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Cardiac arrest following anaesthetic induction in a world-class bodybuilder [Case Report]

Angelilli, Allison; Katz, Edward S; Goldenberg, Ronald M
This is a report of a 41-year-old professional male bodybuilder with a history of active anabolic-androgenic steroid abuse and a normal echocardiogram two years prior to admission who experienced a near-fatal arrhythmia during anaesthetic induction for elective orthopaedic surgery. The patient had severe concentric left ventricular hypertrophy, diffuse left ventricular hypokinesis, decreased ejection fraction and inducible monomorphic ventricular tachycardia. A single-chamber cardioverter/defibrillator was inserted
PMID: 16128379
ISSN: 0001-5385
CID: 67869

Isolated subclavian artery aneurysm: evaluation by transesophageal echocardiography [Case Report]

Shah, Alan; Katz, Edward S; Stern, Alexandra; Tunick, Paul A; Kronzon, Itzhak
A 50-year-old man was evaluated following a motor vehicle accident. Chest X-ray showed a widened mediastinum. Transesophageal echocardiography was helpful in identifying the left subclavian artery and in demonstrating an isolated subclavian artery aneurysm. The TEE findings correlated well with the results of chest CT. Using TEE for the identification of the aortic branches in patients with chest trauma may be critical
PMID: 14717726
ISSN: 0742-2822
CID: 43006

Echocardiography in the identification of unusual surgical errors resulting from attempted closure of secundum atrial septal defects: Report of two cases [Case Report]

Kronzon, Itzhak; Tunick, Paul A; Rosenzweig, Barry P; Katz, Edward S; Colvin, Stephen B
PMID: 12835666
ISSN: 0894-7317
CID: 36723

Bilateral pulmonary artery compression and obstruction by tumor: diagnosis by unusual Doppler flow patterns [Case Report]

Katz, Edward S; Shah, Alan; Rosenzweig, Barry P; Tunick, Paul A; Kronzon, Itzhak
Pulmonary artery obstruction may be caused by tumor within or external to the arteries. Presented here is a patient with life-threatening compromise in pulmonary flow that was caused by a pulmonary neoplasm. The Doppler echocardiogram showed subtotal narrowing of the right pulmonary artery and total occlusion of the left pulmonary artery. In addition, the beneficial effects of chemotherapy were documented by Doppler
PMID: 12574747
ISSN: 0894-7317
CID: 36576

Doppler diagnosis of acute occlusion of the superior vena cava [Case Report]

Benenstein, Ricardo; Nayar, Ambika C; Rosen, Robert; Schlossberg, Peter; Katz, Edward S; Tunick, Paul A; Kronzon, Itzhak
PMID: 12848706
ISSN: 0742-2822
CID: 39153

Effect of treatment on the incidence of stroke and other emboli in 519 patients with severe thoracic aortic plaque

Tunick, Paul A; Nayar, Ambika C; Goodkin, Gregory M; Mirchandani, Sunil; Francescone, Steven; Rosenzweig, Barry P; Freedberg, Robin S; Katz, Edward S; Applebaum, Robert M; Kronzon, Itzhak
Severe aortic plaques seen on transesophageal echocardiography (TEE) are a high-risk cause of stroke and peripheral embolization. Evidence to guide therapy is lacking. Retrospective information was obtained regarding the occurrence of embolic events (stroke, transient ischemic attacks, or peripheral emboli) in 519 patients with severe thoracic aortic plaque seen on TEE since 1988. Treatment with statins, warfarin, or antiplatelet medications was noted. Treatment was not randomized. In a matched-paired analysis, each patient taking each class of therapy was matched for age, gender, previous embolic event, hypertension, diabetes, congestive failure, and atrial fibrillation to someone not taking that medication. Multivariate analysis was also performed. An embolic event occurred in 111 patients (21%). Multivariate analysis showed that statin use was independently protective against recurrent events (p = 0.0001). Matched analysis also showed a protective effect of statins (p = 0.0004; absolute risk reduction 17%, relative risk reduction 59%, number needed to treat [n = 6]). No protective effect was found for warfarin or antiplatelet drugs. The odds ratio for embolic events was 0.3 (95% confidence interval [CI] 0.2 to 0.6) for statin therapy, 0.7 (95% CI 0.4 to 1.2) for warfarin, and 1.4 (95% CI 0.8 to 2.4) for antiplatelet agents. Thus, there is a protective effect of statin therapy, and no significant benefit of warfarin or antiplatelet drugs on the incidence of stroke and other embolic events in patients with severe thoracic aortic plaque on TEE
PMID: 12480041
ISSN: 0002-9149
CID: 36577

The risk of the development of aortic stenosis in patients with "benign" aortic valve thickening

Cosmi, John E; Kort, Smadar; Tunick, Paul A; Rosenzweig, Barry P; Freedberg, Robin S; Katz, Edward S; Applebaum, Robert M; Kronzon, Itzhak
BACKGROUND: Aortic valve thickening (AVT) without aortic stenosis (AS) is common and was often considered benign. However, it has recently been found to be associated with increased morbidity and mortality. It is unknown whether patients with AVT are at risk for the development of AS. METHODS: Our echocardiography database from 1987 to 1993 was searched for cases of AVT with at least 1 year of echocardiographic follow-up. The risk of the development of AS was compared in patients with and without AVT. RESULTS: There were 2131 patients with AVT and at least 1 year of echocardiographic follow-up. Aortic stenosis developed in 338 patients (15.9%) (mild, 10.5%; moderate, 2.9%; and severe, 2.5%). Multivariate analysis, including age, left ventricular hypertrophy, and mitral annular calcification, revealed that only mitral annular calcification was independently and significantly associated with progression to AS. CONCLUSIONS: Aortic valve thickening without stenosis is common, and it may progress to significant AS. It is possible that this development of AS may be responsible for some of the increased morbidity and mortality in patients with AVT
PMID: 12418948
ISSN: 0003-9926
CID: 39568

The current most pressing concerns of implant dentistry

Cronin, Robert; Katz, Edward S; Mayeda, Daniel T; Nicolucci, Blake; Nygaard-Ostby, Per; Palti, Ady
PMID: 12068772
ISSN: 1056-6163
CID: 1558142

Abdominal aortic aneurysms and thoracic aortic atheromas

Reynolds HR; Tunick PA; Kort S; Rosenzweig BP; Freedberg RS; Katz ES; Applebaum RM; Portnay EL; Adelman MA; Attubato MJ; Kronzon I
BACKGROUND: Abdominal aortic aneurysm (AAA) is associated with atherosclerosis elsewhere. Thoracic aortic atheromas (ATHs) seen on transesophageal echocardiography (TEE) are an important cause of stroke and peripheral embolization. The purposes of this study were to determine whether an association exists between AAA and ATHs and to assess the importance of screening patients with ATHs for AAA. METHODS: For the retrospective analysis, 109 patients with AAA and 109 matched controls were compared for the prevalence of ATHs on TEE and for historical variables. For the prospective analysis, screening for AAA on ultrasonography was performed in 364 patients at the time of TEE. RESULTS: Results of the retrospective analysis showed that ATHs were present in 52% of patients with AAA and in 25% of controls (odds ratio [OR] = 3.3; P =.00003). There was a significantly higher prevalence of hypertension, myocardial infarction, heart failure, smoking, and carotid or peripheral arterial disease in patients with AAA. However, only ATHs were independently associated with AAA on multivariate analysis (P =.001). Results of the prospective analysis showed that screening at the time of TEE in 364 patients revealed AAA in 13.9% of those with ATHs and in 1.4% of those without ATHs (P <.0001; OR = 11.4). CONCLUSIONS: (1) There is a strong, highly significant association between abdominal aneurysm and thoracic atheromas. (2) Patients with AAA may be at high risk for stroke because of the concomitance of thoracic aortic atheromas. (3) The high prevalence of abdominal aneurysm in patients with thoracic atheromas suggests that screening for abdominal aneurysm should be carried out in all patients with thoracic atheromas identified by TEE
PMID: 11696839
ISSN: 0894-7317
CID: 26574

Unusual echocardiographic views of bicuspid and tricuspid pulmonic valves [Case Report]

McAleer E; Kort S; Rosenzweig BP; Katz ES; Tunick PA; Phoon CK; Kronzon I
The pulmonary artery is typically seen on transthoracic echocardiography in its longitudinal axis. Therefore, short axis views of the pulmonic valve leaflets are not generally obtained, and the distinction between tricuspid and bicuspid pulmonic valves is difficult or impossible. Bicuspid pulmonic valve is one cause of pulmonic stenosis, which is especially common in tetralogy of Fallot. Presented here are 2 patients in whom the orientation of the pulmonary artery was unusual, and the pulmonic valve was seen en face. The first patient had tetralogy of Fallot and a bicuspid pulmonic valve. The severe obstruction to right ventricular outflow was infundibular. The second patient had severe stenosis of a tricuspid pulmonic valve, which was treated with balloon valvuloplasty. These unusual views of the pulmonic valve leaflets were obtained because of anterior displacement of the pulmonary artery, and precise anatomic delineation of the problem in each case was possible with transthoracic echocardiography
PMID: 11593211
ISSN: 0894-7317
CID: 26604