RESUMO
Eighty year old male patient with heart failure preserved ejection fraction (EF), Obstructive sleep apnea, peripherovascular disease admitted with increasing shortness of breath and found with pulmonary emboli. Baseline 2D-echo-cardiogram performed demonstrated preserved ejection fraction and a right thrombus in transit. Anticoagulation with weight based-low molecular weight heparin was given for six days. Follow-up echo performed demonstrated complete dissolution of right heart thrombi. Since there was complete dis- solution of thrombi seen on right atrium, anticoagulation with Rivaroxaban was given instead.
RESUMO
Eighty year old male patient with heart failure preserved ejection fraction (EF), Obstructive sleep apnea, peripherovascular disease admitted with increasing shortness of breath and found with pulmonary emboli. Baseline 2D-echocardiogram performed demonstrated preserved ejection fraction and a right thrombus in transit. Anticoagulation with weight based-low molecular weight heparin was given for six days. Follow-up echo performed demonstrated complete dissolution of right heart thrombi. Since there was complete dissolution of thrombi seen on right atrium, anticoagulation with Rivaroxaban was given instead.
Assuntos
Anticoagulantes/administração & dosagem , Cardiopatias/diagnóstico por imagem , Embolia Pulmonar/diagnóstico , Trombose/diagnóstico por imagem , Doença Aguda , Idoso de 80 Anos ou mais , Ecocardiografia , Seguimentos , Cardiopatias/tratamento farmacológico , Heparina de Baixo Peso Molecular/administração & dosagem , Humanos , Masculino , Embolia Pulmonar/patologia , Rivaroxabana/administração & dosagem , Trombose/tratamento farmacológicoRESUMO
Cardiovascular diseases are uncommon among trained athletes. Their occurrences mostly depend on the individual's age and fitness levels. Adequate understanding of the cardiovascular adaptations undergone by the competitive athletes' heart is of paramount importance in order to differentiate them from serious cardiovascular conditions. Diagnosing these abnormalities early may prevent rare but devastating potential complications associated with athletic activities and defines appropriate activity restrictions to minimize the risk of sudden cardiac death. This article will review concerns related to competitive athlete's cardiovascular adaptations and diseases, in light of specific recommendations presented in the 36th Bethesda Conference guidelines.
Assuntos
Adaptação Fisiológica , Exercício Físico/fisiologia , Cardiopatias/etiologia , Cardiopatias/fisiopatologia , Coração/fisiologia , Esportes/fisiologia , Atletas , HumanosRESUMO
Sudden cardiac death (SCD) is a long -recognized disease that occurs rarely in trained athletes. Most affected athletes have no symptoms before death. Many attempts have been made to detect those at risk for SCD before athletic participation. However, its overall clinical advantages remain questionable in medical literature. This article will review cardiogenic and non-cardiogenic causes of SCD as well as discuss how this entity affects those athletes older than 35 years.
Assuntos
Morte Súbita Cardíaca/etiologia , Esportes , Adulto , Atletas , HumanosRESUMO
UNLABELLED: Anemia in patients with heart failure (HF is a frequent event, commonly associated with worse prognosis. Despite the high incidence and adverse outcomes associated with anemia no studies have been conducted amongst Hispanics with HF. OBJECTIVE: The study aims to determine the prevalence, predictors and outcomes of anemia in Hispanics admitted to Veteran Affairs Caribbean Healthcare System with diagnosis of Decompensated Congestive Heart Failure (D-CHF). METHODS: Retrospective review of 617 patient medical charts that had been previously discharged with a diagnosis of HF as per International Classification of Diseases-9 code. The clinical, demographic, laboratory and echocardiographic data was assessed for a total of 148 male patient electronic medical records that met the study inclusion criteria. The re-hospitalization and mortality rates were determined from the admission date until April 2010. RESULTS: The burden of anemia with HF is substantial, with anemia present in 68.2% of patients. Anemia was associated with hypoalbuminemia, higher New York Heart Association classification, elevated pro-BNP level at discharge, renal insufficiency and diastolic dysfunction, all of which demonstrated statistical significance. Anemia had 2.18 and 2.95 times likelihood of any-cause mortality (p = 0.003) and cardiovascular deaths (p = 0.02) when compared with HF patients without anemia. CONCLUSIONS: Anemia is a very frequent and serious finding in patients with D-CHF. The study reveals a higher prevalence of anemia in HF patients among Hispanics in comparison with formerly reported studies covering non-Hispanic populations.
Assuntos
Anemia , Insuficiência Cardíaca , Anemia/epidemiologia , Hospitalização , Humanos , Prevalência , Estudos RetrospectivosRESUMO
Case report and review of literature of a 33-year-old-male patient who was suffering from recurrent events of loss of consciousness (syncope) found to have multiple events of sustained and non sustained left bundle-branch morphology ventricular tachycardia during Holter evaluation. Both, the echocardiographic and magnetic resonance studies demonstrated morphological changes as seen in Arrhythmogenic right ventricular cardiomyopathy. Arrhythmogenic Right Ventricular Dysplasia (ARVD) is a rare cardiomyopathy characterized by life-threatening ventricular arrhythmias in the absence of apparent structural left heart disease, predominantly occurring within the male gender. Though it is mostly a hereditary condition, there are some sporadic cases. It is characterized by progressive degeneration and fibrous-fatty replacement of the right ventricular myocardium. The European Society of Cardiology and the International Society and Federation Task force is useful for the diagnosis of the condition because of the difficulties in as well as inaccuracies in tissue diagnosis. Patients with a diagnosis of ARVD who suffers from recurrent syncope events and ventricular arrhythmias an Implantable Cardiovertor-Defibrillator (ICD) is indicated to decrease their risk of sudden cardiac death events.
Assuntos
Displasia Arritmogênica Ventricular Direita/diagnóstico , Síncope/etiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Displasia Arritmogênica Ventricular Direita/genética , Displasia Arritmogênica Ventricular Direita/terapia , Criança , Desfibriladores Implantáveis , Diagnóstico Diferencial , Eletrocardiografia , Eletrocardiografia Ambulatorial , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Linhagem , Recidiva , Taquicardia Ventricular/diagnósticoRESUMO
Prosthetic valve infective endocarditis represents a defined pathological entity which follows an epidemiological and nosological pattern in accordance to an arbitrary classification. Chronologically it is divided into the entities of early and late prosthetic valve endocarditis, each with its own unique characteristics. The clinical features, complications and diagnosis do not vary much from native valve endocarditis. There are clear and precise indications to aid in the diagnosis and treatment of this entity which differ from native valve endocarditis.