Cardiovascular Medicine

3 pages, 974 KB

Open AccessInteresting Images

A Wide Complex Tachycardia in a 31-Year-Old Male

by Hari Vivekanantham and Guy Amit

Cardiovasc. Med. 2024, 27(3), 94; https://doi.org/10.4414/cvm.2024.1412183678 - 29 May 2024

Viewed by 296

We present the case of a young male presenting with a wide complex tachycardia. The diagnostic approach based on the electrocardiogram findings is discussed. The final diagnosis could be made following an adenosine challenge at baseline, underlying the use of this drug for [...] Read more.

We present the case of a young male presenting with a wide complex tachycardia. The diagnostic approach based on the electrocardiogram findings is discussed. The final diagnosis could be made following an adenosine challenge at baseline, underlying the use of this drug for diagnostic purposes even in the absence of ongoing tachycardia. Full article

► Show Figures

Figure 1

3 pages, 588 KB

Open AccessInteresting Images

Post-Operative Takotsubo Cardiomyopathy in Elective Mitral Valve Replacement

by Abhishek Potnis, Sushrut Potwar and Uday Jadhav

Cardiovasc. Med. 2024, 27(3), 90; https://doi.org/10.4414/cvm.2024.1412187259 - 29 May 2024

Viewed by 490

Abstract

Takotsubo cardiomyopathy is a type of stress cardiomyopathy that is usually seen in postmenopausal patients and can be triggered by emotional stress, hypoglycemia, hypothyroidism, and surgery. A patient post cardiac surgery can present with multiple complications causing hemodynamic compromise. Hence, takotsubo cardiomyopathy remains [...] Read more.

Takotsubo cardiomyopathy is a type of stress cardiomyopathy that is usually seen in postmenopausal patients and can be triggered by emotional stress, hypoglycemia, hypothyroidism, and surgery. A patient post cardiac surgery can present with multiple complications causing hemodynamic compromise. Hence, takotsubo cardiomyopathy remains a diagnostic dilemma. Here, we present an interesting electrocardiogram (ECG) of the same condition in a patient after mitral valve replacement with normal patent coronaries but presenting with anterolateral massive infarction with shark fin pattern in the ECG. Full article

► Show Figures

Figure 1

5 pages, 401 KB

Open AccessReview

Should We Pace the His Bundle or the Left Bundle Branch Area?

by Myriam Kaddour and Haran Burri

Cardiovasc. Med. 2024, 27(3), 85; https://doi.org/10.4414/cvm.2024.1379472814 - 29 May 2024

Viewed by 1484

Abstract

His bundle pacing is the most physiological form of pacing as it replicates the patient’s natural ventricular activation. Its adoption has significantly grown over the last years. However, the technique has several limitations, including suboptimal thresholds. Left bundle branch area pacing has been [...] Read more.

His bundle pacing is the most physiological form of pacing as it replicates the patient’s natural ventricular activation. Its adoption has significantly grown over the last years. However, the technique has several limitations, including suboptimal thresholds. Left bundle branch area pacing has been introduced more recently and has gained much interest as it also delivers physiological pacing but with more favorable electrical parameters. However, there are also several unresolved issues with this technique. This article compares these strategies and highlights their advantages and disadvantages to provide guidance on which technique to select for a specific patient. Full article

► Show Figures

Figure 1

4 pages, 292 KB

Open AccessReview

Bempedoic Acid: Results of the CLEAR Program

by Isabella Sudano

Cardiovasc. Med. 2024, 27(3), 80; https://doi.org/10.4414/cvm.2024.1379434015 - 29 May 2024

Viewed by 4403

Abstract

Bempedoic acid is a fairly small molecule acting as a prodrug which is converted into the active compound bempedoyl-CoA in the liver. This active metabolite of bempedoic acid inhibits the enzyme ATP citrate lyase leading to low-density lipoprotein (LDL) reduction. The CLEAR (Cholesterol [...] Read more.

Bempedoic acid is a fairly small molecule acting as a prodrug which is converted into the active compound bempedoyl-CoA in the liver. This active metabolite of bempedoic acid inhibits the enzyme ATP citrate lyase leading to low-density lipoprotein (LDL) reduction. The CLEAR (Cholesterol Lowering via Bempedoic Acid, an ACL-Inhibiting Regimen) Harmony trial showed that bempedoic acid reduced LDL cholesterol (LDL-C) by 12.6–16.5% and the CLEAR Tranquility and Serenity showed a reduction of LDL-C in statin-intolerant patients by a mean of 21% in monotherapy and 38% in combination with ezetimibe. Similar to statins but in contrast to ezetimibe or PCSK9 inhibitors, there was a consistent reduction of high-sensitive C-reactive protein in patients treated with bempedoic acid throughout all those studies. The CLEAR Outcomes trial included patients with established atherosclerotic cardiovascular disease (ASCVD) or a high risk of developing it, a documented intolerance to statin and a LDL ≥2.6 mmol/l despite maximal tolerated lipid-lowering therapy. The study showed that bempedoic acid lowered LDL by 21% and reduced the risk of cardiovascular death, nonfatal myocardial infarction, nonfatal stroke or coronary revascularization (primary composite endpoint) over a median of 3.4 years in statin-intolerant patients. The safety profile showed a slight increase in uric acid, gout and cholelithiasis. Bempedoic acid, used alone or with ezetimibe, is an effective LDL-lowering therapy for patients who do not attain adequate LDL-C control with maximal tolerated statin therapy and in statin-intolerant patients at risk for ASCVD. Full article

► Show Figures

Figure 1

2 pages, 218 KB

Open AccessEditorial

70-jähriger Mann mit Polyneuropathie und kardialer Transthyretin-Amyloidose (ATTR-CM)

by Otmar Pfister

Cardiovasc. Med. 2024, 27(3), 77; https://doi.org/10.4414/cvm.2024.1455989891 - 29 May 2024

Viewed by 210

Abstract

Fall Der 70-jährige Patient stellte sich 2020 bei uns infolge Pensionierung des behandelnden Kar diologen vor. Er klagte über eine kardiale Leistungseinbusse und ausserdem über Prob- leme mit dem Bewegungsapparat [...] Full article

► Show Figures

Figure 1

6 pages, 339 KB

Open AccessReview

Challenges in the Lifetime Management of Patients with Aortic Stenosis

by Bashir Alaour and Thomas Pilgrim

Cardiovasc. Med. 2024, 27(3), 71; https://doi.org/10.4414/cvm.2024.1317114789 - 29 May 2024

Viewed by 725

Abstract

Despite an extensive body of literature, there are still many gaps in the evidence surrounding the lifetime management of aortic stenosis (AS) and upstream interventions to prevent or slow down the progression of the disease are yet to be developed. The contemporary shift [...] Read more.

Despite an extensive body of literature, there are still many gaps in the evidence surrounding the lifetime management of aortic stenosis (AS) and upstream interventions to prevent or slow down the progression of the disease are yet to be developed. The contemporary shift from simple grading to a more outcome-related staging of AS has ren dered the traditional belief that aortic valve intervention is only indicated in severe symptomatic AS obsolete and opened the debate on the optimal timing for intervention. Transcatheter aortic valve implantation (TAVI) has stood the test of time as a convenient, safe and effective treatment of AS across all risk categories. However, with the expansion of TAVI to younger patients with a longer life expectancy, there has been a gradual shift in focus from periprocedural outcomes to lifetime management, especially in patients who are likely to outlive their first valve prosthesis. In a standard scenario, when choosing the first valve, many actors come to the stage, including out comes and challenges of repeated valve implantations. Full article

► Show Figures

Figure 1

2 pages, 206 KB

Open AccessCommentary

«Sie müssen das System entfetten!»

by Thierry Carrel

Cardiovasc. Med. 2024, 27(3), 68; https://doi.org/10.4414/cvm.2024.1379572570 - 29 May 2024

Viewed by 151

Abstract

Vor einigen Jahren wurde meine damalige Klinik am Inselspital von einer deutschen Beratungs Unternehmung durchleuchtet [...] Full article

► Show Figures

Figure 1

1 pages, 77 KB

Open AccessEditorial

New Responsibilities for the HEART-Team

by Luca Koechlin

Cardiovasc. Med. 2024, 27(3), 65; https://doi.org/10.4414/cvm.2024.1324051349 - 29 May 2024

Viewed by 144

Abstract

Dear Readers, In this issue of Cardiovascular Medicine, Bashir Alaour and Thomas Pilgrim take on the demanding task of summarizing the challenges involved in the management of patients with [...] Full article

Journal Menu

Journal Browser

Cardiovasc. Med., Volume 27, Issue 3 (05 2024) – 8 articles

Further Information

Guidelines

MDPI Initiatives

Follow MDPI