1,721,326 research outputs found
Epidemiology and management of aortic disease: aortic aneurysms and acute aortic syndromes
No full textThe aorta is the 'greatest artery', through which oxygenated blood is delivered from the left ventricle to end organs with each cardiac cycle (200 million litres of blood transported in an average lifetime). The aorta can be affected by a wide spectrum of acute factors (such as cocaine use, weight lifting and trauma) and chronic acquired and/or genetic conditions (such as systemic arterial hypertension and phaeochromocytoma), which variously lead to increased aortic wall stress. The medial layer of the aorta can also be subject to abnormalities (such as Marfan syndrome, bicuspid aortic valve, inflammatory vasculitis, atherosclerosis and infections). Despite important advances in diagnostic and therapeutic interventions, data derived from registries and population-based studies highlight that the burden of aortic diseases remains high. Therefore, specific resources need to be allocated to design and implement preventive strategies (healthy lifestyles, modifications to cardiovascular risk factors, and educational and screening programmes) at individual and community levels. In this Review, we discuss the epidemiology, management and outcomes of the most common aortic diseases, namely, aortic aneurysms and acute aortic syndromes
Takotsubo cardiomyopathy: What is the epidemiological scale of the problem?
No full textTakotsubo cardiomyopathy (TTC) occurs mostly in postmenopausal women usually after a relevant emotional and/or physical stress. Male sex and advanced age (≥75 years) appear to be associated with higher rates of hospital complications and mortality. The concurrence of coronary artery disease is a common finding in many patients. The presence of a relevant coronary stenosis (≥50%) not supplying the dysfunctional myocardium is not an exclusion criterion for TTC. Despite the fact that in-hospital and long-term prognoses are generally favorable in the majority of cases, TTC may represent an important cause of sudden cardiac death. Further studies are needed to identify TTC patient cohorts at higher risk of complications and recurrences and to develop appropriate therapeutic strategies
Rationale and proposal for cardio-oncology services in Italy
No full text: In the last 20 years, a substantial improvement in the efficacy of cancer treatment has induced a progressive increase in cancer survival, with an obvious parallel increase in morbidity and mortality related to the adverse effects of anticancer therapy, in particular, cardiovascular complications. In relation to the peculiar aspects related to cardiac and vascular toxicity, clinical management of patients should be ideally reserved for experts in the field of this novel medical discipline, which has been defined as cardio-oncology. The rationale for this choice corresponds to the aim of identifying patients more prone to developing cardiovascular damage, prevent overt cardiotoxicity and conduct active surveillance of treated patients for early identification of cardiac and vascular involvement during short- and long-term follow-up. Due to the burden of treated cancer patients, the development of dedicated cardio-oncology services has become one of the main goals of contemporary medicine, needed to accomplish the peculiar mission of guiding the patients through the narrow path of cancer survival without the expense of cardiovascular damage. The main purpose of cardio-oncology services is to provide dedicated cardiologic care to cancer patients affected by concomitant (subclinical or overt) cardiovascular diseases, either preexisting the cancer onset or acquired during and after the time course of anticancer therapy. In this article, we describe a possible spoke-hub model of cardio-oncology services, which could be appropriately applied in Italy. Rationale, organization, definition of referral criteria, strategies, interventional programs, long-term surveillance and home assistance of this model are described and discussed
Response to: Correspondence on ‘Beta-blockers are associated with better long-term survival in patients with Takotsubo syndrome’ by John E Madias
No full textResponse to: Correspondence on 'Beta-blockers are associated with better long-term survival in patients with Takotsubo syndrome' by Chang et al
No full text
- …
