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378430 occurrences (No.48 in the rank) during 5 years in the PubMed. [no cache] 500 found

303) A few burning questions arose from this case: what was the acute cardiac disease - TLVDS or AMI? Which disease came first - the stroke or the acute cardiac illness? An intricate cause-effect relationship is discussed; and finally, does an obstructive coronary artery disease rule out TLVDS?

--- ABSTRACT ---

PMID:20935571 DOI:10.2459/JCM.0b013e32834037a1

2015 Journal of cardiovascular medicine (Hagerstown, Md.)

* The causality quandary in a patient with stroke, Takotsubo syndrome and severe coronary artery disease.

- Takotsubo-like left ventricular dysfunction syndrome (TLVDS) and acute coronary syndrome have almost always the same clinical presentation and ECG findings. Both diseases may become a potential cardioembolic source to the cerebrovascular system. Stroke has been linked to TLVDS either as the trigger or as a complication. We report on a 67-year-old female patient who presented with an acute ischemic stroke confirmed by computed tomographic scan of the brain. She also had electrocardiographic features and laboratory findings suggestive of both acute myocardial infarction (AMI) and TLVDS. Coronary angiography revealed severe coronary artery stenoses but the coronary lesions did not have any of the features suggestive of an acute pathology. Echocardiography and left ventriculography showed a striking apical ballooning of the left ventricle, which resolved completely within 1 week, a clinical picture and course typical for TLVDS. There were no signs of left ventricular thrombus. A few burning questions arose from this case: what was the acute cardiac disease - TLVDS or AMI? Which disease came first - the stroke or the acute cardiac illness? An intricate cause-effect relationship is discussed; and finally, does an obstructive coronary artery disease rule out TLVDS?

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(1)32 time	(19)5 meaningful	(37)2 5	(55)2 marriage
(2)21 report	(20)4 line	(38)2 6	(56)2 meta-analysis
(3)11 and	(21)3 14	(39)2 72	(57)2 mitochondrial
(4)11 to	(22)3 3	(40)2 application	(58)2 months
(5)10 time,	(23)3 complete	(41)2 approach	(59)2 myocardial
(6)9 year	(24)3 described	(42)2 article	(60)2 postnatal
(7)8 2	(25)3 in	(43)2 attempt	(61)2 presented
(8)8 molar	(26)3 it	(44)2 choice	(62)2 relapse
(9)8 reported	(27)3 order	(45)2 clinical	(63)2 smear
(10)8 step	(28)3 postoperative	(46)2 component	(64)2 stage
(11)8 we	(29)3 record	(47)2 comprehensive	(65)2 step,
(12)7 case	(30)3 sequenced	(48)2 concern	(66)2 test
(13)6 determined	(31)3 the	(49)2 course	(67)2 that
(14)6 group	(32)3 treatment	(50)2 demonstration	(68)2 therapy
(15)6 study	(33)3 two	(51)2 few	(69)2 trimester
(16)5 dose	(34)3 was	(52)2 intentions	(70)2 trimester,
(17)5 evidence	(35)2 null	(53)2 introduction	(71)2 using
(18)5 generation	(36)2 30	(54)2 left

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--- WordNet output for first --- =>初めて, 最初の, 第一の, はじめに, 最初, 第1 Overview of noun first The noun first has 6 senses (first 4 from tagged texts) 1. (9) first, number one -- (the first or highest in an ordering or series; "He wanted to be the first") 2. (5) first, number one, number 1 -- (the first element in a countable series; "the first of the month") 3. (1) beginning, commencement, first, outset, get-go, start, kickoff, starting time, showtime, offset -- (the time at which something is supposed to begin; "they got an early start"; "she knew from the get-go that he was the man for her") 4. (1) first base, first -- (the fielding position of the player on a baseball team who is stationed at first of the bases in the infield (counting counterclockwise from home plate)) 5. first, first-class honours degree -- (an honours degree of the highest class) 6. first gear, first, low gear, low -- (the lowest forward gear ratio in the gear box of a motor vehicle; used to start a car moving) Overview of adj first The adj first has 6 senses (first 5 from tagged texts) 1. (232) first -- (preceding all others in time or space or degree; "the first house on the right"; "the first day of spring"; "his first political race"; "her first baby"; "the first time"; "the first meetings of the new party"; "the first phase of his training") 2. (61) first, 1st -- (indicating the beginning unit in a series) 3. (4) inaugural, initiative, initiatory, first, maiden -- (serving to set in motion; "the magazine's inaugural issue"; "the initiative phase in the negotiations"; "an initiatory step toward a treaty"; "his first (or maiden) speech in Congress"; "the liner's maiden voyage") 4. (4) beginning, first -- (serving to begin; "the beginning canto of the poem"; "the first verse") 5. (3) first, foremost, world-class -- (ranking above all others; "was first in her class"; "the foremost figure among marine artists"; "the top graduate") 6. first -- (highest in pitch or chief among parts or voices or instruments or orchestra sections; "first soprano"; "the first violin section"; "played first horn") Overview of adv first The adv first has 4 senses (first 4 from tagged texts) 1. (58) first, firstly, foremost, first of all, first off -- (before anything else; "first we must consider the garter snake") 2. (40) first, for the first time -- (the initial time; "when Felix first saw a garter snake") 3. (9) first -- (before another in time, space, or importance; "I was here first"; "let's do this job first") 4. (4) foremost, first -- (prominently forward; "he put his best foot foremost") --- WordNet end ---