Cardiovascular Medicine

1 pages, 152 KB

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Subclavian and Axillary Giant Cell Arteritis After Influenza Vaccine

by Marcello Di Valentino, Rolf Wyttenbach, Mario Alerci, Jeanne-Marie Segatto, Felix Mahler, Guido Mariotti and Augusto Gallino

Cardiovasc. Med. 2005, 8(10), 378; https://doi.org/10.4414/cvm.2005.01128 - 28 Oct 2005

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Case report A 64-years-old women with history of rheumatic polymyalgia 11 years before developed sub-acute bilateral claudicatio at both arms few days after injection of influenza vaccine (Fluvarix^®) [...] Full article

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2 pages, 212 KB

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Epanchement Péricardique

by Jürg Schläpfer

Cardiovasc. Med. 2005, 8(10), 376; https://doi.org/10.4414/cvm.2005.01129 - 28 Oct 2005

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Abstract

Description du cas Patiente de 48 ans, éthylo-tabagique, présentant un état grippal récent avec exacerbation d’une toux chronique qui motive l’hospitalisation [...] Full article

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6 pages, 241 KB

Open AccessCase Report

Platypnoe—Orthodeoxie: Eine Seltene Ursache Einer Lageabhängigen Dyspnoe und Arteriellen Hypoxämie

by Urs N. Dürst, Manfred Ritter, Beat Walder and Franz R. Eberli

Cardiovasc. Med. 2005, 8(10), 370; https://doi.org/10.4414/cvm.2005.01130 - 28 Oct 2005

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Platypnea—orthodeoxia: a rare cause of positional dyspnea and arterial hypoxaemia. We report a case of an 83-year-old female patient, that developed positional dyspnea after a fall complicated by a thoracic spine compression fracture. In upright position the dyspnea was disabling occurring already with normal daily activities, such as dressing. The dyspnea could be relieved by recumbancy. In supine position the patient’s arterial saturation was 94% and decreased to 86% in upright position. Transoesophageal echocardiography revealed an atrial septal defect with bi-directional shunt. The atrial septal defect was closed percutaneously with an Amplatzer-Septal-Occluder^® 20 mm. Following the occlusion of the atrial septal defect, arterial oxygen saturation remained stable and the positional dyspnea disappeared. Full article

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8 pages, 281 KB

Open AccessArticle

Usefulness of Serum Interleukin-6 to Discriminate Between Cardiac Myxomas and Non-Myxomatous Cardiac Masses

by Ilker Uçkay, Urs Widmer, Christine Attenhofer Jost, Burkhardt Seifert and Rolf Jenni

Cardiovasc. Med. 2005, 8(10), 361; https://doi.org/10.4414/cvm.2005.01126 - 28 Oct 2005

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Abstract

Background: An elevated interleukin-6 (IL-6) serum level was described as a diagnostic marker for a myxoma. This study tried to assess the value of IL-6 determination to differentiate myxomas from non-myxomatous tumours in patients with an intracardiac mass. Methods: From 1993 to 2001, patients with an intracardiac mass by echocardiography were prospectively included. There were 32 patients: 19 consecutive patients with a cardiac myxoma (all histologically confirmed), and 13 randomly selected patients with non-myxomatous cardiac masses including seven with a cardiac tumour and six with an intracardiac thrombus. Serum IL-6 and C-reactive protein (CRP) levels were compared between groups and correlated with tumour size measured by 2D echocardiography. Additionally, two patients with relapsing myxomas were studied with serial IL-6 determinations and echocardiography. Results: There was no difference in tumour size between myxomas (57 ± 55 ml) and nonmyxomatous masses (50 ± 116 ml; p = 0.83). Average IL-6 levels were 11.6 ± 7.9 pg/ml (range: 0.3–29.5) in 19 patients with myxomas and 16.2 ± 15.5 pg/ml (range: 0–43.7) in 13 with a non-myxomatous heart tumour (p = 0.28). IL-6 levels were elevated in 15 patients with myxomas resulting in a sensitivity of 79% (95% confidence interval CI 54–94%) and in 10 with non-myxomatous tumours resulting in a specificity of 23% (95% confidence interval 5–54%; p = 0.67). There was no significant difference between CRP levels between the different groups (p = 0.77). There was no correlation between serum IL-6 or CRP with tumour size in any of the groups (p > 0.05). ROC analysis showed an area under the curve for IL-6 of 0.47 (95% CI 0.24–0.70) and for CRP 0.50 (95% CI 0.26–0.74). In the two patients with relapsing myxomas, however, there was no relapse without an increase in IL-6. Conclusions: An elevated IL-6 or CRP serum level in a patient with an intracardiac mass is not specific for myxoma or another type of intracardiac tumour. The value of IL-6 as an additive marker to echocardiography in the detection and follow-up of patients with suspected or resected myxomas has yet to be proven. Full article

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11 pages, 236 KB

Open AccessEditorial

Das Phänomen der Aspirin-Resistenz: Eine Kritische Beurteilung der Vorliegenden Evidenz

by Tina Svenstrup Poulsen, Søren Risom Kristensen, Dan Atar and Hans Mickley

Cardiovasc. Med. 2005, 8(10), 346; https://doi.org/10.4414/cvm.2005.01127 - 28 Oct 2005

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Abstract

Aspirin is the mainstay antiplatelet treatment in patients with high risk of cardiovascular atherothrombotic events, and its beneficial effect is documented in several clinical trials. Nevertheless, the effectiveness of aspirin has been questioned by the emergence of the concept of “aspirin resistance” (AR). This phenomenon, although lacking a precise definition, covers the fact that some patients do not exhibit the expected platelet inhibition by use of various techniques for measuring platelet function. In this critical review, we evaluate the methods used for measuring AR. We will discuss the available data regarding the prevalence and the clinical importance of the phenomenon. Finally, the potential mechanisms underlying AR are considered. Full article

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Cardiovasc. Med., Volume 8, Issue 10 (10 2005) – 5 articles

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