Cardiovascular Medicine

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Open AccessLetter

Der Arzt—Ein Auslaufmodell?

by Thomas F. Lüscher

Cardiovasc. Med. 2010, 13(11), 354; https://doi.org/10.4414/cvm.2010.01537 - 10 Nov 2010

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Abstract

Der Arzt—Ein Auslaufmodell? Sie sprechen mir quasi aus dem Herzen [...] Full article

2 pages, 654 KB

Open AccessInteresting Images

Junger Patient Mit «Hartnäckiger» Regelmässiger Tachykardie

by Dörthe Schmidt, Corinna B. Brunckhorst, Firat Duru and Laurent M. Haegeli

Cardiovasc. Med. 2010, 13(11), 352; https://doi.org/10.4414/cvm.2010.01541 - 10 Nov 2010

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Abstract

Fallbeschreibung: Während eines Spitalaufenthalts wegen der Resektion einer arterio-venösen Malformation am Fussrücken klagte ein 23-jähriger Patient plötzlich über regelmässiges Herzrasen mit einer Frequenz von 140/min (Abb. 1) [...] Full article

2 pages, 260 KB

Open AccessInteresting Images

Aorto-Right Atrial Fistula Due to Complicated Prosthetic Valve Endocarditis

by Andreas Rohner, Alain Bernheim, Peter Buser, Beat Kaufmann and Arnheid Kessel-Schaefer

Cardiovasc. Med. 2010, 13(11), 350; https://doi.org/10.4414/cvm.2010.01536 - 10 Nov 2010

Cited by 1 | Viewed by 8

Abstract

In December 2008 a 51-year-old woman with a history featuring aortic valve replacement (ATS 22) in 2007 due to radiation-induced severe aortic stenosis, presented at our emergency department with protracted fever, involuntary loss of weight and malaise [...] Full article

4 pages, 287 KB

Open AccessCase Report

Eine Patientin Mit Therapieresistenter Hypertonie

by Mathias Wolfrum, Ulf Landmesser and Thomas F. Lüscher

Cardiovasc. Med. 2010, 13(11), 346; https://doi.org/10.4414/cvm.2010.01540 - 10 Nov 2010

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Abstract

Zusammenfassung: Trotz der Verfügbarkeit wirksamer Medikamente bleibt die Behandlung der therapierefraktären arteriellen Hypertonie auch für die heutige Medizin eine Herausforderung [...] Full article

4 pages, 585 KB

Open AccessCase Report

Diagnostic Ergometry in an HIV-Positive Patient with Effort Dyspnea

by Ina Bluzaite, Andrea Witteck, Hans Roelli and Hans Rickli

Cardiovasc. Med. 2010, 13(11), 342; https://doi.org/10.4414/cvm.2010.01539 - 10 Nov 2010

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Abstract

A case of a 40-year-old patient with known HIV-infection and new onset of exertional dyspnea with dizziness is presented. At the end of an extensive diagnostic investigation, the underlying exercise-induced second degree 3:1 atrioventricular (AV) block was revealed by means of an ergometry/bicycle [...] Read more.

A case of a 40-year-old patient with known HIV-infection and new onset of exertional dyspnea with dizziness is presented. At the end of an extensive diagnostic investigation, the underlying exercise-induced second degree 3:1 atrioventricular (AV) block was revealed by means of an ergometry/bicycle stress test. After exclusion of reversible causes, a DDD pacemaker was implanted three months after the onset of symptoms. Thereafter, the patient was free from her complaints, but progressed to third degree AV block in the second year of follow-up. Full article

8 pages, 150 KB

Open AccessArticle

Kardiale Resynchronisationstherapie: «Real World»-Erfahrungen Eines Tertiären Zentrums in der Schweiz

by David Hürlimann, Jan Steffel, Gligor Milosevic, Nazmi Krasniqi, Christiane Gruner, Franz Oswald, Mariette Rahn, Volkmar Falk, Georg Noll, Thomas F. Lüscher, Frank Ruschitzka and Johannes Holzmeister

Cardiovasc. Med. 2010, 13(11), 334; https://doi.org/10.4414/cvm.2010.01543 - 10 Nov 2010

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Abstract

Background: Cardiac resynchronisation therapy (CRT) has become a mainstay in the treatment of patients with severe heart failure mainly due to large clinical trials demonstrating a reduction in morbidity and mortality. The aim of the present study was to evaluate the current [...] Read more.

Background: Cardiac resynchronisation therapy (CRT) has become a mainstay in the treatment of patients with severe heart failure mainly due to large clinical trials demonstrating a reduction in morbidity and mortality. The aim of the present study was to evaluate the current practice of CRT in a “real world” setting in a large Swiss tertiary Center. Methods: All patients who underwent CRT-implantation (CRT-pacemaker or CRT-Defibrillators) at Zürich University Hospital between 2003 and 2010 were included in this retrospective analysis. Results: 208 patients (mean age 63.8 ± 10.9 years, 79.3% male) were included in the study. Ischemic etiology of heart failure was present in 49%; 79% of patients were in NYHA functional class III/IV. Mean QRS-duration was 153 ms (±30 ms) and mean ejection fraction 26 ± 8%. Median duration of hospital stay was two days. Perioperative complications were rare and comparable to those of large clinical trials. CRT lead to a considerable clinical and echocardiographic improvement. While NYHA functional class improved from 2.8 ± 0.6 to 2.1 ± 0.7 (p < 0.00001), left ventricular ejection fraction increased to 33 ± 11% (p < 0.00001) and enddiastolic volume index as well as endsystolic volume index were significantly reduced (p = 0.01 and p = 0.004, respectively). Conclusions: The present study demonstrates that CRT is effective and safe under ‚real world’ conditions. Even though CRT implantation rates in Switzerland are currently only average as compared the rest of Europe, positive study results as well as increasing familiarity and positive personal experience will likely result in an increasing proportion of heart failure patients to be evaluated for and treated with CRT. Full article

8 pages, 1060 KB

Open AccessArticle

Stress-Induced Cardiomyopathy in a Primary Reference Hospital: Prevalence and Clinical Presentation

by Chryssovalandou Stelios, Alain Delabays, Jean-Daniel Baumgartner, Eric Eeckhout and Pierre Vogt

Cardiovasc. Med. 2010, 13(11), 326; https://doi.org/10.4414/cvm.2010.01542 - 10 Nov 2010

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Abstract

Introduction: Stress-induced cardiomyopathy or Takotsubo cardiomyopathy is characterised by a transient localised systolic ventricular dysfunction without epicardial coronary artery disease and is typically provoked by emotional or physical stress. It mainly affects women presenting a greater vulnerability of their hyperactive sympathetic system. [...] Read more.

Introduction: Stress-induced cardiomyopathy or Takotsubo cardiomyopathy is characterised by a transient localised systolic ventricular dysfunction without epicardial coronary artery disease and is typically provoked by emotional or physical stress. It mainly affects women presenting a greater vulnerability of their hyperactive sympathetic system. Aims: To determine the prevalence, clinical and paraclinical characteristics, complications, in-hospital mortality and recurrence rate of the disease in a primary Swiss reference centre. Methods: Prospective data collection from 2003 to 2009 of hospitalised patients fulfilling the diagnostic criteria of Takotsubo cardiomyopathy: transient ST segment modifications, reversible apical or mid-ventricular akinesia, absence of evidence of epicardial coronary artery disease and other causes of transient left ventricular dysfunction. Results: A total of 31 patients presented with Takotsubo cardiomyopathy. 87% were female and the mean age was 72 ± 13 years. Symptoms included dyspnea or thoracic pain (74%). A trigger factor was present in 65% of the cases. The mean value of peak creatine kinase was 272 U/l and troponins 1.2 μ/L. The electrocardiograms mainly showed a ST-segment elevation in the precordial leads (74%) and a prolonged QTc-interval (77%). The mean left ventricular ejection fraction was 37 ± 10%. Right ventricular involvement was present in one third of the patients and was characterised by higher initial brain natriuretic peptide values. Three patients (10%) presented with midventricular ballooning. All patients completely recovered their cardiac function. Atrial tachyarrhythmias (16%), mainly fibrillation, and cardiogenic shock (13%) were the most frequent complications. The recurrence rate was 6%. Conclusion: The current study is the largest sample of Takotsubo cardiomyopathy patients in a Swiss primary reference centre. The results compare well with international published series. The prevalence was somewhat higher and dyspnea was more often the presenting symptom. This was likely due to the active search of the pathology, a high index of suspicion in front of a suggestive electrocardiogram and a low threshold for performing an echocardiogram in these patients. Full article

5 pages, 1115 KB

Open AccessEditorial

Wird Die Essentielle Hypertonie Heilbar?

by Thomas F. Lüscher

Cardiovasc. Med. 2010, 13(11), 321; https://doi.org/10.4414/cvm.2010.01538 - 10 Nov 2010

Cited by 1 | Viewed by 7

Abstract

Die Anfänge: William Harvey (1578–1657, Abb. 1A), Autor des bahnbrechenden Werks «De Motu Cordis» [1] und Entdecker des Kreislaufs, musste seinem neuen Konzept eine physikalische Kraft zugrunde legen, die das Blut kreisen liess; den Blutdruck gemessen allerdings hat der geniale [...] Read more.

Die Anfänge: William Harvey (1578–1657, Abb. 1A), Autor des bahnbrechenden Werks «De Motu Cordis» [1] und Entdecker des Kreislaufs, musste seinem neuen Konzept eine physikalische Kraft zugrunde legen, die das Blut kreisen liess; den Blutdruck gemessen allerdings hat der geniale Forscher selber nie. Im Jahr 1727 war es Reverend Stephen Hales—und zu dieser Zeit waren es nicht selten Pastoren, welche die Forschung weiterentwickelten—, welcher als erster einem wachen Pferd mit einer Glaskanüle in der Arteria carotis den arteriellen Druck bestimmte [2] (Abb. 1B) [...] Full article

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Cardiovasc. Med., Volume 13, Issue 11 (11 2010) – 8 articles

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