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    Carbon monoxide poisoning presenting with atrial fibrillation [Karbonmonoksit zehirlenmesine bağlı gelişen atriyal fibrilasyon]
    (TIP ARASTIRMALARI DERNEGI, 2015) Avci A.; Yilmaz A.; Demir K.; Celik M.; Karatas R.
    Carbon monoxide intoxication is one of the most common types of poisoning and it is the leading cause of death by poisoning in the world. We report a carbon monoxide intoxication case presenting with atrial fibrillation on 17 years old healthy boy. 17 years old boy admitted to emergency service after exposuring carbon monoxide gas approximately 3 hours. His first electrocardiography (ECG) showed atrial fibrillation with rapidly ventricular response. After oxygen supply sinus rhythm was achieved spontaneously. Emergency physicians should be aware of the clinical presentation of carbon monooxide intoxication. Every patient that arrived emergency service with acute or chronically carbon monoxide poisoning should undergo cardiovascular investigation, including ECG and measurement of cardiac enzymes. © 2015, TIP ARASTIRMALARI DERNEGI. All rights reserved.
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    Comparison between brachial blood pressures obtained by aneroid sphygmomanometer and central aortic pressures: Factors affecting the measurements [Aneroid sfigmomanometreyle ölçülen brakiyal arter basincinin santral aortik basinçla karşilaştirilmasi ve farka etki eden faktörler]
    (2008) Kayrak M.; Ülgen M.S.; Yazici M.; Demir K.; Do?an Y.; Koç F.; Zengin K.
    Objectives: We compared brachial artery blood pressures (BP) measured by aneroid sphygmomanometer with ascending aortic blood pressures and evaluated the factors affecting the differences between the two methods. Study design: The study included 463 patients (177 women, 286 men; mean age 60±11 years) undergoing routine coronary angiography. Simultaneously, ascending aortic pressures were measured using a pigtail catheter and brachial artery pressures were measured from the right arm with an aneroid sphygmomanometer. Pulse pressure, fractional pulse pressure, and pulsatility index were calculated from systolic and diastolic BP values. Results: Overall, systolic (-3.1±10 mmHg) and diastolic (+3.0±7.1 mmHg) brachial pressures showed significant deviations from aortic pressures (p=0.001). Although systolic BP did not differ significantly in both methods for men and women, brachial diastolic BP was significantly different in women (+4.8 mmHg, p=0.0001). Brachial diastolic BP showed a greater deviation from the aortic diastolic pressure in patients ?60 years of age (+4.5 mmHg and +1.1 mmHg, respectively; p=0.0001). Deviation of systolic BP in hypertensive patients (-4 mmHg) was greater than that in normotensives (-2.0 mmHg, p=0.04). Deviation of brachial systolic BP was highly correlated with increases in aortic systolic pressure (p=0.0001). Differences between the two methods in systolic (-5.8 mmHg, p=0.01) and diastolic (+4.2 mmHg, p=0.03) BP were significant in patients with coexisting diabetes and hypertension. Body mass index and arm circumference were not correlated with deviations between the two methods. Conclusion: The main factors (female gender, age, hypertension, diabetes) affecting BP differences between the two methods should be considered in clinical practice.
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    In ectopic origin of the left coronary artery from the right sinus of Valsalva [Sol ana koronerin sa? sinus Valsalvadan tek koroner ostium gibi çıkışı]
    (TIP ARASTIRMALARI DERNEGI, 2013) Avci A.; Demir K.
    The incidence of various coronary artery anomalies ranges between 0.3 and 0.8% in patients undergoing cardiac catheterization. Anomalous coronary arteries are not considered a risk factor for development of coronary atherosclerosis. Most anomalies are discovered as incidental findings during coronary arteriography or at autopsy. In this case, the coronary angiography was performed the patient admitted with atrioventricular complet block and, left main coronary artery arising from the right sinus of Valsalva as a single coronary ostium was seen. This is an extremely rare coronary anomaly.
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    Isolated mitral valve prolapsus does not affect left ventricular function [İzole mitral kapak prolapsusu sol ventrikül fonksiyonunu etkilemez]
    (2011) Demir K.; Koc F.; Can I.; Vatankulu M.A.; Yazici M.; Ülgen M.S.
    Aim: Idiopathic mitral valve prolapsus (MVP) is characterized by myxomatous degeneration of mitral valve. The most common determinant of cardiovascular mortality in patients with MVP is left ventricular (LV) dysfunction. Therefore we aimed to evaluate LV functions of cases with isolated MVP by tissue Doppler echocardiography (TDE). Method: Twenty five patients with MVP (mean age, 31±12 years) were enrolled the study as MVP group. Control group was consisted 20 age and sex matched patients (mean age, 34±9 years) were enrolled to this study. LV functions were detected by using conventional echocardiography and TDE. Myocardial peak systolic (Sm), early (Em) and late (Am) diastolic filling velocities, Em/Am, isovolumetric contraction time (ICT), isovolumetric relaxation time (IRT) and ejection time (ET) were obtained in the basal segments of the inferior-septal and lateral wall. Myocardial performance index (MPI) was calculated. Result: Mild degree mitral regurgitation was present in 10 (40%) of patients with MVP, and moderate degree mitral regurgitation was present in 2 (8%) of patients. No difference was found between the two groups with regard to diastolic parameters. TDE-derivated MPI values were similar in all segments in two groups. There was significant difference between the two groups with regard to LV mean Sm and lateral wall Sm (11.6±2.8 vs. 9.4±1.0, p=0.001; 13.0±3.9 vs. 9.2±2.3, p=0.001 respectively). Conclusion: Isolated MVP without significant mitral regurgitation does not affect LV diastolic functions and MPI. However, Sm of late ral wall and LV mean was higher in patients with MVP than patients without MVP.
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    Severe hypokalemia-associated rhabdomyolise and unusual poliuria in patient with primary aldosteronism
    (2012) Demir K.; Sonmez O.; Kayrak M.; Ozdemir K.
    Primary aldosteronism is a syndrome that is characterized with hypertension, hypopotasemia, high level of plasma aldosterone, and low plasma renin activity. The case we present is a 56-year-old male who referred to our neurology clinic with proximal muscle weakness and fatigue. Because of uncontrolled blood pressure, a cardiology consultation was performed for the planning of antihypertensive treatment. As prolonged QT intervals and giant U waves due to serious hypokalemia (K+:1,04), cardiology clinic took over the patient for risks of arrhythmia. After primary hyperaldosteronism diagnosis was established, the treatment was initiated and severe polyuria developed during the treatment (19L/day).