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Reviews in Cardiovascular Medicine

Nasrien E Ibrahim, Akshay S Desai, Jagmeet P Singh, James L Januzzi
Heart failure (HF) is a chronic and complex disease entity with an enormous morbidity and mortality. Many of the therapies used in the management of HF were developed decades ago, but recently more novel monitoring and therapeutic strategies have emerged. The employment of these strategies may reduce morbidity and mortality in patients with HF. This article reviews the epidemiology of HF and some of the novel strategies developed to assess risk and monitor these challenging patients. It also discusses the evidence behind some of the newer treatments available that are recently included in the HF management guidelines...
2017: Reviews in Cardiovascular Medicine
Guram G Imnadze, Andro G Kacharava
Typically, myocardial bridging (MB) is considered a relatively benign condition; however, serious complications such as angina pectoris, myocardial infarction (MI), and sudden cardiac death may occur. The diagnosis and appropriate treatment of this pathology are important. We report a case of acute anterior wall ST-elevation MI occurring as a complication of MB involving the mid segment of the left anterior descending artery in a young, otherwise healthy woman who underwent a primary stenting procedure. Pathophysiologic mechanisms underlying the process leading from MB to acute MI vary, and so should the therapy for those patients...
2016: Reviews in Cardiovascular Medicine
Anna Mollar, Gema Miñana, Maria Pilar Villanueva, Jorge Guijarro, Julio Núñez
Respiratory infections are well-known precipitant factors for heart failure decompensations. Nevertheless, the diagnosis of life-threatening infections, such as pneumonia, is challenging. Pneumonia and acute heart failure often display overlapping clinical findings and, in other cases, more accurate infection-related findings are missing. In recent years, procalcitonin has emerged as a promising tool for early and accurate diagnosis of pneumonia and, interestingly, for guiding antibiotic therapy in patients with acute heart failure...
2016: Reviews in Cardiovascular Medicine
Bhaskar Bhardwaj, Udit B Bhatnagar, Darcy G Conaway
Staphylococcus warneri is a coagulase-negative staphylococcal (CoNS) bacterium. It is a common saprophyte on human skin, present in approximately 50% of the healthy adult population; it has emerged as a cause of serious infection in the past two decades. In most cases, there is a predisposing condition, such as a new implant or surgical procedure, before the identification of S warneri as the pathogen. It is believed that CoNS are mostly associated with prosthetic valve infections. S warneri can lead to a slow growing and an indolent course and late diagnosis...
2016: Reviews in Cardiovascular Medicine
Ashish H Shah, Nick Ossei-Gerning, Rito Mitra
Percutaneous coronary intervention (PCI) of a resistant, undilatable lesion can result in coronary dissection. Retrograde propagation of a dissection flap into the sinus of Valsalva is a rare phenomenon. It is commonly seen at the time of PCI to a right coronary artery (RCA) and is associated with potentially fatal consequences. Use of rotational atherectomy (RA) is contraindicated in the presence of a coronary dissection. Coronary dissection with preserved flow in asymptomatic patients should be managed conservatively until the dissection heals, but in the case presented here, as coronary flow was compromised, the patient complained of chest pain and ST elevation was observed on electrocardiogram...
2016: Reviews in Cardiovascular Medicine
Matthew M Schumaecker, Timothy R Larsen, David C Sane
It is estimated that the prevalence of primary adrenal insufficiency (Addison disease) is 1 in 10,000 people. There are multiple case reports and several studies that suggest a correlation between Addison disease and abnormalities of cardiac function. The pathophysiology of cardiac abnormalities in this condition is incompletely understood. This review explores what is currently known about the cardiac manifestations of Addison disease.
2016: Reviews in Cardiovascular Medicine
Giulio Giovannetti, Daniele De Marchi, Alessandro Pingitore
Cardiac magnetic resonance (CMR) is a relevant diagnostic tool for the evaluation of cardiac morphology, function, and mass. The assessment of myocardial tissue content through the measurement of longitudinal (T1) and transversal (T2) relaxation properties and the development of different technical advances are important clinical novelties of CMR. Recently, magnetic resonance spectroscopy has been explored for the assessment of the metabolic state of tissue for cardiac function evaluation by using nuclei other than protons, such as (13)C and (23)Na, expanding our knowledge of the kinetics of metabolic processes...
2016: Reviews in Cardiovascular Medicine
Georgios K Efthimiadis, Efstathios Pagourelias, Thomas Zegkos, Despoina Parcharidou, Theofilos Panagiotidis, Alexandra Arvanitaki, Pavlos Rouskas, Haralambos Karvounis
Hypertrophic cardiomyopathy (HCM) is the most common inherited cardiac disease. Its clinical course is variable, ranging from a benign asymptomatic or mildly symptomatic course throughout life, to severe symptoms (dyspnea, angina, palpitations) or cardiovascular events (syncope and thromboembolism). Sudden cardiac death (SCD) remains the most striking manifestation of the disease, affecting a minority of patients. This review focuses on the medical treatments applied according to the symptomatology in obstructive and nonobstructive HCM; a special reference is made to atrial fibrillation and arterial hypertension, which often coexist with the disease...
2016: Reviews in Cardiovascular Medicine
Daniel Levin, Shweta Bansal, Anand Prasad
Contrast-induced nephropathy related to cardiac and peripheral vascular procedures is a major problem in the United States and abroad. Measures to prevent and treat this complication have been hampered by the lack of clinical tools to detect acute kidney injury following contrast administration. Emerging novel serum and urinary biomarkers may provide sensitive detection of early kidney injury prior to creatinine elevation and allow for more precise risk stratification and management of patients. This article discusses the biologic and clinical data supporting the development and utility of several promising biomarkers in the management of patients undergoing cardiac catheterization and percutaneous coronary intervention...
2016: Reviews in Cardiovascular Medicine
Nachiket Patel, Elizabeth Ngo, Timothy E Paterick, Khawaja Afzal Ammar, Krishnaswamy Chandrasekaran, A Jamil Tajik
A rapid diagnosis of ST-segment elevation myocardial infarction (STEMI) is mandatory for optimal treatment of an acute coronary syndrome. However, a small number of patients with suspected STEMI are afflicted with other medical conditions. These medical conditions are rare, but important clinical entities that should be considered when evaluating a STEMI alert. These conditions include coronary vasospasm, Takotsubo cardiomyopathy, coronary arteritis/aneurysm, myopericarditis, Brugada syndrome, left bundle branch block, early repolarization, aortic dissection, infective endocarditis with root abscess, subarachnoid hemorrhage, ventricular aneurysm after transmural myocardial infarction, and hemodynamically significant pulmonary embolism with right ventricular strain...
2016: Reviews in Cardiovascular Medicine
Peter A McCullough, Mohammad Kazem Fallahzadeh, Refaat M Hegazi
There is an expanding prevalence pool of heart failure (HF) due to the increasing prevalence of survivors of myocardial infarction, diabetes, hypertension, chronic kidney disease, and obesity. There is increasing interest in the role of nutrition in all forms of HF, given observations concerning micro- and macronutrient deficiencies, loss of lean body mass or sarcopenia, and their relationships with hospitalization and death. This review examines the relationships among loss of lean body mass, macro- and micronutrient intake, and the natural history of HF, particularly in the elderly, in whom the risks for all-cause rehospitalization, infection, falls, and mortality are increased...
2016: Reviews in Cardiovascular Medicine
Barry H Greenberg
The treatment of heart failure with reduced ejection (HFrEF) is changing rapidly. Advances over the past several decades have focused on blocking the adverse effects of neurohormonal activation. This approach has resulted in marked improvement in outcomes in the HFrEF population. Despite these advances, however, mortality and morbidity remain high and HFrEF patients have poor quality of life. New approaches to therapy now offer additional benefits. Combined neprilysin inhibition and angiotensin receptor blockade using sacubitril-valsartan (LCZ696) has been shown to be superior to an angiotensin-converting enzyme inhibitor in HFrEF patients...
2016: Reviews in Cardiovascular Medicine
Sandeep K Krishnan, Norman E Lepor
Hyperkalemia is a common electrolyte disorder associated with life-threatening cardiac arrhythmias and increased mortality. Patients at greatest risk for hyperkalemia include those with diabetes and those with impaired renal function in whom a defect in the excretion of renal potassium may already exist. Hyperkalemia is likely to become more common clinically because angiotensin receptor blockers and angiotensin-converting enzyme inhibitors are increasingly being used in higher doses and are thought to confer cardiovascular and renal protection...
2016: Reviews in Cardiovascular Medicine
(no author information available yet)
No abstract text is available yet for this article.
2016: Reviews in Cardiovascular Medicine
Juan M Vinardell, Maria D Avila, Orlando Santana
Isolated left ventricular noncompaction is either a distinct cardiomyopathy or a morphologic trait shared by several different types of cardiomyopathies. Although there is no current gold standard for its diagnosis, cardiac imaging is the most commonly accepted modality. Described is a case of left ventricular noncompaction that resolved 2 years after the initial diagnosis.
2016: Reviews in Cardiovascular Medicine
Manish Patwardhan, Sanjay Mehra, Assad Movahed, Ramesh Daggubati
The percutaneous transradial approach for coronary angiography and percutaneous coronary intervention is increasing in the United States. Although its vascular safety profile is better than the traditional femoral approach, it is important to learn about potential complications. In this article, we present two cases of vascular complications, namely, pseudoaneurysm and radial artery occlusion, after transradial cardiac catheterization, along with a review of the relevant literature.
2016: Reviews in Cardiovascular Medicine
Emily Tat, Richard Cheng, Jeffrey S Helfenstein
A 48-year-old woman with 40 years of intermittent squeezing chest pain presented with worsening symptoms. Results of an ambulatory electrocardiogram, echocardiogram, and exercise treadmill were unremarkable. Persistent symptoms prompted a computed tomography coronary angiogram (CTCA) that revealed mid-left anterior descending artery myocardial bridging (MB) that was not physiologically significant by exercise single-photon emission CT. Conservative treatment was pursued. Anatomic MB is prevalent in a large proportion of the general population and are increasingly identified by CTCA...
2016: Reviews in Cardiovascular Medicine
Seema Pursnani, Raj Khandwalla, Rigved Tadwalkar
No abstract text is available yet for this article.
2016: Reviews in Cardiovascular Medicine
Norman E Lepor
No abstract text is available yet for this article.
2016: Reviews in Cardiovascular Medicine
Marco Marchesini, Lucia Uguccioni, Rosario Parisi, Gianmaria Mattioli, Francesca Terzi, Roberto Olivieri, Alessandro Capucci, Rossella Fattori
Until recently, the only imaging technique for the diagnosis and management of hypertrophic cardiomyopathy (HCM) was two-dimensional echocardiography, and the use of cardiac magnetic resonance imaging (cMRI) was limited to patients with poor acoustic windows. Now, cMRI has gained an essential role in the diagnosis of HCM, providing superior visualization of myocardial hypertrophy-even in remote zones of the left ventricle-and visualization of subtle changes in thickness and contractility over time. The morphologic accuracy of cMRI allows for the differentiation of HCM from other pathologic conditions with hypertrophic phenotype...
2016: Reviews in Cardiovascular Medicine
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