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    Refractory Pulmonary Edema and Upper Body Hypoxemia During Veno-Arterial Extracorporeal Membrane Oxygenation-A Case for Atrial Septostomy.
    Artif Organs 2018 Jan 18. Epub 2018 Jan 18.
    Department of Critical Care Medicine, Mayo Clinic, Phoenix, AZ, USA.
    Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) provides mechanical circulatory support for patients with advanced cardiogenic shock, facilitating myocardial recovery and limiting multi-organ failure. In patients with severely limited left ventricular ejection, peripheral VA-ECMO can further increase left ventricular and left atrial pressures (LAP). Failure to decompress the left heart under these circumstances can result in pulmonary edema and upper body hypoxemia, that is, myocardial and cerebral ischemia. Read More

    [Analysis of prognosis and associated risk factors in pediatric idiopathic pulmonary arterial hypertension].
    Zhonghua Er Ke Za Zhi 2018 Jan;56(1):23-28
    Department of Pediatric Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Disease, Beijing 100029, China.
    Objective: To analyze the prognosis and associated risk factors of pediatric idiopathic pulmonary arterial hypertension. Methods: A total of 119 patients under 18 years of age diagnosed as idiopathic pulmonary arterial hypertension in the Pulmonary Arterial Hypertension Center in Beijing Anzhen Hospital between June 2007 and May 2017 were enrolled in this retrospective study. The clinical informations and follow-up data were collected. Read More

    A Case of Multifaceted Assessment in an Elderly Patient With Acute Decompensated Heart Failure.
    Cardiol Res 2017 Dec 22;8(6):339-343. Epub 2017 Dec 22.
    Department of Cardiology, Fukuoka University School of Medicine, Fukuoka, Japan.
    Heart failure (HF) is a common health problem worldwide, including in Japan. Unfortunately, patient outcomes remain poor, with a 5-year survival rate of approximately 50%. Therefore, we need to assess the precise conditions, including cardiac function, in patients with HF, particularly in the elderly. Read More

    Burden and correlates of readmissions related to pulmonary edema in US hemodialysis patients: a cohort study.
    Nephrol Dial Transplant 2017 Dec 25. Epub 2017 Dec 25.
    Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA.
    Background: Pulmonary edema is prevalent and may be a common cause of hospital readmissions in hemodialysis patients. We aimed to estimate the national burden of, and identify correlates of, readmissions related to pulmonary edema among hemodialysis patients.

    Methods: In this retrospective cohort study using national registry data, we identified prevalent US hemodialysis patients (n = 215 251) with index admissions while under Medicare primary coverage in 2011-13. Read More

    Marked edema of colonic stoma after colectomy and severe pulmonary hypertension: Report of two cases.
    Clin Res Hepatol Gastroenterol 2017 Dec 29. Epub 2017 Dec 29.
    Department of Surgical Oncology, Faculty of Medicine, the University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan.
    Introduction: Pulmonary hypertension (PH) is a disease with a poor prognosis and is a risk for perioperative heart and respiratory failure. Few reports exist regarding a colectomy performed in patients with PH. Herein, we report two cases of colectomy performed in patients with severe PH, accompanied with marked edema of the colonic stoma after surgery. Read More

    Pre-eclampsia and heart failure: a close relationship.
    Ultrasound Obstet Gynecol 2017 Dec 20. Epub 2017 Dec 20.
    Maternal Fetal Medicine Unit, Department of Obstetrics and Gynecology, University of Brescia, Italy.
    Heart failure (HF) is a clinical syndrome characterized by signs (e.g., pulmonary crackles, peripheral edema, jugular turgor) and symptoms (e. Read More

    Why do physicians prescribe dialysis? A prospective questionnaire study.
    PLoS One 2017 20;12(12):e0188309. Epub 2017 Dec 20.
    Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.
    Introduction: The incidence of unplanned dialysis initiation (DI) with consequent increased comorbidity, mortality and reduced modality choice remains high, but the optimal timing of dialysis initiation (DI) remains controversial, and there is a lack of studies of specific reasons for DI. We investigated why and when physicians prescribe dialysis and hypothesized that physician motivation for DI is an independent factor which may have clinical consequences.

    Methods: In the Peridialysis study, an ongoing multicenter prospective study assessing the causes and timing of DI and consequences of unplanned dialysis, physicians in 11 hospitals were asked to describe their primary, secondary and further reasons for prescribing DI. Read More

    Pneumonia as a trigger for atrial fibrillation.
    J Rural Med 2017 Nov 30;12(2):146-148. Epub 2017 Nov 30.
    Department of Pathology, Mercer University School of Medicine, USA.
    In a rural mountainous region on a Friday, a 78-year-old man was seen in his physician's office for leg edema and diagnosed with new onset atrial fibrillation. He was discharged home to start medications for atrial fibrillation and heart failure. He was hospitalized the next day with septic shock due to pneumococcal pneumonia. Read More

    Signs and symptoms in adult patients with acute dyspnea: a systematic review and meta-analysis.
    Eur J Emerg Med 2018 Feb;25(1):3-11
    Department of Public Health and Primary Care (General Practice), KU Leuven, University of Leuven, Leuven, Belgium.
    Introduction: Rapid and accurate diagnosis of patients with a new episode of acute dyspnea is a common challenge for Primary Care or Emergency Physicians.

    Objective: To determine the diagnostic accuracy of signs and symptoms in adult patients with a new episode of acute dyspnea presenting to a GP or an Emergency Physician (EP).

    Patients And Methods: This was a diagnostic systematic review. Read More

    A Simplified Approach to Extravascular Lung Water Assessment Using Point-of-Care Ultrasound in Patients with End-Stage Chronic Renal Failure Undergoing Hemodialysis.
    Blood Purif 2017 Dec 7;45(1-3):79-87. Epub 2017 Dec 7.
    Department of Anesthesia, Montreal Heart Institute and Université de Montréal, Montreal, Québec, Canada.
    Background: Fluid overload leading to pulmonary congestion is an important issue in patients undergoing hemodialysis. This study aimed to determine if a simplified method of extravascular lung water assessment using ultrasound provided clinically relevant information.

    Methods: This prospective study recruited 47 patients from a single hemodialysis center. Read More

    [Experts consensus on the management of the right heart function in critically ill patients].
    Zhonghua Nei Ke Za Zhi 2017 Dec;56(12):962-973
    Department of Critical Care Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China.
    To establish the experts consensus on the right heart function management in critically ill patients. The panel of consensus was composed of 30 experts in critical care medicine who are all members of Critical Hemodynamic Therapy Collaboration Group (CHTC Group). Each statement was assessed based on the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) principle. Read More

    Massive pelvic recurrence of uterine leiomyomatosis with intracaval-intracardiac extension: video case report and literature review.
    BMC Surg 2017 Nov 29;17(1):118. Epub 2017 Nov 29.
    Division of General Surgery and Liver Transplantation, San Camillo-Forlanini Hospital POIT - L. Spallanzani INMI, Rome, Italy.
    Background: Uterine leiomyomas represent the gynecological neoplasm with the highest prevalence worldwide. This apparently benign pathological entity may permeate into the venous system causing the so-called intravenous leiomyomatosis of the uterus (IVL). IVL may seldom extend to large caliber veins and reach the right cardiac chambers or pulmonary arteries and cause signs of right sided congestive heart failure and sudden death. Read More

    Indications and practical approach to non-invasive ventilation in acute heart failure.
    Eur Heart J 2018 Jan;39(1):17-25
    Department of Cardiology and Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland.
    In acute heart failure (AHF) syndromes significant respiratory failure (RF) is essentially seen in patients with acute cardiogenic pulmonary oedema (ACPE) or cardiogenic shock (CS). Non-invasive ventilation (NIV), the application of positive intrathoracic pressure through an interface, has shown to be useful in the treatment of moderate to severe RF in several scenarios. There are two main modalities of NIV: continuous positive airway pressure (CPAP) and pressure support ventilation (NIPSV) with positive end expiratory pressure. Read More

    Symptomatic Heart Failure After Transjugular Intrahepatic Portosystemic Shunt Placement: Incidence, Outcomes, and Predictors.
    Cardiovasc Intervent Radiol 2017 Nov 27. Epub 2017 Nov 27.
    Department of Gastroenterology and Hepatology, Cleveland Clinic, Cleveland, OH, USA.
    Purpose: To assess the incidence of symptomatic heart failure (SHF) occurring after transjugular intrahepatic portosystemic shunt (TIPS) placement, identify potential predictors of SHF, and evaluate clinical presentation and outcomes in cases of post-TIPS SHF.

    Materials And Methods: A prospectively maintained TIPS database was used to identify patients who underwent new TIPS placements at a large urban tertiary care center between 1995 and 2014. SHF was defined as otherwise unexplained new-onset dyspnea, hypoxemia, radiologic pulmonary edema, an increased need for diuretics, or need for intubation within 7 days after TIPS placement. Read More

    Assessment of Pulmonary Edema: Principles and Practice.
    J Cardiothorac Vasc Anesth 2017 Aug 19. Epub 2017 Aug 19.
    Cardiothoracic Anesthesia Service, VA Connecticut Healthcare System, Yale University School of Medicine, New Haven, CT.
    Pulmonary edema increasingly is recognized as a perioperative complication affecting outcome. Several risk factors have been identified, including those of cardiogenic origin, such as heart failure or excessive fluid administration, and those related to increased pulmonary capillary permeability secondary to inflammatory mediators. Effective treatment requires prompt diagnosis and early intervention. Read More

    Microvascular dysfunction and cardiac fibrosis in heart failure with preserved ejection fraction: a case report.
    ESC Heart Fail 2017 Nov 26;4(4):645-648. Epub 2017 Jun 26.
    Section of Cardiology, Department of Medicine, University of Chicago, Chicago, IL, 60637, USA.
    We report the case of a 55-year-old woman with heart failure with preserved ejection fraction (HFpEF), who presented with hypertensive urgency and pulmonary oedema. The patient was medically optimized and underwent cardiac catheterization revealing pulmonary hypertension, elevated pulmonary capillary wedge pressure, normal cardiac index, and non-obstructive coronary disease. Invasive evaluation of coronary flow revealed blunted coronary flow reserve and increased index of microvascular resistance. Read More

    Haemodynamic monitoring of cardiac status using heart sounds from an implanted cardiac device.
    ESC Heart Fail 2017 Nov 4;4(4):605-613. Epub 2017 Jul 4.
    Scottish National Advanced Heart Failure Service, Golden Jubilee National Hospital, Clydebank, UK.
    Aim: The aim of this study was to evaluate the haemodynamic correlates of heart sound (HS) parameters such as third HS (S3), first HS (S1), and HS-based systolic time intervals (HSTIs) from an implantable cardiac device.

    Methods And Results: Two unique animal models (10 swine with myocardial ischaemia and 11 canines with pulmonary oedema) were used to evaluate haemodynamic correlates of S1, S3, and HSTIs, namely, HS-based pre-ejection period (HSPEP), HS-based ejection time (HSET), and the ratio HSPEP/HSET during acute haemodynamic perturbations. The HS was measured using implanted cardiac resynchronization therapy defibrillator devices simultaneously with haemodynamic references such as left atrial (LA) pressure and left ventricular (LV) pressure. Read More

    Fulminant adrenergic myocarditis complicated by pulmonary edema, cardiogenic shock and cardiac arrest.
    Am J Emerg Med 2017 Nov 10. Epub 2017 Nov 10.
    Department of Coronary Disease and Heart Failure, Faculty of Medicine, Jagiellonian University Medical College, The John Paul II Hospital, Krakow, Poland.
    Adrenergic myocarditis is an uncommon presentation of pheochromocytoma and extremely rare cause of de novo acute heart failure (AHF). We present a case of a 31-year-old Caucasian woman with a history of hypertension and recurrent occipital headaches who was admitted to the emergency department due to severe de novo AHF presenting as pulmonary edema and cardiogenic shock. During the hospital admission the patient experienced asystolic cardiac arrest and was successfully resuscitated, intubated, and mechanically ventilated. Read More

    Unilateral Pulmonary Edema in a Patient with Worsening Tricuspid Valve Regurgitation: A Secret Inside Pulmonary Veins.
    J Cardiovasc Echogr 2017 Oct-Dec;27(4):153-155
    Department of Echocardiography, San Raffaele Hospital, Milan, Italy.
    We present the case of a 69-year-old patient who was referred to the Department of Echocardiography for surgical treatment of severe tricuspid valve regurgitation (TVR) with advanced congestive heart failure. In 2013 the patient underwent unsuccessful percutaneous ablation for permanent atrial fibrillation. In 2015, following numerous episodes of atrial fibrillation and congestive heart failure with left pleural effusion, the patient was admitted to another center. Read More

    A coronary artery fistula having connection between 2 coronary arteries and the left ventricle: A case report.
    Medicine (Baltimore) 2017 Nov;96(45):e8546
    Division of Cardiology, Daegu Catholic University Medical Center, Daegu, Korea.
    Rationale: Cases of coronary artery fistula having a connection with the cardiac cavity are rare. Here, we report a case in which 2 coronary arteries empty into the left ventricular cavity together.

    Patient Concerns: A 63-year-old woman who was diagnosed as having hypertension 20 years prior presented with dyspnea. Read More

    Pulmonary arteriovenous extracorporeal membrane oxygenation to avoid pulmonary overflow during total artificial heart implantation.
    Int J Artif Organs 2017 Nov 2. Epub 2017 Nov 2.
    Division of Cardiac Surgery, University of Rochester Medical Center, Rochester, New York - USA.
    Total artificial hearts (TAH) can be used as a bridge to transplant or, occasionally, as destination therapy for patients with severe biventricular dysfunction. Not infrequently TAHs are placed in patients with severe low flow states, in which the lungs of these patients are unable to adjust rapidly to the "normal" right ventricular output of a TAH. These patients may develop variable degrees of pulmonary edema secondary to stress failure of the pulmonary capillaries requiring increased respiratory support, which can occasionally be fatal. Read More

    Diastolic heart failure associated with hemangiosarcoma infiltrating left ventricular walls in a dog.
    Can Vet J 2017 Nov;58(11):1167-1170
    Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Sciences (Osuga, Morita, Ohta, Takiguchi), and Veterinary Teaching Hospital (Nakamura), Graduate School of Veterinary Medicine, Hokkaido University, Sapporo, Hokkaido 060-0808, Japan; North Lab, Sapporo, Hokkaido 003-0027, Japan (Kagawa).
    A 9-year-old Shetland sheepdog was diagnosed with cardiogenic pulmonary edema. Echocardiography revealed focally thickened left ventricular free wall and interventricular septum and left atrial dilation. Left ventricular systolic function was preserved. Read More

    Aorto-Atrial Fistulas - A Contemporary Review.
    Cardiol Rev 2017 Oct 25. Epub 2017 Oct 25.
    1Touro College of Osteopathic Medicine, New York, NY; 2 Department of Anaesthesia, Deenanath Mangeshkar Hospital & Research Center, Pune, Maharashtra, India; 3 Department of Pulmonary, Critical Care and Sleep Medicine, Hofstra Northwell School of Medicine - Northwell Health System, New Hyde Park, NY; 4 Division of Cardiology, Hartford Hospital, Hartford, CT; 5 Department of Cardiology, Bieganski Hospital - Medical University of Lodz, Łódź, Poland.
    Aorto-atrial fistulas are a relatively rare, but potentially life-threatening condition, where an anomalous connection forms between the aortic structures and the cardiac atria. Aorto-atrial fistulas are most often the result of an underlying condition concerning the cardiac structures. It may be congenital, secondary to conditions such as aortic dissection, infective endocarditis, or valve replacement, or iatrogenic in nature. Read More

    The Starling Relationship and Veno-Arterial ECMO: Ventricular Distension Explained.
    ASAIO J 2017 Oct 23. Epub 2017 Oct 23.
    From the Department of Anesthesiology, Columbia University, New York, New York.
    The use of veno-arterial (VA) extracorporeal membrane oxygenation (ECMO) to support patients with acute heart failure has been associated with ventricular distension and pulmonary edema, the mechanism of which is not fully understood. This study examined the impact of VA ECMO on left ventricular (LV) Starling curves to elaborate a framework for anticipating and treating LV distension. A previously developed and validated model of the cardiovascular system was used to generate pressure-volume (PV) loops and Starling curves while holding mean arterial pressure (mABP) constant at a range of values either by adjusting systemic resistance or by adding VA ECMO support. Read More

    The respiratory system in pediatric chronic heart disease.
    Pediatr Pulmonol 2017 Dec 27;52(12):1628-1635. Epub 2017 Oct 27.
    Department of Pediatric Cardiology, Onassis Cardiac Surgery Center, Athens, Greece.
    Cardiovascular disease in the pediatric population closely affects the respiratory system inducing water retention in the lungs and pulmonary edema, airway compression by cardiovascular structures, restrictive pulmonary physiology as a result of hemodynamic changes and surgical repair, susceptibility to respiratory infections, development of pulmonary hypertension, thrombosis, or hemorrhage. Chronic heart failure and congenital heart disease are characterized by various respiratory manifestations and symptoms mimicking lung disease, which are frequently difficult to diagnose and treat. Pulmonary function is multiply affected in pediatric heart disease with mostly restrictive but also obstructive and diffusion abnormalities. Read More

    The use of the RenalGuard system in cardiac surgery with cardiopulmonary bypass: a first in man prospective, observational, feasibility pilot study.
    Open Heart 2017 10;4(2):e000669. Epub 2017 Oct 10.
    University of Wolverhampton, Wolverhampton, UK.
    Objectives: As proof of concept, this prospective, observational study assessed the feasibility and early clinical outcomes of performing on-pump cardiac surgery with the RenalGuard system.

    Background: Acute kidney injury (AKI) is reported in up to 30% of patients undergoing cardiac surgery and is a recognised independent predictor of both morbidity and mortality. Forced diuresis with the RenalGuard system reduces the incidence of AKI during percutaneous coronary intervention procedures but its use in cardiac surgery has not been explored. Read More

    [Pulmonary arterial hypertension as leading manifestation of methylmalonic aciduria: clinical characteristics and gene testing in 15 cases].
    Beijing Da Xue Xue Bao Yi Xue Ban 2017 Oct;49(5):768-777
    Department of Pediatrics, Peking University First Hospital, Beijing 100034, China.
    Objective: To deepen our understanding of Methylmalonic aciduria (MMA) associated pulmonary hypertension (PH) by analyzing the characteristics of clinical presentation, pulmonary high resolusion CT(HRCT), treatment response and gene mutation.

    Methods: This study includes 15 cases of pediatric patients with MMA associated PH diagnosed and treated in Peking University First Hospital pediatric department between May 2012 and May 2016 with symptoms of PH as their leading presentation. Clinical symptoms and signs were recorded, Routine blood laboratory examinations was done including arterial blood gas analysis. Read More

    The challenge of Takotsubo syndrome: heterogeneity of clinical features.
    Swiss Med Wkly 2017 Oct 17;147:w14490. Epub 2017 Oct 17.
    University Hospital Zurich, University Heart Centre, Department of Cardiology, Zurich, Switzerland.
    Takotsubo syndrome (TTS) was first described in 1991 as a rare, spontaneous and completely reversible left ventricular regional systolic dysfunction. Today the incidence of TTS is estimated at 2% in patients with an initial diagnosis of acute coronary syndrome (ACS). Notably, the incidence can be as high as 5. Read More

    Obstructive sleep apnea in pregnancy is associated with adverse maternal outcomes: a national cohort.
    Sleep Med 2017 Oct 26;38:50-57. Epub 2017 Jul 26.
    Department of Medicine, Warren Alpert Medical School of Brown University, Providence, RI, USA.
    Objective: Pregnancy and the obesity epidemic impacting women of reproductive age appear to predispose women to obstructive sleep apnea (OSA) in pregnancy. The aim of this study is to examine the association between OSA and adverse maternal outcomes in a national cohort.

    Methods: The National Perinatal Information Center in the US was used to identify women with a delivery discharge diagnosis of OSA from 2010 to 2014. Read More

    Extent of jugular venous distension and lower extremity edema are the best tools from history and physical examination to identify heart failure exacerbation.
    Herz 2017 Oct 9. Epub 2017 Oct 9.
    Division of Cardiovascular Medicine, Linda and Jack Gill Heart Institute, University of Kentucky, Lexington, KY, USA.
    Introduction: We aimed to identify the best tools from history and physical examination that predict severity of heart failure (HF) exacerbation among patients with an ejection fraction (EF) ≤ 30%.

    Methods: Patients enrolled in the ESCAPE trial were divided into tertiles according to the combined value of pulmonary capillary wedge pressure (PCWP) and right atrial pressure (RAP) which we used as a marker of volume loading of both pulmonary and systemic compartments. Variables of congestion from history and physical examination were examined across tertiles. Read More

    A case study of likely wild-type cardiac transthyretin amyloidosis causing rapid deterioration.
    J Intensive Care Soc 2017 May 29;18(2):138-142. Epub 2016 Nov 29.
    Intensive Care Department, Royal Free Hospital, London, UK.
    We present the case of an 88-year-old gentleman who presented to hospital septic with bilateral leg cellulitis, pulmonary oedema and hypotension. He had no history of heart disease but had had bilateral carpal tunnel releases. His condition deteriorated with refractory hypotension in spite of fluid filling, inotropic and vasopressor support. Read More

    Left Ventricular Unloading during Peripheral Extracorporeal Membrane Oxygenator Support: A Bridge To Life In Profound Cardiogenic Shock.
    J Extra Corpor Technol 2017 Sep;49(3):201-205
    Division of Cardiac Surgery, University of Turin, Turin, Italy.
    A limit of peripheral veno-arterial Extracorporeal Membrane Oxigenator (VA-ECMO) is the inadequate unloading of the left ventricle. The increase of end-diastolic pressure reduces the possibility of a recovery and may cause severe pulmonary edema. In this study, we evaluate our results after implantation of VA-ECMO and Transapical Left Ventricular Vent (TLVV) as a bridge to recovery, heart transplantation or long-term left ventricular assit devices (LVAD). Read More

    Importance of Clinical and Laboratory Findings in the Diagnosis and Surgical Prognosis of Patients with Constrictive Pericarditis.
    Arq Bras Cardiol 2017 Nov 2;109(5):457-465. Epub 2017 Oct 2.
    Instituto do Coração (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, SP - Brazil.
    Background: International studies have reported the value of the clinical profile and laboratory findings in the diagnosis of constrictive pericarditis. However, Brazilian population data are scarce.

    Objective: To assess the clinical characteristics, sensitivity of imaging tests and factors related to the death of patients with constrictive pericarditis undergoing pericardiectomy. Read More

    Short-Term Efficacy and Safety of Torasemide and Furosemide in 366 Dogs with Degenerative Mitral Valve Disease: The TEST Study.
    J Vet Intern Med 2017 Nov 4;31(6):1629-1642. Epub 2017 Oct 4.
    Vetoquinol SA, Lure, France.
    Background: Furosemide is the only loop diuretic recommended by the ACVIM consensus guidelines for treatment of congestive heart failure (CHF) in dogs related to degenerative mitral valve disease (DMVD). Torasemide is another potent loop diuretic with a longer half-life and a higher bioavailability.

    Objectives: (1) To demonstrate that torasemide given once a day (q24h) is noninferior to furosemide given twice a day (q12h) for treating dogs with CHF; (2) and to compare the effect of the 2 drugs on the time to reach a composite cardiac endpoint "spontaneous cardiac death, euthanasia due to heart failure or CHF class worsening. Read More

    Non-Exertional Heatstroke: A Case Report and Review of the Literature.
    Am J Case Rep 2017 Oct 4;18:1058-1065. Epub 2017 Oct 4.
    Department of Medicine, Section of Internal Medicine, University of Verona, Verona, Italy.
    BACKGROUND Heatstroke (HS) is a life-threatening condition characterized by an elevation of the core body temperature above 40°C, central nervous system dysfunction, and possible multi-organ failure. HS can trigger systemic inflammation, disseminated intravascular coagulation (DIC), rhabdomyolysis, cerebral edema and seizures, pulmonary edema, heart dysfunctions, and renal and hepatic failure. CASE REPORT We report the case of a 41-year-old Romanian woman with a history of alcoholism who developed HS after arriving by bus in Verona, Italy in June 2016. Read More

    Itraconazole induced congestive heart failure, a case study.
    Curr Drug Saf 2017 Oct 3. Epub 2017 Oct 3.
    Department of General Medicine, Andaman Nicobar Islands Institute of Medical Science, Port Blair. India.
    Only few cases have been reported with cardiovascular side effects, especially congestive heart failure (HF), of intraconazole therapy after black box warning by US-FDA (2001). It is unknown which category of patients should avoid this important antifungal treatment. A middle-aged man having past history of treated pulmonary tuberculosis and obstructive uropathy presented with 2-weeks of progressive cough with scanty purulent sputum and breathlessness without any fever, chest pain, or pedal edema. Read More

    Scorpion-related cardiomyopathy and acute pulmonary edema in a child who is stung by Leiurus abdullahbayrami.
    Turk J Emerg Med 2017 Sep 18;17(3):104-108. Epub 2017 Mar 18.
    Manisa Celal Bayar University Alasehir Vocational High School, 45600, Alaşehir, Manisa, Turkey.
    Venom of Leiurus abdullahbayrami (Scorpiones: Buthidae) is an extremely toxic one and it stimulates voltage-gated sodium and potassium channels. In case of a stung by this scorpion; excessive catecholamine release occur and it impairs left ventricle contractility and consequently a heart failure occurs (scorpion sting-related cardiomyopathy). In addition to this cardiac-induced acute pulmonary, edema may occur in severe cases too. Read More

    Food finds its way to a woman's heart: Campylobacter jejuni-associated myopericarditis.
    Glob Cardiol Sci Pract 2017 Mar 31;2017(1):e201708. Epub 2017 Mar 31.
    Spectrum Health Frederik Meijer Heart & Vascular Institute.
    Campylobacter jejuni-associated myopericarditis (CAM) has been reported infrequently in the literature. We describe a case of immunocompetent young woman presenting with chest pain, with history of recent travel and diarrhea. Evaluation led to diagnosis of myopericarditis associated with this infection. Read More

    Assessment of Lungs for Transplant Recovered from Uncontrolled Donation after Circulatory Determination of Death Donors.
    Ann Am Thorac Soc 2017 Sep;14(Supplement_3):S251
    2 Carolina Donor Services, Durham, North Carolina.
    Rationale: To address the lung donor shortage, we obtained institutional review board and US Food and Drug Administration approval to transplant lungs recovered from uncontrolled donation after circulatory determination of death donors (uDCDDs).

    Objectives: To compare outcomes of recipients of lungs recovered from uDCDDs vs. brain-dead donors. Read More

    DJ-1 activates autophagy in the repression of cardiac hypertrophy.
    Arch Biochem Biophys 2017 Nov 21;633:124-132. Epub 2017 Sep 21.
    Department of Cardiology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China; Key Laboratory on Assisted Circulation, Ministry of Health, Guangzhou, China. Electronic address:
    Cardiac hypertrophy is the risk factor of heart failure when the heart is confronted with pressure overload or neurohumoral stimuli. Autophagy, a conserved degradative pathway, is one of the important mechanisms involved in the regulation of cardiac hypertrophy. DJ-1 is a traditional anti-oxidative protein and emerging evidence suggested that DJ-1 might modulate autophagy. Read More

    Epidemiology, pathogenesis, and management of takotsubo syndrome.
    Clin Auton Res 2017 Sep 15. Epub 2017 Sep 15.
    Department of Clinical Science and Education Södersjukhuset, Karolinska Institutet, Sjukhusbacken 10, 118 83, Stockholm, Sweden.
    Takotsubo syndrome is a recently recognized acute cardiac disease entity with a clinical presentation resembling that of an acute coronary syndrome. The typical takotsubo syndrome patient has a unique circumferential left (bi-) ventricular contraction abnormality profile that extends beyond a coronary artery supply territory and appears to follow the anatomical cardiac sympathetic innervation. The syndrome predominantly affects postmenopausal women and is often preceded by emotional or physical stress. Read More

    Percutaneous extracorporeal membrane oxygenation in electrical storm: five case reports addressing efficacy, transferring allowance or radiofrequency ablation support.
    Eur Heart J Acute Cardiovasc Care 2017 Sep 1:2048872617730036. Epub 2017 Sep 1.
    Department of Cardiology, University Hospital of Salamanca - IBSAL, Salamanca, Spain.
    Extracorporeal membrane oxygenation systems have undergone rapid technological improvements and are now feasible options for medium-term support of severe cardiac or pulmonary failure. We report five cases of electrical storm that was rescued by the insertion of peripheral veno-arterial extracorporeal membrane oxygenation systems. This device could help to restore systemic circulation as well as permitting organ perfusion in patients with cardiogenic shock in relation to electrical storm thus achieving greater electrical stability. Read More

    State-wide reduction in in-hospital cardiac complications in association with the introduction of a national standard for recognising deteriorating patients.
    Resuscitation 2017 Dec 30;121:172-178. Epub 2017 Aug 30.
    Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, The Alfred Centre, 99 Commercial Road, Melbourne, VIC 3004, Australia.
    Aim: To examine whether introducing a national standard to improve the recognition of and response to clinical deterioration, was associated with a reduction in cardiovascular events in the hospital environment.

    Method: Interrupted time series was used to analyse the trajectories of monthly complication rates for 4.69 million admissions in 218 hospitals. Read More

    Acute and Midterm Outcomes of Transcatheter Pulmonary Valve Replacement for Treatment of Dysfunctional Left Ventricular Outflow Tract Conduits in Patients With Aortopulmonary Transposition and a Systemic Right Ventricle.
    Circ Cardiovasc Interv 2017 Sep;10(9)
    From the Heart Institute, Cincinnati Children's Hospital Medical Center, OH (W.W., J.T.T., C.M.M., B.H.G.); Division of Cardiology, Ahmanson/Adult Congenital Heart Disease Center, Los Angeles, CA (J.A.); Division of Pediatric Cardiology, Department of Pediatrics, University of Iowa Children's Hospital (O.A.); Division of Pediatric Cardiology, Department of Pediatrics, University of Michigan C. S. Mott Children's Hospital, Ann Arbor (A.K.A., M.L.B.); Division of Cardiology, the Children's Hospital of Philadelphia, PA (M.J.G.); Seattle Children's Hospital, University of Washington (T.K.J.); Division of Cardiology, Department of Pediatrics, University of Utah, Salt Lake City (M.H.M.); Division of Cardiology, UCSF Benioff Children's Hospital, University of California (J.J.M.); Division of Pediatric Cardiology, Columbia University College of Physicians and Surgeons, Morgan Stanley Children's Hospital of New York Presbyterian (M.E.T.); and Division of Cardiology, Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (T.Z.).
    Background: Transcatheter pulmonary valve replacement (TPVR) is an established therapy for dysfunctional right ventricular (RV) outflow tract conduits. TPVR in patients with congenitally corrected transposition of the great arteries, subpulmonary left ventricle, and left ventricular outflow tract (LVOT) conduit dysfunction has not been studied. Unique anatomic and physiological aspects of this population may contribute to distinct risks and outcomes. Read More

    The lung water cascade in heart failure.
    Echocardiography 2017 Oct 28;34(10):1503-1507. Epub 2017 Aug 28.
    Nottola Hospital, Siena, and Cardiothoracic Department, Pisa University Hospital, Pisa, Italy.
    In heart failure patients, we hypothesize the occurrence of the "lung water cascade," with the various markers hierarchically ranked in a well-defined time sequence: (1) early, proximal hemodynamic event with increase in pulmonary capillary wedge pressure; (2) intermediate, direct imaging sign of pulmonary edema (easily detectable at bedside by lung ultrasound as B-lines); (3) late, distal clinical symptoms and signs such as dyspnea and pulmonary crackles. Completion of the cascade (from hemodynamic to pulmonary to clinical congestion) can require minutes (as with exercise), hours or even weeks (as with impending acute heart failure). Backward rewind of the downhill cascade can be achieved with timely pulmonary decongestion therapy, such as diuretics or dialysis, restoring a relatively dry lung. Read More

    A systematic review of diagnostic methods to differentiate acute lung injury/acute respiratory distress syndrome from cardiogenic pulmonary edema.
    Crit Care 2017 Aug 25;21(1):228. Epub 2017 Aug 25.
    Children's Hospital of Richmond at Virginia Commonwealth, Richmond, VA, 23298, USA.
    Background: Discriminating acute lung injury (ALI) or acute respiratory distress syndrome (ARDS) from cardiogenic pulmonary edema (CPE) is often challenging. This systematic review examines studies using biomarkers or images to distinguish ALI/ARDS from CPE.

    Methods: Three investigators independently identified studies designed to distinguish ALI/ARDS from CPE in adults. Read More

    Cardio-Pulmonary Interactions: Physiologic Basis and Clinical Applications.
    Ann Am Thorac Soc 2017 Aug 18. Epub 2017 Aug 18.
    University of Pittsburgh Medical Center, Critical Care Medicine , Professor of Critical Care Medicine and Bioengineering , 606 Scaife Hall , 3550 Terrace Street , Pittsburgh, Pennsylvania, United States , 15261 ;
    The hemodynamic effects of ventilation can be grouped into three concepts: 1) spontaneous ventilation is exercise; 2) changes in lung volume alter autonomic tone, pulmonary vascular resistance, and can compress the heart in the cardiac fossa; 3) spontaneous inspiratory efforts decrease intrathoracic pressure (ITP) increasing venous return and impeding left ventricular (LV) ejection; whereas positive pressure ventilation decreases venous return and unloads LV ejection. Spontaneous inspiratory efforts may induce acute LV failure and cardiogenic pulmonary edema. Reversing the associated negative ITP swings by using non-invasive continuous positive airway pressure rapidly reverses acute cardiogenic pulmonary edema and improves survival. Read More

    Intratracheal administration of isosorbide dinitrate improves pulmonary artery pressure and ventricular remodeling in a rat model of heart failure following myocardial infarction.
    Exp Ther Med 2017 Aug 28;14(2):1399-1408. Epub 2017 Jun 28.
    Department of Cardiology, Huadong Hospital Affiliated to Fudan University, Shanghai 200040, P.R. China.
    Pulmonary hypertension due to left heart disease is associated with poor outcomes. This study investigated the beneficial effects of isosorbide dinitrate (ISDN) inhalation on pulmonary pressure and ventricular remodeling in a rat model of heart failure (HF) following myocardial infarction (MI). To assess the effect of ISDN on pulmonary pressure, 20 male Sprague-Dawley (SD) rats were randomized to four groups: Normal saline (NS) 1 ml/kg, ISDN 1 mg/kg, NS 3 ml/kg or ISDN 3 mg/kg following coronary ligation. Read More

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