Cardiovascular Medicine

1 pages, 170 KB

Open AccessInteresting Images

Acute Chest Pain in the Era of Digital Watches

by Marcello Di Valentino, Tardu Özkartal, Andrea Menafoglio, François Regoli and Stefano Cafarotti

Cardiovasc. Med. 2023, 26(4), 138; https://doi.org/10.4414/cvm.2023.02238 - 2 Aug 2023

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A 38-year-old male smoker with serum LDL-cholesterol of 6.4 mmol/l and a family history of coronary artery disease (father with acute myocardial infarction at the age of 45)[...] Full article

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2 pages, 295 KB

Open AccessInteresting Images

Wide-Complex Tachycardia in a Patient with Previous Accessory Pathway Ablation

by Tolga Çimen, Nadine Molitor, Thomas Wolber, Fırat Duru and Ardan Muammer Saguner

Cardiovasc. Med. 2023, 26(4), 136; https://doi.org/10.4414/cvm.2023.02236 - 2 Aug 2023

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Abstract

Case Presentation. A 60-year-old man with a history of a right-sided accessory pathway ablated at age 50, presented to a smaller hospital with recurrent palpitations and a regular wide-complex tach ycardia (WCT) (fig. 1) [...] Full article

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3 pages, 401 KB

Open AccessCase Report

The Turkish Sabre

by Teresa Podstatzky-Lichtenstein, Pascal Berdat and Lars Englberger

Cardiovasc. Med. 2023, 26(4), 133; https://doi.org/10.4414/cvm.2023.02235 - 2 Aug 2023

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Abstract

Scimitar syndrome manifesting in adulthood can easily be overlooked owing to mild symptoms. Once diagnosed, operative correction should not be delayed as it can cause severe right heart dysfunction. There are several surgical approaches to recreating normal flow conditions. To identify the best [...] Read more.

Scimitar syndrome manifesting in adulthood can easily be overlooked owing to mild symptoms. Once diagnosed, operative correction should not be delayed as it can cause severe right heart dysfunction. There are several surgical approaches to recreating normal flow conditions. To identify the best suitable method, one needs to take into account the individual patient’s anatomy. Full article

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3 pages, 388 KB

Open AccessCase Report

Atrioventricular Nodal Reentrant Tachycardia with Upper Common Pathway Block

by Jan Berg, Daniel Hofer, Feifan Ouyang and Ardan M. Saguner

Cardiovasc. Med. 2023, 26(4), 130; https://doi.org/10.4414/cvm.2023.02233 - 2 Aug 2023

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Abstract

We present the case of a 34-year-old man with paroxysmal narrow complex tachycardias. An EP study revealed AVNRT with upper common pathway block. Our case shows a diagnostic ap proach and treatment for this rare scenario in the EP lab. Full article

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3 pages, 3365 KB

Open AccessCase Report

Intracardiac Echocardiography to Guide Biopsy of an Intracardiac Right-Sided Mass

by Teodor Serban, Diego Mannhart, Otmar Pfister, Michael Kühne, Christian Sticherling and Patrick Badertscher

Cardiovasc. Med. 2023, 26(4), 127; https://doi.org/10.4414/cvm.2023.02237 - 2 Aug 2023

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Abstract

Introduction: The diagnosis and characterisation of intracardiac tumours is challenging. Transoesophageal echocardiographic guided biopsy is an established method to confirm the pathology. Intracardiac echography (ICE) may help to increase the diagnostic outcome of biopsies, particularly in right-sided cardiac masses. Case Report: We report [...] Read more.

Introduction: The diagnosis and characterisation of intracardiac tumours is challenging. Transoesophageal echocardiographic guided biopsy is an established method to confirm the pathology. Intracardiac echography (ICE) may help to increase the diagnostic outcome of biopsies, particularly in right-sided cardiac masses. Case Report: We report on a 62-year-old patient who presented with recurrent pericardial effusions of unknown origin. Pericardial puncture did not reveal any significant findings. Positron emission tomography-computed tomography revealed a mass in the right atrium. Due to excellent nearfield imaging capacities for right-sided cardiac structures, ICE was used to guide the biopsy. Biopsy was performed safely and demonstrated a primary cardiac angiosarcoma. Conclusion: ICE-guided biopsy can be a reasonable approach, particularly for right-sided structures, allowing a safe, minimally invasive way of diagnosing intracardiac tumours. Full article

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5 pages, 551 KB

Open AccessArticle

Percutaneous Coronary Interventions During Automated Chest Compression for Arrest

by Thomas Fishman, Vincent Ribordy, Serban Puricel, Mario Togni, Sébastien Doll, Diego Arroyo and Stéphane Cook

Cardiovasc. Med. 2023, 26(4), 122; https://doi.org/10.4414/cvm.2023.02279 - 2 Aug 2023

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Abstract

Background: The Lund University Cardiopulmonary Assist System-2/-3 was developed for auto-matic chest compressions during cardiopulmonary resuscitation (mechanical CPR or MCPR) and often allows a patient suffering from cardiac arrest to be taken to the cardiac catheterization room. We report the clinical outcomes of [...] Read more.

Background: The Lund University Cardiopulmonary Assist System-2/-3 was developed for auto-matic chest compressions during cardiopulmonary resuscitation (mechanical CPR or MCPR) and often allows a patient suffering from cardiac arrest to be taken to the cardiac catheterization room. We report the clinical outcomes of percutaneous coronary interventions (PCI) performed in cardiac arrest patients under automatic MCPR devices. Methods: We retrieved all patients with cardiac arrest who were referred to PCI under MCPR devices from the Cardio-FR database (003-REP-CER-FR) from January 2016 to December 2021. Patients who were hemodynamically stable at the time of coronary examination/intervention (even those who had been resuscitated immediately before) were excluded from the analysis. Baseline patient and procedure characteristics were collected. The primary outcome was the return of spontaneous circulation (ROSC). Results: Of all patients who were on MCPR at the cardiac catheterization room, eleven still required active CPR during coronary examination/intervention and were included in the analysis. Mean age was 67.9 ± 10 years, nine were male. The MCPR device was initiated on average after 8.5 ± 8.1 minutes. All patients had ventricular defibrillation and received an average of 3.4 ± 3.6 shocks and 82% adrenaline boluses. The MCPR was used for an average of 51.1 ± 34.4 minutes. Total resuscitation time was on average 59.6 ± 38.3 minutes. Of the eleven patients, nine underwent ad hoc PCI. ROSC was achieved in four patients after 36.5 ± 49.8 minutes. The survival was 36% (four patients) at 24 hours and 27% (three patients) at three months. Only one of the patients resuscitated for >25 minutes survived. Patients with in-hospital cardiac arrest were associated with shorter ROSC (p <0.01), shorter resuscitation time (p = 0.009) and better survival (p = 0.03) than patients with out-of-hospital cardiac arrest. Conclusions: MCPR allows patients in cardiac arrest to reach the cardiac catheterization room. However, the prognosis is grim with high mortality. Only one patient survived after >25 minutes of mechanical resuscitation. Full article

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3 pages, 214 KB

Open AccessReview

Stroke after Valve Intervention–How to Look For an Embolic Source

by H. Yakup Yakupoglu and Tobias A. Fuchs

Cardiovasc. Med. 2023, 26(4), 119; https://doi.org/10.4414/cvm.2023.02232 - 2 Aug 2023

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Abstract

Valve interventions in left sided valvular heart disease, mainly such as transcatheter aortic valve implantations (TAVI) and transcatheter edge-to-edge repairs (TEER) have emerged as alternative treatments in symptomatic severe aortic stenosis and severe mitral regurgitation. However, stroke remains a serious concern. The two [...] Read more.

Valve interventions in left sided valvular heart disease, mainly such as transcatheter aortic valve implantations (TAVI) and transcatheter edge-to-edge repairs (TEER) have emerged as alternative treatments in symptomatic severe aortic stenosis and severe mitral regurgitation. However, stroke remains a serious concern. The two main causes of embolisation after valve intervention are thrombosis and vegetations. This review summarises the role of all the different tools of cardiac imaging including transthoracic echocardiography (TTE), transoesophageal echocardiography (TOE), cardiac computed tomography (CT) and 18F-fluorodeoxyglucose-positron emission tomography (FDG-PET) in the diagnosis and work-up of potential cardiac or aortal sources of embolism associated with valve interventions. TTE provides a more comprehensive understanding of the implanted valve including its location and function. Contrast enhanced echocardiography offers additional value in order to detect left ventricular thrombus. Increased valve gradients can be attributed to patient-prosthesis mismatch, thrombus or pannus on the leaflets. Therefore, echocardiography performed immediately after the procedure, followed by follow-ups 4 weeks post-intervention and then annually is of major importance. In addition to echocardiography, cardiac CT can be highly beneficial for confirming or ruling out an abscess, pseudoaneurysm, fistulae and thrombosis. Nuclear molecular techniques, such as 18F-FDG-PET is another important advanced imaging technique, particularly in the management of infective endocarditis. Full article

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3 pages, 134 KB

Open AccessReview

Arrhythmogenic Syncope

by Claudia Herrera Siklódy and Patrizio Pascale

Cardiovasc. Med. 2023, 26(4), 116; https://doi.org/10.4414/cvm.2023.02202 - 2 Aug 2023

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Abstract

Syncope is defined as a transient loss of consciousness due to transient cerebral hypoperfusion. It is a frequent cause of consulting in the emergency department, and cardiac arrhythmias play an important role in differential diagnosis. This review article outlines the different arrhythmic causes [...] Read more.

Syncope is defined as a transient loss of consciousness due to transient cerebral hypoperfusion. It is a frequent cause of consulting in the emergency department, and cardiac arrhythmias play an important role in differential diagnosis. This review article outlines the different arrhythmic causes of syncope and their management, as well as the warning signs that should raise the sus picion of arrhythmia. Full article

5 pages, 251 KB

Open AccessReview

How to Assess Bleeding Risk in Patients Undergoing Percutaneous Coronary Interventions

by Hans Rickli and Micha T. Maeder

Cardiovasc. Med. 2023, 26(4), 111; https://doi.org/10.4414/cvm.2023.02270 - 2 Aug 2023

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Abstract

A relevant proportion of patients undergoing percutaneous coronary intervention (PCI) have a high risk of bleeding. The associated individual risk of ischaemia can be differentiated by an app-based approach and helps to determine the duration of intensified antithrombotic therapy. Full article

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3 pages, 115 KB

Open AccessEditorial

Ein Paradoxon zum Nachdenken

by Thomas Lüscher

Cardiovasc. Med. 2023, 26(4), 107; https://doi.org/10.4414/cvm.2023.02289 - 2 Aug 2023

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Abstract

Damals, in tiefer Vergangenheit, ging es gelegentlich wild zu und her [...] Full article

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Cardiovasc. Med., Volume 26, Issue 4 (08 2023) – 10 articles

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