Cardiovascular Medicine

7 pages, 590 KB

Open AccessReview

Pre-Participation Cardiovascular Screening in Athletes: When and How?

by Saqib Ghani and Sanjay Sharma

Cardiovasc. Med. 2012, 15(1), 7; https://doi.org/10.4414/cvm.2012.01636 - 25 Jan 2012

Cited by 1 | Viewed by 17

Sudden cardiac death (SCD) in athletes i s a rare but highly tragic event. The majority of SCDs in young athletes are attributable to inherited or congenital cardiac disorders. Athletes harbouring such potentially fatal conditions may remain asymptomatic and sudden death is frequently [...] Read more.

Sudden cardiac death (SCD) in athletes i s a rare but highly tragic event. The majority of SCDs in young athletes are attributable to inherited or congenital cardiac disorders. Athletes harbouring such potentially fatal conditions may remain asymptomatic and sudden death is frequently the first presentation. Most implicated disorders are identifiable during life, and a variety of therapeutic options are available to minimise the risk of SCD. Whereas most health professionals advocate pre-participation cardiovascular screening (PPS) on humanitarian and medical grounds, there is controversy about the most cost-effective method of screening. The American screening model encompasses a cardiovascular health questionnaire and physical examination, while in Italy a mandatory national screening programme is in existence that also incorporates 12-lead ECG. The American model is cheap and pragmatic but has poor sensitivity for the identification of sinister cardiac disorders. In contrast, the Italian model has been shown to exhibit a high sensitivity and specificity for the detection of cardiomyopathies, and has been associated with a dramatic reduction in the incidence of SCD since its inception. However, there are concerns regarding the cost-effectiveness of large-scale ECG screening programmes driven by false positive results and costs of unnecessary additive investigations to confirm or refute the presence of a serious disorder. Nevertheless, major sporting and cardiac organisations have endorsed and advocated the ECGbased screening protocol, which currently remains the most feasible and cost-effective method of pre-participation screening. More efforts are required to address some pertinent issues regarding the universal implementation of PPS programmes. Full article

2 pages, 621 KB

Open AccessInteresting Images

Atrioventricular Block in a Smoker

by Haran Burri, Xavier Perret and Robert F. Bonvini

Cardiovasc. Med. 2012, 15(1), 34; https://doi.org/10.4414/cvm.2012.01633 - 25 Jan 2012

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Abstract

A 53-year-old woman patient presented with multiple episodes of syncope occurring at rest, associated with chest pain [...] Full article

2 pages, 788 KB

Open AccessInteresting Images

Unusual Case of Massive ST-Segment Elevation

by Jean-François Sarrazin and Frank Bogun

Cardiovasc. Med. 2012, 15(1), 32; https://doi.org/10.4414/cvm.2012.01634 - 25 Jan 2012

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Abstract

A 40-year-old man with known severe h ypertension and moderate chronic renal insufficiency initially presented with back and chest pain [...] Full article

2 pages, 788 KB

Open AccessInteresting Images

Pseudoinfarction

by Adrian Attinger and Micha T. Maeder

Cardiovasc. Med. 2012, 15(1), 30; https://doi.org/10.4414/cvm.2012.01637 - 25 Jan 2012

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Abstract

A 66-year-old woman was referred because of suspected acute coronary syndrome (ACS) [...] Full article

4 pages, 505 KB

Open AccessEditorial

Mediokratie Oder Die Konstruktion der Wirklichkeit

by Thomas F. Lüscher

Cardiovasc. Med. 2012, 15(1), 3; https://doi.org/10.4414/cvm.2012.01640 - 25 Jan 2012

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Abstract

Das Problem ist zunächst grundsätzlicher Art: Können wir das Ding-an-sich e rkennen oder sehen wir nur ein Abbild der Wirklichkeit? [...] Full article

12 pages, 3054 KB

Open AccessProceeding Paper

Prevalence and Pathology of Primary Cardiac Tumours

by Cristina Basso, Stefania Rizzo, Marialuisa Valente and Gaetano Thiene

Cardiovasc. Med. 2012, 15(1), 18; https://doi.org/10.4414/cvm.2012.01638 - 25 Jan 2012

Cited by 22 | Viewed by 10

Abstract

Primary cardiac tumours are rare clinical observations, different from secondary neoplasms (ten times more frequent), and 90% of all primary cardiac tumours are benign. Myxoma is by far the most frequent benign tumour (75%), typically located in the left atrium, and manifests with [...] Read more.

Primary cardiac tumours are rare clinical observations, different from secondary neoplasms (ten times more frequent), and 90% of all primary cardiac tumours are benign. Myxoma is by far the most frequent benign tumour (75%), typically located in the left atrium, and manifests with intra-cavitary obstruction, embolism and constitutional symptoms, but it may also be silent and discovered incidentally by echo. Papillary fibroelastoma is a tumour usually arising on the valvular or mural endocardium, which, although quite small, may become symptomatic through embolic e vents. Typical tumours of the paediatric age group are fibroma, rhabdomyoma and teratoma. Primary malignant neoplasms account for 10% of all primary cardiac tumours and are represented by sarcomas (angiosarcoma, leiomyosarcoma, fibrosarcoma, liposarcoma, rhabdomyosarcoma undifferentiated pleomorphic sarcomas) and primary lymphomas. They usually infiltrate the cardiac walls, but may be also solely intra-cavitary, mimicking myxoma. Non neoplastic masses may consist of thrombi and infections, which again can be identified by a thorough surgical pathology examination. Cardiac non invasive imaging through transthoracic and transesophageal echocardiography easily detects heart masses. Cardiac magnetic resonance imaging a nd computed tomography are helpful complementary investigations, for refining diagnosis and in the post-surgery follow-up. Histology with immuno-histochemistry of any cardiac mass is mandatory for diagnosis, therapy and prognosis. Endomyocardial biopsy m ay be of help for histological investigation without thoracotomy particularly in right sided masses. Full article

4 pages, 501 KB

Open AccessReview

Diving and Cardiology

by Martin Kraus and Jürg Wendling

Cardiovasc. Med. 2012, 15(1), 14; https://doi.org/10.4414/cvm.2012.01635 - 25 Jan 2012

Viewed by 12

Abstract

Higher pressure under water and loss of gravity have special physiological effects on the human body and also influence the cardiovascular system. Cardiovascular disease is in addition to other medical problems a risk for diving. A careful examination is necessary for safe diving. [...] Read more.

Higher pressure under water and loss of gravity have special physiological effects on the human body and also influence the cardiovascular system. Cardiovascular disease is in addition to other medical problems a risk for diving. A careful examination is necessary for safe diving. In a cardiovascular evaluation there are three main questions: is there an illness or pathology which may cause either sudden cardiac death, syncope or impaired physical mobility. Full article

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Cardiovasc. Med., Volume 15, Issue 1 (01 2012) – 7 articles

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