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Tahir Tak

Publications and source records attributed to Tahir Tak.

At least 19 recordsLinked to original sources
PubMed2006

The role of echocardiography in diagnosing space-occupying lesions of the heart.

In contrast to primary cardiac tumors, which are less frequent and mostly benign in nature, the majority of intracardiac tumors are metastatic lesions. Cardiac ultrasound has evolved enormously since its emergence in the 1950s and is presently the modality of choice for imaging space-occupying lesions of the heart; it provides high quality, real-time images that are extremely valuable in the evaluation of cardiac masses. Although transthoracic echocardiography is an excellent initial diagnostic technique to evaluate and diagnose cardiac masses, transesophageal echocardiography provides superior image resolution and better visualization of cardiac masses in patients with suboptimal transthoracic echocardiography studies. Computed tomography and magnetic resonance imaging are additional tools used for cardiac imaging and may provide useful information in addition to that obtained by echocardiography, especially when the images obtained by the latter are suboptimal.

Echocardiography↗
PubMed2005

Transcatheter closure of atrial septal defect (secundum type): the role of echocardiography in evaluating interatrial defects.

Atrial septal defects are among the most common congenital heart defects seen in the adult population. The diagnosis is usually made in children and closure is attempted before they are school age. In other cases, where the diagnosis is missed until adulthood, atrial arrhythmias and congestive heart failure are commonly seen. We report the case of an atrial septal defect (secundum type), which was diagnosed in a 72-year-old woman with paroxysmal atrial fibrillation. She also had a history of hypertension and hyperlipidemia. Transthoracic and transesophageal findings were consistent with right-sided volume overload and an atrial septal defect of approximately 1 cm in size. This was corroborated by the findings on cardiac catheterization with a shunt ratio of 1.8. The pulmonary artery pressures were within normal limits. The patient was referred for closure of the atrial septal defect. Presently, the options for septal defect closure are direct suture repair, Dacron patch repair depending on the size of the defect, and percutaneous transcatheter closure. Transcatheter closure is also available in treating selected patients with patent foramen ovale.

Aged↗
PubMed2005

Surgical management of mycotic aneurysm of the left anterior descending artery.

Mycotic aneurysms of the coronary artery with underlying infective endocarditis are rare. The present report discusses the case of a 53-year-old woman with acute ST elevation myocardial infarction in the setting of native aortic valve endocarditis. Percutaneous transluminal coronary angioplasty was performed. Approximately four weeks after hospital admission, the patient had systemic embolization to the extremities with resulting cyanosis of the left toes. She was evaluated for replacement of the aortic valve and underwent a repeat angiogram, which demonstrated a mycotic aneurysm at the site of the angioplasty. She subsequently underwent successful excision of the aneurysm with coronary artery bypass grafting and replacement of the aortic valve with a 21 mm St Jude aortic valve prosthesis. The remaining hospital course was unremarkable.

Aneurysm, Infected↗
PubMed2004

Myocardial infarction in a patient with thrombotic thrombocytopenic purpura.

A 63-year-old male with a prior history of thrombotic thrombocytopenic purpura was admitted with sudden onset of syncope. He denied chest pain. His initial blood chemistries were consistent with acute relapse of thrombotic thrombocytopenic purpura as indicated by microangiopathic hemolytic anemia and thrombocytopenia. The patient had evidence of myocardial injury as indicated by elevation of cardiac enzymes. A 12-lead electrocardiogram demonstrated ST elevation (up to 5 mm) in leads V(2) to V(6). The patient was treated with plasma exchange with fresh frozen plasma in addition to nitroglycerin, metoprolol and prednisone in a tapering dose. After reviewing the literature, we believe that the etiology of myocardial damage remains elusive, but may be secondary to an autoimmune phenomenon resulting in microthrombosis and myocarditis. We were unable to find any documentation about any specific treatment in such patients. Further studies are awaited regarding appropriate treatment of patients with thrombotic thrombocytopenic purpura and acute electrocardiographic changes.

Electrocardiography↗
PubMed2004

Left atrial mass: thrombus mimicking myxoma.

A 31-year-old woman underwent elective transthoracic echocardiography for paroxysmal atrial fibrillation, which showed a large left atrial mass. A two-dimensional echocardiogram showed a large left atrium mass. Subsequent transesophageal echocardiography showed a 3 cm x 3 cm circular mass with smooth contours. The differential diagnosis included myxoma versus thrombus, but because of morphology and mobility of the mass, it was difficult to differentiate one from the other. The patient had been on chronic coumadin therapy for paroxysmal atrial fibrillation. An operation was performed and the intracardiac mass resected. On pathologic examination the mass was diagnosed as an organized thrombus. A brief review of the literature has been presented to discuss the differential diagnosis of the mass in the left atrium.

Adult↗
PubMed2004

Venous thromboembolic disease presenting as inferior vena cava thrombus extending into the right atrium.

With increasing use of echocardiography, especially transesophageal echocardiography, the diagnosis of intracardiac masses has surged. Masses that are most commonly seen in the atrial chambers include thrombi due to atrial fibrillation, cardiac myxomas often located in the atria, and valvular vegetations of infective endocarditis. In this report we present a case of a patient who developed thrombus in the inferior vena cava that extended up to the right atrium and presented as an apparent intracardiac mass. This mass embolized to the right pulmonary artery shortly after diagnosis resulting in pulmonary embolism, which the patient fortunately survived.

Aged↗
PubMed2004

Role of magnetic resonance imaging in visualizing coronary arteries.

Ischemic heart disease is the leading cause of death worldwide. At present, coronary angiography is the gold standard for the diagnosis of coronary artery disease. Conventional coronary angiography is an invasive procedure with a small, yet inherent risk of myocardial infarction, stroke, potential arrhythmias, and death. Other noninvasive diagnostic tools, such as electrocardiography, echocardiography, and nuclear imaging are now widely available but are limited by their inability to directly visualize and quantify coronary artery stenoses and predict the stability of plaques. Coronary magnetic resonance angiography (MRA) is a technique that allows visualization of the coronary arteries by noninvasive means; however, it has not yet reached a stage where it can be used in routine clinical practice. Although coronary MRA is a potentially useful diagnostic tool, it has limitations. Further research should focus on improving the diagnostic resolution and accuracy of coronary MRA. This review summarizes results from several studies comparing coronary MRA with conventional coronary angiography. Current two-dimensional and three-dimensional coronary MRA techniques and their limitations are also discussed.

Coronary Angiography↗
PubMed2004

Comparing stress testing methods. Available techniques and their use in CAD evaluation.

Exercise stress testing remains one of the most widely used techniques in assessing functional capacity and in confirming a diagnosis of CAD. Its sensitivity and specificity are approximately 63% and 74%, respectively. The technique is safe when administered and supervised by qualified personnel who are trained to recognize contraindications and other reasons for termination of the test. More recently, echocardiography has been combined with exercise stress testing. It is a well-tolerated and valuable procedure for noninvasive evaluation of CAD. The sensitivity and specificity of stress echocardiography are higher than those of exercise stress testing and comparable to those of nuclear perfusion imaging. Continuing improvements in digital image analysis, cost, and the availability of contrast agents promise to make noninvasive stress testing even more useful in the years to come. Newer contrast and concomitant perfusion agents are on the horizon and may prove to be a reality in the echocardiographic laboratories of the future.

Clinical Protocols↗
PubMed2004

Aortic valve papillary fibroelastoma.

Papillary fibroelastomas are benign and rare tumors usually involving the cardiac valves. The diagnosis of this condition has gradually increased over the past few years. This is attributed to the increasing number of echocardiographic and transesophageal procedures that are currently performed. The case is presented of a woman diagnosed with an aortic valve mass, the sessile nature of which in the aortic root was considered a potential source of cerebral and coronary embolism. The mass was surgically removed, with no major complications being encountered perioperatively.

Aortic Valve↗
PubMed2003

Current diagnosis and treatment of infective endocarditis.

The incidence of infective endocarditis continues to rise with a yearly incidence of around 15,000 to 20,000 new cases in the USA. As a result, rapid diagnosis, effective treatment and prompt recognition of complications are essential to desirable clinical outcomes. Recent guidelines such as the Duke criteria have incorporated echocardiography for diagnosis of infective endocarditis, making this diagnostic test mandatory for patients with suspected infective endocarditis. The diversity of pathogens that can cause infective endocarditis, some of which cannot be cultured easily, makes diagnosis even more difficult. Coagulase-negative staphylococci and viridans streptococci groups continue to be the major causative microorganisms of infective endocarditis. In the case of culture-negative endocarditis or infective endocarditis caused by fastidious microorganisms, the polymerase chain reaction and probe-based diagnostic methods are available to clinical reference laboratories.

Endocarditis, Bacterial↗
PubMed2003

Pseudoaneurysm of mitral-aortic intervalvular fibrosa.

Pseudoaneurysm of the mitral-aortic intervalvular fibrosa (MAIVF) is one of the rare complications of infective endocarditis. Echocardiography plays an important role in the diagnosis of this condition. Transesophageal echocardiography (TEE) is generally superior to the transthoracic approach in the evaluation of the complications resulting from infective endocarditis. In this report, we discuss a case of infective endocarditis complicated by the development of a pseudoaneurysm of the MAIVF. The anatomic relationship of structures contiguous to the MAIVF and the salient echocardiographic findings of this clinical condition are presented. At surgery the diagnosis was confirmed and appropriate treatment instituted. The postoperative course was uncomplicated.

Aneurysm, False↗
PubMed2003

Incidental massive pericardial effusion diagnosed by myocardial perfusion imaging.

A report on an unusual case of pericardial effusion and tamponade that was found incidentally on myocardial perfusion imaging. This was later confirmed by echocardiography and subsequently treated with pericardiocentesis. Two-dimensional echocardiography is still the "gold standard" for diagnosing pericardial effusion. Nuclear cardiac imaging will probably never have a primary role in the diagnosis of pericardial effusion. However, it may be helpful when the diagnosis of pericardial effusion has not been considered and when this condition is suggested by nuclear imaging findings. The echocardiogram underestimated the amount of pericardial effusion compared to myocardial perfusion imaging in this case, and in contrast to previous published reports. Further, prospective studies need to focus on the sensitivity and specificity of sestamibi nuclear scans in the qualitative and quantitative assessment of pericardial effusions.

Aged↗
PubMed2003

Iatrogenic pseudoaneurysm of femoral artery: case report and literature review.

The case of a patient who developed a femoral artery pseudoaneurysm (FAP) following cardiac catheterization is described. It is one of the most troublesome complications after various invasive cardiovascular procedures related to the femoral arterial access site. Iatrogenic pseudoaneurysms (IPA) form when an arterial puncture site fails to seal, allowing arterial blood to ooze into the surrounding tissues and form a pulsatile hematoma. The FAP occurs in 0.8% to 2.2% after interventional procedures. This problem has become more significant due to the exponential growth of interventional cardiology. Doppler flow mapping has been the mainstay of diagnosis. Diagnostic criteria include: swirling color flow in a mass separate from the affected artery, and a typical "to-and-fro" Doppler waveform in the pseudoaneurysm neck. Ultrasound-guided compression repair has replaced the need for surgical repair of FAP. It has been shown to be a safe and cost-effective method for achieving pseudoaneurysm thrombosis. However, it carries considerable drawbacks including long procedure times, discomfort to patients, high recurrence rate in patients receiving anticoagulant therapy and an overall 3.6% complication rate. Recently, percutaneous thrombin injection in the FAP has gained popularity despite complications associated with the initial use of high dose thrombin (average dose of 1,100 IU). The technique was refined when low-dose thrombin injections were studied and proved to have the same efficacy and consistently high success rates (average dose used 192 IU). However, there is a theoretical risk of developing type I IgE-mediated allergic reaction to bovine thrombin. The indications, advantages, disadvantages, and complications of the various treatment modalities are discussed in this report and review of the literature. Other treatments with collagen injection are also discussed in detail.

Aged↗