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Acute Right Heart Failure

Eskandarain Shafuddin, Catherina L Chang, Manisha Cooray, Kim A McAnulty, Noel C Karalus, Marcus H S Lee, Robert J Hancox
BACKGROUND: Cardiac dysfunction is common in exacerbations of chronic obstructive pulmonary disease (COPD) even in patients without clinically suspected cardiac disorders. AIM: To investigate associations between electrocardiogram and chest radiograph abnormalities and biochemical evidence of cardiac dysfunction (N-terminal pro-B-type natriuretic peptide (NT-proBNP) and troponin T) in patients hospitalised with exacerbations of COPD at Waikato Hospital. METHODS: Independent examiners, blinded to NT-proBNP and troponin T levels, assessed electrocardiograms for tachycardia, atrial fibrillation, ventricular hypertrophy and ischaemic changes in 389 patients and chest radiographs for signs of heart failure in 350 patients...
October 15, 2018: Internal Medicine Journal
Meice Tian, Xianqiang Wang, Huawei Gao, Liqing Wang, Shengshou Hu
INTRODUCTION: Left main coronary artery (LMCA) atresia is a quite rare congenital malformation, which may present with various symptoms. Past literatures were sporadic without recent summary of world-wide cases. We hereby report an adult case of LMCA atresia with concomitant mitral regurgitation and also summarize all cases found in published literatures. CASE PRESENTATION: A 48-year old female presented with sudden dyspnea. Preliminary impression was acute heart failure caused by mitral regurgitation...
October 2018: Medicine (Baltimore)
Shunsuke Ohori, Kishu Fujita, Kiyotaka Morimoto, Masato Suzuki, Toshio Baba, Hideo Yokoyama, Fumikazu Nomura, Youhei Ohkawa, Kenji Sugiki, Takemi Ohno
Infective endocarditis (IE) after transcatheter aortic valve replacement (TAVR) is a rare complication, but has a high mortality. An 86-year-old female with symptomatic severe aortic stenosis underwent TAVR at our hospital and she was discharged without complication after 10 days. She was readmitted with high fever and acute heart failure 1 month later. Blood culture revealed Staphylococcus, and echocardiography showed vegetation on the septal cusp of the tricuspid valve and perforation at the membranous ventricular septum...
October 2018: Kyobu Geka. the Japanese Journal of Thoracic Surgery
Diana Rivero, Mohammad Alhamaydeh, Ziad Faramand, Mohammad Alrawashdeh, Christian Martin-Gill, Clifton Callaway, Barbara Drew, Salah Al-Zaiti
BACKGROUND: Nonspecific ST-T repolarization (NST) abnormalities alter the ST-segment for reasons often unrelated to acute myocardial ischemia, which could contribute to misdiagnosis or inappropriate treatment. We sought to define the prevalence of NST patterns in patients with chest pain and evaluate how such patterns correlate with the eventual etiology of chest pain and course of hospitalization. METHODS: This was a prospective observational study that included consecutive prehospital chest pain patients from three tertiary care hospitals in the U...
October 8, 2018: Heart & Lung: the Journal of Critical Care
E N Bardsley, D J Paterson
Cardiac sympathetic over-activity is a well-established contributor to the progression of neurogenic hypertension and heart failure, yet the underlying pathophysiology remains unclear. Recent studies have highlighted the importance of acutely regulated cyclic nucleotides and their effectors in the control of intracellular calcium and exocytosis. Emerging evidence now suggests that a significant component of sympathetic over-activity and enhanced transmission may arise from impaired cyclic nucleotide signalling, resulting from compromised phosphodiesterase activity, as well as alterations in receptor-coupled G-protein activation...
October 11, 2018: Journal of Physiology
Matthieu Turpin, Christelle Chantalat-Auger, Florence Parent, Françoise Driss, François Lionnet, Anoosha Habibi, Bernard Maître, Alice Huertas, Xavier Jaïs, Jason Weatherald, David Montani, Olivier Sitbon, Gérald Simonneau, Fréderic Galactéros, Marc Humbert, Pablo Bartolucci, Laurent Savale
The long-term effects of chronic blood exchange transfusions (BETs) on pre-capillary pulmonary hypertension complicating sickle cell disease (SCD) are unknown.13 homozygous SS SCD patients suffering from pre-capillary pulmonary hypertension and treated by chronic BETs were evaluated retrospectively. Assessments included haemodynamics, New York Heart Association Functional Class (NYHA FC), 6-min walk distance (6MWD) and blood tests.Before initiating BETs, all patients were NYHA FC III or IV, median (range) 6MWD was 223 (0-501) m and median (range) pulmonary vascular resistance (PVR) was 3...
October 2018: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
Rikard Grankvist, Mats Jensen-Urstad, Jonathan Clarke, Miia Lehtinen, Philip Little, Johan Lundberg, Fabian Arnberg, Stefan Jonsson, Kenneth R Chien, Staffan Holmin
OBJECTIVES: With emergence of targeted cell transplantation and gene therapy, there is a need for minimally invasive tissue access to facilitate delivery of therapeutic substrate. The objective of this study is demonstrate the suitability of an endovascular device able to directly access tissue and deliver therapeutic agent to the heart, kidney, and pancreas without need to seal the penetration site. METHODS: In vivo experiments were performed in 30 swine, including subgroups with follow-up to evaluate complications...
October 5, 2018: Journal of Internal Medicine
Hanwen Zhang, Wei Du, Danijela Gnjidic, Shanley Chong, Emily Lancsar, Nicholas Glasgow
AIMS: To examine trends in adverse drug reactions (ADR)-related hospitalisations in New South Wales (NSW). METHODS: Data were extracted from the Admitted Patient Data Collection (APDC), a census of hospital separations in NSW. We estimated age-adjusted rates of ADE-related hospitalisation between 1st July 2001 and 30th June 2014, and rates by patient characteristics, main therapeutic medication groups, and clinical condition groups that warranted the hospitalisation...
October 3, 2018: Internal Medicine Journal
Brian C Case, Katherine M Geiser, Rebecca Torguson, Augusto D Pichard, Lowell F Satler, Ron Waksman, Itsik Ben-Dor
OBJECTIVES: To compare coronary revascularization appropriateness for non-acute coronary syndrome cases under the 2017 update vs the 2012 appropriate use criteria (AUC). BACKGROUND: In 2017, the 2012 AUC for coronary revascularization were updated. We examined how applying these new 2017 updates to our previous inappropriate cases would change their appropriateness. METHODS: We identified 50 cases of patients who underwent coronary revascularization for stable ischemic heart disease who were deemed inappropriate under the 2012 AUC...
October 2, 2018: Catheterization and Cardiovascular Interventions
Miyako Imanaka, Masashi Amano, Chisato Izumi, Shunsuke Nishimura, Maiko Kuroda, Takeshi Harita, Suguru Nishiuchi, Jiro Sakamoto, Yodo Tamaki, Soichiro Enomoto, Makoto Miyake, Toshihiro Tamura, Hirokazu Kondo, Kazuo Yamanaka, Yoshihisa Nakagawa
A 37-year-old man presented with heart failure caused by severe aortic regurgitation (AR). He had a history of being involved in a traffic accident 3 months earlier. Imaging tests at admission detected no abnormalities in the aortic valve or aortic wall; however, the left coronary cusp prolapsed slightly on transthoracic echocardiography. He underwent aortic valve replacement because of uncontrolled heart failure and severe AR. Intraoperatively, the intima of the aortic wall just above the commissure of the left and right coronary cusps was torn to the short axial direction...
July 2018: Journal of Cardiology Cases
Micássio Fernandes de Andrade, Valéria Duarte de Almeida, Lara Michelly Soares de Souza, Dayane Carla Costa Paiva, Cléber de Mesquita Andrade, Thales Allyrio Araújo de Medeiros Fernandes
Chagas Disease (CD) is a public health problem in Latin America. The acute phase presents nonspecific symptoms and most patients recover from acute parasitemia and undergo a prolonged asymptomatic phase. Several years later, about 30% of infected individuals develop chronic cardiopathy with progressive cardiomegaly, arrhythmia, thromboembolic events, and heart failure. These symptoms suggest a persistent association with the presence of inflammatory infiltrate and tissue, and cellular destruction in the heart muscle...
October 1, 2018: Parasite Immunology
Nancy M Albert, Marc J Kozinn
Heart failure is a burdensome cardiovascular condition associated with high rates of morbidity and mortality. The 3-month period after hospitalization is a vulnerable phase in which patients are at high risk for mortality and rehospitalization. To reduce risk during this period, patients with heart failure and reduced ejection fraction should receive guideline-directed pharmacological therapies-the right drugs at the right doses-before hospital discharge. Optimal pharmacotherapies for these patients include agents that suppress the renin-angiotensin-aldosterone system, suppress the sympathetic nervous system, enhance vasodilation, slow heart rate when needed, and reduce excess volume...
October 2018: Critical Care Nurse
Daniel Kretzschmar, P Christian Schulze, Markus W Ferrari
Right heart failure (RHF) is a life-threatening condition. Mechanical right heart support offers an option for critically ill patients. The PERKAT® RV device is designed for percutaneous implantation in acute RHF. It consists of a nitinol chamber covered by foils containing inflow valves. An outlet tube is attached to its distal tip. Using an 18F sheath, it is implanted in the inferior vena cava while the tube bypasses the right heart with its tip in the pulmonary trunk. Then, an IABP balloon is inserted in the pump chamber...
September 28, 2018: Journal of Cardiovascular Translational Research
R De Rosa, D Schranz
Elevated left atrial (LA) filling pressures are associated with poor prognosis in patients with heart failure (HF). Recent evidences have shown that, in this setting, the presence of restrictive small atrial defect may protect from an extreme increase in LA pressure and prevent consecutive pulmonary congestion and acute decompensation, without the expense of an unfavourable significant left-to-right shunt. Therefore, decompression of LA by creating a unidirectional but restrictive left-to-right interatrial shunt has been emerging as a new therapeutic strategy in patients suffering from both HF with preserved and reduced ejection fraction...
September 29, 2018: Heart Failure Reviews
Rinaldo Focaccia Siciliano, Danielle Menosi Gualandro, Odeli Nicole Encinas Sejas, Bruno Giuliano Ignoto, Bruno Caramelli, Alfredo Jose Mansur, Roney Orismar Sampaio, Ligia Camera Pierrotti, Giovanna Barbosa, Wilma Golebiovski, Clara Weksler Cristiane Lamas, Natália Rodrigues Querido Fortes, Claudio Querido Fortes, Flavio Tarasoutchi, Tania Mara Varejão Strabelli
PURPOSE: To compare the clinical and epidemiological features, treatment and outcome of patients with isolated right-sided and left-sided fungal endocarditis and to determine the risk factors for in-hospital mortality in patients with Candida sp. endocarditis. METHODS: A retrospective review of all consecutive cases of fungal endocarditis from five hospitals was performed. We compared clinical features between patients with isolated right-sided and left-sided endocarditis...
September 21, 2018: International Journal of Infectious Diseases: IJID
Veselin Mitrovic, Wolf-Georg Forssmann, Jan Schnitker, Stephan B Felix
AIMS: Acute decompensated heart failure (ADHF) has a poor prognosis and limited treatment options. No direct comparisons between ularitide-a synthetic natriuretic peptide being evaluated in ADHF-and other vasoactive substances are available. The aim of this meta-analysis was to determine haemodynamic effect sizes from randomized double-blind trials in ADHF. METHODS AND RESULTS: Eligible studies enrolled patients with ADHF requiring hospitalization and haemodynamic monitoring...
September 24, 2018: ESC Heart Failure
Hui Zhang, Yujuan Bao, Xiangrong Zuo
Right ventricular failure (RVF) is the main cause of death in patients with cardiopulmonary disease, such as pulmonary arterial hypertension (PAH), pulmonary embolism, acute respiratory distress syndrome, and right ventricular infarction. The exact cellular and molecular mechanisms underlying RVF remains unclear. Inflammation may play an important role during the development of RVF, as it does in left heart failure. Cardiac inflammation has been shown in RVF patients and animal models, which played a role in the impairment of the right ventricular contraction and in the maladaptive remodeling...
August 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
Sherif Elmahdy, Christian C Shults, Muhamad Alhaj Moustafa
Stent migration is an uncommon complication of endovascular stenting procedures. It could cause serious cardiovascular complications. In this article, we describe an interesting case of acute heart failure as a result of stent embolization from the left common iliac vein into the right ventricle and how it was identified and managed.
January 2018: Journal of Investigative Medicine High Impact Case Reports
Andrija Vidic, Jerrica E Shuster, Zackary D Goff, Anuradha Godishala, Susan M Joseph, John T Chibnall, Paul J Hauptman
BACKGROUND: Targeted treatment for decompensated right heart failure (RHF) with or without left heart failure is lacking. Vasopressin antagonists (vaptans) may offer an option by increasing urine output and fluid mobilization when used in acute decompensated RHF without impacting blood pressure or renal function, both common complications of loop diuretics. METHODS AND RESULTS: We searched electronic medical records from 2 institutions over 4 years for patients with RHF treated with vaptans...
August 13, 2018: International Journal of Cardiology
Fabio Esposito, Odile Mathieu-Costello, Peter D Wagner, Russell S Richardson
KEY POINTS: The vascular endothelial growth factor (VEGF) responses to acute submaximal exercise and training effects in patients with heart failure with reduced ejection fraction (HFrEF) were investigated. Six patients and six healthy matched controls performed knee-extensor exercise (KE) at 50% of maximum work rate before and after (only patients) KE training. Muscle biopsies were taken to assess skeletal muscle structure and the angiogenic response. Before training, during this submaximal KE exercise, patients with HFrEF exhibited higher leg vascular resistance and greater noradrenaline spillover...
September 7, 2018: Journal of Physiology
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