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5 results on '"Chung, Kiyon"'

3. Improvement of Cardiac Vegetations in Antiphospholipid Syndrome with Enoxaparin and Corticosteroids after Rivaroxaban Failure

Author

Granowicz, Eric and Chung, Kiyon

Subjects
Article Subject
Abstract

Cardiac disease is a well-known complication of antiphospholipid syndrome (APS), with many patients presenting with valvular thickening or vegetations, referred to as Libman–Sacks endocarditis (LSE). Because cases of APS with cardiac involvement are relatively rare, paucity of large clinical trials studying this complication has made management challenging. In the absence of acute heart failure and embolic events, a medical approach is usually selected, consisting of anticoagulation and possibly corticosteroids when another underlying autoimmune disease is present. However, the role of various anticoagulant classes and the duration of steroid therapy continue to be debated. Here, we present a 45-year-old woman who developed two vegetations in the setting of secondary APS while taking rivaroxaban before experiencing marked improvement with the use of enoxaparin and steroids.

Published
2018
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4. Atrial Myxoma Presenting as Myocardial Infarction Diagnosed by Echocardiography, Managed Endoscopically with Robot-Assisted Surgery.

Author

Chaudhuri AA, Simmons C Jr, Ellison D, Hemp J, and Chung K

Abstract

Atrial myxomatous embolization into the coronary arteries is a rare event. Management of large myxomas is usually via surgical resection involving a median sternotomy. Echocardiography is not a routine part of non-ST-elevation myocardial infarction (NSTEMI) management. Here, we present the case of a 70-year-old Caucasian man with a history of hypertension and hyperlipidemia who presented to the emergency department with an NSTEMI. Transthoracic echocardiogram and transesophageal echocardiogram revealed a large and highly mobile atrial mass, traversing through the mitral valve orifice during diastole. Coronary angiography revealed a focal 60% lesion in the right coronary artery and no other significant obstructive coronary artery disease, suggesting that the cause of his presentation was tumor embolization into the coronary circulation. The patient underwent robot-assisted endoscopic resection of his atrial mass and was discharged in stable condition on postoperative day 2. Pathology revealed atrial myxoma. To our knowledge, this is the first reported case of an atrial myxoma presenting with an NSTEMI and managed with a robot-assisted endoscopic approach. This case also highlights the importance of routine early echocardiography in patients presenting with NSTEMI.

Published
2016
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5. Myocardial perfusion imaging in acute coronary syndromes: potential use in decision making for emergent revascularization.

Author

Chung K and Gill EA

Subjects
Angioplasty, Balloon, Cardiac Catheterization, Decision Making, Electrocardiography, Humans, Male, Middle Aged, Myocardial Infarction therapy, Radionuclide Imaging, Myocardial Infarction diagnostic imaging
Abstract

We report two cases of patients presenting to the emergency department with chest pain who had low risk electrocardiographic findings. Myocardial perfusion imaging (MPI) revealed a significant area of decreased uptake suggestive of acute transmural infarction. In both cases, biochemical markers later confirmed the diagnosis of myocardial infarction. Cardiac catheterization revealed a large area at risk which was then treated with percutaneous intervention. As MPI is increasingly utilized in the acute evaluation of chest pain, it may serve as a useful adjunct in selecting patients who may benefit from emergent cathertization and revascularization.

Published
2004
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