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Note the absence of catheter damping or ischemia; right: self-termination of the VT, with restoration of blood pressure and minimal separation between pressure curves (Pd, red curve; Pa, yellow curve). Further adenosine injections demonstrated a minimum fractional flow reserve of 0.93 (non-significant).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "David Martí, María José Morales, Salvador Álvarez, Jorge Palazuelos, Ignacio Rada" "autores" => array:5 [ 0 => array:2 [ "nombre" => "David" "apellidos" => "Martí" ] 1 => array:2 [ "nombre" => "María José" "apellidos" => "Morales" ] 2 => array:2 [ "nombre" => "Salvador" "apellidos" => "Álvarez" ] 3 => array:2 [ "nombre" => "Jorge" "apellidos" => "Palazuelos" ] 4 => array:2 [ "nombre" => "Ignacio" "apellidos" => "Rada" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2174204916302768" "doi" => "10.1016/j.repce.2016.12.011" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => 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Cardiology</span>" "titulo" => "Coronary sinus atrial septal defect in a 65-year-old woman: Diagnosis by two- and three-dimensional echocardiography" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "67" "paginaFinal" => "68" ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Comunicação interauricular do tipo seio coronário em mulher de 65 anos: diagnóstico por ecocardiografia 2D e 3D" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1481 "Ancho" => 1802 "Tamanyo" => 259447 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A) Coronary sinus dilatation on transthoracic echocardiography (TTE), 4-chamber view; (B) agitated saline through a peripheral left brachial vein during the Valsalva maneuver; (C) mid-esophageal bicaval view with coronary sinus drainage below the inferior vena cava; (D) cross-sectional 2-chamber view showing a posteromedial left atrial wall defect communicating with the coronary sinus; (E and F) three-dimensional real-time TEE with the mitral valve (MV) as reference point and the left atrial wall defect marked with an asterisk.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Rafael De la Espriella-Juan, Rafael Payá-Serrano, Andrés Cubillos-Arango, Bruno Bochard-Villanueva, Sergio Sánchez-Álvarez, Salvador Morell-Cabedo" "autores" => array:6 [ 0 => array:2 [ "nombre" => "Rafael" "apellidos" => "De la Espriella-Juan" ] 1 => array:2 [ "nombre" => "Rafael" "apellidos" => "Payá-Serrano" ] 2 => array:2 [ "nombre" => "Andrés" "apellidos" => "Cubillos-Arango" ] 3 => array:2 [ "nombre" 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"fechaPublicacion" => "2017-01-01" "aid" => "923" "documento" => "simple-article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "crp" "cita" => "Rev Port Cardiol. 2017;36:63.e1-5" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 1938 "formatos" => array:3 [ "EPUB" => 150 "HTML" => 1434 "PDF" => 354 ] ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case report</span>" "titulo" => "Acute myocardial infarction caused by left atrial myxoma: Role of intracoronary catheter aspiration" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "pt" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "63.e1" "paginaFinal" => "63.e5" ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Enfarte agudo do miocárdio causado por um mixoma da aurícula esquerda: papel do cateter de aspiração coronário" ] ] "contieneResumen" => array:2 [ "en" => true "pt" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 827 "Ancho" => 1503 "Tamanyo" => 436774 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Electrocardiogram showing ST-segment elevation in leads I, aVL, and V2-6 consistent with acute anterior/lateral ST-segment elevation myocardial infarction.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Ahmad Al-Fakhouri, Muhammad Janjua, Michele DeGregori" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Ahmad" "apellidos" => "Al-Fakhouri" ] 1 => array:2 [ "nombre" 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"tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "65" "paginaFinal" => "66" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "David Martí, María José Morales, Salvador Álvarez, Jorge Palazuelos, Ignacio Rada" "autores" => array:5 [ 0 => array:4 [ "nombre" => "David" "apellidos" => "Martí" "email" => array:1 [ 0 => "docalcala@hotmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "María José" "apellidos" => "Morales" ] 2 => array:2 [ "nombre" => "Salvador" "apellidos" => "Álvarez" ] 3 => array:2 [ "nombre" => "Jorge" "apellidos" => "Palazuelos" ] 4 => array:2 [ "nombre" => "Ignacio" "apellidos" => "Rada" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Interventional Cardiology Unit, Department of Cardiology, Central Defense Hospital, University of Alcalá, Madrid, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Reserva do fluxo fracionado: ter em atenção o intervalo QT" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 890 "Ancho" => 1702 "Tamanyo" => 339434 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Left: resting electrocardiogram with negative T waves and prolonged QT interval; right: intermediate coronary stenosis in the mid left anterior descending artery.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 74-year-old woman presented with intermittent chest pain and dyspnea after emotional stress. The electrocardiogram showed sinus rhythm, deep and symmetric T-wave inversion in the anterior leads, and prolonged QT interval (corrected QT: 542 ms) (<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>, left). The echocardiogram revealed apical dyskinesia, so the patient was scheduled for early catheterization. Quantitative coronary angiography showed an intermediate tubular stenosis in the mid left anterior descending artery (<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>, right, and <a class="elsevierStyleCrossRef" href="#sec0035">Supplementary Video</a>), that was further functionally assessed by means of a pressure wire (PressureWire™ Guidewire, St. Jude Medical, Inc., St. Paul, MN).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Baseline fractional flow reserve (FFR) was 0.97. An initial intracoronary adenosine injection of 120 μg triggered a presyncopal polymorphic ventricular tachycardia, self-limiting in 12 seconds (<a class="elsevierStyleCrossRef" href="#fig0010">Figure 2</a>). A second lower-dose injection of 60 μg was followed by another episode of non-sustained polymorphic VT. Then atropine 1 mg was administered intravenously, heart rate increased above 80 beats per minute, and further adenosine boluses (up to 240 μg) were well tolerated. Minimum FFR was 0.93, so intervention was safely deferred.</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">Adenosine has largely replaced papaverine as the hyperemic agent of choice due to anecdotal evidence of ventricular arrhythmias with the latter. However, in patients with long QT interval adenosine may not be so safe, as it can promote triggered activity and precipitate ventricular tachycardia. A long QT interval is frequently seen in patients with stress cardiomyopathy. In these cases, premedication with atropine or determination of adenosine-free indices such as the instantaneous wave-free ratio can increase the safety of functional assessment of coronary stenosis.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Ethical disclosures</span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Protection of human and animal subjects</span><p id="par0020" class="elsevierStylePara elsevierViewall">The authors declare that no experiments were performed on humans or animals for this study.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Confidentiality of data</span><p id="par0025" class="elsevierStylePara elsevierViewall">The authors declare that they have followed the protocols of their work center on the publication of patient data.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Right to privacy and informed consent</span><p id="par0030" class="elsevierStylePara elsevierViewall">The authors declare that no patient data appear in this article.</p></span></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conflicts of interest</span><p id="par0035" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:3 [ "identificador" => "sec0005" "titulo" => "Ethical disclosures" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0010" "titulo" => "Protection of human and animal subjects" ] 1 => array:2 [ "identificador" => "sec0015" "titulo" => "Confidentiality of data" ] 2 => array:2 [ "identificador" => "sec0020" "titulo" => "Right to privacy and informed consent" ] ] ] 1 => array:2 [ "identificador" => "sec0025" "titulo" => "Conflicts of interest" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2015-12-07" "fechaAceptado" => "2015-12-27" "apendice" => array:1 [ 0 => array:1 [ "seccion" => array:1 [ 0 => array:4 [ "apendice" => "<p id="par0045" class="elsevierStylePara elsevierViewall"><elsevierMultimedia ident="upi0005"></elsevierMultimedia></p>" "etiqueta" => "Appendix A" "titulo" => "Supplementary material" "identificador" => "sec0035" ] ] ] ] "multimedia" => array:3 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 890 "Ancho" => 1702 "Tamanyo" => 339434 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Left: resting electrocardiogram with negative T waves and prolonged QT interval; right: intermediate coronary stenosis in the mid left anterior descending artery.</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 641 "Ancho" => 1601 "Tamanyo" => 157466 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Left: afterdepolarizations and initiation of polymorphic ventricular tachycardia (VT) following adenosine injection. Note the absence of catheter damping or ischemia; right: self-termination of the VT, with restoration of blood pressure and minimal separation between pressure curves (Pd, red curve; Pa, yellow curve). Further adenosine injections demonstrated a minimum fractional flow reserve of 0.93 (non-significant).</p>" ] ] 2 => array:5 [ "identificador" => "upi0005" "tipo" => "MULTIMEDIAECOMPONENTE" "mostrarFloat" => false "mostrarDisplay" => true "Ecomponente" => array:3 [ "fichero" => "mmc1.mp4" "ficheroTamanyo" => 1447952 "Video" => array:2 [ "flv" => array:5 [ "fichero" => "mmc1.flv" "poster" => "mmc1.jpg" "tiempo" => 0 "alto" => 0 "ancho" => 0 ] "mp4" => array:2 [ "fichero" => "mmc1.m4v" "poster" => "mmc1.jpg" ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/21742049/0000003600000001/v1_201701200114/S2174204916302768/v1_201701200114/en/main.assets" "Apartado" => array:4 [ "identificador" => "9915" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Images in cardiology" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21742049/0000003600000001/v1_201701200114/S2174204916302768/v1_201701200114/en/main.pdf?idApp=UINPBA00004E&text.app=https://revportcardiol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204916302768?idApp=UINPBA00004E" ]
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