Biomedical subjects

Michael Shenoda

Publications and source records attributed to Michael Shenoda.

3 recordsLinked to original sources

PubMed2006

Left ventricular lead stabilization utilizing a coronary stent.

Cardiac resynchronization therapy has been recently demonstrated to have a mortality and morbidity benefit in heart failure (HF) patients with cardiac dyssynchrony. Currently, the most widely used method of left ventricular (LV) lead placement involves transvenous placement of leads via the coronary sinus (CS) and into a tributary branch. Lead dislodgement is a common cause for reoperation, and continues to be a common problem despite advances in equipment and operator techniques. We describe a case where a coronary stent was placed in a lateral branch of the CS to stabilize the lead against the vessel wall.

Aged↗

PubMed2006

Refractory coronary vasospasm following drug-eluting stent placement treated with cyproheptadine.

Serotonin (5-hydroxytryptamine) has been recently shown to be an important mediator of coronary vasospasm. Its divergent effect on normal and atherosclerosed arteries has been demonstrated in both animal and human studies. We present a case of coronary vasospasm in a 55-year-old man with repeated episodes of chest pain following coronary percutaneous intervention. Repeat angiography demonstrated no reocclusion or complication. The patient's symptoms were resistant to treatment with maximum doses of two calcium channel antagonists and oral and intravenous nitrates, but responded to cyproheptadine, a nonselective serotonin antagonist. Currently, there are only two reported cases of coronary vasospasm following balloon angioplasty responding to treatment with serotonin antagonists. This is the first case reported case following drug-eluting stent deployment.

Calcium Channel Blockers↗

PubMed2005

Myocardial calcification as a rare cause of congestive heart failure: a case report.

Myocardial calcification is a manifestation of either metastatic or dystrophic calcium deposition in the myocardium. Dystrophic calcification of the myocardium is most commonly seen in long-term survivors of substantial myocardial infarctions. Current literature has reported only 3 cases of myocardial calcification with normal coronary arteries. We present a case of an 80-year-old woman with multiple admissions over a 5-year period for congestive heart failure. She was found to have a normal left ventricular ejection fraction and normal coronary arteries on left heart catheterization. A high resolution computed tomography (CT) study of the chest revealed extensive left ventricular myocardial calcifications, which were not present 4 years earlier on CT. The patient's history and clinical presentation revealed no etiologic factors for her calcified myocardium.

Aged, 80 and over↗