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Acute Right Heart Failure

J Müller-Engelmann, M Paparoupa, A Nierhaus, A Wittig, M Möller, R Gradaus, F Schuppert
Acute necrotizing esophagitis ("black esophagus") is defined as complete necrosis of the esophageal mucosa, which typically affects the entire circumference. We report a case of a healthy 62-year-old woman, who became hemodynamically unstable due to stress cardiomyopathy with acute right heart failure. Transfusion-dependent anemia occurred 24 h later and an upper gastrointestinal endoscopy revealed a black discoloured mucosa of the distal esophagus. After hemodynamic stabilization and treatment with proton pump inhibitors and sucralfate, complete healing of the esophageal mucosa was achieved...
December 10, 2018: Medizinische Klinik, Intensivmedizin und Notfallmedizin
Srilekha Sridhara, Christopher Lichtenwalter, Shahnaz Mazdeh, Beeletsega T Yeneneh
A positive Murphy's sign in a patient with right upper quadrant abdominal pain is the arrest of inspiration during deep palpation of the quadrant. It is usually suggestive of acute cholecystitis. We report an unusual case of a positive Murphy's sign not due to acute cholecystitis, but rather from a pericardial hematoma from a right atrial tear causing right heart failure. The patient required an atrial tear repair to prevent a cardiac tamponade.
October 2, 2018: Curēus
Qi Jin, Qin Luo, Zhihui Zhao, Qing Zhao, Xue Yu, Lu Yan, Liu Gao, Zhihong Liu
BACKGROUND: Takotsubo syndrome (TTS) is an acute cardiac condition with reversible heart failure which is often triggered by psychological and physical stressful events. Although pulmonary embolism (PE) was reported as a trigger for TTS, the concurrence of TTS and PE has been rarely reported, let alone that triggered by PE. Here we describe a case of a postmenopausal female presenting with symptoms similar to myocardial ischemia, which may be caused by PE, and review the available literature that may help clinicians with their practice to similar situations since no published guidelines are available...
December 10, 2018: BMC Cardiovascular Disorders
Carol R Reinero, L Ari Jutkowitz, Nathan Nelson, Isabelle Masseau, Samuel Jennings, Kurt Williams
BACKGROUND: Histologic features of pulmonary veno-occlusive disease (PVOD) and pulmonary capillary hemangiomatosis (PCH) have been described in dogs but without a thorough clinical description. OBJECTIVES: To report the clinical features, diagnostics, treatment, and outcome of dogs with histologic evidence of PVOD and PCH. ANIMALS: Fifteen pet dogs meeting histopathologic criteria of PVOD (occlusive remodeling of small-sized to medium-sized pulmonary veins) or PCH (alveolar capillary proliferation and congestion), or both...
November 29, 2018: Journal of Veterinary Internal Medicine
(no author information available yet)
We are pleased to announce that the following 2 articles have been selected for the the UEDA Heart Awards for the Year 2018. First PlaceRole of Right Ventricular Dysfunction and Diabetes Mellitus in N-terminal pro-B-type Natriuretic Peptide Response of Patients With Severe Mitral Regurgitation and Heart Failure After MitraClipHidehiro Kaneko, Michael Neuss, Jens Weissenborn, Christian ButterInt Heart J 2017; 58 (2): 225-231. Second PlaceNanoparticle-Mediated Delivery of Pitavastatin to Monocytes/Macrophages Inhibits Left Ventricular Remodeling After Acute Myocardial Infarction by Inhibiting Monocyte-Mediated InflammationYajing Mao, Jun-ichiro Koga, Masaki Tokutome, Tetsuya Matoba, Gentaro Ikeda, Kaku Nakano, Kensuke EgashiraInt Heart J 2017; 58 (4): 615-623...
2018: International Heart Journal
Jacopo Colombo, Iryna Arendar, Ugo Pastorino, Daniela Codazzi
INTRODUCTION: Thoracic surgery can have serious side effects. Accurate preoperative evaluation to assess which patients with anatomically resectable disease are suitable candidates for surgery is mandatory. CASE DESCRIPTION: A 58-year-old man, scheduled for left pneumonectomy for lung cancer, passed all the preoperative examinations suggested by guidelines and underwent the surgery. Three days after pneumonectomy, he experienced hemorrhagic shock and subsequent acute respiratory distress syndrome...
November 28, 2018: Tumori
Advay G Bhatt, Dan L Musat, Nicolle Milstein, Jacqueline Pimienta, Laura Flynn, Tina Sichrovsky, Mark W Preminger, Suneet Mittal
OBJECTIVES: This study sought to evaluate the clinical and procedural characteristics impacting outcomes during implementation of a His bundle pacing (HBP) program in a real-world setting. BACKGROUND: Right ventricular pacing is associated with an elevated risk of heart failure, but device reprogramming and upgrades have significant challenges. HBP has emerged as an alternative and is reported to be highly successful in the hands of highly experienced centers. METHODS: All patients referred for permanent pacemaker implantation at the Valley Hospital (Ridgewood, New Jersey) between October 2015 and October 2017 were evaluated; a subset of 24% was selected for HBP...
November 2018: JACC. Clinical Electrophysiology
Naohide Ageyama, Hiroyuki Kurosawa, Ousuke Fujimoto, Tomoya Uehara, Michiaki Hiroe, Yasushi Arano, Toshimichi Yoshida, Yasuhiro Yasutomi, Kyoko Imanaka-Yoshida
Inflammation after myocardial infarction (MI) may be a major factor influencing ventricular remodeling, leading to congestive heart failure and arrhythmia. Therefore, inflammation in the heart needs to be monitored. Tenascin-C (TNC) is an extracellular matrix molecule not normally expressed, but it is strongly upregulated when associated with active inflammation. Based on this characteristic, we successfully imaged in vivo inflammatory lesions in rat models using 111 Indium (111 In)-labeled anti-TNC antibodies...
November 20, 2018: International Heart Journal
Benedikt Schäfer, Clemens-Alexander Greim
The anesthetist is increasingly faced with more complex operations in combination with an aging patient population characterized by pre-existing conditions. Acute right heart failure is often not recognized as the cause of cardiopulmonary insufficiency. Echocardiography has emerged as an important diagnostic tool. Not only perioperatively and in the intensive care unit, transesophageal (TEE) and transthoracic echocardiography (TTE) allow the diagnosis of right heart failure at bedside, promptly and with low invasiveness...
November 2018: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
Noemi Pavo, Rajashri Yarragudi, Heidi Puttinger, Henrike Arfsten, Guido Strunk, Andja Bojic, Martin Hülsmann, Andreas Vychytil
BACKGROUND: In patients with refractory heart failure (HF) peritoneal dialysis (PD) is associated with improved functional status and decrease in hospitalization. However, previous studies did not focus on right ventricular dysfunction as an important pathophysiologic component of cardiorenal syndrome. METHODS: In a prospective cohort study PD was started in 40 patients with refractory right HF (with/without left HF). Refractoriness to conservative therapy was defined as persistent right heart congestion/ascites with intensified diuretic treatment and/or ≥2 hospitalizations within 6 months because of cardiac decompensation despite optimal medical treatment, and/or acute renal failure during intensified conservative treatment of cardiac decompensations...
2018: PloS One
Marek Jastrzębski, Paweł Moskal, Danuta Czarnecka
His bundle (HB) pacing emerges as a potential new standard ventricular pacing option. The presented tracings were recorded on an electrophysiology system during HB pacemaker implantation in a 72-year-old patient with heart failure and chronic atrial fibrillation This article is protected by copyright. All rights reserved.
November 12, 2018: Journal of Cardiovascular Electrophysiology
Jaroslav A Hubacek, Jevgenija Vymetalova, Vera Lanska, Dana Dlouha
Heart transplantation is a relatively common treatment for end-stage heart failure. The major complication of heart transplantation is organ rejection. Epigenetic could play a role in the pathogenesis of organ rejection, and the FTO gene is a mediator of DNA methylation. We analysed a tagging FTO SNP rs17817449 in both donor and recipient DNA obtained through 370 heart transplantations. Recipient FTO genotypes were not associated with either type of rejection or with the general increase in the risk of rejection...
November 8, 2018: Clinical Transplantation
Nimeh Najjar, Martin Cerda, Jorge Trabanco, Vinoo Ramsaran, James Cury
Asphyxiating thoracic dystrophy (ATD also known as Jeune syndrome) is a very rare disorder with an incidence in the United States of 1 case per 100,000-130,000 live births. Chronic alveolar hypoventilation leading to concurrent hypoxia is the main cause of morbidity and mortality in these patients due to its complications. A 22-year-old male with past medical history of ATD and severe kyphoscoliosis presented with progressively worsening shortness of breath for several days. Past surgical history was significant for multiple reconstructive sternal surgeries, his first surgery was at the age of two...
2018: Respiratory Medicine Case Reports
Marek Jastrzebski, Adrian Baranchuk, Kamil Fijorek, Roksana Kisiel, Piotr Kukla, Tomasz Sondej, Danuta Czarnecka
Aims: QRS narrowing with initiation of biventricular pacing might be an acute electrocardiographic indicator of correction of left bundle branch block (LBBB)-induced depolarization delay and asynchrony. However, its impact on prognosis remains controversial, especially in non-LBBB patients. Our goal was to evaluate the impact of QRS narrowing on long-term mortality and morbidity in a large cohort of patients undergoing cardiac resynchronization therapy (CRT) with different pre-implantation QRS types: LBBB, non-LBBB, and permanent right ventricular pacing...
November 6, 2018: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Jae-Hyeong Park, Jin Joo Park, Jun-Bean Park, Goo-Yeong Cho
Background Few studies have shown that right ventricular ( RV ) function is independently related to adverse events regardless of left ventricular ( LV ) function in heart failure. We evaluated the prognostic value of global longitudinal strain ( GLS ) of both ventricles in patients with acute heart failure. Methods and Results We measured biventricular strains in 1824 randomly selected patients (973 men, aged 70±14 years) from a strain registry. A total of 799 patients (43.8%) died during the median follow-up duration of 31...
October 2, 2018: Journal of the American Heart Association
Marc A Simon, Rick G Schnatz, Jared D Romeo, John J Pacella
Background Heart failure is one of the most costly diagnosis-related groups, largely because of hospital readmissions. Objective assessment of volume status to ensure optimization before hospital discharge could significantly reduce readmissions. We previously demonstrated an ultrasound method of quantifying percentage of cross-sectional area ( CSA ) change of the right internal jugular vein with Valsalva that reliably estimates central venous pressure. Methods and Results Patients admitted with acute decompensated heart failure ( ADHF ) underwent ultrasound measurements of the right internal jugular vein at end-expiration and during the strain phase of Valsalva to determine a percentage of CSA change...
August 7, 2018: Journal of the American Heart Association
Behnood Bikdeli, José Luis Lobo, David Jiménez, Philip Green, Carmen Fernández-Capitán, Alessandra Bura-Riviere, Remedios Otero, Marco R DiTullio, Silvia Galindo, Martin Ellis, Sahil A Parikh, Manuel Monreal
Background Transthoracic echocardiography ( TTE ) is often considered for risk stratification of patients with acute pulmonary embolism ( PE ). We sought to determine the contemporary utilization of early TTE (within 72 hours of PE diagnosis) and explored the association between TTE findings and PE -related mortality. Methods and Results Data from the RIETE (Registro Informatizado Enfermedad TromboEmbolica) registry, a multicenter registry of consecutive patients with acute PE , were used (2001-July 2017)...
September 4, 2018: Journal of the American Heart Association
Gustavo A Cortes-Puentes, Richard A Oeckler, John J Marini
Skillfully implemented mechanical ventilation (MV) may prove of immense benefit in restoring physiologic homeostasis. However, since hemodynamic instability is a primary factor influencing mortality in acute respiratory distress syndrome (ARDS), clinicians should be vigilant regarding the potentially deleterious effects of MV on right ventricular (RV) function and pulmonary vascular mechanics (PVM). During both spontaneous and positive pressure MV (PPMV), tidal changes in pleural pressure (PPL ), transpulmonary pressure (PTP , the difference between alveolar pressure and PPL ), and lung volume influence key components of hemodynamics: preload, afterload, heart rate, and myocardial contractility...
September 2018: Annals of Translational Medicine
Nao Konagai, Shigefumi Fukui, Masataka Kitano, Yasuhide Asaumi, Michio Nakanishi, Takeshi Ogo, Tomoyuki Fujita, Yoshihiko Ohnishi, Junjiro Kobayashi, Satoshi Yasuda
In patients with an atrial septal defect (ASD) and left ventricular (LV) dysfunction associated with coronary artery disease (CAD), to avoid the development of acute left heart failure (HF) and an increase in myocardial oxygen consumption following ASD closure, it is conceivable that coronary artery revascularization should be performed prior to ASD closure. We report the case of a 67-year-old man with a large secundum ASD and LV ejection fraction of 15.6% resulting from severe ischemic cardiomyopathy and triple-vessel CAD, both of which contributed to biventricular HF characterized by high left-to-right shunt (Qp:Qs of 7...
October 25, 2018: International Heart Journal
Qian Zhang, Chun-Mei Wang, Shu-Tian Shi, Hong Chen, Yu-Jie Zhou
BACKGROUND: The incidence of left ventricular thrombus (LVT) is 4% to 15% in patients with anterior acute ST-segment elevation myocardial infarction (ant-AMI) in the era of primary percutaneous coronary intervention (PPCI). And patients with LVT have higher in-hospital mortality. HYPOTHESIS: There is a relationship between LVT formation and 1-year major adverse cardio-cerebrovascular events (MACCE) in patients with ant-AMI treated by PPCI. METHODS: Our study population included 1488 consecutive patients with ant-AMI...
October 27, 2018: Clinical Cardiology
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