1,721,114 research outputs found
Might midodrine be useful in patients with decompensated and worsening chronic heart failure? Author's reply
Full text linkWe thank Fernández–Fernández et al. for their interest in our manuscript and for raising the question about the potential use of midodrine in patients with decompensated and worsening chronic heart failure
Linking functional capacity and heart failure outcomes: Easy assessment, major implications
No full textN/
Intravascular imaging beyond ischaemia assessment: a possible way for improving risk stratification
Full text linkN/
Direct cellular reprogramming: the hopes and the hurdles
No full textComment on Direct cellular reprogramming for cardiac repair and regeneration
Uncommon cause of ST-segment elevation in V1-V3: incremental value of cardiac magnetic resonance imaging
No full textAlthough ST-segment elevation in precordial leads is a
characteristic of anterior left ventricular infarction (LVI), it
may also be observed in patients with proximal right coronary
occlusion. An isolated right ventricular infarction
(RVI) accounts for only 3 % of all myocardial infarctions
(MI) [1]; in these cases, the ST-segment elevation in the
precordial leads V1–V3 also may occur in the absence of
inferior electrocardiographic changes [2], whereas the
combination of RVI with inferior LVI suppresses ST-segment
elevation in the precordial leads and yields an STsegment
elevation in leads DII, DIII, and aVF [3].
Although certain electrocardiographic features have been
suggested to help differentiate ST-segment elevation secondary
to isolated RVI from LVI [3], it may be impossible
to make a differential diagnosis on the basis of electrocardiography
alone because these features are not pathognomonic.
Furthermore, when a patient is admitted for
typical chest pain, slight ST-segment elevation in leads
V1–V3 and significant increase of cardiac troponin but
with normal coronary main vessels at the coronary angiography,
the diagnosis of a RVI is challenging; taking into
account the multiple causes of myocardial injury and
treatment consequences, there is great clinical need to
clarify the underlying reason for cardiac troponin release.
Although some studies report that echocardiography is a
valuable clinical tool for the evaluation of global RV
function [4], geometric assumptions in modeling the
complex RV shape restricts the ability of this technique in
accurate and precise quantification of RV function; furthermore,
RV function assessment can be difficult in
patients with poor acoustic window or when minor alterations
of RV function are present.
Cardiac magnetic resonance (CMR) provides a comprehensive,
multifaceted view of the heart and can be
useful to characterize an infarct site and size accurately [5].
CMR in this particular setting can confirm the presence of
a minor RVI and aid to exclude other potential causes of
troponin rise with normal coronary main vessels at the coronary
angiography, such as embolic myocardial infarction or
myocarditis [6]. Acute MI treatment [7–10] and traditional
predictors of long-term mortality after acute MI are well
characterized [11–14] but with introduction of CMR, new
predictors of cardiovascular events are emerging [15, 16] and
the evaluation of RV function using CMR can improve risk
stratification and potentially refine patient management after
MI [17]. Moreover, the extent of myocardial scar characterized
by CMR is significantly associated with the occurrence
of spontaneous ventricular arrhythmias [18].
There have been few reports of anterior ST-segment
elevation caused by isolated RVI due to right ventricle
branch occlusion [19–21]. Occlusion of the conus branch
has been described essentially as a complication of coronary
angioplasty or during cardiac surgery [19–21]. Only
one report described a spontaneous RVI with culprit lesion
in the conus branch [22]. Assessment of isolated RVI due
to a critical stenosis of the conus branch by magnetic resonance
is never been reported
How Coronary Perforation Looks at Optical Coherence Tomography Imaging
No full textCoarctation of the aorta is an unusual finding in an adult person during their sixth decade of life. We present a 52-year-old male who presented with left ventricular failure with low ejection fraction and atrial fibrillation who was incidentally detected to have critical coarctation of the aorta, which was successfully managed with balloon angioplasty. The patient had a favorable result at 6 months of clinical follow-up
Infolding of Self-Expandable Transcatheter Valve: A Complication that Needs Prompt Diagnosis During TAVR Procedure
No full textInfolding of self-expandable prosthetic valve is a possible complication of transcatheter aortic valve replacement (TAVR). A prompt diagnosis during the procedure before full deployment of the valve is extremely important to avoid potentially lethal consequences
- …
