Acute cardiac care最新文献

{"title":"Pulmonary artery rupture with pseudoaneurysm formation secondary to Swan-Ganz catheter balloon inflation.","authors":"Auras R Atreya,&nbsp;Sonali Arora,&nbsp;Gregory Valania","doi":"10.3109/17482941.2016.1174270","DOIUrl":"https://doi.org/10.3109/17482941.2016.1174270","url":null,"abstract":"<p><p>Pulmonary artery catheters have been extensively used for hemodynamic assessment over the past several decades. We present a case that highlights the management of a known, but rare and catastrophic complication of pulmonary artery catheter based therapy. An elderly lady with acute decompensated heart failure, severe pulmonary hypertension, and atrial fibrillation on anticoagulation had a pulmonary artery catheter inserted for hemodynamic monitoring. Subsequently, the patient developed acute hemoptysis and damped pulmonary artery pressure waveforms during inflation of the catheter tip balloon. The possibility of pulmonary artery rupture was immediately recognized and confirmed with CT angiogram of the chest. Emergent interventional radiology guided coil embolization of pulmonary artery rupture and pseudoaneurysm was successful.</p>","PeriodicalId":87385,"journal":{"name":"Acute cardiac care","volume":"17 4","pages":"77-79"},"PeriodicalIF":0.0,"publicationDate":"2015-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3109/17482941.2016.1174270","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34563357","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":"A shift in coronary care unit patient population: Ten year experience from an urban tertiary care center.","authors":"Joseph M Krepp,&nbsp;Shrinivas Hebsur,&nbsp;Julio A Panza,&nbsp;Howard A Cooper,&nbsp;Federico M Asch","doi":"10.1080/17482941.2016.1203160","DOIUrl":"https://doi.org/10.1080/17482941.2016.1203160","url":null,"abstract":"<p><p>The need for cardiovascular expertise in the treatment of advanced heart failure (AHF), malignant arrhythmias, and structural heart disease has shifted the role of the CCU to a more diverse and medically complex patient population. This study's purpose was to analyze the temporal trends in the principal diagnosis leading to admission to the CCU in a tertiary referral hospital. Over the last 15 years, the CCU has evolved from a medical unit strictly focusing on the care of patients with ACS to an advanced cardiac intensive care unit. The trends observed at our center provide further evidence that today's CCU contains a broader, more complex, critically-ill patient population.</p>","PeriodicalId":87385,"journal":{"name":"Acute cardiac care","volume":"17 4","pages":"83-84"},"PeriodicalIF":0.0,"publicationDate":"2015-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/17482941.2016.1203160","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34733658","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":"A local network for extracorporeal membrane oxygenation in refractory cardiogenic shock.","authors":"Carlotta Sorini Dini,&nbsp;Chiara Lazzeri,&nbsp;Marco Chiostri,&nbsp;Gian Franco Gensini,&nbsp;Serafina Valente","doi":"10.3109/17482941.2016.1174272","DOIUrl":"https://doi.org/10.3109/17482941.2016.1174272","url":null,"abstract":"<p><strong>Background: </strong>Veno-arterial extracorporeal membrane oxygenation (VA ECMO) represents a therapeutic option in patients with refractory cardiogenic shock (RCS). This strategy is limited to a restricted number of centres with capabilities for implanting VA ECMO and management patients on this support. We report on the initial experience of our ECMO referral centre for patients with RCS.</p><p><strong>Methods: </strong>We retrospectively analysed our ECMO data registry for RCS of 14 patients treated with VA ECMO, consecutively admitted to our intensive cardiac care unit (ICCU), which is an ECMO referral centre.</p><p><strong>Results: </strong>Six patients (6/14, 42%) came from peripheral centres, four were transferred to our ICCU directly. During ICCU stay, four patients died (28.5%) due to multi-organ failure, seven showed a complete recovery while one underwent cardiac transplantation. The remaining two patients died while waiting for cardiac transplantation because of cerebral haemorrhage. The 30-day overall mortality rate was 42.8%, all survivors showed a good neurologic outcome.</p><p><strong>Conclusions: </strong>In our series, the survival rate of RCS patients supported by VA ECMO is high (57%) and the transfer of RCS patients is feasible and safe. Our data support that a network for RCS is needed to transfer patients in well experienced centres even on ECMO support.</p>","PeriodicalId":87385,"journal":{"name":"Acute cardiac care","volume":"17 4","pages":"49-54"},"PeriodicalIF":0.0,"publicationDate":"2015-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3109/17482941.2016.1174272","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34455906","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":"Iatrogenic left main coronary artery dissection due to pin-hole balloon rupture: Not to be panicked….","authors":"Balakumaran Jeyakumaran,&nbsp;Ajay Raj,&nbsp;Bhagya Narayan Pandit,&nbsp;Tarun Kumar,&nbsp;Surender Deora","doi":"10.3109/17482941.2016.1174271","DOIUrl":"https://doi.org/10.3109/17482941.2016.1174271","url":null,"abstract":"<p><p>Iatrogenic left main coronary artery (LMCA) dissection is a rare complication and may have devastating consequences if not immediately intervened. The management includes urgent revascularization mostly with percutaneous coronary intervention (PCI) with bail-out stenting and rarely requires coronary artery bypass graft (CABG) surgery. In clinically and hemodynamically stable patients, a conservative approach may be preferred. Here, we present a rare case of iatrogenic retrograde LMCA dissection due to pin-hole rupture of angioplasty balloon that was managed conservatively.</p>","PeriodicalId":87385,"journal":{"name":"Acute cardiac care","volume":"17 4","pages":"80-82"},"PeriodicalIF":0.0,"publicationDate":"2015-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3109/17482941.2016.1174271","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34627837","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":"The potential of cystatin-C to evaluate the prognosis of acute heart failure: A comparative study.","authors":"Tae-Hun Kim,&nbsp;Hyungseop Kim,&nbsp;In-Cheol Kim","doi":"10.1080/17482941.2016.1203440","DOIUrl":"https://doi.org/10.1080/17482941.2016.1203440","url":null,"abstract":"<p><strong>Background: </strong>The prognosis of acute heart failure (HF) can be determined by cardio-renal function which is assessed by cystatin-C (Cys-C). We evaluated whether Cys-C could be a more useful prognostic indicator in acute HF, compared with uric acid (UA) and N-terminal pro-B-type natriuretic peptide (NT-proBNP).</p><p><strong>Methods: </strong>Two hundred thirty-two HF patients in the emergency room were studied using measurements of Cys-C, UA, and NT-proBNP. During the follow-up, cardiac events, defined as the composites of recurrent HF or cardiac death, were determined.</p><p><strong>Results: </strong>Seventy-seven cardiac events (28 cardiac deaths, 49 recurrent HFs) occurred over two years. The events group revealed higher levels of Cys-C, UA, and NT-proBNP. They showed increased blood urea nitrogen and creatinine, reduced septal tissue Doppler velocity (TVI-Sm), and low frequencies of beta-blockers (BB), diuretics and angiotensin-converting enzyme inhibitors/-receptor blockers. Cys-C (the best cutoff: 1.7 mg/l) had a steady, persistent hazard ratio (HR) over two years. On multivariate analysis, Cys-C, TVI-Sm, and BB were significant predictors for adverse events. Cys-C provided an incremental value for prognosis more than NT-proBNP and UA did over the follow-up period.</p><p><strong>Conclusions: </strong>Compared with UA and NT-proBNP, Cys-C could be better prognostic biomarker for cardiac events two years after acute HF.</p>","PeriodicalId":87385,"journal":{"name":"Acute cardiac care","volume":"17 4","pages":"72-76"},"PeriodicalIF":0.0,"publicationDate":"2015-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/17482941.2016.1203440","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34734284","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":"Diabetes in acute coronary syndrome patients: do we see only the tip of the iceberg?","authors":"M. Vavlukis, Gordana Kamceva, D. Kitanoski, B. Pocesta, E. Caparovska, Hajber Taravari, Enes Shehu, Ivica Bojovski, F. Janusevski, Filip Taneski, I. Kotlar, S. Kedev","doi":"10.13140/RG.2.1.1338.6961","DOIUrl":"https://doi.org/10.13140/RG.2.1.1338.6961","url":null,"abstract":"Aim of the study: To analyse the influence of glycoregulation in pts. with known or newly detected diabetes, on in-hospital morbidity/mortality in patients with acute coronary syndrome. Methods: randomly selected ACS patients were analysed for: stress glycaemia, HgbA1c, risk profile, lipid profile, SINTAX score, TIMI flow, LV function and in-hospital morbidity/mortality. We comparatively analysed pts. based on the level of HgbA1c (⩾ 6,5% vs 6.5%). Mean values of HgbA1c and stress glycaemia were as follows: NonD - 5.19±0.56 and 6.82±1.87; PD - 5.99±0.19 and 8.32±3.17; ND - 8.19±1.15 and 17.68.19±1.15; CD - 5.79±0.55 and 8.89±4.38; and UD - 9.36±1.33 and 16.23±6.24; (ANOVA p >0.000). No significant difference was found between NonD and CD pts., and between ND and UD (high in the last two), but there was significant difference in HgbA1c (p 0.000, Kappa agreement (0.516; sig p>0.000). TG levels were increased only in UD, and ND groups: 1.93±1.06, and 2.36±1.22, (ANOVA p=0.026, Tukey test ND vs NonD p=0.050; and vs PD p=0.016), without significant difference in other lipid fractions. Mean SINTAX score was 15.45±8.2, without significant inter-gorup differences. TIMI flow before PCI significantly differed across the groups, the lowest being in ND - 0.14±0.36 and PD - 1.13±1.42 pts. (group value 1.37±1.42; ANOVA p=0.001; Tukey test: NonD vs ND 0.000; and 0.043 vs CD). Mean EF was 51.51±8.5, without significant inter-group difference. 29 in-hospital events in 22 (19%) patients were registered: 7.7% arrhythmias, 6.9% heart failure, 3.4% GIT bleedings, and 2.6% CVI. In-hospital mortality was 4.3%. In multivariate logistic regression analysis, ejection fraction, stress glycaemia, and HgbA1c were identified as independent predictors of in-hospital outcome. Conclusion: High prevalence of unknown diabetes in ACS patients exists, leading to worse CAD, even in comparison with pts with known, well controlled diabetes. Stress glycaemia, HgbA1c and ejection fraction are independent predictors of in-hospital morbidity/mortality.","PeriodicalId":87385,"journal":{"name":"Acute cardiac care","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2015-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66244253","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":"Mayo registry for telemetry efficacy in arrest (MR TEA) study: An assessment of the effect of admission diagnosis on outcomes from in-hospital cardiopulmonary arrest","authors":"D. Snipelisky, J. Ray, G. Matcha, A. Roy, Brooke Clark, Adrian G. Dumitrascu, Veronica Bosworth, Anastasia Whitman, Patricia C. Lewis, T. Vadeboncoeur, F. Kusumoto, Caroline Burton","doi":"10.1080/17482941.2016.1203439","DOIUrl":"https://doi.org/10.1080/17482941.2016.1203439","url":null,"abstract":"Introduction: Little data exists evaluating how different risk factors influence outcomes following in-hospital arrests. Methods: A retrospective review of patients that suffered a cardiopulmonary arrest between 1 May 2008 and 30 June 2014 was performed. Patients were stratified into subsets based on cardiac versus non-cardiac reasons for admission. Results: 199 patients met inclusion criteria, of which 138 (69.3%) had a non-cardiac reason for admission and 61 (30.7%) a cardiac etiology. No difference in demographics and non-cardiac comorbidities were present. Cardiac-related comorbidities were more prevalent in the cardiac etiology subset. Arrests with a shockable rhythm were more common in the cardiac group (P < 0.0001), yet return of spontaneous circulation from the index event was similar (P = 0.254). More patients in the cardiac group were alive at 24-h post resuscitation (n = 34, 55.7% versus n = 49, 35.5%; P = 0.0085), discharge (n = 21, 34.4% versus n = 19, 13.8%; P = 0.0018), and at last follow-up (n = 13, 21.3% versus n = 14, 10.1%; P = 0.0434). Conclusion: Although patients with cardiac and non-cardiac etiologies for admission have similar rates of return of spontaneous circulation, those with cardiac etiologies are more likely to survive to hospital discharge and outpatient follow-up.","PeriodicalId":87385,"journal":{"name":"Acute cardiac care","volume":"12 1","pages":"67 - 71"},"PeriodicalIF":0.0,"publicationDate":"2015-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/17482941.2016.1203439","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60086001","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":"Chronic obstructive airway disease among patients hospitalized with acute heart failure; clinical characteristics, precipitating factors, management and outcome: Observational report from the Middle East","authors":"H. Khafaji, K. Sulaiman, Rajvir Singh, K. Alhabib, N. Asaad, A. Alsheikh-Ali, M. Al-Jarallah, B. Bulbanat, W. Almahmeed, M. Ridha, N. Bazargani, H. Amin, A. Al‐Motarreb, H. A. Faleh, A. Elasfar, P. Panduranga, J. Suwaidi","doi":"10.1080/17482941.2016.1203438","DOIUrl":"https://doi.org/10.1080/17482941.2016.1203438","url":null,"abstract":"Background: The purpose of this study was to report the prevalence, clinical characteristics, contributing factors, management and outcome of patients with chronic obstructive pulmonary disease (COPD) among patients hospitalized with heart failure (HF). Methods: Data were derived from Gulf Care (Gulf acute heart failure registry), a prospective multicenter study of 5005 consecutive patients hospitalized with acute heart failure during February to November 2012 in seven Middle Eastern countries. Data were described and compared for demographics, management and outcomes. Results: The prevalence of COPD among HF patients was 10%. COPD patients were older, more likely to be female and to have diabetes, hypertension, chronic kidney disease and sleep apnea (P = 0.001 for all) when compared to non-COPD patients. Contributing factors for hospitalization were systemic infection and atrial arrhythmias in COPD patients compared to acute coronary syndrome, uncontrolled hypertension and anemia in the non-COPD patients. Left-ventricular ejection fraction was higher in COPD patients; while BNP levels were comparable between the two groups. Non-invasive ventilation was used more frequently among COPD patients compared to non-COPD patients (P = 0.001). On multivariate logistic regression analysis, COPD was not associated with increased risk in-hospital and one-year death among acute heart failure (AHF) population and β blockers treatment appear to have neutral mortality effect in COPD patients with HF. Conclusion: COPD have distinct cardiovascular risk profile and precipitating factors for hospitalization with HF when compared to non-COPD patients. COPD history had no impact on the short-term and one-year mortality.","PeriodicalId":87385,"journal":{"name":"Acute cardiac care","volume":"17 1","pages":"55 - 66"},"PeriodicalIF":0.0,"publicationDate":"2015-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/17482941.2016.1203438","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60085970","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":"Left ventricular free wall rupture complicating acute STEMI","authors":"G. Fent, E. Grech, Y. Parviz, N. Briffa","doi":"10.3109/17482941.2015.1110244","DOIUrl":"https://doi.org/10.3109/17482941.2015.1110244","url":null,"abstract":"","PeriodicalId":87385,"journal":{"name":"Acute cardiac care","volume":"17 1","pages":"45 - 45"},"PeriodicalIF":0.0,"publicationDate":"2015-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3109/17482941.2015.1110244","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69458206","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":"Practical implications of novel serum ELISA-assay for matrix metalloproteinase-8 in acute cardiac diagnostics","authors":"Mikko T Nieminen, Paula Vesterinen, T. Tervahartiala, I. Kormi, J. Sinisalo, P. Pussinen, T. Sorsa","doi":"10.3109/17482941.2015.1115077","DOIUrl":"https://doi.org/10.3109/17482941.2015.1115077","url":null,"abstract":"Matrix metalloproteinases (MMPs) play a major role in inflammatory processes as they degrade extracellular proteins and modify immune responses. Inflammation is the driving factor in atherogenesis and MMPs, particularly MMP-8, has been linked to atherosclerotic plaque progression. MMP-8 is shown to be strongly associated with cardiovascular diseases (CVDs) and its complications thus providing a potential marker to identify patients at risk. Previously, laborious and expensive immunofluorometric assay (IFMA) was needed to reliably detect MMP-8 levels in serum. In this study, we compared a novel in-house ELISA-assay, dentoELISA, to the standard IFMA in determination of serum MMP-8 concentrations. As a cheaper and non-laborious assay, ELISA proved to be diagnostically as sensitive and specific as the IFMA. ROC statistics showed highly similar areas under the curve for both assays (0.779 versus 0.781). Furthermore, the concentrations measured by ELISA correlated significantly with concentrations determined with IFMA (r = 0.881, P < 0.001). In our study population, MMP-8 levels were significantly higher in the acute coronary syndrome patients (n = 2071) in comparison to reference population without significant coronary artery disease (n = 653). With this background, MMP-8-ELISA could provide interesting new approaches to novel CVD diagnostics.","PeriodicalId":87385,"journal":{"name":"Acute cardiac care","volume":"17 1","pages":"46 - 47"},"PeriodicalIF":0.0,"publicationDate":"2015-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3109/17482941.2015.1115077","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69458209","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}