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  • 1.
    Hubbert, Laila
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Cardiology in Linköping.
    Sundbom, Per
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Cardiology in Linköping.
    Loebe, Matthias
    Methodist DeBakey Heart & Vascular Center, Houston, TX, USA.
    Peterzén, Bengt
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Thoracic and Vascular Surgery.
    Granfeldt, Hans
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Thoracic and Vascular Surgery.
    Ahn, Henrik
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Thoracic and Vascular Surgery.
    Acoustic Analysis of a Mechanical Circulatory Support2014In: Artificial Organs, ISSN 0160-564X, E-ISSN 1525-1594, Vol. 38, no 7, p. 593-598Article in journal (Refereed)
    Abstract [en]

    Mechanical circulatory support technology is continually improving. However, adverse complications do occur with devastating consequences, for example, pump thrombosis that may develop in several parts of the pump system. The aim of this study was to design an experimental clot/thrombosis model to register and analyze acoustic signals from the left ventricular assist device (LVAD) HeartMate II (HMII) (Thoratec Corporation, Inc., Pleasanton, CA, USA) and detect changes in sound signals correlating to clots in the inflow, outflow, and pump housing. Using modern telecom techniques, it was possible to register and analyze the HMII pump-specific acoustic fingerprint in an experimental model of LVAD support using a mock loop. Increase in pump speed significantly (P less than 0.005) changed the acoustic fingerprint at certain frequency (0-23 000 Hz) intervals (regions: R1-3 and peaks: P1,3-4). When the ball valves connected to the tubing were narrowed sequentially by similar to 50% of the inner diameter (to mimic clot in the out-and inflow tubing), the frequency spectrum changed significantly (P less than 0.005) in P1 and P2 and R1 when the outflow tubing was narrowed. This change was not seen to the same extent when the lumen of the ball valve connected to the inflow tube was narrowed by similar to 50%. More significant (P less than 0.005) acoustic changes were detected in P1 and P2 and R1 and R3, with the largest dB figs. in the lower frequency ranges in R1 and P2, when artificial clots and blood clots passed through the pump system. At higher frequencies, a significant change in dB figs. in R3 and P4 was detected when clots passed through the pump system. Acoustic monitoring of pump sounds may become a valuable tool in LVAD surveillance.

  • 2.
    Sundbom, Per
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Cardiology in Linköping. Medicin- och geriatrikkliniken, Höglandssjukhuset, Eksjö.
    Acoustic and afterload evaluation of left ventricular assist devices2019Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Background: Heart Failure is a serious condition with consequences not only for the individual patient but also for the society with a 5-year mortality rate of 45-60%, and a substantial economic burden. The estimated prevalence in Sweden is 2.2% and the age adjusted prevalence increases with higher age. The fundamental treatment for heart failure is pharmaceutical in combination with life-style changes, and physiotherapy. For patients with advanced heart failure, the use of long-term circulatory support can be an option as a bridge to transplantation, or as destination therapy. However, this treatment entails a risk of multiple adverse events. The incidence of pump thrombosis increased as a clinical problem in 2012 and the need for diagnostic methods were desired. The aim of this thesis was to develop and to evaluate the use of a mock loop circuit to study the acoustics of left ventricular assist devices, to evaluate different recording devices and to study the effect of afterload on pump function.

    Methods: Two different mock loops, with the possibility to insert artificial thrombus and to adjust preload and afterload were created to facilitate recording of the left ventricular assist devices. An iPhone/iPodTM was used as recording device since remote monitoring is desirable. The sounds from HeartMate IITM during different conditions were studied. The iPhone/iPod was evaluated in comparison to dedicated recording equipment, and the mock loop recordings to clinical situation. The sound from HeartMate 3TM was studied, compared between in vivo and in vitro recordings, and the use of an electronic stethoscope was evaluated. The impact of afterload on left ventricular assist devices was studied in a mock loop circuit with different changes in preload and afterload.

    Results: Mock loop circuit is a promising method to safely change the surrounding conditions as the pump is working. The sound from both HeartMate IITM and HeartMate 3TM can be recorded and analyzed in frequency and time domain. When inserting artificial thrombus in a HeartMate IITM the frequency spectrum is altered. The use of dedicated recording devices is superior to both electronic stethoscope and iPhone/iPodTM, but these handheld devices can be used in clinical settings. The recordings from mock loop circuit and patients appear similar for both HeartMate IITM and HeartMate 3TM. The flow of the devices is affected by the afterload. The HeartMate 3TM is more resistant to increased clot analogs within the pump. For both pumps, best efficacy is seen for clean circuits. The flow rate from the monitor might be misleading since the measured flow rate and the flow rate from monitor can differ due to surrounding conditions. The estimated flow might be adjusted by fitting a parabolic curve.

    Conclusion: The use of mock loop circuit to study both flow and sound under different conditions is valid. It is possible to record and study the sound from both HeartMate IITM and HeartMate 3TM. The sound holds information of pump function and appears similar in vivo and in vitro. All recording devices can be used, but dedicated equipment is superior to the more handheld devices, although these might have a function as a screening device. The flow measurement on the monitor might not be valid and optimization of fluid status and afterload can further increase pump efficiency.

  • 3.
    Sundbom, Per
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Cardiology in Linköping.
    Ahn, Henrik
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Thoracic and Vascular Surgery.
    Kornhall, B
    Skane University Hospital, Lund.
    Loebe, M
    Division of Transplant and Assist Devices at Methodist DeBakey Heart & Vascular Centre, Houston, Texas, USA.
    Granfeldt, Hans
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Thoracic and Vascular Surgery.
    (556) – Change in Acoustic Fingerprints at Increased Pump Speed During Echocardiographic Ramp Test2014Conference paper (Refereed)
    Abstract [en]

    Purpose

    The continuous flow mechanical circulatory support HeartMate II (Thoratec Corporation, Inc. Pleasanton, USA) (HMII), generates an auditory signal (acoustic fingerprint) that can be registered by routine auscultation. A temporary or permanent change in sound indicates a change in pump function. Previous mock loop studies have shown that changes in acoustic fingerprint are due to changes in speed, so the aim of this study was to see if the acoustic fingerprint changed during an echocardiographic ramp test.

    Methods

    Four stable, event-free patients included in the SoundMate study performed an echocardiographic ramp test. The speed was increased stepwise by 400 rpm between 8 000 and 12 000 rpm, and the left ventricular end diastolic diameter, flow, power consumption and blood pressure were measured. Sounds from HMII were recorded using an iPhone™ (Apple Inc. Cupertino, CA, USA) with the stethoscope application iStethPro™ (Dr. Peter J Bentley, UK) and the frequency map analyzed using the Audacity™ program (Unicode, Ash, Chinen and Crook, USA). The acoustic fingerprint is divided into regions (R1: 1 000-6 500, R2: 8 500-14 000, R3: 15 000-21 000 Hz) and peaks (P1: 0-1 000, P2: 6 500-8 500, P4: 21 000-23 000 Hz) in order to facilitate calculations and clarify changes in frequency.

    Results

    There were significant (p<005) changes in the acoustic fingerprint when increasing the pump speed between 8 000 and 12 000 rpm. In 2/4 patients there were no significant changes in P1, otherwise there were significant changes in all regions and peaks. During the ramp test the power increased in mean 7 W, flow 3,1 L/min and the blood pressure measured with Doppler increased by ~15 mmHg. The left ventricular size decreased with ~2 cm.

    Conclusion

    The acoustic fingerprint changes with pump speed. This implies that when using sound check for detection of pump dysfunction, a new baseline should be set after every adjustment of speed.

  • 4.
    Sundbom, Per
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Cardiology in Linköping.
    Hedayati, Elham
    Karolinska Institutet, Stockholm.
    Peterzén, Bengt
    Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Thoracic and Vascular Surgery.
    Granfeldt, Hans
    Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Thoracic and Vascular Surgery.
    Ahn, Henrik
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Thoracic and Vascular Surgery.
    Hübbert, Laila
    Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Cardiology in Linköping.
    Kardiotoxicitet med terminal hjärtsvikt och nästan sex år med Heartmate II i väntan på hjärttransplantation2013Conference paper (Other academic)
  • 5.
    Sundbom, Per
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Cardiology in Linköping.
    Hedayati, Elham
    Karolinska Institute, Sweden; St Gorans University Hospital, Sweden.
    Peterzén, Bengt
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Thoracic and Vascular Surgery.
    Granfeldt, Hans
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Thoracic and Vascular Surgery.
    Casimir Ahn, Henrik
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Thoracic and Vascular Surgery.
    Hübbert, Laila
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Cardiology in Linköping.
    Young Woman With Breast Cancer and Cardiotoxicity With Severe Heart Failure Treated With a HeartMate II (TM) for Nearly 6 Years Before Heart Transplantation2014In: ASAIO journal (1992), ISSN 1058-2916, E-ISSN 1538-943X, Vol. 60, no 6, p. E3-E4Article in journal (Refereed)
    Abstract [en]

    Cardiotoxicity is a multifactorial problem, which has emerged with the improvement of cancer therapies and survival. Heart transplantation is relatively contraindicated in patients with breast cancer, until at least 5 years after complete remission. We present a case where a young woman who in 2001, at the age of 31, was diagnosed with breast cancer. She was considered cured, but 4 years later she suffered a relapse. During her second treatment, in 2006, she suffered from severe heart failure. She received a HeartMate II, as a long-term bridge to transplantation and 6 years later she was successfully transplanted. In this case report we discuss the use of mechanical circulatory support in cancer patients with drug-induced heart failure.

  • 6.
    Sundbom, Per
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Cardiology in Linköping.
    Hübbert, Laila
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Cardiology in Linköping.
    Armeryd, Therése
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Cardiology in Linköping.
    Karlsson, Monica
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Cardiology in Linköping.
    Lindén, Marita
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Cardiology in Linköping.
    Anderson, Chris
    Linköping University, Department of Clinical and Experimental Medicine, Division of Inflammation Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Dermatology and Venerology.
    The place of skin cancer screening in heart transplant recipient follow-up protocols: a case series2014In: Enliven: Surgery and Transplantation, ISSN 2379-5719, Vol. 1, no 1Article in journal (Refereed)
    Abstract [en]

    ObjectivesFor solid organ transplant recipients the risk of skin cancer is markedly increased due to immunosuppression. Many studies propose an annual, or morefrequent, skin screening program by a dermatologist. As the number of transplant recipients increases and survival times improve, the need for screeningand rapid response (as required) access is increasing.

    DesignIn a quality control study we retrospectively examined the medical records of patients participating in an annual screening program between 1997 and2012. A total of 69 medical records were studied and we here describe the program and present the findings.

    ResultsWe found malignant melanoma in 3 cases. Cutaneous squamous cell carcinoma occurred in 16 patients and basal cell carcinoma in 12 patients. Themost frequent skin lesions were actinic keratoses, reported in 20 patients.

    ConclusionsIncidence rates for all diagnoses were elevated compared to the general population. Awareness of the increased risk for skin malignancies is of importanceto those involved in the care of solid organ transplant recipients. Routines for early discovery of skin tumors are needed both in the form of screening,which can also establish risk group status and give preventive education, and as rapid response access for skin lesion diagnosis and treatment.

  • 7.
    Sundbom, Per
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Cardiology in Linköping.
    Hübbert, Laila
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Cardiology in Linköping.
    Serrander, Lena
    Linköping University, Department of Clinical and Experimental Medicine, Division of Microbiology and Molecular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Infectious Diseases.
    Progressive multifocal leukoencephalopathy after heart transplantation: 4 years of clinically stable infection on low-dose immunosuppressive therapy2017In: Oxford Medical Case Reports, E-ISSN 2053-8855, Vol. 2017, no 2, p. 15-17Article in journal (Refereed)
    Abstract [en]

    Progressive multifocal leukoencephalopathy (PML), caused by reactivation of JC-virus is a relatively rare complication seen in patients with compromised immune system. There are no evidence-based treatment available and prognosis is poor. Withdrawal of immunosuppressant can result in further neurological deterioration and for patients with solid organ transplantations, fatal graft rejection. We report a 52-year-old women that presented with seizures within 1 month after heart transplantation. Initial diagnosis was vascular disease. After clinical deterioration 10 months after transplantation, further examinations led to the diagnosis. Minimizing tacrolimus, to a concentration of 2 ng/ml, and extensive physical therapy has improved the physical capacity of the patient. The patient has now been clinically stable for 4 years and extended survival for 5 years. This case adds to the limited adult cases of PML within the population of heart transplant recipients and the need for increased awareness to minimize diagnosis delay.

  • 8.
    Sundbom, Per
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Höglandssjukhuset, Sweden.
    Roth, Michael
    Linköping University, Department of Electrical Engineering, Automatic Control. Linköping University, Faculty of Science & Engineering.
    Granfeldt, Hans
    Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Thoracic and Vascular Surgery. Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine.
    Karlsson, Daniel
    Linköping University, Department of Biomedical Engineering, Division of Biomedical Engineering. Linköping University, Faculty of Science & Engineering.
    Ahn, Henrik Casimir
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Thoracic and Vascular Surgery.
    Gustafsson, Fredrik
    Linköping University, Department of Electrical Engineering, Automatic Control. Linköping University, Faculty of Science & Engineering.
    Hübbert, Laila
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Cardiology in Linköping. Karolinska Univ Hosp, Sweden; Karolinska Inst, Sweden.
    Sound analysis of a left ventricular assist device: A technical evaluation of iOS devices2018In: International Journal of Artificial Organs, ISSN 0391-3988, E-ISSN 1724-6040, Vol. 41, no 5, p. 254-260Article in journal (Refereed)
    Abstract [en]

    Introduction: The use of left ventricular assist device (LVAD) has grown rapidly. Adverse events do continue to occur. In recent years, analysis of LVAD sound recordings emerged as a means to monitor pump function and detect pump thrombosis. The aim of this study was to characterize the sounds from HeartMate II and to evaluate the use of handheld iOS devices for sound recordings. Method: Signal analysis of LVAD sound recordings, with dedicated recording equipment and iOS devices, was performed. Two LVADs running in mock loop circuits were compared to an implanted LVAD. Spectral analysis and parametric signal models were explored to quantify the sound and potentially detect changes in it. Results: The sound recordings of two LVADs in individual mock loop circuits and a third one implanted in a patient appeared to be similar. Qualitatively, sound characteristics were preserved following changes in pump speed. Recordings using dedicated equipment showed that HeartMate II sound comprises low-frequency components corresponding to pump impeller rotation, as well as high-frequency components due to a pulse width modulation of the electric power to the pump. These different signal components interact and result in a complicated frequency spectrum. The iPhone and iPod recordings could not reproduce the sounds as well as the dedicated equipment. In particular, lower frequencies were affected by outside disturbances. Discussion: This article outlines a systematic approach to LVAD sound analysis using signal processing methods to quantify and potentially detect changes, and describes some of the challenges, for example, with the use of inexpensive recording devices.

  • 9.
    Sundbom, Per
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Cardiology in Linköping. Department of Medicine and Geriatrics, Höglandet Hospital, Eksjö.
    Roth, Michael
    Linköping University, Department of Electrical Engineering, Automatic Control. Linköping University, Faculty of Science & Engineering.
    Granfeldt, Hans
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Karlsson, Daniel M.
    Linköping University, Department of Biomedical Engineering. Linköping University, Faculty of Science & Engineering.
    Ahn, Henrik
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Thoracic and Vascular Surgery.
    Gustafsson, Fredrik
    Linköping University, Department of Electrical Engineering, Automatic Control. Linköping University, Faculty of Science & Engineering.
    Dellgren, Göran
    Department of Cardiothoracic Surgery, Sahlgrenska University Hospital, Gothenburg; Transplant Institute, Sahlgrenska University Hospital, Gothenburg.
    Hübbert, Laila
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Cardiology in Norrköping. Transplant Institute, Sahlgrenska University Hospital, Gothenburg.
    Sound analysis of the magnetically levitated left ventricular assist device HeartMate 32019In: International Journal of Artificial Organs, ISSN 0391-3988, E-ISSN 1724-6040, Vol. 42, no 12, p. 717-724Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: The HeartMate 3 has shown lower rates of adverse events compared to previous devices due to the design and absence of mechanical bearings. For previous devices, sound analysis emerged as a way to assess pump function. The aims of this study were to determine if sound analysis can be applied to the HeartMate 3 in vivo and in vitro and to evaluate an electronic stethoscope.

    METHOD: Sound recordings were performed with microphones and clinical accessible electronic stethoscope. The recordings were studied in both the time and the frequency domains. Recordings from four patients were performed to determine if in vivo and in vitro recordings are comparable.

    RESULTS: The results show that it is possible to detect sound from HeartMate 3 and the sound spectrum is clear. Pump frequency and frequency of the pulsatile mode are easily determined. Frequency spectra from in vitro and in vivo recordings have the same pattern, and the major proportion (96.7%) of signal power is located at the pump speed frequency ±40 Hz. The recordings from the patients show low inter-individual differences except from location of peaks originating from pump speed and harmonics. Electronic stethoscopes could be used for sound recordings, but the dedicated equipment showed a clearer sound spectrum.

    DISCUSSION: The results show that acoustic analysis can also be performed with the HeartMate 3 and that in vivo and in vitro sound spectrum is similar. The frequency spectra are different from previous devices, and methods for assessing pump function or thrombosis need further evaluation.

  • 10.
    Sundbom, Per
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Cardiology in Linköping. Department of Medicine and Geriatrics, Höglandssjukhuset, Eksjö, Sweden.
    Suutari, Anne-Marie
    Department of Medicine and Geriatrics, Höglandssjukhuset, Eksjö, Sweden.
    Abdulhadi, Karim
    Department of Medicine and Geriatrics, Höglandssjukhuset, Eksjö, Sweden.
    Broda, Wojciech
    Department of Medicine and Geriatrics, Höglandssjukhuset, Eksjö, Sweden.
    Csegedi, Melinda
    Department of Medicine and Geriatrics, Höglandssjukhuset, Eksjö, Sweden.
    Salmonella enteritidis causing myocarditis in a previously healthy 22-year-old male2018In: Oxford Medical Case Reports, E-ISSN 2053-8855, Vol. 2018, no 12, p. 447-451, article id omy106Article in journal (Refereed)
    Abstract [en]

    Myocarditis is mostly caused by viral infections and rarely caused by bacterial pathogens, especially in immunocompetent individuals. Bacterial myocarditis due to Salmonella is rare, especially in countries with improved sanitation that minimize contamination of Salmonella typhi serotypes. We here present a case of a previous healthy 22-year-old male that came to the emergency room with chest pain. His symptoms occurred after a period of profuse diarrhea, fever and hematochezia. Magnetic resonance imaging confirmed the diagnosis of myocarditis. Stool culture was positive for Salmonella enteritidis. Myocarditis due to Salmonella is rare but may still occur in western countries. The inter-individual response to the pathogens and its virulence mechanisms and male gender is factors for developing myocarditis. We here add to the numbers of cases with myocarditis due to S. enteritidis. A higher suspicion and more frequent ECG and troponin testing might result in an increase of patients with subclinical myocarditis.

  • 11. Tajik, B
    et al.
    Vidlund, M
    Sundbom, Per
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Cardiology in Linköping.
    Friberg, Örjan
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Thoracic and Vascular Surgery.
    Holm, Jonas
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Thoracic and Vascular Surgery.
    Vanky, Farkas
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Thoracic and Vascular Surgery.
    Svedjeholm, Rolf
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Thoracic and Vascular Surgery.
    Intravenous glutamatereduces the need for inotropes in patients with heart failure after CABG foracute coronary syndrome?2014Conference paper (Other academic)
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