1,721,338 research outputs found

    Late Iatrogenic Coronary Sinus Hematoma During Cardiac Surgery

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    Retrograde cardioplegia is commonly used in cardiac surgery to induce cardioplegic arrest. However, this method could be potentially associated with coronary sinus injuries, which can be fatal or extremely difficult to manage. This report describes the conservative management of an iatrogenic coronary sinus hematoma by daily transthoracic echocardiography and weekly computed tomography follow-up. (Level of Difficulty: Intermediate.

    Heart-Brain axis: is microvascular dysfunction the link between stroke and Takotsubo syndrome?

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    Takotsubo syndrome (TS) is characterized by transient left ventricular dysfunction, often triggered by psychological or physiological stress. Increasing evidence highlights the critical role of the brain-heart axis in TS, with small blood vessels acting as central mediators. Recent data indicate a significant association between TS and cerebrovascular events, particularly ischemic stroke. Studies show that the incidence of stroke in TS patients is 1–2% per patient-year, which may occur during the acute phase or later due to ongoing autonomic and microvascular dysfunction. This underscores the shared mechanisms of microvascular impairment between the heart and brain in TS. Imaging techniques are essential for detecting microvascular abnormalities in both the heart and brain, providing valuable insights into the interconnected nature of microvascular dysfunction across the heart-brain axis. The aim of this review is to investigate the potential shared pathophysiological mechanisms that link TS and stroke, with a specific emphasis on microvascular dysfunction as a common factor. By examining the role of the heart-brain axis in both conditions and emphasizing the crucial role of advanced imaging techniques, this review seeks to clarify how microvascular abnormalities can simultaneously affect the cardiovascular and cerebrovascular systems. Additionally, it provides insights into the clinical implications of these findings, highlighting the importance of viewing TS and stroke as interconnected conditions within a shared pathological framework. Understanding these mechanisms may not only improve early detection but also pave the way for novel therapeutic strategies targeting both cardiac and cerebral microvascular health, potentially enhancing outcomes for TS patient

    Cardiovascular magnetic resonance in β-thalassemia major: beyond T2*

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    Β-thalassemia major (TM) patients underwent regular transfusions to prevent complications of chronic anemia. However, these regular transfusions result in progressive iron accumulation in vital organs, including the heart. Myocardial iron overload can lead to cardiac dysfunction and ultimately to heart failure. Diagnosis of cardiac dysfunction in β-TM patients is usually made through clinical examination, electrocardiogram, and echocardiography. Cardiac magnetic resonance (CMR), through the measurement of T2* relaxation time, represents the diagnostic modality of choice for assessing myocardial iron overload and guiding the iron chelation therapy. Despite a tailored chelation therapy reducing myocardial iron overload, heart failure remains the leading cause of morbidity and mortality even in well-treated β-TM patients. Advances in CMR, including myocardial strain, parametric mapping (T1, T2, and extracellular volume), and late gadolinium enhancement (LGE) measurements, have expanded its role in the diagnosis, prognosis, and follow-up of these patients. This review seeks to offer a thorough overview of the potential uses of CMR in β-TM, extending beyond the established role of T2* measurement in guiding chelation therapy. It delves into the emerging applications of new CMR imaging biomarkers that could improve the overall management of β-TM patients
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