Volume 8 • Issue 2 • June-2022 – JCE – Journal of Cardiovascular Emergencies

The Neutrophil-to-Lymphocyte Ratio’s Predictive Utility in Acute Pulmonary Embolism: Systematic Review

Sun, 04 Sep 2022 13:53:12 +0000

ABSTRACT
Acute pulmonary embolism is a cardiovascular emergency with a significant morbidity and mortality. In the last decade, attempts have been made to find prognostic markers for pulmonary embolism. We conducted a systematic review of the literature for studies that assess the relationship between the neutrophil-to-lymphocyte ratio (NLR) and disease progression in patients with pulmonary embolism. We included a total of seven studies published between 2016 and 2021, reporting on a total of 4,272 patients. The mean NLR observed in these studies was 5.93, with values ranging from 5.12 to 7.3. Elevated NLR was significantly associated with an increased rate of mortality in all studies. Furthermore, the collected data revealed a 2-to-15 times higher mortality rate in the group with NLR values higher than the mean. Due to its accessibility and the simplicity with which it can be calculated, as well as the outcomes revealed in this review, we strongly emphasize that NLR should be used more in medical practice.

Acute Thrombosis of the Left Main on the Tennis Court in a Young Patient – a Case Report

Theofana Mihăilă, Aurelian Roșca, Bianca Ion — Sat, 03 Sep 2022 03:46:08 +0000

ABSTRACT
In acute coronary syndromes, timely revascularization of the obstructed artery is crucial. In young patients, acute myocardial infarction can have a very severe evolution and is frequently
associated with cardiogenic shock. We present the case of a 36-year-old male patient, smoker with no other apparent risk factors for coronary artery disease, who suffered a cardiac arrest while playing tennis. Emergency coronary angiography revealed acute occlusion of the left anterior descendent artery, which was promptly revascularized. The patient had a good
clinical evolution and was discharged after six days. The case underlines the importance of a well-functioning emergency system and STEMI network, able to provide life-saving therapy in a timely manner.

Diagnostic and Treatment Algorithm in a Plurivascular Patient – Case Report

Annamária Magdás, Zsuzsánna Ágnes Szász, Andrea Mária Kalapács — Fri, 02 Sep 2022 17:54:11 +0000

ABSTRACT
Introduction: Atherosclerosis represents the main cause of arterial stenosis, mostly affecting the arteries of the lower extremities. Atherosclerotic arterial disease presents multiple localizations, including the carotid, subclavian, coronary, and kidney arteries. The severity of the stenosis does not always correlate with the symptomatology. Case report: We present the case of a patient with multisite atherosclerotic disease. A 70-year-old smoker male patient, with a history of myocardial infarction and renal artery stenosis, presented in the emergency department complaining of vertigo, chest pain, and intermittent claudication. The diagnostic and treatment algorithm represented a challenge. Imaging assessment showed atherosclerotic lesions in a new vascular territory, which involved the left subclavian artery with a stenosis of 70%. Conclusions: Subclavian artery stenosis can be a hidden form of atherosclerotic disease, often undiagnosed, which needs urgent interventional treatment and can be easily unmasked using simple tools such as measuring the blood pressure on both arms. Patients with atherosclerotic
lesions must undergo comprehensive screening for multisite atherosclerotic disease.

Double Trouble: Interrupting DAPT and COVID-19

Theofana Mihăilă, Aurelian Roșca, Bianca Ion — Thu, 01 Sep 2022 03:44:10 +0000

ABSTRACT
Cardiovascular disorders have been described as relevant risk factor for severe COVID infection. Stent thrombosis is a life-threatening complication that may occur subacutely. We present an interesting case of a middle-aged woman who developed acute stent thrombosis while interrupting dual antiplatelet therapy (DAPT) ticagrelor, during an episode of coronavirus disease (COVID-19). In our case, the patient’s not-compliance to DAPT, associated with COVID-19 infection and a hyperinflammatory and hypercoagulable state associated with it played a major role in the development of stent thrombosis. The hypercoagulable and hyperinflammatory state associated with COVID-19 has important implications for cardiac patients, especially those undergoing complex coronary intervention, predisposing them to an increased risk of post-PCI complications.