Water for contrast-induced nephropathy? A thirst for knowledge.
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Contrast Media↗
Biomedical subjects
Gordon E Pate
Publications and source records attributed to Gordon E Pate.
An unusual complication of coil embolization of a large coronary-pulmonary fistula.
A 58-year-old man with hemoptysis was found to have a large fistula from his circumflex artery to the pulmonary system. Coil embolization was performed. This resulted in occlusion of the fistula, including a small branch likely supplying the sinus node. Following the procedure he developed junctional bradycardia but remained hemodynamically stable. He had a brief period of atrial fibrillation which, after 48 hours, reverted to a rhythm from an ectopic focus in the low right atrium. This case highlights an unusual complication of fistula embolization and emphasizes the need for caution when occluding vessels which may supply the sinus node.
Atrial Fibrillation↗
Association between aortic stenosis and hypertension.
BACKGROUND AND AIM OF THE STUDY: Hypertension causes increased shear stress across the aortic valve. Shear stress across endothelial cells in vitro induces inflammation, which has been demonstrated on stenosed valve leaflets in vivo. In theory, longstanding hypertension could result in aortic stenosis. The study aim was to identify a possible clinical association between these two conditions. METHODS: Data relating to patients with a primary or secondary discharge diagnosis of hypertension or aortic stenosis in the Republic of Ireland were obtained from the Hospital In-Patient Enquiry National File for 1995 to 1999 inclusive. Proportions were compared using chi-squared testing. RESULTS: A total of 3.39 million discharges occurred during this period. Hypertension was the primary or secondary diagnosis in 6.2%, and aortic stenosis in 0.33%. Both conditions were present in 0.07%. Hypertension was present in 21.0% of those with aortic stenosis, and aortic stenosis in 1.1% of those with hypertension. Hypertension was associated with aortic stenosis with an odds ratio of 4.0 (95% confidence interval 3.9 to 4.2, p = 0.0001). CONCLUSION: Aortic stenosis and hypertension were significantly associated in patients discharged from hospital. If hypertension is shown to be contributing to aortic valve disease then, potentially, better blood pressure control might prevent the progression of stenosis.
Aortic Valve Stenosis↗