1,721,088 research outputs found
Multimodality imaging in athlete’s heart
No full textWhen athlete’s heart occurs with its most marked expression, its features may overlap with those of some structural cardiac diseases, including cardiomyopathies, valvular diseases, aortopathies, myocarditis, and coronary artery anomalies. Identifying the underlying cardiac pathology is essential to reduce the potential for sudden cardiac death. A broad spectrum of imaging modalities can be used to discriminate between extreme physiology and structural cardiac disease during the athlete’s cardiovascular evaluation. For this purpose, a practical step-by-step approach is recommended, based on the use of first-line screening tools (personal and family history, physical examination, and resting ECG), and, if needed, second- and third-line diagnostic modalities (exercise testing and cardiopulmonary exercise testing, rest and exercise echocardiography, cardiac magnetic resonance, cardiac computed tomography, and nuclear imaging)
Sports cardiology: A glorious past, a well-defined present, a bright future
Full text linkThe attention towards sports cardiology has dramatically grown after the introduction of preparticipation screening and the need for specific education on electrocardiogram interpretation in athletes, given the differences between athletes and the general population. The present article stresses the need for specific skills, knowledge, and clinical expertise in sports cardiology, which are essential for appropriately screening competitive athletes to prevent sudden cardiac death and avoid overdiagnosis. However, disqualification from sports competitions may lead to sports inactivity, and athletes may enter a gray zone where little or no information is provided about what they can or cannot do to stay active. However, modern sports cardiology cannot neglect the patient's needs and the importance of the safe practice of regular exercise. In this context, the personalized exercise prescription plays a crucial role in the core curriculum and the clinical activity of professionals involved in sports cardiology programs. Given its specificities, sports cardiology requires a formal education plan for medical school students and all residents. Additional education and practice are required for young colleagues who want to focus their professional lives on sports cardiology. The future directions of emerging modern sports cardiology should not neglect the importance of a scientific community that works together, designing multicenter international outcomes-based research to address the many remaining areas of uncertainty
Subocclusion of the sinus node artery during coronary angioplasty: arrhythmological considerations
No full textWe report the case of a 58-year-old man who developed atrial fibrillation as a result of iatrogenic subocclusion of a diseased sinus node artery, originating from the left circumflex artery (LCx), occurring during LCx stenting, suggestive of an ischemic etiology of sinus node dysfunctio
The role of optical coherence tomography in clarifying the mechanisms for dobutamine stress echocardiography-induced takotsubo cardiomyopathy
No full textTakotsubo cardiomyopathy is a clinical disorder characterized by a transient dilatation and akynesis or dyskinesis of the left ventricular (LV) apex, mimicking an anterior wall acute myocardial infarction in the absence of significant coronary artery disease (CAD). It typically occurs during an episode of severe emotional or physical stress. Recent reports suggested the potential of dobutamine stress echocardiography (DSE) in inducing the aforementioned syndrome. The transient dysfunction of the LV does not fit any known coronary distribution. Furthermore, there is no obstructive CAD demonstrated at angiography to account for the observed dysfunction. Consequently, the pathophysiology of this syndrome is still undetermined. Here, we report a case of DSE-induced Takotsubo cardiomyopathy in which high-resolution intracoronary imaging was utilized to exclude possible vessel alterations to help provide potential mechanistic explanations for the development of this conditio
Interpretation of T-wave inversion in physiological and pathological conditions: Current state and future perspectives
Full text linkThe presence of T-wave inversion (TWI) at 12-lead electrocardiogram (ECG) in competitive athletes is one of the major diagnostic challenges for sports physicians and consulting cardiologists. Indeed, while the presence of TWI may be associated with some benign conditions and it may be occasionally seen in healthy athletes presenting signs of cardiac remodeling, it may also represent an early sign of an underlying, concealed structural heart disease or life-threatening arrhythmogenic cardiomyopathies, which may be responsible for exercise-related sudden cardiac death (SCD). The interpretation of TWI in athletes is complex and the inherent implications for the clinical practice represent a conundrum for physicians. Accordingly, the detection of TWI should be viewed as a potential red flag on the ECG of young and apparently healthy athletes and warrants further investigations because it may represent the initial expression of cardiomyopathies that may not be evident until many years later and that may ultimately be associated with adverse outcomes. The aim of this review is, therefore, to report an update of the literature on TWI in athletes, with a specific focus on the interpretation and management. © 2020 The Authors. Clinical Cardiology published by Wiley Periodicals, Inc
Left ventricular hypertrophy in athletes: How to differentiate between hypertensive heart disease and athlete’s heart
No full textAthlete’s heart is typically accompanied by a remodelling of the cardiac chambers induced by exercise. However, although competitive athletes are commonly considered healthy, they can be affected by cardiac disorders characterised by an increase in left ventricular mass and wall thickness, such as hypertension. Unfortunately, training-induced increase in left ventricular mass, wall thickness, and atrial and ventricular dilatation observed in competitive athletes may mimic the pathological remodelling of pathological hypertrophy. As a consequence, distinguishing between athlete’s heart and hypertension can sometimes be challenging. The present review aimed to focus on the differential diagnosis between hypertensive heart disease and athlete’s heart, providing clinical information useful to distinguish between physiological and pathological remodelling
Zero-fluoroscopy catheter ablation of premature ventricular contractions at left coronary cusp near left main coronary artery
Full text linkThe left coronary cusp is the commonest site of origin for coronary cusp PVC. Catheter ablation without fluoroscopy is highly effective, feasible, and safe but it could be related to risks because of proximity to the coronary arteries. The use of ICE integration allowed an improvement in the safety and efficiency of these procedures. © 2020 The Authors. Clinical Case Reports published by John Wiley & Sons Ltd
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