Right bundle branch block as a marker for interatrial septal abnormalities

Bakalli, Aurora; Koçinaj, Dardan; Georgievska-Ismail, Ljubica; Bekteshi, Tefik; Pllana, Ejup; Sejdiu, Basri

doi:10.1017/s1047951111000795

Cited by 7 publications

(10 citation statements)

References 40 publications

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“…RBBB quite frequently occurs with PFO in healthy people and can even be used as a marker for PFO 30. PFO can be a problem for other recreational sports as well, such as recreational diving, which is becoming more and more popular, and also requires a Valsalva maneuver.…”

Section: Discussionmentioning

confidence: 99%

Recurrent myocardial infarctions in a young football player secondary to thrombophilia, associated with elevated factor VIII activity

Vacek¹,

Yu²,

Rehman³

et al. 2014

IMCRJ

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Myocardial infarction (MI) due to coronary atherosclerosis in young adults is uncommon; rare causes such as cocaine abuse, arterial dissection, and thromboembolism should be considered. A 21-year-old football player, and otherwise healthy African American man, developed chest pain during exercise while bench-pressing 400 lbs. Acute MI was diagnosed based on physical examination, electrocardiography findings, and elevated cardiac enzymes. Coronary arteriography showed a thrombus occluding the proximal left anterior descending artery (LAD). Aggressive antiplatelet therapy with aspirin, clopidogrel, and eptifibatide was pursued, in addition to standard post-MI care. This led to the successful resolution of symptoms and dissolution of the thrombus, demonstrated by repeat coronary arteriography. Five months later, he presented with similar symptoms during exercise after lifting heavy weights, and was found to have another acute MI. Coronary arteriography again showed a thrombus occluding the LAD. No evidence of coronary artery dissection or vasospasm was found. Only mild atherosclerotic plaque burden was observed on both occasions by intravascular ultrasound. A bare metal stent was placed at the site as it was thought this site had acted as a nidus for small plaque rupture and thrombus formation. Elevated serum factor VIII activity at 205% (reference range 60%–140%) was found, a rare cause of hypercoagulability. Further workup revealed a patent foramen ovale during a Valsalva maneuver by transesophageal echocardiography. Both events occurred during weight lifting, which can transiently increase right heart pressure in a similar way to the Valsalva maneuver. In light of all the findings, we concluded that an exercise-related increase in factor VIII activity led to coronary arterial thrombosis in the presence of a small ruptured plaque. Alternatively, venous clots may have traversed the patent foramen ovale and occluded the LAD. In addition to continuing aggressive risk factor modification, anticoagulation therapy with warfarin was initiated with close follow-up.

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Section: Discussionmentioning

confidence: 99%

Recurrent myocardial infarctions in a young football player secondary to thrombophilia, associated with elevated factor VIII activity

Vacek¹,

Yu²,

Rehman³

et al. 2014

IMCRJ

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show abstract

“…For the follow-up analysis of LA volumes, TTE is typically used, but 3D techniques, such as real-time 3D echocardiography (Zhang et al, 2017), multi-slice CT (Polaczek et al, 2019) and MRI (Tsao et al, 2005), especially LGE MRI (McGann et al, 2014), may provide more accurate information. For the measurement of LA wall thickness, TEE provides high spatial resolution and has been used by Bakalli et al (2012). CT is an ideal modality, thanks to its high resolution, and MRI is widely considered to be the gold standard for the viability assessment of wall pathology (Karim et al, 2018).…”

Section: Imaging During Ablation Proceduresmentioning

confidence: 99%

Medical Image Analysis on Left Atrial LGE MRI for Atrial Fibrillation Studies: A Review

Li¹,

Zimmer²,

Schnabel³

et al. 2021

Preprint

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Late gadolinium enhancement magnetic resonance imaging (LGE MRI) is commonly used to visualize and quantify left atrial (LA) scars. The position and extent of scars provide important information of the pathophysiology and progression of atrial fibrillation (AF). Hence, LA scar segmentation and quantification from LGE MRI can be useful in computerassisted diagnosis and treatment stratification of AF patients. Since manual delineation can be time-consuming and subject to intra-and inter-expert variability, automating this computing is highly desired, which nevertheless is still challenging and under-researched.This paper aims to provide a systematic review on computing methods for LA cavity, wall, scar and ablation gap segmentation and quantification from LGE MRI, and the related literature for AF studies. Specifically, we first summarize AF-related imaging techniques, particularly LGE MRI. Then, we review the methodologies of the four computing tasks in detail, and summarize the validation strategies applied in each task. Finally, the possible future developments are outlined, with a brief survey on the potential clinical applications of the aforementioned methods. The review shows that the research into this topic is still in early stages. Although several methods have been proposed, especially for LA segmentation, there is still large scope for further algorithmic developments due to performance issues related to the high variability of enhancement appearance and differences in image acquisition.

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“…More accurate diagnostic aspects may characterize this association as mutually dependent changes. Moreover, CRBBB in childhood and teenagehood could be a relevant indicator to motivate the search for abnormalities in atrial septum as it occurs in ASD, POF or aneurysm, changes found in approximately 80% of these cases 1 . In this context, it is unknown the association of LAHB, found in this patient.…”

Section: Complementary Testsmentioning

confidence: 99%

Case 4 / 2014 - 15-year-old Patient with Atrial Septal Aneurysm, Right Bundle Branch Block and Paroxysmal Atrial Fibrillation

Atik¹

2014

Arquivos Brasileiros De Cardiologia

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Right bundle branch block as a marker for interatrial septal abnormalities

Abstract: Right bundle branch block should serve as a valuable indicator to motivate a detailed search for interatrial septal abnormalities.

Cited by 7 publications

References 40 publications

Recurrent myocardial infarctions in a young football player secondary to thrombophilia, associated with elevated factor VIII activity

Recurrent myocardial infarctions in a young football player secondary to thrombophilia, associated with elevated factor VIII activity

Medical Image Analysis on Left Atrial LGE MRI for Atrial Fibrillation Studies: A Review

Case 4 / 2014 - 15-year-old Patient with Atrial Septal Aneurysm, Right Bundle Branch Block and Paroxysmal Atrial Fibrillation

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