P. Cacoub (Professeur des Universités, praticien hospitalier), N. Limal (Chef de Clinique-assistant), J.-C. Piette (Professeur des Universités, praticien hospitalier)
{"title":"Artériopathies iatrogènes et toxiques","authors":"P. Cacoub (Professeur des Universités, praticien hospitalier), N. Limal (Chef de Clinique-assistant), J.-C. Piette (Professeur des Universités, praticien hospitalier)","doi":"10.1016/j.emcaa.2005.01.002","DOIUrl":"https://doi.org/10.1016/j.emcaa.2005.01.002","url":null,"abstract":"<div><p>Although not rare, iatrogenic and toxic arterial diseases remain, most of the time, underdiagnosed. Numerous vasomotor manifestations have been reported, such as Raynaud’s phenomenon, livedo, ergotism, erythermalgia, and acrocyanosis. Positive and etiologic diagnoses are based on the medical history and do not require further investigations. In this review, we describe main characteristics of those arterial diseases induced by ergotamine, beta-blocking agents, anti-neoplastic drugs, calcium channel blockers, and appetite-suppressant drugs. Other iatrogenic non-drug arterial diseases, and iatrogenic arteriopathies due to professional toxics, cocaine or amphetamines are also reviewed.</p></div>","PeriodicalId":100413,"journal":{"name":"EMC - Cardiologie-Angéiologie","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2005-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.emcaa.2005.01.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72074830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
L. Fauchier (Praticien hospitalier, ancien Chef de clinique-assistant des Hôpitaux), J.-P. Fauchier (Professeur des Universités-Praticien hospitalier)
{"title":"Antiarythmiques","authors":"L. Fauchier (Praticien hospitalier, ancien Chef de clinique-assistant des Hôpitaux), J.-P. Fauchier (Professeur des Universités-Praticien hospitalier)","doi":"10.1016/j.emcaa.2005.03.003","DOIUrl":"https://doi.org/10.1016/j.emcaa.2005.03.003","url":null,"abstract":"<div><p>The efficacy and limitations of the currently available antiarrhythmic agents (AAA) are well known. Class 1 AAA are efficient but contraindicated in coronary artery disease and heart failure, two conditions often associated with atrial fibrillation which is their main indication. Sotalol may be efficient but may induce torsades de pointes. Amiodarone is at present the most efficient AAA but it has a very poor tolerance, with frequent thyroid dysfunction. New AAA are being evaluated but they may also induce adverse events. Proarrhythmic effects of AAA may in 5% to 10% worsen atrial or ventricular arrhythmia or induce severe bradyarrhythmia. They may be in part prevented by low initial dose of AAA, avoidance of dangerous association, elimination of precipitating factors and close monitoring of exposed patients. Difficulties in medical approach of treating arrhythmias have led to the development of non pharmacological strategies (mainly radiofrequency ablation and defibrillation), and the prescription of AAA for sustained ventricular arrhythmia was markedly decreased compared to that of implantable defibrillator in the recent years. However, atrial fibrillation is so frequent that pharmacotherapy is chosen as first-line treatment in most patients, particularly when considering the complexity of non pharmacological approaches, and even if simple rate control may also be considered for some patients. Therefore, it remains necessary to develop new AAA agents with effective and safe profiles, particularly in heart failure.</p></div>","PeriodicalId":100413,"journal":{"name":"EMC - Cardiologie-Angéiologie","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2005-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.emcaa.2005.03.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72074865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
P. Soury , C. Lepechou , J.-M. Guinebretiere , C. Laurian
{"title":"Léiomyoscarcomes de la veine cave inférieure","authors":"P. Soury , C. Lepechou , J.-M. Guinebretiere , C. Laurian","doi":"10.1016/j.emcaa.2004.08.008","DOIUrl":"https://doi.org/10.1016/j.emcaa.2004.08.008","url":null,"abstract":"<div><p>Leiomyosarcoma of the inferior vena cava is an uncommon malignant tumor. Radical surgical excision as primary treatment provides the best chance of prolonged survival. Poor prognosis is due to a high rate of locoregional recurrence after surgical removal. The utilization of adjuvant therapies such as radiotherapy or chemotherapy is more limited. Multidisciplinary management is recommended as the best therapeutic strategy.</p></div>","PeriodicalId":100413,"journal":{"name":"EMC - Cardiologie-Angéiologie","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2005-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.emcaa.2004.08.008","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72019731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
B. Kastler (Professeur) , A. Livolsi (Praticien hospitalier) , P. Germain (Cardiologue) , E. Rodière , J.-F. Litzler , Y. Bernard (Professeur)
{"title":"IRM des cardiopathies congénitales","authors":"B. Kastler (Professeur) , A. Livolsi (Praticien hospitalier) , P. Germain (Cardiologue) , E. Rodière , J.-F. Litzler , Y. Bernard (Professeur)","doi":"10.1016/j.emcaa.2004.10.002","DOIUrl":"https://doi.org/10.1016/j.emcaa.2004.10.002","url":null,"abstract":"<div><p>The incidence of congenital heart disease in live births is low; nevertheless, its early diagnosis and the establishment of appropriate presurgical management are critical. The significant progress in surgical treatment realized over the last two decades has resulted in the survival of many patients who would previously have died from their congenital malformation. Recently, a trend toward the use of new techniques such as magnetic resonance imaging (MRI) has been observed, in an attempt to obviate the need for more invasive or ionizing means. MRI has the potential of providing three-dimensional detailed anatomic and functional information on the cardiovascular system. It is not limited by intervening gas or bones, and provides a large view. Thus MRI clearly emerged as an excellent imaging modality complementary to sonography both during the preoperative and during the postoperative management. MRI bridges the gap between echocardiography and angiography, and consequently diagnostic angiographic procedures have become unnecessary. Indeed angiography has drawbacks; it is risky and invasive, exposes to radiation hazards and requires deeper sedation which is deleterious especially in evaluating a pediatric population.</p></div>","PeriodicalId":100413,"journal":{"name":"EMC - Cardiologie-Angéiologie","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2005-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.emcaa.2004.10.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72066779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
D. Leys (Professeur de neurologie), J.-P. Pruvo (Professeur de radiologie)
{"title":"Pathologie vasculaire de la moelle","authors":"D. Leys (Professeur de neurologie), J.-P. Pruvo (Professeur de radiologie)","doi":"10.1016/j.emcaa.2004.10.001","DOIUrl":"https://doi.org/10.1016/j.emcaa.2004.10.001","url":null,"abstract":"<div><p>Compared to cerebral ischemia, spinal cord ischemia remains rare, and results in various types of neurological deficiencies such as abrupt and complete paraplegia. Magnetic resonance imaging is a valuable tool to rule out other causes of acute spinal cord syndromes and to show the infarct. Most spinal cord infarcts are due to aortic diseases (atherosclerosis, aneurysm, dissection), or are of iatrogenic origin (surgery of the aorta and aortography). Spinal hemorrhagic strokes are usually the consequence of arterio-venous malformations or coagulation disorders. These malformations require interventional radiology.</p></div>","PeriodicalId":100413,"journal":{"name":"EMC - Cardiologie-Angéiologie","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2005-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.emcaa.2004.10.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72066783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Varices","authors":"F. Vin (Angéiologue)","doi":"10.1016/j.emcaa.2004.10.003","DOIUrl":"https://doi.org/10.1016/j.emcaa.2004.10.003","url":null,"abstract":"<div><p>Chronic venous disease is a common affection in industrialized countries; data from epidemiological population-based studies show a prevalence ranging from 30 to 40%. Varicose veins refer to a permanent dilatation of superficial veins characterized by dilated, tortuous and lengthened subcutaneous veins, according to Arnoldi. In the lower limbs, varicose veins are observed in the essential superficial venous disease, in the postthrombotic syndrome, and in vascular dysplasia. In a context of essential superficial venous disease which is a hereditary disease, the evolution is chronic and insidious. For a long time this disease was neglected, both by patients and doctors; today, varicose veins are better investigated as a result of the development of non-invasive investigation techniques. Besides, the development of new therapies, which may be utilized as monotherapy or combined therapy, achieve a better treatment and stabilization of the disease in ambulatory conditions or with a short duration hospitalization. In addition to unaesthetic consequences, non-treated venous insufficiency may result in trophic complications such as stasis dermatitis, white atrophy, hypodermic inflammation, or leg ulceration. Patients with these complications usually report a significant social and professional impact. Early diagnosis and treatment, and better management with adapted therapies are necessary to prevent the evolution of the disease and the occurrence of such tissular complications, and also to reduce the costs in terms of public health. Today, adequate public information, prevention strategies, and early detection have notably reduced the frequency of these complications.</p></div>","PeriodicalId":100413,"journal":{"name":"EMC - Cardiologie-Angéiologie","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2005-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.emcaa.2004.10.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72066778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
P. Soury, C. Lepechou, J. Guinebretière, C. Laurian
{"title":"Léiomyoscarcomes de la veine cave inférieure","authors":"P. Soury, C. Lepechou, J. Guinebretière, C. Laurian","doi":"10.1016/J.EMCAA.2004.08.008","DOIUrl":"https://doi.org/10.1016/J.EMCAA.2004.08.008","url":null,"abstract":"","PeriodicalId":100413,"journal":{"name":"EMC - Cardiologie-Angéiologie","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2005-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84081486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Pasquet (Chef de clinique adjoint), B. Gerber (Chef de clinique adjoint), J.-L. Vanoverschelde (Chef de service)
{"title":"Viabilité myocardique","authors":"A. Pasquet (Chef de clinique adjoint), B. Gerber (Chef de clinique adjoint), J.-L. Vanoverschelde (Chef de service)","doi":"10.1016/j.emcaa.2004.09.001","DOIUrl":"https://doi.org/10.1016/j.emcaa.2004.09.001","url":null,"abstract":"<div><p>Left ventricular dysfunction is one of the leading causes of morbidity and mortality among patients with coronary artery disease. Presence of reversible dysfunction or viable myocardium has important clinical and prognostic implications. Myocardial revascularization in patients with viable myocardium improves symptoms of heart failure and survival, even in those patients with severely depressed ventricular function in whom heart transplant could be considered.</p></div>","PeriodicalId":100413,"journal":{"name":"EMC - Cardiologie-Angéiologie","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2005-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.emcaa.2004.09.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72066781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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