Context:Regional pericarditis is elusive and difficult to diagnosis. Healthcare providers should be familiar with post-cardiac ablation complications as this procedure is now widespread and frequently performed. The management of regional pericarditis differs greatly from that of acute myocardial infarction.Case report:A 52 year-old male underwent atrial fibrillation ablation and developed severe mid-sternal chest pain the following day with electrocardiographic findings suggestive of acute myocardial infarction, and underwent coronary angiography, a left ventriculogram, and 2D transthoracic echocardiogram, all of which were unremarkable without evidence of obstructive coronary disease, wall motion abnormalities, or pericardial effusions. Ultimately, the patient was diagnosed with regional pericarditis. After diagnosis, the patient's presenting symptoms resolved with treatment including nonsteroidal anti-inflammatory agents and colchicine.Conclusion:This is the first reported case study of regional pericarditis status post cardiac ablation. Electrocardiographic findings were classic for an acute myocardial infarction; however, coronary angiography and left ventriculogram demonstrated no acute coronary occlusion or ventricular wall motion abnormalities. Healthcare professionals must remember that the electrocardiographic findings in pericarditis are not always classic and that pericarditis can occur status post cardiac ablation.
Low-risk women presenting to the ED with chest pain have an excellent short- and long-term prognosis. A majority of patients did not receive predischarge testing, and their length of stay was reduced by >50% compared with those with predischarge testing. These findings suggest that such patients may not require predischarge testing for disposition from a CPU, which can reduce length of stay, decrease cost, and improve resource utilization.
Atrial fibrillation affects over 2.5 million people in the USA and more than 6 million people in Europe. The most devastating complication of atrial fibrillation is systemic thromboembolism, manifesting as ischemic stroke. The left atrial appendage, accounts for 90% of the atrial thrombi in atrial fibrillation. There are two strategies to prevent left atrial appendage thrombi: long term anticoagulation; and eliminating the source of the thrombus, that is, excision/exclusion of the left atrial appendage surgically or percutaneously. In this review, a detailed discussion of all aspects of the LARIAT device are presented including pre-procedural work up, intra-procedural details and post-procedural complications and follow-up, along with the evidence base in the literature for use of this device.
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