Medicine (Abingdon, England : UK ed.)最新文献_第4页

Medicine (Abingdon, England : UK ed.) Pub Date : 2026-08-01 Epub Date: 2026-06-23 DOI: 10.1016/j.mpmed.2026.05.004

Jonathan Hinton, James Richard Wilkinson

引用次数: 0

Sudden cardiac death in young athletes: aetiologies, mechanisms and implications for screening 年轻运动员的心源性猝死：病因、机制和筛查意义

Medicine (Abingdon, England : UK ed.) Pub Date : 2026-08-01 Epub Date: 2026-06-23 DOI: 10.1016/j.mpmed.2026.05.012

Kentaro Yamagata, Dominic Richard Mears, Aneil Malhotra

{"title":"Sudden cardiac death in young athletes: aetiologies, mechanisms and implications for screening","authors":"Kentaro Yamagata, Dominic Richard Mears, Aneil Malhotra","doi":"10.1016/j.mpmed.2026.05.012","DOIUrl":"10.1016/j.mpmed.2026.05.012","url":null,"abstract":"<div><div>Sudden cardiac death (SCD) in young athletes is rare but highly visible and catastrophic when it occurs. Most cases arise from previously undiagnosed cardiovascular disease that becomes malignant under the adrenergic and haemodynamic stress of exercise. Incidence estimates vary by method and cohort, but are generally up to 6.8 per 100,000 athlete–years. Recent registry studies continue to demonstrate higher incidence among male and Black/African Caribbean athletes. The dominant substrates include sudden arrhythmic death syndrome, hypertrophic cardiomyopathy, arrhythmogenic cardiomyopathy, congenital coronary anomalies, myocarditis and inherited channelopathies such as long QT syndrome. Geographical differences reflect genetics and detection strategies. Pre-participation cardiac screening may reduce the risk of SCD in young athletes and is recommended in both American and European guidelines. Debate persists over the value of resting electrocardiogram screening in pre-participation evaluation compared with strategies based solely on history and physical examination. However, history-based screening alone demonstrates a low sensitivity for detecting serious cardiac disorders, many of which are asymptomatic. Risk reduction rests on earlier detection of potentially life-threatening cardiac conditions, sport-specific expert consultation and treatment, and adequate emergency action planning with immediate defibrillation access. This review summarises epidemiology, important cardiac conditions associated with SCD and strategies for detecting serious cardiac conditions.</div></div>","PeriodicalId":74157,"journal":{"name":"Medicine (Abingdon, England : UK ed.)","volume":"54 8","pages":"Pages 602-606"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148703939","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}

引用次数: 0

Myocarditis: an update 心肌炎：最新进展

Medicine (Abingdon, England : UK ed.) Pub Date : 2026-08-01 Epub Date: 2026-06-23 DOI: 10.1016/j.mpmed.2026.05.009

Matthew Sadler, Aamir Shamsi, Daniel Bromage

引用次数: 0

Management of sudden cardiac death 心源性猝死的处理

Medicine (Abingdon, England : UK ed.) Pub Date : 2026-08-01 Epub Date: 2026-06-29 DOI: 10.1016/j.mpmed.2026.06.001

Themistoklis Katsimichas, Sanjay Sharma, Michael Papadakis

{"title":"Management of sudden cardiac death","authors":"Themistoklis Katsimichas, Sanjay Sharma, Michael Papadakis","doi":"10.1016/j.mpmed.2026.06.001","DOIUrl":"10.1016/j.mpmed.2026.06.001","url":null,"abstract":"<div><div>Sudden cardiac death (SCD) remains a major public health challenge. While coronary artery disease accounts for most adult cases, inherited and congenital cardiac disorders predominate in individuals aged <35 years. Although overall survival rates of out-of-hospital sudden cardiac arrest (SCA) remain near 10%, early bystander basic life support, rapid deployment of automated external defibrillators and prompt transfer to specialist centres can considerably improve survival. Outside the context of coronary artery occlusion, an inherited cardiac condition should be considered, particularly for individuals aged <50 years. Survivors of SCA require comprehensive clinicogenetic diagnostic evaluation. For victims of SCD, expert post-mortem evaluation and molecular autopsy is essential in guiding family screening and preventive therapy. Relatives of SCD victims show a high prevalence of inherited conditions, underscoring the importance of assessment in specialized centres. Interventions ranging from lifestyle modification to implantation of implantable cardioverter–defibrillators have the potential to prevent further tragedies. Cardiac screening of young and athletic individuals has the potential to identify those at risk and implement targeted prevention strategies.</div></div>","PeriodicalId":74157,"journal":{"name":"Medicine (Abingdon, England : UK ed.)","volume":"54 8","pages":"Pages 598-601"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148703941","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}

引用次数: 0

Devices for heart failure 治疗心力衰竭的器械

Medicine (Abingdon, England : UK ed.) Pub Date : 2026-08-01 Epub Date: 2026-08-03 DOI: 10.1016/j.mpmed.2026.05.015

A. Elserwey, P.M. Haydock

引用次数: 0

Acute heart failure and shock 急性心力衰竭和休克

Medicine (Abingdon, England : UK ed.) Pub Date : 2026-08-01 Epub Date: 2026-06-24 DOI: 10.1016/j.mpmed.2026.05.011

Muhammad N. Ibrahim, Andrew Morley-Smith, Aderonke T. Abiodun

{"title":"Acute heart failure and shock","authors":"Muhammad N. Ibrahim, Andrew Morley-Smith, Aderonke T. Abiodun","doi":"10.1016/j.mpmed.2026.05.011","DOIUrl":"10.1016/j.mpmed.2026.05.011","url":null,"abstract":"<div><div>Acute heart failure (AHF) is a complex syndrome characterized by a rapid onset of symptoms and signs of heart failure, most commonly driven by vascular congestion and, in severe cases, systemic hypoperfusion leading to multiorgan dysfunction. It is a leading cause of hospitalization among patients >65 years of age. The pathophysiology of acute cardiac dysfunction is diverse, reflecting its wide array of precipitating factors and aetiologies. Targeted treatments should be implemented promptly for reversible causes of AHF, including acute myocardial infarction, arrhythmias and valvular abnormalities. However, management is predominantly supportive and focuses on relieving congestion and correcting respiratory failure. In AHF patients with cardiogenic shock, early referral to the coronary or critical care service and discussion with tertiary heart failure centres is essential to facilitate appropriate haemodynamic support and consideration of advanced therapies. Once stabilized, patients should undergo early initiation and rapid uptitration of guideline-directed medical therapy before discharge, tailored to the degree of ventricular dysfunction. Despite advances in treatment, outcomes remain poor, especially in the context of frailty and significant multimorbidity. Therefore, holistic AHF management must also incorporate patient education, structured follow-up with the specialist heart failure team, robust post-discharge support and proactive management of co-morbidities.</div></div>","PeriodicalId":74157,"journal":{"name":"Medicine (Abingdon, England : UK ed.)","volume":"54 8","pages":"Pages 548-554"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148703950","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}

引用次数: 0

Atrial fibrillation 心房纤颤

Medicine (Abingdon, England : UK ed.) Pub Date : 2026-08-01 Epub Date: 2026-06-23 DOI: 10.1016/j.mpmed.2026.05.002

Maria Stefil, Gregory Y. H Lip

{"title":"Atrial fibrillation","authors":"Maria Stefil, Gregory Y. H Lip","doi":"10.1016/j.mpmed.2026.05.002","DOIUrl":"10.1016/j.mpmed.2026.05.002","url":null,"abstract":"<div><div>Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia, with a high prevalence in elderly individuals. It is associated with increased mortality and morbidity from stroke, systemic embolism and heart failure. AF can be characterized according to stroke risk, symptom severity, severity of AF burden and substrate severity under a novel 4S-AF scheme. Management of AF has moved towards a holistic or integrated care approach, and the Atrial fibrillation Better Care (ABC) pathway provides a simple strategy streamlining integrated management. ‘A’ stands for avoid stroke, with direct oral anticoagulants being the preferred option. All individuals with AF should be risk-stratified for stroke and bleeding, with the CHA<sub>2</sub>DS<sub>2</sub>-VASc and HAS-BLED scores, respectively. ‘B’ stands for better symptom management. The subsequent approach to management of AF is largely patient-centred and symptom-driven, broadly described as ‘rhythm control’ and ‘rate control’. Rate control is usually with β-adrenoceptor blockers or non-dihydropyridine calcium channel blockers. Rhythm control can require antiarrhythmic drugs and/or electrophysiological procedures. ‘C’ stands for cardiovascular and co-morbidity risk reduction. Associated co-morbidities such as hypertension, diabetes mellitus, heart failure, cardiac ischaemia and sleep apnoea should be addressed, and lifestyle changes (obesity, alcohol excess, smoking) and psychological morbidity discussed.</div></div>","PeriodicalId":74157,"journal":{"name":"Medicine (Abingdon, England : UK ed.)","volume":"54 8","pages":"Pages 576-581"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148703944","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}

引用次数: 0

Cardiomyopathies 心肌病

Medicine (Abingdon, England : UK ed.) Pub Date : 2026-08-01 Epub Date: 2026-06-23 DOI: 10.1016/j.mpmed.2026.05.008

Simon Hobson, Caroline J. Coats

{"title":"Cardiomyopathies","authors":"Simon Hobson, Caroline J. Coats","doi":"10.1016/j.mpmed.2026.05.008","DOIUrl":"10.1016/j.mpmed.2026.05.008","url":null,"abstract":"<div><div>Cardiomyopathies are a diverse group of diseases that affect the heart muscle. They are an important cause of heart failure, arrhythmia and sudden cardiac death across all age groups and geographies. Cardiomyopathies are classified into several phenotypes: dilated, hypertrophic, restrictive, arrhythmogenic and, more recently, non-dilated left ventricular cardiomyopathy. Dilated cardiomyopathy is characterized by ventricular enlargement and systolic dysfunction, while hypertrophic cardiomyopathy is defined by unexplained myocardial hypertrophy, often with preserved or hyperdynamic systolic function. Restrictive cardiomyopathy is associated with impaired left ventricular filling and diastolic dysfunction. Genetics play an important role, with pathogenic variants identified in many patients which has implications for family screening. Acquired causes including inflammatory conditions, toxins, metabolic disease and multisystem conditions are also common and clinically relevant to diagnose, as treatments can differ. For general physicians, early recognition is crucial. Red flags include unexplained heart failure, conduction disease, syncope, ventricular arrhythmias and a family history of cardiomyopathy or sudden death. Advances in imaging, genetics and therapies that target the underlying disease mechanisms are transforming this field, making timely referral to specialist services increasingly important for optimal patient care.</div></div>","PeriodicalId":74157,"journal":{"name":"Medicine (Abingdon, England : UK ed.)","volume":"54 8","pages":"Pages 564-570"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148703947","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}

引用次数: 0

Direct current cardioversion 直流复律

Medicine (Abingdon, England : UK ed.) Pub Date : 2026-08-01 Epub Date: 2026-06-22 DOI: 10.1016/j.mpmed.2026.05.005

Paul R. Roberts

引用次数: 0

Self-assessment/CPD answers 自我评价/ CPD答案

Medicine (Abingdon, England : UK ed.) Pub Date : 2026-08-01 Epub Date: 2026-06-23 DOI: 10.1016/j.mpmed.2026.05.016

引用次数: 0