14,858 results match your criteria Cardiogenic Shock


Approach to Acute Cardiovascular Complications in COVID-19 Infection.

Circ Heart Fail 2020 Jun 5. Epub 2020 Jun 5.

Department of Medicine, Division of Cardiology, Columbia University Irving Medical Center/New York-Presbyterian Hospital, New York, NY.

The novel coronavirus disease 2019, otherwise known as COVID-19, is a global pandemic with primary respiratory manifestations in those who are symptomatic. It has spread to more than 187 countries with a rapidly growing number of affected patients. Underlying cardiovascular disease is associated with more severe manifestations of COVID-19 and higher rates of mortality. Read More

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http://dx.doi.org/10.1161/CIRCHEARTFAILURE.120.007220DOI Listing

Challenges and Controversies in the Management of ACS in Elderly Patients.

Curr Cardiol Rep 2020 Jun 4;22(7):51. Epub 2020 Jun 4.

Section of Cardiology, Department of Internal Medicine, Baylor College of Medicine, Houston, TX, USA.

Purpose Of Review: Elderly patients presenting with acute coronary syndrome (ACS) represent a challenging patient population. A high index of suspicion is needed for their diagnosis, as they are less likely to present with typical anginal symptoms compared to their younger counterparts.

Recent Findings: Disrupted coronary plaques with superimposed thrombosis are the predominant pathophysiology of ACS; however, an increased proportion of calcified nodules is encountered in elderly patients. Read More

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http://dx.doi.org/10.1007/s11886-020-01298-xDOI Listing

A narrative review on the management of Acute Heart Failure in Emergency Medicine Department.

Eur J Transl Myol 2020 Apr 1;30(1):8612. Epub 2020 Apr 1.

Department of Emergency Medicine, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

The main urgent symptom presented to an emergency department is acute heart failure (AHF). In that considerable risksof morbidity and mortality, it is important to plan precision medicine to achieve the most suitable outcomes. The object of this review is to provide a summary of contemporary management procedures of emergency medicine in a department of acute heart failure. Read More

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http://dx.doi.org/10.4081/ejtm.2019.8612DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7254439PMC

Suprasternal approach to transcatheter aortic valve replacement in a complex congenital pediatric patient presenting with cardiogenic shock.

Cardiovasc Revasc Med 2020 Apr 29. Epub 2020 Apr 29.

Section of Interventional Cardiology, Division of Cardiovascular Disease, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States of America.

Transcatheter aortic valve replacement (TAVR) offers well established benefit for adults with severe aortic stenosis, although applications in the pediatric population remain limited. We describe a case of a 15-year-old male with complex congenital heart disease presenting with cardiogenic shock in the setting of mixed severe aortic stenosis (AS) and severe aortic insufficiency (AI). Self-expanding TAVR was performed via suprasternal approach with robust clinical improvement. Read More

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http://dx.doi.org/10.1016/j.carrev.2020.04.032DOI Listing

Cardiogenic Shock in Aortic Stenosis: Is It the Time for "Primary" TAVR?

JACC Cardiovasc Interv 2020 Jun;13(11):1326-1328

Department of Cardiology, Bichat Claude Bernard Hospital, Paris VII University, Paris, France.

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http://dx.doi.org/10.1016/j.jcin.2020.04.005DOI Listing

Demographics, Procedural Characteristics, and Clinical Outcomes When Cardiogenic Shock Precedes TAVR in the United States.

JACC Cardiovasc Interv 2020 Jun;13(11):1314-1325

Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.

Objectives: This paper details trends and outcomes in U.S. patients undergoing transcatheter aortic valve replacement (TAVR) who present pre-procedurally with cardiogenic shock. Read More

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http://dx.doi.org/10.1016/j.jcin.2020.02.033DOI Listing

COVID-19 and cardiogenic shock. Different cardiovascular presentations with high mortality.

Rev Esp Cardiol (Engl Ed) 2020 Apr 27. Epub 2020 Apr 27.

Servicio de Cardiología, Hospital Universitario Ramón y Cajal, Madrid, Spain.

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http://dx.doi.org/10.1016/j.rec.2020.04.012DOI Listing

Radial versus femoral artery access for percutaneous coronary artery intervention in patients with acute myocardial infarction and multivessel disease complicated by cardiogenic shock: Subanalysis from the CULPRIT-SHOCK trial.

Am Heart J 2020 Apr 30;225:60-68. Epub 2020 Apr 30.

First Department of Medicine-Cardiology, University Medical Centre Mannheim (UMM), University of Heidelberg, Mannheim, Germany.

Background: The use and impact of transradial artery access (TRA) compared to transfemoral artery access (TFA) in patients undergoing percutaneous coronary intervention (PCI) for acute myocardial infarction (MI) complicated by cardiogenic shock (CS) remain unclear.

Methods: This is a post hoc analysis of the CULPRIT-SHOCK trial where patients presenting with MI and multivessel disease complicated by CS were randomized to a strategy of culprit-lesion-only or immediate multivessel PCI. Arterial access was left at operator's discretion. Read More

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http://dx.doi.org/10.1016/j.ahj.2020.04.014DOI Listing

UPDATE ON ACUTE MYOCARDITIS.

Trends Cardiovasc Med 2020 Jun 1. Epub 2020 Jun 1.

"De Gasperis" Cardio Center, Niguarda Hospital, Milan, Italy.

Acute myocarditis (AM), a recent-onset inflammation of the heart, has heterogeneous clinical presentations, varying from minor symptoms to high-risk cardiac conditions with severe heart failure, refractory arrhythmias, and cardiogenic shock. AM is moving from being a definitive diagnosis based on histological evidence of inflammatory infiltrates on cardiac tissue to a working diagnosis supported by high sensitivity troponin increase in association with specific cardiac magnetic resonance imaging (CMRI) findings. Though experts still diverge between those advocating for histological definition versus those supporting a mainly clinical definition of myocarditis, in the real-world practice the diagnosis of AM has undoubtedly shifted from being mainly biopsy-based to solely CMRI-based in most of clinical scenarios. Read More

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http://dx.doi.org/10.1016/j.tcm.2020.05.008DOI Listing

[Myocarditis in 2020].

Rev Med Suisse 2020 Jun;16(696):1133-1139

Service de Cardiologie, HUG, 1211 Genève 14.

Myocarditis is an inflammatory disease of the myocardium caused by various etiologies with a dominance of viral infections and potential post-infectious autoimmunity. The clinical presentation ranges from chest pain to severe complications including cardiogenic shock, ventricular arrhythmias, and progression to dilated cardiomyopathy. The diagnostic approach is challenging and includes several investigations, such as an ECG, an echocardiography, troponin testing and the exclusion of coronary artery disease. Read More

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Mechanical assist devices for acute cardiogenic shock.

Cochrane Database Syst Rev 2020 Jun 4;6:CD013002. Epub 2020 Jun 4.

Cardiothoracic Surgery, John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.

Background: Cardiogenic shock (CS) is a state of critical end-organ hypoperfusion due to a primary cardiac disorder. For people with refractory CS despite maximal vasopressors, inotropic support and intra-aortic balloon pump, mortality approaches 100%. Mechanical assist devices provide mechanical circulatory support (MCS) which has the ability to maintain vital organ perfusion, to unload the failing ventricle thus reduce intracardiac filling pressures which reduces pulmonary congestion, myocardial wall stress and myocardial oxygen consumption. Read More

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http://dx.doi.org/10.1002/14651858.CD013002.pub2DOI Listing

Prognosis Value of Early Veno Arterial PCO2 Difference in Patients Under Peripheral Veno Arterial Extracorporeal Membrane Oxygenation.

Shock 2020 Jun 2. Epub 2020 Jun 2.

Service d'Anesthésie Réanimation, CHU de Dijon, Dijon, France, BP 77908, 21709 Dijon Cedex, France.

Introduction: Veno arterial membrane oxygenation (VA ECMO) is increasingly used for cardiogenic failure. However, hemodynamic targets for adequate resuscitation remain a challenge. The PCO2 gap and the ratio between PCO2 gap and the arteriovenous difference in oxygen (PCO2 gap/Da-vO2) are marker of peripheral hypoperfusion. Read More

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http://dx.doi.org/10.1097/SHK.0000000000001554DOI Listing

Inotropic agents in cardiogenic shock.

Curr Opin Crit Care 2020 Jun 2. Epub 2020 Jun 2.

Second Cardiology Department, Head of Emergency Medicine Department, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece.

Purpose Of Review: Cardiogenic shock is a multifactorial and diverse entity in which inotropes are the cornerstone therapy. Although published clinical trials have focused on pharmacologic treatment of cardiogenic shock, there is lack of an established and widely accepted decision-making algorithm on the use of inotropic agents in cardiogenic shock.

Recent Findings: The current review incorporates cardiogenic shock pathophysiology, inotropes and vasopressors pharmacodynamics. Read More

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http://dx.doi.org/10.1097/MCC.0000000000000744DOI Listing

Characteristics of ST-elevation myocardial infarction with failed thrombolysis.

Asian Cardiovasc Thorac Ann 2020 Jun 3:218492320932074. Epub 2020 Jun 3.

UN Mehta Institute of Cardiology and Research Centre, Ahmedabad, Gujarat, India.

Background: Fibrinolytic therapy is an important reperfusion strategy, especially when primary percutaneous coronary interventions cannot be offered to ST-elevation myocardial infarction patients. Given that failed reperfusion after fibrinolytic therapy is common, it is pragmatic that the predictors, outcomes, and angiographic profiles of patients with failed thrombolysis are carefully scrutinized.

Methods: We prospectively studied clinical variables and outcomes over 30 months in 243 ST-elevation myocardial infarction patients who received fibrinolytics as primary treatment. Read More

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http://dx.doi.org/10.1177/0218492320932074DOI Listing

Extra-corporeal membrane oxygenation and Eculizumab: Atypical treatments for typical haemolytic uraemic syndrome.

J Intensive Care Soc 2020 May 7;21(2):191-193. Epub 2019 Mar 7.

Haematology Department, University College London Hospital, London, UK.

A 19-year-old female with no medical history presented with bloody diarrhoea. Investigations revealed an acute kidney injury, thrombocytopenia and microangiopathic haemolysis. A diagnosis of haemolytic uraemic syndrome secondary to Shiga toxin-producing 055 was confirmed and supportive therapy commenced in the intensive therapy unit. Read More

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http://dx.doi.org/10.1177/1751143719832184DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7238477PMC

Clinical trials of acute mechanical circulatory support in cardiogenic shock and high-risk percutaneous coronary intervention.

Curr Opin Cardiol 2020 Jul;35(4):332-340

The Cardiovascular Center for Research and Innovation, Tufts Medical Center, Boston, Massachusetts, USA.

Purpose Of Review: Acute mechanical circulatory support devices have become widely used in cardiogenic shock and high-risk percutaneous coronary intervention (PCI) but there remains significant controversy over the evidence supporting their use and the specific roles of various devices. In this review, we summarize major recent studies and identify key areas of future investigation.

Recent Findings: In cardiogenic shock, uncontrolled single arm studies emphasizing early mechanical circulatory support (MCS) have showed promising results, but randomized trials have either been stopped prematurely or enrolled patients with advanced shock unlikely to benefit from MCS. Read More

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http://dx.doi.org/10.1097/HCO.0000000000000751DOI Listing

Vasopressor use in cardiogenic shock.

Curr Opin Crit Care 2020 Jun 1. Epub 2020 Jun 1.

Service de Réanimation Médicale Brabois, CHRU Nancy, Pôle Cardio-Médico-Chirurgical.

Purpose Of Review: Data and interventional trials on vasopressor use during cardiogenic shock are scarce. Their use is limited by their side-effects and the lack of solid evidence regarding their effectiveness in improving outcomes. In the present article, we review the current use of vasopressor therapy during cardiogenic shock. Read More

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http://dx.doi.org/10.1097/MCC.0000000000000743DOI Listing

Complete recovery of fulminant cytotoxic CD8 T-cell-mediated myocarditis after ECMELLA unloading and immunosuppression.

ESC Heart Fail 2020 Jun 2. Epub 2020 Jun 2.

Department of Cardiology, Institute for Clinical and Experimental Medicine-IKEM, Videnska 1958/9, 140 21, Prague 4, Czech Republic.

A 19-year-old woman with no previous cardiac history was admitted to the hospital with third-degree atrioventricular block and left ventricular dysfunction. Her condition quickly deteriorated to severe biventricular failure and cardiogenic shock requiring mechanical circulatory support. An endomyocardial biopsy revealed lymphocytic myocarditis with no PCR-detectable viral genomes, with CD8 T-cell predominance and pro-inflammatory macrophage expansion shown by myocardial flow cytometry. Read More

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http://dx.doi.org/10.1002/ehf2.12697DOI Listing

Left ventricle unloading strategies in ECMO: A single-center experience.

J Card Surg 2020 Jun 2. Epub 2020 Jun 2.

Division of Pulmonary and Critical Care Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.

Introduction: Extracorporeal membrane oxygenation (ECMO) is a life-saving technology capable of restoring perfusion but is not without significant complications that limit its realizable therapeutic benefit. ECMO-induced hemodynamics increase cardiac afterload risking left ventricular distention and impaired cardiac recovery. To mitigate potentially harmful effects, multiple strategies to unload the left ventricle (LV) are used in clinical practice but data supporting the optimal approach is presently lacking. Read More

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http://dx.doi.org/10.1111/jocs.14644DOI Listing

Isolated Pulmonary Fusariosis Caused by Neocosmospora pseudensiformis in a Liver Transplant Recipient: A Case Report and Review of the Literature.

Transpl Infect Dis 2020 Jun 1:e13344. Epub 2020 Jun 1.

Division of Infectious Diseases and Tropical Medicine, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.

Neocosmospora pseudensiformis (formerly Fusarium pseudensiforme) is a hyaline mold in the Fusarium solani species complex that has been changed to the genus Neocosmospora. Invasive fusariosis is a rare fungal infection in solid organ transplantation. The most commonly reported manifestation of invasive fusariosis in this setting is localized cutaneous fusariosis. Read More

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http://dx.doi.org/10.1111/tid.13344DOI Listing

Influence of Timing and Predicted Risk on Mortality in Impella-Treated Infarct-Related Cardiogenic Shock Patients.

Front Cardiovasc Med 2020 14;7:74. Epub 2020 May 14.

Department of Cardiology, University Hospital Odense, Odense, Denmark.

In-hospital mortality in acute myocardial infarction-related cardiogenic shock (AMI-CS) remains high. The only adequately powered randomized trial showed no benefit of routine use of the intra-aortic balloon pump in AMI-CS. We compared individually predicted mortality using CardShock- and IABP-Shock II-scores in AMI-CS patients treated with an Impella microaxial pump, who met the IABP-Shock II-trials inclusion/exclusion criteria, to observed mortality on circulatory support in order to determine whether standardized use of an Impella microaxial flow-pump in AMI-CS is associated with lower than predicted mortality rates and whether timing of implantation or selecting patients based on predicted risk is meaningful. Read More

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http://dx.doi.org/10.3389/fcvm.2020.00074DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7240000PMC

The Use of Beta Blockers in Takotsubo Syndrome as Compared to Acute Coronary Syndrome.

Front Pharmacol 2020 14;11:681. Epub 2020 May 14.

First Department of Medicine, Medical Faculty Mannheim, University Heidelberg, Mannheim, Germany.

Background: Takotsubo syndrome (TTS) and acute coronary syndrome (ACS) patients have a similar mortality rate. In this study, we sought to determine the short- and long-term outcome of TTS patients as compared to ACS patients both treated with beta-blockers.

Objectives: In the present study we described the data of 5 years of follow up of 103 TTS and 422 ACS patients both treated with beta-blockers. Read More

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http://dx.doi.org/10.3389/fphar.2020.00681DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7240099PMC

Ruptured cerebral mycotic aneurysm in a left ventricular assist device patient with bacteremia.

Int J Artif Organs 2020 May 30:391398820925493. Epub 2020 May 30.

Division of Cardiac Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.

A 50-year-old male with a history of nonischemic dilated cardiomyopathy presented in cardiogenic shock and ultimately underwent durable left ventricular assist device implantation. He recovered well initially but developed persistent bacteremia. His indwelling pacemaker leads were extracted due to evidence of vegetation. Read More

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http://dx.doi.org/10.1177/0391398820925493DOI Listing

Spinal cord infarction during venoarterial-extracorporeal membrane oxygenation support.

J Artif Organs 2020 May 30. Epub 2020 May 30.

Hopital Universitaire Pitie Salpetriere, Paris, France.

Spinal cord infarction (SCI) is a rare disease among central nervous system vascular diseases. Only a little is known about venoarterial extracorporeal membrane oxygenation (VA-ECMO)-related SCI. Retrospective observational study conducted, from 2006 to 2019, in a tertiary referral center on patients who developed VA-ECMO-related neurovascular complications, focusing on SCI. Read More

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http://dx.doi.org/10.1007/s10047-020-01179-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7260457PMC

Coronary revascularization and circulatory support strategies in patients with myocardial infarction, multi-vessel coronary artery disease, and cardiogenic shock: Insights from an international survey.

Am Heart J 2020 May 3;225:55-59. Epub 2020 May 3.

Leon H. Charney Division of Cardiology, Department of Medicine, New York University School of Medicine, New York, NY.

Cardiogenic shock (CS) complicating acute myocardial infarction (MI) is associated with high mortality. In the absence of data to support coronary revascularization beyond the infarct artery and selection of circulatory support devices or medications, clinical practice may vary substantially.

Methods: We distributed a survey to interventional cardiologists and cardiothoracic surgeons through relevant professional societies to determine contemporary coronary revascularization and circulatory support strategies for MI with CS and multi-vessel coronary artery disease (CAD). Read More

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http://dx.doi.org/10.1016/j.ahj.2020.04.011DOI Listing

Transcatheter mitral valve repair with MitraClip for severe mitral regurgitation and cardiogenic shock during the COVID-19 pandemic.

Cardiovasc Revasc Med 2020 May 23. Epub 2020 May 23.

Department of Cardiology, Houston Methodist DeBakey Heart & Vascular Center, 6550 Fannin St., Suite 1901, Houston, TX 77030, USA. Electronic address:

Transcatheter mitral valve repair with MitraClip (Abbott) is largely an elective procedure. The ongoing coronavirus disease 2019 (COVID-19) pandemic has posed challenges to health care systems; in many cases elective interventions have been curtailed. Patients with severe mitral regurgitation (MR) and cardiogenic shock are high-risk surgical candidates and at risk of a poor outcome without intervention. Read More

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http://dx.doi.org/10.1016/j.carrev.2020.05.030DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7244416PMC

Bedside insertion of impella percutaneous ventricular assist device in patients with cardiogenic shock.

Int J Cardiol 2020 May 27. Epub 2020 May 27.

Department of Anesthesia and Intensive Care, IRCCS ISMETT, UPMC Italy, Via E. Tricomi 5, Palermo, Italy.

Background Bedside insertion of Impella percutaneous ventricular assistant device (pVAD) (Abiomed, Danvers, MA) under transesophageal echocardiographic (TEE) guidance is an attractive strategy enabling lifesaving treatment in patients with cardiogenic shock and who cannot to be transported promptly to the catheterization laboratory (Cathlab). Methods In this retrospective, single-center study, we reviewed all consecutive patients supported with Impella pVAD for CS. We compared the characteristics and outcomes of those who underwent Impella pVAD insertion under fluoroscopic guidance (Fluoro group) in the Cathlab with those who underwent insertion under TEE guidance at bedside (TEE group). Read More

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http://dx.doi.org/10.1016/j.ijcard.2020.05.080DOI Listing

Mechanical circulatory support for takotsubo syndrome: a systematic review and meta-analysis.

Int J Cardiol 2020 May 27. Epub 2020 May 27.

Cardiac Arrest Center, Advanced Heart Failure Unit, Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany.. Electronic address:

Background: Cardiogenic shock occurs in 10%-15% of patients with Takotsubo syndrome (TS). For several reasons catecholamines, and especially inotropes, should be avoided in TS. Temporary mechanical circulatory support (MCS) appears attractive as bridge-to-recovery, but prospective studies are lacking. Read More

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http://dx.doi.org/10.1016/j.ijcard.2020.05.033DOI Listing

SARS-COV-2 infection presenting as ST-elevationmyocardial infarction.

Catheter Cardiovasc Interv 2020 May 30. Epub 2020 May 30.

Department of Medicine, Division of Cardiology, Montefiore Health System, Albert Einstein College of Medicine, New York, New York, USA.

We describe a patient presenting with chest discomfort, anterolateral ST elevation, and developing acute cardiogenic shock secondary to SARS-COV-2infection-patient zero presenting to our institution's cardiac catheterization laboratory. The emergent presentation with limited clinical information led to exposure of personnel. The diagnosis was complicated by two negative tests for SARS-COV-2, and high-clinical suspicion from the patient's occupational history led to additional testing in order to confirm the diagnosis. Read More

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http://dx.doi.org/10.1002/ccd.28974DOI Listing

Incidence and clinical outcomes of bleeding complications and acute limb ischemia in STEMI and cardiogenic shock.

Catheter Cardiovasc Interv 2020 May 30. Epub 2020 May 30.

Division of Cardiology, Department of Internal Medicine, Tuft University Medical Center, Boston, Massachusetts, USA.

Background: Bleeding complications and acute limb ischemia (ALI) are devastating vascular complications in patients with ST-segment elevation myocardial infarction (STEMI). Cardiogenic shock (CS) can further increase this risk due to multiorgan failure. In the contemporary era, percutaneous mechanical circulatory support is commonly used for management of CS. Read More

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http://dx.doi.org/10.1002/ccd.29003DOI Listing

Hybrid approach to postmyocardial infarction ventricular septal defect repair.

Catheter Cardiovasc Interv 2020 May 30. Epub 2020 May 30.

Department of Medicine/Cardiology, NorthShore University HealthSystem, Evanston, Illinois, USA.

Postinfarction ventricular septal rupture is a rare and devastating complication of myocardial infarction. Despite attempts at acute surgical and percutaneous defect closure, morbidity and mortality remain high. Herein, we describe a hybrid surgical and catheter-based approach to defect closure in a 63-year-old woman with postinfarction ventricular septal rupture and cardiogenic shock. Read More

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http://dx.doi.org/10.1002/ccd.29000DOI Listing

First Successful Treatment of Coronavirus Disease 2019 Induced Refractory Cardiogenic Plus Vasoplegic Shock by Combination of Percutaneous Ventricular Assist Device and Extracorporeal Membrane Oxygenation: A Case Report.

ASAIO J 2020 06;66(6):607-609

From the Department of Cardiology and Angiology I, Heart Center Freiburg University, Faculty of Medicine, University of Freiburg, Freiburg, Germany.

The novel coronavirus severe acute respiratory syndrome coronavirus 2 is infecting hundreds of thousands of humans around the globe. The coronavirus disease 2019 (COVID-19) is known to generate mild as well as critical courses. Complications on the intensive care units include acute respiratory distress syndrome, acute cardiac, and kidney injury as well as shock. Read More

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http://dx.doi.org/10.1097/MAT.0000000000001178DOI Listing

Disparities of demographics, clinical characteristics, and hospital outcomes of AMI pilgrims vs non-pilgrims-tertiary center experience.

Egypt Heart J 2020 May 29;72(1):31. Epub 2020 May 29.

King Abdullah Medical City, Muzdallfa Road, Makkah, Saudi Arabia.

Background: Acute myocardial infarction (AMI) is usually caused by rupture of an atherosclerotic plaque leading to thrombotic occlusion of a coronary artery. Cardiovascular disease has recently emerged as the leading cause of death during hajj. Our aim is to demonstrate the AMI pilgrim's related disparities and comparing them to non-pilgrim patients. Read More

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http://dx.doi.org/10.1186/s43044-020-00068-yDOI Listing

Frequency of Management of Cardiogenic Shock With Mechanical Circulatory Support Devices According to Race.

Am J Cardiol 2020 Jun 6;125(12):1782-1787. Epub 2020 Apr 6.

Division of Cardiovascular Medicine, Department of Medicine, Yale University School of Medicine, New Haven, Connecticut.

Mechanical circulatory support (MCS) has influenced the management of cardiogenic shock (CS), but the association between race and MCS utilization is unknown. We sought to evaluate the effect of race on MCS utilization in CS and whether there are racial differences in in-hospital outcomes. Our study was a population-based retrospective cohort study that enrolled patients with CS, defined by International classification of disease, ninth Revision, clinical modification (ICD-9-CM) codes, between 2013 and 2015 from the National Inpatient Sample. Read More

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http://dx.doi.org/10.1016/j.amjcard.2020.03.025DOI Listing

First implantation of the pulsatile left ventricular assist device iVAC2L in a heart failure patient infected with influenza type A.

Hellenic J Cardiol 2020 May 26. Epub 2020 May 26.

(3rd) Department of Cardiology, Ippokrateio General Hospital, Aristotle University of Thessaloniki, Greece.

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http://dx.doi.org/10.1016/j.hjc.2020.05.002DOI Listing

The high-risk ECG pattern of ST-elevation myocardial infarction: A substudy of the randomized trial of primary PCI with or without routine manual thrombectomy (TOTAL trial).

Int J Cardiol 2020 May 26. Epub 2020 May 26.

Heart Center, Department of Cardiology, Tampere University Hospital, Finland; Faculty of Medicine and Health Technology, Tampere University, Finnish Cardiovascular Research Center, Tampere, Finland.

Background: Useful tools for risk assessment in patients with STEMI are needed. We evaluated the prognostic impact of the evolving myocardial infarction (EMI) and the preinfarction syndrome (PIS) ECG patterns and determined their correlation with angiographic findings and treatment strategy.

Methods: This substudy of the randomized Trial of Routine Aspiration Thrombectomy with PCI versus PCI Alone in Patients with STEMI (TOTAL) included 7860 patients with STEMI and either the EMI or the PIS ECG pattern. Read More

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http://dx.doi.org/10.1016/j.ijcard.2020.05.053DOI Listing

Epidemiology, Pathophysiology and Contemporary Management of Cardiogenic Shock - A position statement from the Heart Failure Association (HFA) of the European Society of Cardiology (ESC).

Eur J Heart Fail 2020 May 29. Epub 2020 May 29.

Faculty of Medicine, University of Belgrade, Belgrade, Serbia.

Cardiogenic Shock (CS) is a complex multifactorial clinical syndrome with extremely high mortality, developing as a continuum, and progressing from the initial insult (underlying cause) to the subsequent occurrence of organ failure and death. There is a large spectrum of CS presentations resulting from the interaction between an acute cardiac insult and a patient's underlying cardiac and overall medical condition. Phenotyping patients with CS may have clinical impact on management because classification would support initiation of appropriate therapies. Read More

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http://dx.doi.org/10.1002/ejhf.1922DOI Listing

Acute Myocardial Ischemia Following Bee Sting in an Adolescent Male: A Case Report.

Am J Case Rep 2020 May 29;21:e922120. Epub 2020 May 29.

Division of Pediatric Critical Care, Children's Hospital of Illinois, Peoria, IL, USA.

BACKGROUND Epinephrine for anaphylactic shock is the standard life-saving treatment in the emergency department. Cardiac symptoms after epinephrine administration in a child with no prior cardiac history are often not suspected. We describe a presentation of diastolic cardiac dysfunction after anaphylaxis from a bee sting in an adolescent male. Read More

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http://dx.doi.org/10.12659/AJCR.922120DOI Listing

Effects of the COVID-19 Pandemic on the Management of Patients With ST-Elevation Myocardial Infarction in a Tertiary Cardiovascular Center.

Crit Pathw Cardiol 2020 May 27. Epub 2020 May 27.

Cardiovascular Intervention Research Center, Rajaie Cardiovascular, Medical, and Research Center.

Background: In the COVID-19 pandemic, the appropriate reperfusion strategy in patients with ST-segment elevation myocardial infarction (STEMI) is unclear.

Methods: This retrospective single-center study consecutively enrolled patients who presented with STEMI and scheduled for primary percutaneous coronary intervention (PPCI) during the outbreak of COVID- 19. Due to the delay in the reporting of the PCR test results, our postprocedural triage regarding COVID-19, followed by the isolation strategy, was based on lung CT scan results. Read More

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http://dx.doi.org/10.1097/HPC.0000000000000228DOI Listing

Left ventricular unloading in ST-elevation myocardial infarction without cardiogenic shock.

Authors:
Mohamad Alkhouli

Artif Organs 2020 May 27. Epub 2020 May 27.

Department of Cardiovascular Medicine, Mayo Clinic School of Medicine, Rochester, MN, USA.

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http://dx.doi.org/10.1111/aor.13721DOI Listing

Impact of Patient- and System-Level Delays on Reperfusion Among Patients With ST-Elevation Myocardial Infarction.

CJC Open 2020 May 30;2(3):94-103. Epub 2020 Jan 30.

Division of Cardiology, University of British Columbia, Vancouver, British Columbia, Canada.

Background: Patients with ST-elevation myocardial infarction (STEMI) presenting to percutaneous coronary intervention (PCI)-capable hospitals often experience delays for primary PCI (pPCI). We sought to describe the effect of specific delay intervals and patient/system-level factors on STEMI reperfusion times.

Methods: We analyzed all consecutive patients with STEMI who presented to 2 PCI-capable hospital emergency departments (EDs) between June 2007 and March 2016 who received successful pPCI. Read More

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http://dx.doi.org/10.1016/j.cjco.2020.01.005DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7242498PMC

Thrombotic risk in central venoarterial extracorporeal membrane oxygenation post cardiac surgery.

Perfusion 2020 May 27:267659120922016. Epub 2020 May 27.

Anesthesia and Intensive Care, Royal Papworth Hospital NHS Foundation Trust, Cambridge, UK.

Introduction: Post-cardiotomy cardiogenic shock is an accepted indication for venoarterial extracorporeal membrane oxygenation. The true incidence and risk factors for the development of thrombosis in this setting remain unclear.

Methods: Patients supported with central venoarterial extracorporeal membrane oxygenation due to ventricular dysfunction precluding weaning from cardiopulmonary bypass were retrospectively identified. Read More

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http://dx.doi.org/10.1177/0267659120922016DOI Listing

Evaluation of pharmacoinvasive strategy versus percutaneous coronary intervention in patients with acute myocardial infarction with ST segment elevation at the National Institute of Cardiology (PHASE-MX).

Arch Cardiol Mex 2020 ;90(2):158-162

Urgencias y Unidad de Cuidados Coronarios, Instituto Nacional de Cardiología Ignacio Chávez, México.

Objective: The objective of PHASE-MX registry is to validate the efficacy and safety of the pharmacoinvasive strategy in comparison with percutaneous coronary intervention (PCI) in patients with acute myocardial infarction with ST segment elevation (STEMI) in a metropolitan region of Mexico. The primary outcome will consist of the composite of cardiovascular death, re-infarction, stroke and cardiogenic shock.

Methods: The PHASE-MX registry will include a prospective cohort of patients with STEMI who received reperfusion treatment (mechanical of pharmacological) in the first 12 h after the onset of symptoms. Read More

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http://dx.doi.org/10.24875/ACM.19000185DOI Listing
January 2020

Acute mesenteric ischaemia in refractory shock on veno-arterial extracorporeal membrane oxygenation.

Eur Heart J Acute Cardiovasc Care 2020 May 27:2048872620915655. Epub 2020 May 27.

Service d'anesthésie-réanimation chirurgicale, réanimation chirurgicale polyvalente, DMU CARE, DHU A-TVB, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor, France.

Background: Acute mesenteric ischaemia is a severe complication in critically ill patients, but has never been evaluated in patients on veno-arterial extracorporeal membrane oxygenation (V-A ECMO). This study was designed to determine the prevalence of mesenteric ischaemia in patients supported by V-A ECMO and to evaluate its risk factors, as well as to appreciate therapeutic modalities and outcome.

Methods: In a retrospective single centre study (January 2013 to January 2017), all consecutive adult patients who underwent V-A ECMO were included, with exclusion of those dying in the first 24 hours. Read More

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http://dx.doi.org/10.1177/2048872620915655DOI Listing

Outcomes of percutaneous temporary biventricular mechanical support: a systematic review.

Heart Fail Rev 2020 May 26. Epub 2020 May 26.

Division of Cardiac Surgery, Sidney Kimmel Medical College, Thomas Jefferson University, 1025 Walnut St, Suite 607, Philadelphia, PA, 19107, USA.

Percutaneous biventricular assist devices (BiVAD) are a recently developed treatment option for severe cardiogenic shock. This systematic review sought to identify indications and outcomes of patients placed on percutaneous BiVAD support. An electronic search was performed to identify all appropriate studies utilizing a percutaneous BiVAD configuration. Read More

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http://dx.doi.org/10.1007/s10741-020-09971-7DOI Listing

Temporal Trends in Percutaneous Coronary Intervention and Coronary Artery Bypass Grafting: Insights From the Washington Cardiac Care Outcomes Assessment Program.

J Am Heart Assoc 2020 Jun 27;9(11):e015317. Epub 2020 May 27.

Division of Cardiology University of Washington Seattle WA.

Background Patient selection and outcomes for percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) have changed over the past decade. However, there is limited information on outcomes for both revascularization strategies in the same population. The study evaluated temporal changes in risk profile, procedural characteristics, and clinical outcomes for PCI- and CABG-treated patients. Read More

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http://dx.doi.org/10.1161/JAHA.119.015317DOI Listing

Intra-aortic Balloon Pump vs Peripheral Ventricular Assist Device Utilization in the US.

Ann Thorac Surg 2020 May 23. Epub 2020 May 23.

Cardiovascular Outcomes Research Laboratories (CORELAB), David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California; Division of Cardiac Surgery, University of California, Los Angeles, Los Angeles, California. Electronic address:

Background: The objective of the present study was to characterize practical utilization trends and outcomes for intra-aortic balloon pump (IABP) and percutaneous left ventricular assist device (pVAD) in cardiogenic shock at a national level.

Methods: An analysis of all adult patients admitted non-electively for cardiogenic shock from January 2008 through December 2017 was performed using the National Inpatient Sample (NIS). Trends of inpatient IABP and pVAD use were analyzed using survey weighted estimates and the modified Cochran-Armitage test for significance. Read More

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http://dx.doi.org/10.1016/j.athoracsur.2020.03.129DOI Listing

An outlook on biomarkers in cardiogenic shock.

Curr Opin Crit Care 2020 May 20. Epub 2020 May 20.

Heart Institute, Hospital Universitari Germans Trias i Pujol, Badalona.

Purpose Of Review: Cardiogenic shock is a severe complication with mortality rates of ∼50% that requires a rapid and complex management to aid and identify the highest and lowest risk patients. To that end, novel cardiogenic shock biomarkers are needed to improve risk stratification and to personalize therapy.

Recent Findings: Established biomarkers such as BNP, NT-proBNP, ST2, and troponins provide insufficient predictive value in cardiogenic shock. Read More

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http://dx.doi.org/10.1097/MCC.0000000000000739DOI Listing