Luca Baldetti, Piero Gentile, Mauro Gori, Anna Mara Scandroglio, Nicola Gasparetto, Paolo Trambaiolo, Serafina Valente, Marco Marini
{"title":"[The pulmonary artery catheter in the intensive cardiac care unit].","authors":"Luca Baldetti, Piero Gentile, Mauro Gori, Anna Mara Scandroglio, Nicola Gasparetto, Paolo Trambaiolo, Serafina Valente, Marco Marini","doi":"10.1714/4318.43037","DOIUrl":"https://doi.org/10.1714/4318.43037","url":null,"abstract":"<p><p>More than 50 years after its introduction in clinical practice, the increase in the intensity of care offered by the cardiac intensive care units, the shift in the population of patients treated and the wider availability of circulatory supports, still makes the pulmonary artery catheter (PAC) an essential tool for diagnosis, monitoring and prognosis in patients suffering from cardiogenic shock. In this review, we will discuss how to identify those patients who can benefit most from its use, the configuration and the correct insertion technique of a PAC. A pragmatic guide will also be provided for the interpretation of the hemodynamic indexes (direct and calculated) that the PAC is able to reveal as well as a summary of the most common errors in reading or interpreting the pressure curves provided by the PAC. In this article, we will then present a practical guide on how to use the PAC in a modern cardiac intensive care unit.</p>","PeriodicalId":12510,"journal":{"name":"Giornale italiano di cardiologia","volume":"25 9","pages":"624-639"},"PeriodicalIF":0.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142139863","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}
Paolo Verdecchia, Gianpaolo Reboldi, Giovanni Mazzotta, Martina Zappa, Fabio Angeli
{"title":"[Secondary hypertension: diagnosis and treatment].","authors":"Paolo Verdecchia, Gianpaolo Reboldi, Giovanni Mazzotta, Martina Zappa, Fabio Angeli","doi":"10.1714/4318.43040","DOIUrl":"10.1714/4318.43040","url":null,"abstract":"<p><p>Hypertension does not recognize obvious pathogenic causes in the majority of patients (essential hypertension). However, a secondary underlying cause of hypertension can be recognized in 5-10% of unselected hypertensive patients, and this prevalence may increase to more than 20% in patients with hypertension that is difficult to control or frankly resistant to treatment. In children, secondary hypertension is most often due to aortic coarctation, distal thoracic or abdominal aortic stenosis, or specific gene mutations. In adults or elderly individuals, secondary hypertension is most often due to atherosclerotic renal artery stenosis, primary hyperaldosteronism, and Cushing's disease or syndrome. Parenchymal nephropathy and hyperparathyroidism can cause hypertension at all ages, while pheochromocytoma and paraganglioma tend to occur more often in adolescents or young adults. In general, secondary hypertension should be suspected in subjects with: (a) onset of hypertension under 30 years of age especially if in the absence of hypertensive family history or other risk factors for hypertension; (b) treatment-resistant hypertension; c) severe hypertension (>180/110 mmHg), malignancy, or hypertensive emergencies; d) rapid rise in blood pressure values in previously well controlled patients. Any clinical signs suspicious or suggestive of hypertension from endocrine causes, a \"reverse dipping\" or \"non-dipping'\" profile at 24 h ambulatory blood pressure monitoring not justified by other factors, signs of obvious organ damage may be helpful clues for diagnosis. Finally, patients snoring or with clear sleep apnea should also be considered for possible secondary hypertension.</p>","PeriodicalId":12510,"journal":{"name":"Giornale italiano di cardiologia","volume":"25 9","pages":"660-672"},"PeriodicalIF":0.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142139861","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":"[Ventricular tachycardia: the cause you do not think about].","authors":"Beatrice Dal Passo, Elisabetta Tonet","doi":"10.1714/4318.43046","DOIUrl":"10.1714/4318.43046","url":null,"abstract":"","PeriodicalId":12510,"journal":{"name":"Giornale italiano di cardiologia","volume":"25 9","pages":"e"},"PeriodicalIF":0.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142139864","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}
Francesca Cortese, Michele Clemente, Serena Di Marino, Marco Fabio Costantino, Giampaolo Luzi
{"title":"[A pathognomonic case of isolated right ventricular infarction].","authors":"Francesca Cortese, Michele Clemente, Serena Di Marino, Marco Fabio Costantino, Giampaolo Luzi","doi":"10.1714/4318.43045","DOIUrl":"10.1714/4318.43045","url":null,"abstract":"","PeriodicalId":12510,"journal":{"name":"Giornale italiano di cardiologia","volume":"25 9","pages":"693-694"},"PeriodicalIF":0.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142139854","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}
Elisabetta Mariucci, Gabriele Bronzetti, Andrea Donti
{"title":"[Sudden cardiac arrest in children and adolescents: diagnosis, clinical presentation and peculiarities].","authors":"Elisabetta Mariucci, Gabriele Bronzetti, Andrea Donti","doi":"10.1714/4318.43038","DOIUrl":"10.1714/4318.43038","url":null,"abstract":"<p><p>Sudden cardiac arrest/death in pediatric patients is a rare but potentially preventable event. Cardiomyopathies and channelopathies are the most common causes which are detectable with ECG and transthoracic echocardiography in asymptomatic subjects. Coronary artery anomalies are a rare cause of sudden cardiac arrest/death, but these events suggest that ECG and echocardiography, focused on the site of origin of the coronary arteries, should be both part of the screening tool of young athletes. Finally, the rare cardiac arrest events in young patients with ventricular preexcitation without prior symptoms or markers of high risk suggest that transcatheter ablation should be considered in all pediatric patients with ventricular preexcitation because it can eliminate the small long-term risk of sudden cardiac arrest/death, but a careful consideration of the most appropriate timing is mandatory.</p>","PeriodicalId":12510,"journal":{"name":"Giornale italiano di cardiologia","volume":"25 9","pages":"640-649"},"PeriodicalIF":0.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142139862","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}
Gabriella Bufano, Pietro Mazzeo, Maria Delia Corbo, Vincenzo Fioretti, Costantino Smaldone, Eugenio Stabile
{"title":"[Giant tricuspid annular calcification and kyphoscoliosis: is there a link?]","authors":"Gabriella Bufano, Pietro Mazzeo, Maria Delia Corbo, Vincenzo Fioretti, Costantino Smaldone, Eugenio Stabile","doi":"10.1714/4318.43044","DOIUrl":"10.1714/4318.43044","url":null,"abstract":"<p><p>Although mitral annular calcification is a common degenerative condition of the fibrous mitral annulus, tricuspid annular calcification, especially isolated, is rare. We report the case of a 73-year-old male, with a history of hypertension and severe kyphoscoliosis, referred to the emergency department for progressive dyspnea and leg swelling. Echocardiography revealed a dilated right heart with a homogeneous, hyperechoic, crescent shaped mass along the tricuspid annulus. Computed tomography confirmed the calcific nature of the lesion. Right heart catheterization revealed mild pre-capillary pulmonary hypertension and a mild spirometrically-defined restrictive ventilatory defect. Kyphoscoliosis has recently been associated with alterations in cardiac deformation and with an increased risk of restrictive lung disease. In our patient, we hypothesized that both these anomalies could have led to premature tricuspid annular degeneration resulting in a giant tricuspid calcification.</p>","PeriodicalId":12510,"journal":{"name":"Giornale italiano di cardiologia","volume":"25 9","pages":"690-692"},"PeriodicalIF":0.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142139858","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":"[An exotically and dangerous pattern].","authors":"Angelo Melpignano, Michele Trichilo, Alessandro Capecchi","doi":"10.1714/4318.43042","DOIUrl":"10.1714/4318.43042","url":null,"abstract":"","PeriodicalId":12510,"journal":{"name":"Giornale italiano di cardiologia","volume":"25 9","pages":"684"},"PeriodicalIF":0.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142139856","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}
Stefania Angela Di Fusco, Maurizio Giuseppe Abrignani, Giulia Bugani, Rita Myriam Cristina Intravaia, Marco Flori, Furio Colivicchi
{"title":"[Air pollution and cardiovascular disease].","authors":"Stefania Angela Di Fusco, Maurizio Giuseppe Abrignani, Giulia Bugani, Rita Myriam Cristina Intravaia, Marco Flori, Furio Colivicchi","doi":"10.1714/4318.43041","DOIUrl":"https://doi.org/10.1714/4318.43041","url":null,"abstract":"<p><p>Although there is substantial evidence on the harmful effects of air pollution on human health, these are scarcely considered in the general clinical practice and also in the context of cardiovascular disease prevention. In light of the numerous epidemiological and basic research studies that have demonstrated the unfavorable impact of air pollution on the cardiovascular system, this review aims to bring this aspect to the attention of clinicians. This work describes the main air polluting components that can contribute to the onset and progression of cardiovascular diseases. The pathophysiological mechanisms underlying the impact of pollutants on the cardiovascular system and the available evidence regarding their effect on cardiovascular risk factors are reported. This article also examines the evidence relating to the correlation between environmental pollutants and some specific cardiovascular diseases, including acute coronary syndromes, cerebrovascular diseases, heart failure, and arrhythmias. Finally, the possible strategies to be implemented to limit pollution-induced cardiovascular damage are analyzed.</p>","PeriodicalId":12510,"journal":{"name":"Giornale italiano di cardiologia","volume":"25 9","pages":"673-683"},"PeriodicalIF":0.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142139855","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":"In questo numero.","authors":"","doi":"10.1714/4318.43035","DOIUrl":"https://doi.org/10.1714/4318.43035","url":null,"abstract":"","PeriodicalId":12510,"journal":{"name":"Giornale italiano di cardiologia","volume":"25 9","pages":"0"},"PeriodicalIF":0.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142139865","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}
Daniele Ronco, Matteo Matteucci, Giulio Massimi, Vittoria Lodo, Sara Garis, Arianna Scarantino, Corinne Messina, Alessandra Francica, Marco Russo, Roberto Lorusso, Fabio Barili, Alessandro Parolari
{"title":"[Percutaneous treatment of post-acute myocardial infarction mechanical complications: state of the art].","authors":"Daniele Ronco, Matteo Matteucci, Giulio Massimi, Vittoria Lodo, Sara Garis, Arianna Scarantino, Corinne Messina, Alessandra Francica, Marco Russo, Roberto Lorusso, Fabio Barili, Alessandro Parolari","doi":"10.1714/4318.43036","DOIUrl":"https://doi.org/10.1714/4318.43036","url":null,"abstract":"<p><p>Left ventricular free wall rupture, ventricular pseudoaneurysm, papillary muscle rupture and ventricular septal rupture are life-threatening mechanical complications of acute myocardial infarction. Despite significant improvements over the last decades in overall mortality for patients with myocardial infarction, the outcome of subjects who develop post-infarction mechanical complications remains poor. Surgical treatment is considered the standard of care. However, percutaneous approaches (such as pericardial fibrin-glue injection for left ventricular free wall rupture, transcatheter edge-to-edge mitral repair for papillary muscle rupture and device closure for ventricular pseudoaneurysm or septal rupture) have been proposed in selected high-risk or inoperable patients, or in subjects with ideal characteristics for feasibility, as therapeutic alternatives to open surgery. The aim of the present review is to provide a comprehensive overview of the percutaneous strategies for the management of post-acute myocardial infarction mechanical complications.</p>","PeriodicalId":12510,"journal":{"name":"Giornale italiano di cardiologia","volume":"25 9","pages":"615-623"},"PeriodicalIF":0.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142139860","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}