11 results on '"Preet Randhawa"'
Search Results
2. Acute myocardial infraction and pulmonary embolism in a same patient with COVID -19: a rare association
- Author
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Preet Randhawa, Parminder P. Singh, Nirmal Guragai, Parminder Kaur, Balraj Singh, and Jasjit S. Walia
- Subjects
coronavirus disease-2019 ,acute pulmonary embolism ,thromboembolism ,acute myocardial infarction ,Internal medicine ,RC31-1245 - Abstract
Coronavirus disease-2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 is associated with a hypercoagulable state leading to increased incidence of thromboembolism. However, it is exceedingly rare to see presence of both arterial and venous thromboembolism simultaneously. Herein, we report an unusual presentation of a 39-year-old male with recently diagnosed COVID -19 who initially had acute myocardial infarction secondary to thrombotic occlusion of right coronary artery followed by acute pulmonary embolism. Health care providers should be aware of this uncommon yet possible co-existence of two life-threatening manifestations in order to prevent fatal consequences.
- Published
- 2021
- Full Text
- View/download PDF
3. Spontaneous coronary artery dissection associated with incidental finding of left ventricular thrombus
- Author
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Melvin Santana, Nirmal Guragai, Biren Patel, Rahul Vasudev, Preet Randhawa, Meherwan Joshi, Habib Mirette, and Fayez Shamoon
- Subjects
spontaneous coronary artery dissection ,left ventricular thrombus ,myocardial infarction ,Internal medicine ,RC31-1245 - Abstract
Spontaneous Coronary Artery Dissection (SCAD) is one of the nonatherosclerotic causes of Acute Coronary Syndrome. It’s extremely rare for SCAD to present in an asymptomatic male, with incidental finding of Left Ventricular (LV) thrombus on echocardiogram. This report presents the case of a 36-year-old male with such an atypical presentation of Spontaneous Coronary Artery Dissection with Left Ventricular apical thrombus as a complication. The patient received successful medical management, with excellent clinical outcomes. This case highlights the importance of an early recognition and treatment strategy for both conditions using medical therapy.
- Published
- 2021
- Full Text
- View/download PDF
4. Gadolinium-based coronary angiography in a patient with prior known anaphylaxis to iodine-based dye
- Author
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Nirmal Guragai, Sherif Roman, Rahul Vasudev, Upamanyu Rampal, Preet Randhawa, Fayez Shamoon, Hartaj Virk, Mahesh Bikkina, JW Moses, and Apurva Motivala
- Subjects
angiography ,complication ,gadolinium use ,iodine contrast allergy ,pci complication ,percutaneous coronary intervention ,stenting ,ventricular fibrillation ,Internal medicine ,RC31-1245 - Abstract
Gadodiamide is a gadolinium-based chemical element that is considered safe and well tolerated in patients without renal dysfunction and is therefore routinely used as a contrast agent in magnetic resonance imaging. Although radio-opaque, it is not frequently used for coronary angiography due to its less than optimal image quality and prohibitive cost. Our center’s previous experience was less than satisfactory but the addition of a power injection system yielded good quality diagnostic images. We report a case of 63 years old male with a known history of severe, life-threatening anaphylactic reaction to previous iodinated dye presenting with persistent angina despite optimal medical therapy. Coronary and bypass graft angiography was performed using 24 cc of undiluted Gadodiamide (OMNISCAN) with a power injector (ACIST®) without any incidents or premedication with an interpretable angiogram.
- Published
- 2021
- Full Text
- View/download PDF
5. A Case of STEMI Masquerading Brugada Syndrome: Emphasizing the Importance of Clinical Decision Making in Emergencies
- Author
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Nirmal Guragai MD, Rahul Vasudev MD, Dhaval Shah MD, Balraj Singh MD, Parminder Kaur MD, Ashen Fernando MD, Fayez Shamoon MD, Raja Pullatt MD, Meherwan Joshi MD, and Preet Randhawa MD
- Subjects
Medicine (General) ,R5-920 ,Pathology ,RB1-214 - Abstract
Brugada syndrome is a rare arrhythmogenic syndrome that is associated with an increased risk of ventricular fibrillation and sudden cardiac death. Electrocardiographic findings include patterns similar to a right bundle branch block (RBBB) and persistent ST-segment elevation in precordial leads (V1 and V2). There are numerous reports of Brugada syndrome mimicking ST-segment elevation myocardial infraction (STEMI); however, we describe a case of 47-year-old male who presented with STEMI mimics Brugada syndrome with preexisting RBBB. The patient developed polymorphic ventricular tachycardia generating into ventricular fibrillation right before catheterization making the diagnosis more challenging. The patient, eventually, was found to have obstructive coronary artery disease and no evidence of abnormal sodium channelopathy on further testing. This case highlights the importance of meticulous history taking and appropriate diagnostic test in establishing proper diagnosis of STEMI in a patient with preexisting RBBB, which can mimic Brugada syndrome.
- Published
- 2021
- Full Text
- View/download PDF
6. Gadolinium-based coronary angiography in a patient with prior known anaphylaxis to iodine-based dye
- Author
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Sherif Roman, Upamanyu Rampal, Nirmal Guragai, Mahesh Bikkina, Apurva Motivala, Hartaj Virk, Jeffrey W. Moses, Fayez Shamoon, Preet Randhawa, and Rahul Vasudev
- Subjects
medicine.medical_specialty ,PCI complication ,medicine.medical_treatment ,Gadolinium ,stenting ,chemistry.chemical_element ,Case Report ,complication ,030204 cardiovascular system & hematology ,Iodine ,gadolinium use ,03 medical and health sciences ,0302 clinical medicine ,iodine contrast allergy ,Internal Medicine ,medicine ,030212 general & internal medicine ,medicine.diagnostic_test ,business.industry ,Gadodiamide ,percutaneous coronary intervention ,Angiography ,Percutaneous coronary intervention ,ventricular fibrillation ,medicine.disease ,RC31-1245 ,chemistry ,Iodine contrast allergy ,Radiology ,Complication ,business ,Anaphylaxis ,medicine.drug - Abstract
Gadodiamide is a gadolinium-based chemical element that is considered safe and well tolerated in patients without renal dysfunction and is therefore routinely used as a contrast agent in magnetic resonance imaging. Although radio-opaque, it is not frequently used for coronary angiography due to its less than optimal image quality and prohibitive cost. Our center’s previous experience was less than satisfactory but the addition of a power injection system yielded good quality diagnostic images. We report a case of 63 years old male with a known history of severe, life-threatening anaphylactic reaction to previous iodinated dye presenting with persistent angina despite optimal medical therapy. Coronary and bypass graft angiography was performed using 24 cc of undiluted Gadodiamide (OMNISCAN) with a power injector (ACIST®) without any incidents or premedication with an interpretable angiogram.
- Published
- 2021
7. A Case of STEMI Masquerading Brugada Syndrome: Emphasizing the Importance of Clinical Decision Making in Emergencies
- Author
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Ashen Fernando, Balraj Singh, Preet Randhawa, Parminder Kaur, Fayez Shamoon, Dhaval Shah, Rahul Vasudev, Meherwan Joshi, Raja Pullatt, and Nirmal Guragai
- Subjects
Male ,medicine.medical_specialty ,Medicine (General) ,Epidemiology ,Bundle-Branch Block ,Clinical Decision-Making ,Case Report ,030204 cardiovascular system & hematology ,Sudden cardiac death ,Electrocardiography ,03 medical and health sciences ,0302 clinical medicine ,R5-920 ,ST-elevation myocardial infraction ,Clinical decision making ,Internal medicine ,medicine ,Pathology ,Humans ,RB1-214 ,030212 general & internal medicine ,cardiovascular diseases ,Safety, Risk, Reliability and Quality ,Brugada Syndrome ,Brugada syndrome ,business.industry ,Brugada ,Middle Aged ,Right bundle branch block ,ventricular fibrillation ,medicine.disease ,right bundle branch block ,Electrocardiographic Finding ,Increased risk ,Ventricular fibrillation ,Cardiology ,ST Elevation Myocardial Infarction ,Emergencies ,business ,Safety Research - Abstract
Brugada syndrome is a rare arrhythmogenic syndrome that is associated with an increased risk of ventricular fibrillation and sudden cardiac death. Electrocardiographic findings include patterns similar to a right bundle branch block (RBBB) and persistent ST-segment elevation in precordial leads (V1 and V2). There are numerous reports of Brugada syndrome mimicking ST-segment elevation myocardial infraction (STEMI); however, we describe a case of 47-year-old male who presented with STEMI mimics Brugada syndrome with preexisting RBBB. The patient developed polymorphic ventricular tachycardia generating into ventricular fibrillation right before catheterization making the diagnosis more challenging. The patient, eventually, was found to have obstructive coronary artery disease and no evidence of abnormal sodium channelopathy on further testing. This case highlights the importance of meticulous history taking and appropriate diagnostic test in establishing proper diagnosis of STEMI in a patient with preexisting RBBB, which can mimic Brugada syndrome.
- Published
- 2021
8. Rare Association of Non-Bacterial Thrombotic Endocarditis, Myocardial Infarction, and Acute Limb Ischemia Secondary to Rheumatoid Arthritis: Comprehensive Case Series With Literature Review
- Author
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Preet Randhawa, Raul Angel Garcia, Nirmal Guragai, Mirette Habib, and Rahul Vasudev
- Subjects
Aortic valve ,medicine.medical_specialty ,Acute coronary syndrome ,medicine.medical_treatment ,Cardiology ,Infectious Disease ,030204 cardiovascular system & hematology ,Malignancy ,Chest pain ,non-st elevation myocardial infraction ,03 medical and health sciences ,0302 clinical medicine ,Rheumatology ,Internal medicine ,medicine ,Endocarditis ,Myocardial infarction ,Embolization ,non-bacterial thrombotic endocarditis ,business.industry ,General Engineering ,medicine.disease ,medicine.anatomical_structure ,Rheumatoid arthritis ,rheumatoid arthriitis ,limb ischemia ,medicine.symptom ,business ,030217 neurology & neurosurgery - Abstract
Most cases of non-bacterial thrombotic endocarditis (NBTE) tend to be related to malignancy or rheumatologic and autoimmune disorders like systemic lupus erythematosus. Rheumatoid arthritis (RA) itself has been associated with increased atherosclerosis, coronary artery plaque formation, and endothelial damage. However, it is rare to see NBTE in RA, simultaneously presenting with the acute coronary syndrome and acute limb ischemia due to distant embolization. Here we present a case of a 46-year-old female presenting with chest pain and right leg numbness, found to have ST-elevation myocardial infarction (STEMI) and occlusion of a peripheral artery due to embolization of vegetation present in the aortic valve. We also provide an extensive literature review of the relationship between NBTE and MI. One must be extra vigilant in managing these patients, especially if the size of vegetation is large as it has a tendency to embolize causing devastating complications.
- Published
- 2021
9. A Rare Case of Myocarditis Mimicking ST-Elevation Myocardial Infarction
- Author
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Rahul Vasudev, Nirmal Guragai, Raja Pullatt, Ashen Fernando, and Preet Randhawa
- Subjects
medicine.medical_specialty ,Viral Myocarditis ,Myocarditis ,st-elevation myocardial infarction ,medicine.medical_treatment ,Cardiology ,030204 cardiovascular system & hematology ,Chest pain ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,Palpitations ,Internal Medicine ,Myocardial infarction ,cardiovascular diseases ,Cardiac catheterization ,Ejection fraction ,business.industry ,General Engineering ,Dilated cardiomyopathy ,medicine.disease ,dilated cardiomyopathy ,viral myocarditis ,medicine.symptom ,myocarditis ,business ,030217 neurology & neurosurgery - Abstract
Myocarditis is caused by acute injury and inflammation of cardiac myocytes and is most commonly caused by a viral infection. Myocarditis remains a rare diagnosis and manifests with a wide spectrum of non-specific symptoms that include chest pain, dyspnea, and palpitations associated with electrocardiographic abnormalities that resemble that of ST-elevation myocardial infarction (STEMI). Therefore, clinical diagnosis is often challenging and is often misdiagnosed. We present a case of a 22-year-old male who presented with left-sided non-radiating chest pain associated with shortness of breath, elevated troponin of 3.2 ng/ml (
- Published
- 2020
10. RARE CASE OF CONSTRICTIVE PERICARDITIS DUE TO METASTATIC PERICARDIAL MALIGNANCY WITHOUT RECURRENCE TO PRIMARY MALIGNANT SITE
- Author
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Bhavik N. Patel, Abanoub Rushdy, Muhammad Atif Masood Noori, Fayez Shamoon, Meherwan Joshi, Preet Randhawa, and Biren Patel
- Subjects
Constrictive pericarditis ,medicine.medical_specialty ,business.industry ,Rare case ,medicine ,Radiology ,Cardiology and Cardiovascular Medicine ,Malignancy ,medicine.disease ,business - Published
- 2021
11. Right coronary artery anatomical variants: where and how?
- Author
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Pallavi, Solanki, Christine, Gerula, Preet, Randhawa, Michael, Benz, James, Maher, Bunyad, Haider, Marc, Klapholz, Jack, Palmaro, Diane, Alfano, and Edo, Kaluski
- Subjects
Coronary Vessel Anomalies ,Coronary Sinus ,Prevalence ,Humans ,Choristoma ,Coronary Angiography ,Tomography, X-Ray Computed ,Coronary Vessels ,Magnetic Resonance Imaging ,Algorithms ,Echocardiography, Transesophageal ,Retrospective Studies - Abstract
Ectopic origin of the right coronary artery (RCA) occurs in approximately 1.0% of studied populations. We investigated the prevalence and location of ectopic RCAs among patients undergoing coronary angiography (CA) and assessed its effects on resource utilization.Cases of ectopic RCAs were prospectively collected over 21 months among patients undergoing cardiac catheterization at a University Hospital. "Ectopic RCA" was defined as a RCA originating outside the posterior two-thirds of the right coronary sinus.The study population included 2,120 patients, of which 23 (1.1%) had ectopic RCAs. Of these, 15 (65%) originated from the anterior third of the right sinus, while 8 (35%) originated from the anterior half of the left sinus. Mean procedure and fluoroscopy times were 60 +/- 33 and 15 +/- 12 minutes (min) for the former, and 78 +/- 35 and 31 +/- 20 min for the latter, while mean contrast volume for CA was 112 +/- 62 ml and 192 +/- 85 ml, respectively. 26% required a second CA or a second intervention to image the RCA.Ectopic RCAs pose a clinical problem, consuming time and resources. The search for an ectopic RCA should have90 degree boundaries limited to the anterior third of the right sinus and anterior half of the left sinus.
- Published
- 2010
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