1,721,243 research outputs found
Echocardiographic tools for prognostic stratification in transthyretin cardiac amyloidosis: a new arrow in the quiver
No full textMyocardial postsystolic motion in ischemic and not ischemic myocardium: The clinical value of tissue Doppler
No full textStress-induced cardiomyopathy in pheochromocytoma: the way we treat and the way we think
No full textVentricular Septal Defect Complicating Inferior Acute Myocardial Infarction: A Case of Percutaneous Closure
No full textVentricular septal defect (VSD) is one of the most serious mechanical complications of acute myocardial infarction (AMI). Despite the incidence of post-AMI VSD in reperfusion era has reduced from 1%-2% to 0.17%-0.31%, it is a still life-threatening condition with poor prognosis. Surgical VSD closure is considered the best treatment approach since conservative management carries an extremely high mortality rate. Over the last decade, percutaneous transcatheter closure has emerged as an alternative therapeutic strategy for a patient with post-AMI VSD, with outcomes similar to cardiac surgery (30-day mortality 14%-66%). We present a case of inferior AMI complicated by posterobasal VSD and cardiogenic shock successfully treated with percutaneous closure. The role of echocardiography in diagnosis, management, and percutaneous procedure guiding has been emphasized
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
[Cardiovascular management of patients with chronic myeloid leukemia treated with BCR-ABL tyrosine kinase inhibitors: it is time for a shared management]
No full text: Chronic myeloid leukemia is a rare myeloproliferative disease, characterized by a chromosomal translocation detected in 95% of cases, defined as "Philadelphia chromosome", encoding for the BCR-ABL fusion protein with continuous activation of the tyrosine kinase domain. Over the last 20 years, treatment has been revolutionized by the use of BCR-ABL tyrosine kinase inhibitors (TKI). Imatinib is the first TKI approved with a good cardiovascular safety profile, while some second-generation (nilotinib and dasatinib) and third-generation (ponatinib) drugs, developed to overcame drug resistance, can be associated with cardiovascular adverse events. The major adverse effect of dasatinib is pulmonary hypertension, reversible after treatment discontinuation. Conversely, nilotinib or ponatinib assumption is associated with a higher incidence of ischemic events, including coronary artery disease, cerebral stroke and peripheral arterial disease. Therefore, the management of patients receiving TKI therapy should include an integrated multidisciplinary evaluation and follow-up, involving highly specialized figures such as a cardiologist, hematologist and/or oncologist and the application of dedicated pathways, in order to prevent the onset or manage cardiovascular complications associated with these drugs
The Role of Stress Echocardiography in Valvular Heart Disease
Full text linkPURPOSE OF REVIEW: Stress echocardiography is recommended in valvular heart disease when there is a mismatch between resting transthoracic echocardiography findings and symptoms during activities of daily living. We describe the current methodology and the evidence supporting these applications. RECENT FINDINGS: The comprehensive stress echo assessment includes valve function (gradients and regurgitation), left ventricular global systolic and diastolic function, left atrial volume, pulmonary congestion, pulmonary arterial pressure, and right ventricular function, integrated with blood pressure response with cuff sphygmomanometer, chronotropic reserve with heart rate, and symptoms. SUMMARY: Recent guidelines recommend the evaluation of asymptomatic severe or symptomatic non-severe mitral regurgitation or stenosis with exercise stress and suspected low-flow, low-gradient severe aortic stenosis with reduced ejection fraction with low dose (up to 20 mcg, without atropine) dobutamine stress. Prospective, large-scale studies based on a comprehensive protocol (ABCDE +) capturing the multiplicity of clinical phenotypes are needed to support stress echo-driven treatment strategies
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
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