The Experts below are selected from a list of 120 Experts worldwide ranked by ideXlab platform

Cholenahally Nanjappa Manjunath - One of the best experts on this subject based on the ideXlab platform.

Ping Yang - One of the best experts on this subject based on the ideXlab platform.

  • Cardiovascular Syphilis associated acute myocardial infarction a case report
    Medicine, 2021
    Co-Authors: Xue Wang, Zhiyuan Wang, Cuiying Mao, Heyu Meng, Fanbo Meng, Ping Yang
    Abstract:

    Rationale In recent decades, the incidence of advanced Syphilis has declined due to early recognition and the application of effective antibiotics. Advanced Syphilis often manifests in the Cardiovascular system as simple aortitis, aortic valve insufficiency, coronary artery stenosis or obstruction, Aortic aneurysm and mucinous myocarditis. In most case reports on the subject, acute myocardial infarction caused by Syphilis was reported to be due to aortic valve insufficiency and coronary stenosis as a result of the involvement of the aorta. Patient concerns The patient was a 48-year-old woman. She was admitted to our hospital because of intermittent upper abdominal pain with chest tightness for 3 hours. The patient reported a past Syphilis infection, when she was hospitalized for hysteromyoma surgery four years ago, and had no related treatment. Diagnosis According to the characteristics of coronary angiography and results of lab tests and echocardiography, she was finally diagnosed with myocardial infarction associated with Syphilis. Interventions At the first diagnosis of Syphilis, the patient did not received antibiotics treatment. After the diagnosis of myocardial infarction, she received the percutaneous coronary intervention (PCI) operation assisted by extracorporeal membrane oxygenation (ECMO) technology, successfully got drug -eluted stents in right coronary artery ostium and left main ostium. Then the patient received penicillin to treat the Syphilis infection. Outcomes After coronary revascularization, the cardiac function of the patients was gradually improved, and the left ventricular ejection fraction was gradually improved after combined with optimized drug therapy. Lessons The Cardiovascular system is often involved in the stages of advanced Syphilis with severe complications like myocardial infarction. Standard treatment should be given as soon as Syphilis is diagnosis. For stenosis of coronary ostium, the PCI assisted by ECMO technology did not only ensure the effectiveness of the treatment, but also reduce the surgical risk of the patient. This case indicated the effectiveness of ECMO-assisted PCI, and thus may provide a reference for future patient treatment.

K Subramanyan - One of the best experts on this subject based on the ideXlab platform.

Xue Wang - One of the best experts on this subject based on the ideXlab platform.

  • Cardiovascular Syphilis associated acute myocardial infarction a case report
    Medicine, 2021
    Co-Authors: Xue Wang, Zhiyuan Wang, Cuiying Mao, Heyu Meng, Fanbo Meng, Ping Yang
    Abstract:

    Rationale In recent decades, the incidence of advanced Syphilis has declined due to early recognition and the application of effective antibiotics. Advanced Syphilis often manifests in the Cardiovascular system as simple aortitis, aortic valve insufficiency, coronary artery stenosis or obstruction, Aortic aneurysm and mucinous myocarditis. In most case reports on the subject, acute myocardial infarction caused by Syphilis was reported to be due to aortic valve insufficiency and coronary stenosis as a result of the involvement of the aorta. Patient concerns The patient was a 48-year-old woman. She was admitted to our hospital because of intermittent upper abdominal pain with chest tightness for 3 hours. The patient reported a past Syphilis infection, when she was hospitalized for hysteromyoma surgery four years ago, and had no related treatment. Diagnosis According to the characteristics of coronary angiography and results of lab tests and echocardiography, she was finally diagnosed with myocardial infarction associated with Syphilis. Interventions At the first diagnosis of Syphilis, the patient did not received antibiotics treatment. After the diagnosis of myocardial infarction, she received the percutaneous coronary intervention (PCI) operation assisted by extracorporeal membrane oxygenation (ECMO) technology, successfully got drug -eluted stents in right coronary artery ostium and left main ostium. Then the patient received penicillin to treat the Syphilis infection. Outcomes After coronary revascularization, the cardiac function of the patients was gradually improved, and the left ventricular ejection fraction was gradually improved after combined with optimized drug therapy. Lessons The Cardiovascular system is often involved in the stages of advanced Syphilis with severe complications like myocardial infarction. Standard treatment should be given as soon as Syphilis is diagnosis. For stenosis of coronary ostium, the PCI assisted by ECMO technology did not only ensure the effectiveness of the treatment, but also reduce the surgical risk of the patient. This case indicated the effectiveness of ECMO-assisted PCI, and thus may provide a reference for future patient treatment.

William C. Roberts - One of the best experts on this subject based on the ideXlab platform.

  • full blown Cardiovascular Syphilis with aneurysm of the innominate artery
    American Journal of Cardiology, 2009
    Co-Authors: William C. Roberts, Forrester Dubus Lensing, Harry Kourlis, Jonathan Warren Newberry, Michael John Smerud, Elizabeth C Burton, Robert F Hebeler
    Abstract:

    The investigators report the case of a 44-year-old man who presented acutely and was found to have saccular aneurysm of the innominate artery, narrowed or totally occluded aortic arch arteries, and marked thickening of the thoracic aorta except for the wall behind the sinuses of Valsalva. The abdominal aorta was entirely normal. Results of the serologic test for Syphilis were strongly positive. Because Cardiovascular Syphilis appears to be a disease that affects the vasa vasora and because these channels are limited to the thoracic aorta, the abdominal aorta is uninvolved, as demonstrated so nicely in the patient described in this case report. Because most patients with Cardiovascular Syphilis are much older than the patient described, it is unusual to see a perfectly normal abdominal aorta, as in the present patient. In conclusion, Syphilis producing aneurysm of the innominate artery is unusual but is always associated with syphilitic involvement of the thoracic aorta.

  • identifying Cardiovascular Syphilis at operation
    American Journal of Cardiology, 2009
    Co-Authors: William C. Roberts, Rahul Bose, Albert Carl Henry, Baron L Hamman
    Abstract:

    To describe the morphologic features so the process can be easily identified during surgery, we studied 34 patients with Cardiovascular Syphilis, 32 of whom underwent excision and replacement of the ascending aorta or aortic valve or both. Of the 34 patients, 22 were treated at Baylor University Medical Center from 1998 to 2008 and 12 at non–Baylor University Medical Center hospitals from 1958 to 1987. In all 34 patients, the tubular portion of the aorta was diffusely thickened and the sinus portion of the aorta was apparently uninvolved. The process involved all 3 layers of the aorta, with thickening of the adventitia, mainly by fibrous tissue. Within the fibrous tissue were collections of plasma cells and lymphocytes, focal destruction of the media without thickening, and marked thickening of the intima by atherosclerotic-appearing lesions. Serologic tests for Syphilis were done in only 14 patients (41%) and were positive (reactive) in 6 (43%) of them. The ascending aorta, however, was similar in all 34 patients. In conclusion, Cardiovascular Syphilis has not disappeared. Its identification during surgery can prompt appropriate antibiotic therapy postoperatively. Although the serologic test results for Syphilis might be negative, antibiotic therapy is recommended for patients with panaortitis requiring resection of the ascending aorta with or without aortic regurgitation.

  • Natural History of Syphilitic Aortitis
    The American journal of cardiology, 2009
    Co-Authors: William C. Roberts, Travis James Vowels
    Abstract:

    No large studies of Cardiovascular Syphilis at necropsy have been reported since 1964. We examined at necropsy 90 patients who had characteristic morphologic findings of syphilitic aortitis. None had ever undergone Cardiovascular surgery. With the exception of 2 cases seen more recently, the hearts and aortas of the 90 patients were examined and categorized by one of us (W.C.R.) from 1966 to 1990. All 90 had extensive involvement of the tubular portion of the ascending aorta by the syphilitic process, which spared the sinuses of Valsalva in all but 4 patients. The aortic arch was also involved in 49 (91%) of 54 patients and the descending thoracic aorta in 47 (90%) of 52 patients. Syphilis was the cause of death in 23 (26%) of the 90 patients. It was secondary to rupture of the ascending or descending thoracic aorta in 12, severe aortic regurgitation leading to heart failure in 10, and severe narrowing of the aortic ostium of the right coronary artery in 1 patient. Of the 40 patients who had undergone serologic testing for Syphilis, 28 (70%) had a positive (reactive) finding. Those patients with a negative or nonreactive test or who did not undergo a serologic test for Syphilis had morphologic and histologic findings in the aorta at necropsy similar to the findings of those patients who had had a positive serologic test for Syphilis. In conclusion, Cardiovascular Syphilis has not disappeared. In patients with dilated ascending aortas, with or without aortic regurgitation, a serologic test for Syphilis is recommended. If the findings are positive or if characteristic morphologic features of Cardiovascular Syphilis are suspected, irrespective of the results of the serologic tests, antibiotic therapy appears desirable.