • A rare case series of mechanical prosthetic heart valve structural deterioration presented as severe mitral regurgitation
    Jignesh Kothari, Sandip Lukhi, Utkarsh Sanghavi, Devvrat Desai, Ishan Gohil
    Heart, Vessels and Transplantation.2023; 7(Issue 4): 278.     CrossRef
  • An unusual cause of acute mitral regurgitation in TTK Chitra heart valve prosthesis
    Muthukumar Sundaram, Aayush Poddar, Ancy Robinson, Soundaravalli Balakrishnan, Muralidharan Srinivasan, Chandrasekar Padmanabhan
    Indian Journal of Thoracic and Cardiovascular Surgery.2021; 37(5): 546.     CrossRef
Cardiac Transplantation for a Patient with Intra-aortic Balloon Pump and Extracorporeal Membrane Oxygenator due to Cardiogenic Shock after Acute Myocardial Infarction: A Case Report
Jae Hang Lee, Young Ok Lee, Byoung Ju Min, Byung Su Yoo, Ki Bong Kim
Korean J Crit Care Med. 2010;25(3):194-198.
DOI: https://doi.org/10.4266/kjccm.2010.25.3.194
  • 2,428 View
  • 141 Download
AbstractAbstract PDF
A 66-year-old male patient who suffered from chest pain and dyspnea was admitted to our hospital. He was diagnosed as having an acute myocardial infarction, and recovered from cardiogenic shock after cardiopulmonary-cerebral resuscitation. Under the support of extracorporeal membrane oxygenator (ECMO) he underwent successful percutaneous coronary intervention. After this, an intra-aortic balloon pump (IABP) was inserted to increase coronary perfusion and reduce the impedance to left ventricular ejection. After 6 days, the patient was weaned from ECMO support; however, IABP therapy and infusion of inotropic agents were required to maintain adequate hemodynamic status. One week later, cardiac transplantation was performed successfully without major complications.

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