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Cardiogeneic Shock

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https://www.readbyqxmd.com/read/27909767/interventional-therapies-in-acute-myocardial-infarction-complicated-by-cardiogenic-shock
#1
S de Waha, S Desch, G Fuernau, J Pöss, J Ledwoch, A Jobs, I Eitel, H Thiele
Cardiogenic shock remains the most common cause of death in patients with acute myocardial infarction. Early revascularization of the infarct-related artery has been shown to reduce mortality and is the therapeutic cornerstone. The optimal revascularization strategy of additional non-culprit lesions remains yet to be determined. Further, uncertainties exist with respect to access site choice, antiplatelet regimen as well as mechanical support devices. This review outlines current evidence on the interventional management of cardiogenic shock complicating acute myocardial infarction...
December 1, 2016: Herz
https://www.readbyqxmd.com/read/27904524/integration-of-medical-therapy-and-mechanical-circulatory-support-in-the-management-of-acute-heart-failure
#2
Patrick Horn, Malte Kelm, Ralf Westenfeld
Acute heart failure is still characterized by poor prognosis with high mortality. Diagnosis is based on clinical symptoms and hemodynamic measurements. Early coronary revascularization in cardiogenic shock complicating myocardial infarction improves outcome. The further contemporary therapeutic options in the management of acute heart failure are limited to a merely symptomatic effect with relief of dyspnea, reduction of volume overload and improvement of hemodynamic parameters by vasodilators (in hypertension) or inotropic and vasopressor agents (in hypotension)...
December 1, 2016: Archives of Medical Science: AMS
https://www.readbyqxmd.com/read/27904102/manifestation-of-latent-left-ventricular-outflow-tract-obstruction-in-the-acute-phase-of-takotsubo-cardiomyopathy
#3
Kazuyuki Ozaki, Takeshi Okubo, Komei Tanaka, Yukio Hosaka, Keiichi Tsuchida, Kazuyoshi Takahashi, Hirotaka Oda, Tohru Minamino
Objective Left ventricular outflow tract (LVOT) obstruction is a complication in 15-25% of patients with Takotsubo cardiomyopathy and sometimes leads to catastrophic outcomes, such as cardiogenic shock or cardiac rupture. However, the underlying mechanisms have not been clarified. Methods and Results We experienced 22 cases of Takotsubo cardiomyopathy during 3 years, and 4 of these 22 cases were complicated with LVOT obstruction in the acute phase (mean age 79±5 years, 1 man, 21 women). The LVOT pressure gradient in the acute phase was 100±17 mmHg...
2016: Internal Medicine
https://www.readbyqxmd.com/read/27896787/extracorporeal-membrane-oxygenation-for-pheochromocytoma-induced-cardiogenic-shock
#4
Guillaume Hekimian, Fatima Kharcha, Nicolas Bréchot, Matthieu Schmidt, Cécile Ghander, Guillaume Lebreton, Xavier Girerd, Christophe Tresallet, Jean-Louis Trouillet, Pascal Leprince, Jean Chastre, Alain Combes, Charles-Edouard Luyt
BACKGROUND: Pheochromocytoma, a rare catecholamine-producing tumor, might provoke stress-induced Takotsubo-like cardiomyopathy and severe cardiogenic shock. Because venoarterial-extracorporeal membrane oxygenation (VA-ECMO) rescue of pheochromocytoma-induced refractory cardiogenic shock has rarely been reported, we reviewed our ICU patients' presentations and outcomes. METHODS: All pheochromocytoma-induced refractory cardiogenic shock cases managed with VA-ECMO (January 2007-March 2015) were prospectively included and reviewed...
December 2016: Annals of Intensive Care
https://www.readbyqxmd.com/read/27895342/innovations-in-cardiovascular-care-historical-perspective-contemporary-practice-recent-trends-and-future-directions
#5
Hasanat Sharif, Mayera Tufail
Cardiovascular diseases continue to be a major cause of mortality and morbidity in the world population. First open heart procedure was performed by Gibbon in 1953, since then many advancements have been introduced to the field of cardiac surgery. Minimally invasive techniques were introduced, which include minimally invasive coronary artery bypass grafting (CABG), off-pump technique, minimally invasive valve surgery or transcatheter techniques to implant stentless or sutureless valves. The hybrid strategy to address coronary disease combines catheterisation procedures with standard surgical techniques...
October 2016: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/27892719/is-a-pulse-absolutely-necessary-during-cardiopulmonary-bypass
#6
Gengo Sunagawa, Marijan Koprivanac, Jamshid H Karimov, Nader Moazami, Kiyotaka Fukamachi
The benefits and disadvantages of pulsatility in mechanical circulatory support devices have been argued since before the first use of cardiopulmonary bypass (CPB) with a nonpulsatile pump. The debate over the superiority of either pulsatile or nonpulsatile perfusion during CPB persists, but recently, the evidence in favor of pulsatile perfusion during CPB is increasing. Complications associated with chronic nonpulsatile flow in patients implanted with left ventricular assist devices have renewed interest in generating pulsatility with these devices...
November 28, 2016: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/27888446/cesarean-section-in-the-setting-of-severe-pulmonary-hypertension-requiring-extracorporeal-life-support
#7
Ryosuke Hara, Shuhei Hara, Chin Siang Ong, Gary Schwartz, Christopher Sciortino, Narutoshi Hibino
We describe the use of veno-arterial extracorporeal membrane oxygenation (ECMO) in a 35-year-old female with severe fixed pulmonary hypertension who went into cardiogenic shock during a Cesarean section. Pregnancy in the presence of severe pulmonary hypertension is typically contraindicated due to high maternal mortality rates. This patient visited our hospital at 37 weeks of gestation after experiencing dyspnea and chest pain. Clinical evaluation revealed severe fixed pulmonary hypertension. At the time of the planned delivery, femoral lines were placed; in case of emergency, ECMO became necessary during the delivery...
November 25, 2016: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27885669/occult-adrenocortical-carcinoma-and-unexpected-early-childhood-death
#8
Mark Pilla, John Gilbert, Lynette Moore, Roger W Byard
A four-year-old previously well boy collapsed unexpectedly and was taken immediately to hospital, where he developed seizures and cardiogenic shock with lethal, rapidly progressing multi-organ failure. At autopsy, the height was >90th percentile and there were indications of early virilization. Internally, a friable tumor of the left adrenal gland was identified that had invaded the left renal vein and inferior vena cava. Histology revealed typical features of an adrenocortical carcinoma with aggregated trabeculae of cells containing abundant eosinophilic cytoplasm and large pleomorphic nuclei...
November 25, 2016: Journal of Forensic Sciences
https://www.readbyqxmd.com/read/27885393/erratum-to-venoarterial-extracorporeal-membrane-oxygenation-for-cardiac-arrest-cardiogenic-shock
#9
Anders Aneman, Peter Macdonald
No abstract text is available yet for this article.
November 24, 2016: Intensive Care Medicine
https://www.readbyqxmd.com/read/27884422/a-new-risk-score-to-predict-long-term-cardiac-mortality-in-patients-with-acute-myocardial-infarction-complicated-by-cardiogenic-shock-and-treated-with-primary-percutaneous-intervention
#10
Ruben Vergara, Renato Valenti, Angela Migliorini, Giampaolo Cerisano, Nazario Carrabba, Letizia Giurlani, David Antoniucci
Poor data exist about predictors of long-term cardiac mortality in patients presenting acute myocardial infarction (AMI) complicated by cardiogenic shock (CS) treated with primary percutaneous coronary intervention (p-PCI), and current risk-adjustment models in this setting are not adequate. We retrospectively analyzed our registry of patients with AMI treated with p-PCI. The aim of this study was to identify the independent predictors of 2-year cardiac mortality in patients presenting CS. A Risk Score was created assigning at any independent variable a value directly correlated with its power to increase mortality...
November 1, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/27881700/veno-venous-ecmo-as-a-safe-bridge-to-recovery-in-a-patient-with-severe-peripartum-cardiomyopathy-learning-from-errors
#11
Christopher Ull, Thomas Armin Schildhauer, Justus T Strauch, Andreas Mügge, Justyna Swol
Peripartum cardiomyopathy (PPCM) is a rare disorder of unknown etiology and pathogenesis. The most important tool for diagnostic confirmation is transthoracic echocardiography. The recommended management of PPCM in pregnancy is summarized by the European Society of Cardiology Heart Failure Guidelines. Few data exist on the treatment of patients with fulminant PPCM and the need for extracorporeal membrane oxygenation (ECMO) in this context. We report on a young multiparous woman with cardiogenic shock caused by severe PPCM who was successfully, but atypically, supported with veno-venous ECMO as a bridge to recovery immediately after the birth of her third child...
November 23, 2016: Perfusion
https://www.readbyqxmd.com/read/27878629/clinical-outcomes-in-pediatric-patients-hospitalized-with-fulminant-myocarditis-requiring-extracorporeal-membrane-oxygenation-a-meta-analysis
#12
REVIEW
Haolan Xiong, Bingqing Xia, Jingyu Zhu, Binfei Li, Wenqi Huang
We conducted a meta-analysis to provide the survival rates for pediatric patients hospitalized with fulminant myocarditis requiring ECMO. The literature search was conducted using Embase, PubMed, MEDLINE and Elsevier for studies published before April 1, 2016. We focus on survival rates for pediatric patients hospitalized with fulminant myocarditis requiring ECMO, and studies that reported only on adult patients were excluded. Summary of the survival rates was obtained using fixed-effect or random-effect meta-analysis which determined by I (2)...
November 23, 2016: Pediatric Cardiology
https://www.readbyqxmd.com/read/27871570/peroperative-cardiogenic-shock-suggesting-acute-coronary-syndrome-as-initial-manifestation-of-lyme-carditis
#13
C Clinckaert, S Bidgoli, T Verbeet, R Attou, P Gottignies, J Massaut, P Reper
Carditis can complicate Lyme disease in an estimated <5% of cases, and cardiogenic shock and severe cardiac arrhythmias are described with electrocardiographic abnormalities that could be suggestive of coronary manifestations. We report a case of severe persistent biventricular heart failure complicated by cardiac arrhythmias as initial manifestation of a Lyme disease developing peroperatively electrocardiographic abnormalities suggesting acute transmural myocardial infarction.
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27867655/veno-arterial-extracorporeal-membrane-oxygenation-va-ecmo-in-postcardiotomy-cardiogenic-shock-how-much-pump-flow-is-enough
#14
COMMENT
Federico Pappalardo, Andrea Montisci
Post-cardiotomy cardiogenic shock (PCCS) is a complication of heart surgery associated with a poor prognosis: veno-arterial extracorporeal membrane oxygenation (VA ECMO) ensures end-organ perfusion while fully replacing heart and lung function, though it is associated with unsatisfactory results. Few studies have identified reliable predictors of poor prognosis early in the course of extracorporeal support. A recent study showed the strong prognostic power of urine output in the first 24 hours of VA ECMO in predicting early and late mortality of PCCS...
October 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/27867292/new-impella-cardiac-power-device-used-in-patient-with-cardiogenic-shock-due-to-nonischemic-cardiomyopathy
#15
Marek Cena, Frances Karam, Rajesh Ramineni, Wissam Khalife, Alejandro Barbagelata
The new percutaneous Impella CP (Cardiac Power; Abiomed, Inc., Danvers, MA) was designed to provide a higher level of support than Impella 2.5 (Abiomed, Inc.). We present the first documented case of a patient that was transitioned from the Impella 2.5 to Impella CP. A 48-year-old male patient with no medical history was transferred to our institution with a one day history of worsening shortness of breath. The patient was unstable and found to have monomorphic ventricular tachycardia at 220 beats/min that was cardioverted to normal sinus rhythm...
December 2016: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
https://www.readbyqxmd.com/read/27866869/clinical-characteristics-and-outcomes-of-yemeni-patients-with-acute-heart-failure-aged-50years-or-younger-data-from-gulf-acute-heart-failure-registry-gulf-care
#16
A-Nasser Munibari, Ahmed Al-Motarreb, Nora Al-Sagheer, Hana Abu Hadi, Ali Othman, Nawar Al-Wather, Abdu Hamoud, Mutae Alawlagy, Salem Almehdar, Abdulkarim Alhammadi, Mohammed Almogayed, Giorgio Caretta, Anees Al Jabri, Luciano Agati
AIMS: There is a shortage of data about acute heart failure (AHF) in the young, including its underlying causes, clinical presentation and outcomes. We aim to describe clinical characteristics, causes and outcomes of AHF in Yemeni patients aged 50years or younger. METHODS AND RESULTS: we evaluated Yemeni patients with AHF enrolled in Gulf CARE registry. Patients were divided into two groups: young patients (≤50years) and older patients (>50years). A total of 1536 patients with AHF were enrolled, of whom 635 (41...
November 9, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27866018/intravenous-beta-blockers-in-st-segment-elevation-myocardial-infarction-a-systematic-review-and-meta-analysis
#17
Lee H Sterling, Kristian B Filion, Renee Atallah, Pauline Reynier, Mark J Eisenberg
BACKGROUND/OBJECTIVES: The role of intravenous (IV) beta-blockers in conjunction with percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI) remains unclear. We therefore conducted a meta-analysis to assess their role in the acute phase of STEMI. METHODS: We systematically searched the Cochrane Libraries, Medline, and EMBASE for RCTs comparing IV beta-blockers with inactive controls in STEMI patients undergoing PCI. The primary outcome was left ventricular ejection fraction (LVEF)...
November 9, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27865776/post-cardiac-arrest-shock-treated-with-veno-arterial-extracorporeal-membrane-oxygenation-an-observational-study-and-propensity-score-analysis
#18
Wulfran Bougouin, Nadia Aissaoui, Alain Combes, Nicolas Deye, Lionel Lamhaut, Daniel Jost, Carole Maupain, Frankie Beganton, Adrien Bouglé, Nicole Karam, Florence Dumas, Eloi Marijon, Xavier Jouven, Alain Cariou
PURPOSE: Cardiogenic shock due to post-resuscitation myocardial dysfunction is a major cause of mortality among patients hospitalized after cardiac arrest (CA). Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) has been proposed in the most severe cases but the level of evidence is very low. We assessed characteristics, outcome and prognostic factors of patients treated with VA-ECMO for post-CA shock. METHODS: Using a large regional registry, we focused on all CA admitted in ICU...
November 17, 2016: Resuscitation
https://www.readbyqxmd.com/read/27865117/catalytic-iron-in-acute-myocardial-infarction-complicated-by-cardiogenic-shock-a-biomarker-substudy-of-the-iabp-shock-ii-trial
#19
Georg Fuernau, Florian Traeder, Suhas S Lele, Mohan M Rajapurkar, Banibrata Mukhopadhyay, Suzanne de Waha, Steffen Desch, Ingo Eitel, Gerhard Schuler, Volker Adams, Holger Thiele
BACKGROUND: Catalytic iron (CI) is unbound ferric iron with the potential to generate reactive oxygen species with further deleterious vascular effects. In acute coronary syndromes, high levels of CI are linked to all-cause mortality. The prognostic impact of CI and iron metabolism in cardiogenic shock (CS) is currently undetermined. Aims of this study were to investigate the prognostic impact of CI and to identify predictors of high CI levels in patients with CS complicating acute myocardial infarction...
November 9, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27864873/hereditary-haemorrhagic-telangiectasia-to-transplant-or-not-to-transplant-is-there-a-right-time-for-liver-transplantation
#20
Yannick D Muller, Roland Oppliger, Romain Breguet, Philippe Meyer, Laura Rubbia-Brandt, Pierre-Auguste Petignat, Thomas Harr, Eric Dayer, Jörg D Seebach
BACKGROUND & AIMS: Hereditary haemorrhagic telangiectasia is characterized by arterio-venous malformations (AVM). It frequently involves the liver without clinical symptoms, but may lead to biliary ischaemia, portal hypertension, or fatal high-output heart failure. The indication of liver transplantation is controversial. METHODS: Herein, we report the case of a 65-year-old female patient with a 'double Osler syndrome' consisting of hereditary haemorrhagic telangiectasia (HHT) and type I hereditary angioedema diagnosed at the age of 25 and 22 years respectively...
December 2016: Liver International: Official Journal of the International Association for the Study of the Liver
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