Cardiovascular Medicine

4 pages, 1415 KB

Open AccessEditorial

Artificial Intelligence: The Stairway to Better Medicine?

by Thomas F. Lüscher

Cardiovasc. Med. 2021, 24(4), w10075; https://doi.org/10.4414/cvm.2022.02170 - 1 Jul 2022

Artificial intelligence in science
Artificial intelligence (AI) is centre stage in many scientific fields. PubMed lists an impressive number of publications on the topic; as of end of May, 397,379 articles just in medicine [...] Full article

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3 pages, 4954 KB

Open AccessReview

MINOCA and Spontaneous Dissection: Aiagnosis and Therapy

by Sarah Bär and Lorenz Räber

Cardiovasc. Med. 2021, 24(4), 140; https://doi.org/10.4414/cvm.2022.02173 (registering DOI) - 1 Jul 2022

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Abstract

Myocardial infarction with nonobstructive coronary arteries (MINOCA)： Myocardial infarction (MI) with non-obstructive coronary arteries (MINOCA) is defined as MI according to the fourth universal definition of MI [1] without coronary stenosis ≥50% on coronary angiography, and without a specific alternate diagnosis for [...] Read more.

Myocardial infarction with nonobstructive coronary arteries (MINOCA)： Myocardial infarction (MI) with non-obstructive coronary arteries (MINOCA) is defined as MI according to the fourth universal definition of MI [1] without coronary stenosis ≥50% on coronary angiography, and without a specific alternate diagnosis for the acute presentation [2, 3] [...] Full article

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5 pages, 2633 KB

Open AccessCase Report

Caseous Calcification of the Mitral Annulus Leading to Symptomatic Mitral Stenosis

by Nieto Nathalie, Carballo David and Giannakopoulos Georgios

Cardiovasc. Med. 2021, 24(4), w10088; https://doi.org/10.4414/cvm.2021.02174 - 1 Jul 2021

Abstract

Caseous calcification of the mitral annu-lus (CCMA) is a rare variant of mitral annular calcification, which can be difficult to diagnose and can be misdiag-nosed as a cardiac tumour or abscess. Multimodality imaging is important for the diagnosis of this entity and to [...] Read more.

Caseous calcification of the mitral annu-lus (CCMA) is a rare variant of mitral annular calcification, which can be difficult to diagnose and can be misdiag-nosed as a cardiac tumour or abscess. Multimodality imaging is important for the diagnosis of this entity and to avoid unnecessary surgical treatment. We present the case of a 77-year-old female patient with initially asymp-tomatic CCMA who later developed third degree atrioven-tricular heart block. Four years after the initial diagnosis, she was admitted to hospital for acute heart failure due to mitral stenosis. Multimodality imaging including transthoracic and transoesophageal echocardiography, and computed tomography showed an increase in the size of the caseous calcification with symptomatic mitral stenosis. Full article

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5 pages, 1349 KB

Open AccessCommunication

Swiss Cardiology in the European Showcase

by Ruth Amstein

Cardiovasc. Med. 2021, 24(4), w10073; https://doi.org/10.4414/cvm.2021.02249 - 1 Jul 2021

Abstract

Cardiology Update Davos, 24–26 October 2021: The Cardiology Update in Davos is one of the the major meetings in the field of cardiology in Europe, with a long tradition [...] Full article

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9 pages, 662 KB

Open AccessReview

Supraventricular Tachycardia

by Philipp Krisai and Christian Sticherling

Cardiovasc. Med. 2021, 24(4), w02167; https://doi.org/10.4414/cvm.2021.02167 - 1 Jul 2021

Abstract

Introduction. Supraventricular tachycardias (SVTs) are common in the general population and usually symptomatic [...] Full article

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4 pages, 4289 KB

Open AccessCase Report

Flecainide Induced ST Segment Changes Can Mimic Pathological ECG Changes in Patients Undergoing Exercise Testing: A Case Report

by Matthias Kruzik, Maria Padrutt, Julia Stehli, Corinna Brunckhorst, Christian Schmied and David Niederseer

Cardiovasc. Med. 2021, 24(4), 184; https://doi.org/10.4414/cvm.2021.02178 - 1 Jul 2021

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Abstract

BACKGROUND: Flecainide, a class IC antiarrhythmic drug, is used frequently in patients with supraventricular arrhythmias, mostly atrial fibrillation, and less commonly for ventricular arrhythmias. With its strong affinity to sodium channels in the cardiac cells it affects phase 0 of the action potential [...] Read more.

BACKGROUND: Flecainide, a class IC antiarrhythmic drug, is used frequently in patients with supraventricular arrhythmias, mostly atrial fibrillation, and less commonly for ventricular arrhythmias. With its strong affinity to sodium channels in the cardiac cells it affects phase 0 of the action potential leading to conduction slowing, which is reflected in widening of the QRS, and it can also prolong the PR interval. These unspecific electrocardiogram (ECG) changes may mimic myocardial ischaemia in patients undergoing myocardial stress testing. The current case report reflects the diagnostic difficulties arising from this phenomenon. CASE SUMMARY: A 66-year-old patient who had been treated with flecainide for a decade for atrial fibrillation showed significant QRS widening and ST segment depression during exercise testing. The patient did not exhibit symptoms of myocardial ischaemia. A subsequent single photon emission computed tomography (SPECT) scan revealed a 10–15% cardiac ischaemic area. Invasive coronary angiography showed a chronic, complete obstruction of the left circumflex artery, which was percutaneously revascularised. DISCUSSION: This case demonstrates how pharmacological effects of flecainide and other class IC antiarrhythmic drugs may lead to suspicion of cardiac ischaemia due to QRS widening and unspecific ST-segment changes. In these patients, accurate ECG interpretation is important to avoid unnecessary invasive procedures such as coronary angiography. On the other hand, significant underlying coronary artery disease may nonetheless be present, warranting invasive diagnostic testing. Noninvasive cardiac imaging may facilitate the process of distinguishing real ischaemia from flecainide-induced ECG changes. Full article

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3 pages, 3707 KB

Open AccessCase Report

Balloon-Protection of the Left Phrenic Nerve During Epicardial Catheter Ablation of Ventricular Tachycardia

by David Garay, Laurent Roten, Tobias Reichlin and Samuel H. Baldinger

Cardiovasc. Med. 2021, 24(4), 179; https://doi.org/10.4414/cvm.2021.02179 - 1 Jul 2021

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Abstract

During epicardial radiofrequency ablation procedures for ventricular tachycardia the proximity to the left phrenic nerve may limit or even prohibit ablation of the arrhythmia, especially in the lateral segments of the left ventricle. We report a case of successful epicardial ventricular tachycardia ablation [...] Read more.

During epicardial radiofrequency ablation procedures for ventricular tachycardia the proximity to the left phrenic nerve may limit or even prohibit ablation of the arrhythmia, especially in the lateral segments of the left ventricle. We report a case of successful epicardial ventricular tachycardia ablation with balloon-protection of the phrenic nerve and discuss necessary equipment and techniques. Full article

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5 pages, 2733 KB

Open AccessReview

Hypertension in Frail Patients

by Andreas W. Schoenenberger

Cardiovasc. Med. 2021, 24(4), 164; https://doi.org/10.4414/cvm.2021.02176 - 1 Jul 2021

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Abstract

Introduction. During the past two decades, the term “frailty” has become a vogue expression, with an exponentially growing use in the medical literature [...] Full article

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6 pages, 870 KB

Open AccessReview

Advanced Heart Failure: When and What to Consider for Left Ventricular Assist Device Implantation?

by Roger Hullin, Julien Regamey, Patrick Yerly, Stefania Aur, Tamila Abdurashidova, Valentina Rancati, Piergiorgio Tozzi and Matthias Kirsch

Cardiovasc. Med. 2021, 24(4), 123; https://doi.org/10.4414/cvm.2021.02169 - 1 Jul 2021

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Abstract

Survival and quality of life improved signiffcantly with the dramatic changes of heart failure (HF) treatment in the last decades [1]. An unanticipated consequence of this favorable development is the emergence of a patient population increasingly refractory to standard HF treatment. This paradox [...] Read more.

Survival and quality of life improved signiffcantly with the dramatic changes of heart failure (HF) treatment in the last decades [1]. An unanticipated consequence of this favorable development is the emergence of a patient population increasingly refractory to standard HF treatment. This paradox relates to the fact that none of the currently available drugs or devices completely silences HF disease or protects from the occurrence of new episodes of myocardial damage, the development of cardiorenal syndrom or right heart failure. Full article

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13 pages, 15154 KB

Open AccessArticle

Composite Graft Replacement of the Aortic Root: Experience in a Tertiary Care Teaching Institution

by Meyer Judith, Schoenhoff Florian and Carrel Thierry

Cardiovasc. Med. 2021, 24(4), 1; https://doi.org/10.4414/cvm.2021.02172 (registering DOI) - 1 Jul 2021

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Abstract

Composite graft replacement is an established surgical procedure that radically treats pathologies of the aortic root, especially when the aortic valve cannot be spared. We analysed the intraoperative details and the short-term outcome of a large consecutive series of patients operated on in [...] Read more.

Composite graft replacement is an established surgical procedure that radically treats pathologies of the aortic root, especially when the aortic valve cannot be spared. We analysed the intraoperative details and the short-term outcome of a large consecutive series of patients operated on in a teaching tertiary institution. Out of 877 patients who received a composite graft during a 13-year period, we excluded all those who were operated on as an emergency because of a type A acute aortic dissection, those who underwent this procedure as a redo surgery and those who presented with a destructive endocarditis of the aortic root. Finally 622 patients with a mean age of 59.5 ± 12.5 years (range 16–85) were analysed. Of these, 423 patients (68%) were male, and the mean body mass index was 27.8 ± 4.3 kg/m2 (18.4–37.3). Annulo-aortic dilatation with or without aortic valve dysfunction was the most frequent indication (n = 448), bicuspid valve with aortic root and/or ascending aortic dilatation was found in 107 patients and typical aortic root dilatation in the presence of Marfan/Loeys-Dietz syndrome was found in 33 patients. A large majority of patients presented with moderate or severe aortic regurgitation (n = 409, 65%), and aortic stenosis was present in 164 patients (26.5%). Early mortality occurred in nine patients (1.4%). Causes of death were: low output syndrome in three patients, severe cerebrovascular complications in four and respiratory or multiorgan failure in one patient each. Multivariate logistic regression analysis showed that severely reduced left ventricular function (left ventricular ejection fraction [LVEF] <0.35) (odds ratio [OR] 4.9, 95% confidence interval [CI] 1.7–12.2), aortic regurgitation grade IV (OR 6.35, 95% CI 1.8–17.8), new York Heart Association functional class III or IV (OR 2.94, 95% CI 1.5–7.4) and need for additional coronary artery bypass graft surgery (OR 4.25, 95% CI 1.6–11.3) were the independent risk factors for mortality as well as for early morbidity. Composite graft replacement is a standard procedure to treat different pathologies of the aortic root and is associated with a low perioperative risk. This justifies liberal indications in the case of a moderately dilated aortic root (4.5–5 cm) in younger patients (<60 years) and in those with a particular cardiovascular risk profile. Full article

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3 pages, 5465 KB

Open AccessLetter

Albrecht von Haller Young Investigator Awards 2021

by Thomas Lüscher

Cardiovasc. Med. 2021, 24(4), 02216; https://doi.org/10.4414/cvm.2021.02216 (registering DOI) - 1 Jul 2021

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Abstract

Albrecht von Haller (1708 – 1777; Abb. 1) war ein bedeutender, umfassend gebildeter Arzt, Anatom, Physiologe und Naturforscher [...] Full article

6 pages, 3309 KB

Open AccessReview

Dissection Coronaire Spontanée

by Lesko Tomas, Deriaz Denis and Girod Grégoire

Cardiovasc. Med. 2021, 24(4), 02171; https://doi.org/10.4414/cvm.2021.02171 - 1 Jul 2021

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Abstract

Spontaneous coronary artery dissection. Spontaneous coronary artery dissection (SCAD) has emerged recently as an underestimated cause of acute coronary syndrome (ACS), myocardial infarction and sudden cardiac death [...] Full article

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Cardiovasc. Med., Volume 24, Issue 4 (07 2021) – 12 articles

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