{"title":"[The heart patient at high altitude: not just thin air].","authors":"Stefano Savonitto, Luigi Piatti","doi":"10.1714/4129.41230","DOIUrl":"https://doi.org/10.1714/4129.41230","url":null,"abstract":"<p><p>The exposure to high altitude, with its inherent hypobaric hypoxia, elicits transient compensatory physiological responses of the cardiovascular and respiratory system which, however, do not preclude a safe sojourn at least up to 3500 m to the vast majority of well compensated patients with heart disease on stable drug therapy. Existing scientific statements of the European and American Societies of Cardiovascular and High-Mountain Medicine have released specific and helpful recommendations, though mostly based on expert consensus rather than solid evidence. The risk of cardiac events has been recorded only during sports activities, does not seem to depend on altitude and is similar to what is observed during intense exercise at sea level. Besides altitude itself, other aspects of the mountain environment should be considered, such as lower temperature, wind and dehydration which all require careful planning and equipment typical of the alpine sports. The distance of most mountain areas from medical centers able to provide effective care in time-dependent emergencies, and the lack in most cases of dedicated protocols, should also be considered as an important, most likely the most important limiting factor in high-risk patients.</p>","PeriodicalId":12510,"journal":{"name":"Giornale italiano di cardiologia","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71411594","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":"[European guidelines on acute coronary syndromes: what's new?]","authors":"Leonardo De Luca, Ciro Indolfi","doi":"10.1714/4129.41225","DOIUrl":"10.1714/4129.41225","url":null,"abstract":"","PeriodicalId":12510,"journal":{"name":"Giornale italiano di cardiologia","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71411587","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}
Miriam Stucchi, Michele Galasso, Lorenzo De Censi, Antonio Cirò, Patrizia Pedrotti, Cristina Giannattasio
{"title":"[Persistent ST-elevation with elevated myocardial necrosis markers: a case of myocardial contusion].","authors":"Miriam Stucchi, Michele Galasso, Lorenzo De Censi, Antonio Cirò, Patrizia Pedrotti, Cristina Giannattasio","doi":"10.1714/4129.41233","DOIUrl":"https://doi.org/10.1714/4129.41233","url":null,"abstract":"<p><p>Myocardial contusion is a rare and potentially fatal complication of chest trauma. There is no unique definition for this entity: some authors define myocardial contusion as a mild increase in cardiac biomarkers in the context of chest trauma, while for others the diagnosis requires evidence of pathologic findings at cardiac imaging. Consequently, the real incidence of myocardial contusion remains unknown, varying in reports between 8% and 71%. We describe a case of cardiac contusion secondary to a low-energy blunt chest trauma, manifesting as persistent ST-elevation associated with elevation of myocardial necrosis markers, with consequent myocardial stunning of the right ventricular free wall. As there is no consensus regarding the diagnostic pathway, it is essential to integrate first-level exams (ECG and laboratory findings) with cardiac magnetic resonance imaging, to define the presence of cardiac contusion and its extent, particularly if the echocardiographic data are unconclusive.</p>","PeriodicalId":12510,"journal":{"name":"Giornale italiano di cardiologia","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71411592","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 ECG that speaks for itself].","authors":"Federica Frascaro, Federico Sanguettoli, Rita Pavasini","doi":"10.1714/4129.41228","DOIUrl":"10.1714/4129.41228","url":null,"abstract":"","PeriodicalId":12510,"journal":{"name":"Giornale italiano di cardiologia","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71411584","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}
Jacopo Costantino, Francesco Maria Ajmone, Enrico Maggio, Federico Ballatore, Giulia Manguso, Piera Ciaramella, Nicola Galea, Maria Alfarano, Paolo Severino, Carlo Lavalle, Carmine Dario Vizza, Cristina Chimenti
{"title":"[Anticoagulant therapy in left ventricular non-compaction: when, how and why].","authors":"Jacopo Costantino, Francesco Maria Ajmone, Enrico Maggio, Federico Ballatore, Giulia Manguso, Piera Ciaramella, Nicola Galea, Maria Alfarano, Paolo Severino, Carlo Lavalle, Carmine Dario Vizza, Cristina Chimenti","doi":"10.1714/4129.41229","DOIUrl":"https://doi.org/10.1714/4129.41229","url":null,"abstract":"<p><p>Left ventricular non compaction (LVNC) comprises a heterogeneous group of diseases that can cause heart failure, arrhythmias, and thromboembolic events. In particular, the prevalence of thromboembolism in patients with LVNC is relevant compared to the general population. Atrial fibrillation and left ventricular thrombosis are strong predictors and require anticoagulant treatment in primary or secondary prevention, with a significant reduction in the risk of events. Long-term oral anticoagulation can be considered in patients with LVNC associated with left ventricular systolic dysfunction and sinus rhythm. On the contrary, it is not entirely clear whether the presence of deep intertrabecular recesses that cause blood flow stagnation can itself represent a thrombogenic substrate even in the absence of ventricular dysfunction and in sinus rhythm, thus indicating the use of anticoagulation.This article addresses the open question of the indication for anticoagulant therapy in LVNC, through a review of the current evidence on thromboembolic risk stratification and the initiation of anticoagulant therapy and by proposing a flow-chart as a guide to decision-making according to the clinical picture of the patient.</p>","PeriodicalId":12510,"journal":{"name":"Giornale italiano di cardiologia","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71411586","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":"10.1714/4129.41223","DOIUrl":"https://doi.org/10.1714/4129.41223","url":null,"abstract":"","PeriodicalId":12510,"journal":{"name":"Giornale italiano di cardiologia","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71411597","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":"[European guidelines on cardiomyopathies: what's new?]","authors":"Attilio Iacovoni, Gianfranco Sinagra","doi":"10.1714/4129.41224","DOIUrl":"10.1714/4129.41224","url":null,"abstract":"","PeriodicalId":12510,"journal":{"name":"Giornale italiano di cardiologia","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71411588","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}
Alessia Argirò, Mattia Zampieri, Alberto Marchi, Annamaria Del Franco, Eszter Dalma Pàlinkàs, Giulia Biagioni, Chiara Chiti, Carlotta Mazzoni, Alessandra Fornaro, Mattia Targetti, Francesco Cappelli, Iacopo Olivotto
{"title":"[Therapeutic approaches in hypertrophic cardiomyopathy: from symptom relief to precision therapy].","authors":"Alessia Argirò, Mattia Zampieri, Alberto Marchi, Annamaria Del Franco, Eszter Dalma Pàlinkàs, Giulia Biagioni, Chiara Chiti, Carlotta Mazzoni, Alessandra Fornaro, Mattia Targetti, Francesco Cappelli, Iacopo Olivotto","doi":"10.1714/4100.40979","DOIUrl":"https://doi.org/10.1714/4100.40979","url":null,"abstract":"<p><p>Hypertrophic cardiomyopathy is the most common genetic cardiomyopathy. Main complications include the development of arrhythmias and heart failure, and the latter may be triggered by left ventricular outflow tract obstruction. The treatment of left ventricular outflow tract obstruction includes pharmacological therapies (beta-blockers, calcium channel blockers, disopyramide) and septal reduction therapies (alcohol septal ablation, surgical myectomy). Myosin inhibitors represent a new therapeutic opportunity and in recent clinical trials proved effective in symptom relief, improvement of functional capacity and quality of life in patients with obstructive hypertrophic cardiomyopathy. In this narrative review we will summarize the available and under development therapeutic approaches for hypertrophic cardiomyopathy.</p>","PeriodicalId":12510,"journal":{"name":"Giornale italiano di cardiologia","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41094930","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":"[Clinical and prognostic relevance of integrated cardiac imaging in hypertrophic cardiomyopathy].","authors":"Giovanni Orazio, Andrea Erriquez, Gianluca Campo","doi":"10.1714/4100.40988","DOIUrl":"10.1714/4100.40988","url":null,"abstract":"","PeriodicalId":12510,"journal":{"name":"Giornale italiano di cardiologia","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41111905","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 unexpected case of right heart dilation in the elderly].","authors":"Michele Pagliaccia, Serenella Conti, Alessandro Bufi, Valentino Borghetti, Marcella De Paolis, Marcello Dominici","doi":"10.1714/4100.40984","DOIUrl":"https://doi.org/10.1714/4100.40984","url":null,"abstract":"<p><p>Atrial septal defects (ASD) represent the most common congenital heart defect diagnosed in adulthood. Adults with an ASD are often asymptomatic, but sometimes may present with non-specific symptoms such as dyspnea on exertion or exercise intolerance. Isolated sinus venosus atrial defect is an extremely rare anomaly. Sinus venosus defects occur more commonly in the superior (rather than inferior) portion of the embryologic sinus venosus and commonly occur with partial anomalous pulmonary venous return, particularly of the right upper pulmonary vein. We describe the case of an 80-year-old man with an undiagnosed, hemodynamically significant superior sinus venosus type of ASD who presented with persistent dyspnea and hypoxia after COVID-19 disease. Although cardiac magnetic resonance represents the gold standard for the morpho-functional evaluation of ASDs, transesophageal echocardiography is an accessible method for diagnosing the superior sinus venosus type of ASD and three-dimensional transesophageal echocardiography is useful for obtaining an \"en face\" view of the ASD and important surrounding structures.</p>","PeriodicalId":12510,"journal":{"name":"Giornale italiano di cardiologia","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41121617","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}