Cardiovascular Medicine

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Mechanical Complication of an Infarct or of Its Treatment?

by Juliane Vierecke, Stefan Stortecky, Stefan Blöchlinger, Lukas Hunziker and Christian Seiler

Cardiovasc. Med. 2016, 19(12), 335; https://doi.org/10.4414/cvm.2016.00448 - 21 Dec 2016

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At : in the morning, a -year-old male patient in cardiogenic shock was admitted from an outside hospital. Four hours earlier, the patient had become symptomatic with epigastric pain, emesis and syncope, and suffered cardio respiratory arrest [...] Full article

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3 pages, 1574 KB

Open AccessCase Report

Atrioventricular Nodal Reentrant Tachycardia After Heart Transplant

by Zaid Sabti, Otmar Pfister and Tobias Reichlin

Cardiovasc. Med. 2016, 19(12), 332; https://doi.org/10.4414/cvm.2016.00440 - 21 Dec 2016

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Abstract

We report the case of a 59-year old patient with a history of orthotopic heart transplantation, who was referred to us because of recurrent syncope due to atrioventricular nodal reentrant tachycardia. This case report is one of few in the literature describing an [...] Read more.

We report the case of a 59-year old patient with a history of orthotopic heart transplantation, who was referred to us because of recurrent syncope due to atrioventricular nodal reentrant tachycardia. This case report is one of few in the literature describing an invasive treatment approach to a classical supraventricular tachycardia attributable to a pre-existing substrate of the donor’s heart. Full article

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4 pages, 1694 KB

Open AccessCase Report

Recurrent Pyarthrosis of the Knee Causing Aortic Valve Endocarditis

by Alicja Zientara, Gerhard Eich and Michele Genoni

Cardiovasc. Med. 2016, 19(12), 328; https://doi.org/10.4414/cvm.2016.00447 - 21 Dec 2016

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Abstract

We present a rare case of a 75-year-old man with recurrent Streptococcus pneumoniae endocarditis caused by septic knee arthritis and complicated by a severe second infection after implantation of a total knee endoprosthesis. During the first episode of pneumococcal arthritis, the oligosymptomatic [...] Read more.

We present a rare case of a 75-year-old man with recurrent Streptococcus pneumoniae endocarditis caused by septic knee arthritis and complicated by a severe second infection after implantation of a total knee endoprosthesis. During the first episode of pneumococcal arthritis, the oligosymptomatic patient was discharged under antibiotic therapy. He returned to hospital with cardiac decompensation 1 week later. The initial finding was a perforation of the left aortic valve cusp without vegetation or abscess, which led to conventional aortic valve replacement with a biological prosthesis 12 days after diagnosis. Ceftriaxone was administered for a cumulative duration of 6 weeks after the operation day. There were no further complaints concerning the knee and the patient could be mobilised for cardiac rehabilitation. Twelve months later, the patient received an endoprosthesis of the affected knee. After another 6 months he developed a severe second infection with involvement of the aortic valve prosthesis and a huge periannular abscess. As the main infective focus, the knee endoprosthesis had to be explanted before aortic root treatment. Correct treatment by means of modified Duke criteria, interaction of interdisciplinary approach and the definition of appropriate procedure timing represent the main challenge in this exceptional case, and are worth discussing. Full article

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6 pages, 1530 KB

Open AccessEditorial

Chlortalidone: Outdated or Reborn?

by David A. Jaques, Antoinette Péchère-Bertschi and Belén Ponte

Cardiovasc. Med. 2016, 19(12), 322; https://doi.org/10.4414/cvm.2016.00446 - 21 Dec 2016

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Abstract

Most current guidelines on hypertension regard thiazide and thiazide-like diuretics as equivalent for the first-line treatment of essential hypertension. However, hydrochlorothiazide has been favoured over the thiazide-like chlortalidone in clinical practice for unclear reasons. Although definite scientific evidence is lacking, an objective analysis [...] Read more.

Most current guidelines on hypertension regard thiazide and thiazide-like diuretics as equivalent for the first-line treatment of essential hypertension. However, hydrochlorothiazide has been favoured over the thiazide-like chlortalidone in clinical practice for unclear reasons. Although definite scientific evidence is lacking, an objective analysis of the literature indicates that chlortalidone is superior to hydrochlorothiazide regarding blood pressure control and major health outcomes. Haemodynamic, as well as nonhaemo dynamic pleomorphic effects could account for these differences. Moreover, the safety profiles of the two molecules seem comparable. Initial concerns about adverse effects, the relative lack of single-pill combination and economical interests have presumably prevented the widespread use of chlortalidone over the years. Based on the available evidence, we think that chlortalidone and thiazide diuretics should not be regarded as equivalent and encourage clinicians to consider chlortalidone as a potential first-line antihypertensive agent. Full article

7 pages, 1550 KB

Open AccessReview

Perioperative Myocardial Infarction: Invasive vs. Conservative Approach

by Bruce M. Biccard, Miodrag Filipovic, Victoria Koenigb and Hans Rickli

Cardiovasc. Med. 2016, 19(12), 315; https://doi.org/10.4414/cvm.2016.00449 - 21 Dec 2016

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Abstract

Patients with a myocardial injury during and after noncardiac surgery have an elevated risk of death. They may have significant coronary artery disease amenable to revascularisation, but over 50% of these patients develop an infarct in territories without significant stenosis of the corresponding [...] Read more.

Patients with a myocardial injury during and after noncardiac surgery have an elevated risk of death. They may have significant coronary artery disease amenable to revascularisation, but over 50% of these patients develop an infarct in territories without significant stenosis of the corresponding vessel, and the clinical presentation does not easily allow differentiation between these situations. Coronary angiography and revascularisation in surgical patients suffering perioperative cardiac events is therefore controversial. Coronary angiography with a view to possible revascularisation may be appropriate preoperatively in cases of significant left main coronary artery stenosis and moderate to severe inducible myocardial ischaemia in intermediate risk vascular patients. In the peri- and postoperative setting, coronary angiography is indicated with ST elevation and possibly persistent haemodynamic instability following a significant troponin rise. Late coronary angio graphy after surgery may be indicated in vascular patients at a high risk for subsequent cardiac events. Coronary angiography may be contraindicated in patients with comorbidities associated with poor intermediate term survival or uncertain acute coronary syndromes. All other generally accepted indications for coronary angiography in medical patients are far more controversial in surgical patients, because of the risk of perioperative bleeding. In these patients, the benefits of medical therapy alone may outweigh the risks of coronary angiography to identify coronary lesions amenable to revascularisation. The medical therapy of all surgical patients with a myocardial injury following noncardiac surgery should be intensified. Full article

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6 pages, 1531 KB

Open AccessReview

Pearls in the ESC/ERS Guidelines 2015: Ventricular Arrhythmias and Sudden Cardiac Death

by Carina Blomström Lundqvist

Cardiovasc. Med. 2016, 19(12), 309; https://doi.org/10.4414/cvm.2016.00450 - 21 Dec 2016

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Abstract

The 2015 European Society of Cardiology guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death (SCD) is a European update of the joint guidelines with American College of Cardiology/American Heart Association published in 2006. The new [...] Read more.

The 2015 European Society of Cardiology guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death (SCD) is a European update of the joint guidelines with American College of Cardiology/American Heart Association published in 2006. The new SCD guideline is an extensive document that was subject to a thorough and extensive evaluation by 74 peer reviewers. Preventive measures against the burden of coronary artery disease and heart failure have, in the past 20 years, resulted in reduced cardiovascular mortality in high-income countries. Cardiovascular diseases still account for a significant 17 million deaths every year worldwide, of which approximately 25% are SCD. In the aging population, coronary artery disease and heart failure dominate whereas in the young rarer disorders such as channelopathies, cardiomyopathies and myocarditis are the commoner cardiac causes of SCD. The new SCD guidelines give a detailed description of how to conduct an adequate autopsy in order to not overlook genetic disorders, a policy that will have important implications for screening of relatives. Other updated and new recommendations for the prevention of sudden death relate to the use of implantable cardiac defibrillators, cardiac resynchronisation therapy and catheter ablation in different patient populations. In this review, the most important updated and new recommendations are summarised, compared with previous guidelines and related to their support in the literature. Full article

2 pages, 1670 KB

Open AccessEditorial

Chefredaktion «Cardiovascular Medicine» ab 2017

by Thomas F. Lüscher

Cardiovasc. Med. 2016, 19(12), 307; https://doi.org/10.4414/cvm.2016.00442 - 21 Dec 2016

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Abstract

«Cardiovascular Medicine», gegründet als «Kardiovaskuläre Medizin/Medecine cardiovasculaire», hat sich als die wichtigste kardiologische Fachzeitschri der Schweiz etabliert [...] Full article

1 pages, 1007 KB

Open AccessEditorial

Research Prize of the Swiss Heart Foundation 2017

by Swiss Heart Foundation Research Committee

Cardiovasc. Med. 2016, 19(12), 1; https://doi.org/10.4414/cvm.2016.00451 - 21 Dec 2016

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Abstract

The Swiss Heart Foundation awards an annual prize of Swiss Francs 20 000 for one or several outstanding publications/accepted manuscripts of scientific research in the field of prevention, diagnosis and/or treatment of cardiovascular diseases [...] Full article

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Cardiovasc. Med., Volume 19, Issue 12 (12 2016) – 8 articles

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