cardiovascular-agents and Staphylococcal-Infections

Takotsubo cardiomyopathy consists of a transient dysfunction of the left ventricle. It is characterised by an impaired left ventricular segmentary contractility, without significant coronary lesions in the coronary angiography. It usually occurs after an episode of physical or emotional stress. We present the case of a 70 year-old woman, who, in the postoperative period of an ankle osteosynthesis, developed a Takotsubo cardiomyopathy in the context of a sepsis caused by Staphylococcus aureus. She presented with acute lung oedema and a clinical picture of low cardiac output. The echocardiogram showed left ventricular medioapical akinesia. Coronary angiography was normal. She was treated with supportive measures with good progress. At 33 days from onset she was able to be discharged from hospital to home with normal systolic function on echocardiography.

Topics: Aged; Ankle Fractures; Atrial Fibrillation; Bacteremia; Cardiovascular Agents; Female; Fracture Fixation, Internal; Humans; Postoperative Complications; Staphylococcal Infections; Takotsubo Cardiomyopathy

We present three cases of pediatric patients with thrombocytopenia-associated multiple organ failure and the evidence for providing extracorporeal organ support. All three patients had severe cardiac dysfunction, respiratory failure, and acute kidney injury treated with venoarterial extracorporeal membrane oxygenation, continuous renal replacement therapy, and plasma exchange. Despite the presence of multiple organ failure and high risk of mortality, all three patients survived with minimal long-term sequelae.

Topics: ADAM Proteins; ADAMTS13 Protein; Adolescent; Bacteremia; Cardiopulmonary Resuscitation; Cardiovascular Agents; Child; Combined Modality Therapy; Extracorporeal Membrane Oxygenation; Fluid Therapy; Heart Arrest; Hemofiltration; Hemolytic-Uremic Syndrome; High-Frequency Ventilation; Humans; Infarction, Middle Cerebral Artery; Influenza A virus; Influenza, Human; Male; Methicillin-Resistant Staphylococcus aureus; Multiple Organ Failure; Osteomyelitis; Plasma Exchange; Staphylococcal Infections; Thrombotic Microangiopathies; Tracheostomy

Coronary artery stent infection is a rare complication of percutaneous intervention. We report a case of fulminant coronary stent infection with Staphylococcus aureus presenting as a pseudoaneurysm of the left circumflex artery following repeated implantation of drug-eluting stents in the setting of multiple episodes of recurrent in-stent restenosis. We speculate that sirolimus- and paclitaxel-eluting stents may be more likely to predispose to infection than bare metal stents because of their immunomodulating and antiproliferative effects.

Topics: Aged; Aneurysm, False; Aneurysm, Infected; Blood Vessel Prosthesis Implantation; Cardiovascular Agents; Cell Proliferation; Coronary Restenosis; Fatal Outcome; Humans; Immunosuppressive Agents; Male; Paclitaxel; Prosthesis-Related Infections; Sirolimus; Staphylococcal Infections; Staphylococcus aureus; Stents