Characterization of Ischemic Colitis Associated with Myocardial Infarction: An Analysis of 23 Patients

Cappell, Mitchell S.; Mahajan, Deepak; Kurupath, Vinod

doi:10.1016/j.amjmed.2005.10.061

Cited by 27 publications

(28 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The IMA occlusion is detected at enhanced CT as luminal defect [28]. Hypertension, diabetes mellitus, ischemic heart disease, congestive heart disease, age, and hyperlipidemia are known risk factors [29], as well as renal failure [9–11].…”

Section: Discussionmentioning

confidence: 99%

CT Findings in Acute, Subacute, and Chronic Ischemic Colitis: Suggestions for Diagnosis

Iacobellis

Berritto

Fleischmann

et al. 2014

BioMed Research International

View full text Add to dashboard Cite

Purpose. This paper aims at evaluating CT findings of occlusive and nonocclusive ischemic colitis (IC), in correlation with the etiology and the different phases of the disease. Materials and Methods. CT examination and clinical history of 32 patients with proven IC were retrospectively reviewed. The CT findings were analyzed according to the different phases of the disease (acute, subacute, and chronic). Results. Among the 32 CT examinations performed in the acute phase, 62.5% did not present signs of occlusion of the superior mesenteric artery (SMA) or inferior mesenteric artery (IMA), whereas IMA occlusion was detected in 37.5% of CT examinations. In the acute phase, the presence of pericolic fluid was found in 100% of patients undergoing progressive resorption from acute to subacute phase if an effective reperfusion occurred; the bowel wall thickening was observed in 28.1% patients in acute phase and in 86.4% patients evaluated in subacute phase. The unthickened colonic wall was found in all conditions where ischemia was not followed by effective reperfusion (71.9% of cases), and it was never found in chronic phase, when the colon appeared irregularly thickened. Conclusion. CT allows determining the morphofunctional alterations associated with the IC discriminating the occlusive forms from the nonocclusive forms. CT, furthermore, allows estimating the timing of ischemic damage.

show abstract

Section: Discussionmentioning

confidence: 99%

CT Findings in Acute, Subacute, and Chronic Ischemic Colitis: Suggestions for Diagnosis

Iacobellis

Berritto

Fleischmann

et al. 2014

BioMed Research International

View full text Add to dashboard Cite

show abstract

“…cardiogenic shock, septic shock etc. [7] Although our patient didn't strictly meet clinical or hemodynamic criteria (1.8 L/min/m 2 ) for cardiogenic shock, her cardiac index was severely reduced (1.9 L/min/m 2 ). Splanchnic vasoconstriction associated with these low cardiac output states further reduces bowel perfusion.…”

Section: Discussionmentioning

confidence: 99%

Reverse takotsubo cardiomyopathy presenting as abdominal pain: An atypical presentation

Thind

Agrawal

2017

CRIM

View full text Add to dashboard Cite

Reverse takotsubo cardiomyopathy is the rarest variant of takotsubo cardiomyopathy. We present a case of reverse takotsubo cardiomyopathy presenting as abdominal pain likely due to non-occlusive mesenteric ischemia. A 58-year-old female presented with abdominal pain, nausea, vomiting, and diarrhea for 2 days. Upon presentation, she was normotensive but tachycardic. Her lactic acid level was 2.8 mmol/L and troponin-T was 0.62 ng/ml. The electrocardiogram showed non-specific ST changes. CT scan of abdomen revealed bowel wall thickening in transverse colon and splenic flexure. Patient was started on aggressive intravenous fluid therapy for possible infectious colitis.The next day, patient started becoming progressively more dyspneic, hypoxic, and hypotensive. A chest X-ray at that time showed signs of severe congestive heart failure. Echocardiogram revealed left ventricular ejection fraction of 20% with akinesis of proximal and mid-ventricular walls. Patient was intubated for hypoxic respiratory failure and started on milrinone infusion for acutely depressed cardiac function. Inotropes were weaned off the next day, and she was successfully extubated on day 4. Subsequently, gastrointestinal symptoms resolved. Cardiac catheterization was performed later during the hospitalization that showed normal coronary arteries. Repeat echocardiogram done 3 months later showed return of cardiac function to normal.

show abstract

“…The literature provides evidence that a distinct group of patients with ischemic colitis and simultaneous myocardial infarction have significantly more sequelae and worse in-hospital prognoses. 8 Thus, it becomes important to make a distinction between myocardial injury in association with stress (as in our case) and myocardial infarction in association with thrombus (a much worse prognosis).…”

Section: Discussionmentioning

confidence: 99%

Necrotic Bowel Induces Takotsubo-Like Myocardial Injury

Koci¹,

Eltibi²,

Hadley³

et al. 2014

Texas Heart Institute Journal

View full text Add to dashboard Cite

Although chest pain in association with ST-segment P atients who report chest pain receive priority attention from emergency department (ED) providers-especially when that pain is associated with electrocardiographic (ECG) changes and with cardiac biomarkers consistent with acute coronary syndrome (ACS). In these cases, a consulting cardiologist needs to quickly decide whether to transfer the patient for invasive heart catheterization. We report a challenging ED clinical situation in which cardiac injury and "acute abdomen" occurred simultaneously. Despite time constraints, a thorough and comprehensive patient evaluation must be performed in order to avoid unnecessary invasive interventions. Case ReportIn July 2012, a 63-year-old woman presented at our emergency room with abdominal pain that had started several hours earlier. An abdominal computed tomogram showed signs of colonic thickening, thereby raising suspicion of ischemic colitis. As evaluated by a surgeon, the patient's clinical status (no guarding or abdominal rebounding), hemodynamic results, and laboratory values (normal lactic acid) did not warrant emergent surgical management. Therefore, the patient was at first treated in the ED via supportive measures that included pain management and the administration of fluids and antibiotics. Six to seven hours later, she reported chest pain. Cardiac enzyme tests, including retroactive measurements of troponin T from the first laboratory draw, showed abnormal levels of troponin T, rising from 0.13 to 0.23 ng/mL (negative <0.03 ng/mL), together with a normal creatine kinase level and an abnormal creatine kinase-MB fraction at 10.5 ng/mL (normal, <5 ng/mL). An ECG showed a 1-to 2-mm ST elevation in leads V 2 and V 3 , which was sufficiently suspect to trigger an urgent cardiology consultation to evaluate the possible need for cardiac catheterization in advance of abdominal surgery.Laboratory data showed a white-cell count of 8.5 ×10 9 /L, a hematocrit of 36.5%, and a platelet count of 191 ×10 9 /L. Two serial measurements of lactic acid were normal. Abdominal computed tomography with contrast agent revealed mildly dilated fluid-filled loops of small bowels, possible small-bowel obstruction secondary to adhesions, and a small area of nondistended small bowel between 2 distended loops.At our bedside evaluation, the patient was very uncomfortable because of diffuse severe pain in the mid-epigastric and lower sternal areas, associated with diaphoresis and nausea. Vital signs were a temperature of 98.3 °F, a heart rate of 90 beats/min, a respiratory rate of 18 breaths/min, an oxygen saturation of 98% on 2 L/min oxygen

show abstract

Characterization of Ischemic Colitis Associated with Myocardial Infarction: An Analysis of 23 Patients

Cited by 27 publications

References 24 publications

CT Findings in Acute, Subacute, and Chronic Ischemic Colitis: Suggestions for Diagnosis

CT Findings in Acute, Subacute, and Chronic Ischemic Colitis: Suggestions for Diagnosis

Reverse takotsubo cardiomyopathy presenting as abdominal pain: An atypical presentation

Necrotic Bowel Induces Takotsubo-Like Myocardial Injury

Contact Info

Product

Resources

About