Journal of cardiovascular medicine
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J Cardiovasc Med (Hagerstown) · Nov 2010
ReviewMedical therapy of pericardial diseases: part II: Noninfectious pericarditis, pericardial effusion and constrictive pericarditis.
The treatment of pericardial diseases is largely empirical because of the relative lack of randomized trials compared with other cardiovascular diseases. The main forms of pericardial diseases that can be encountered in the clinical setting include acute and recurrent pericarditis, pericardial effusion with or without cardiac tamponade, and constrictive pericarditis. Medical treatment should be targeted at the cause as much as possible. In this article, the therapy of more common forms of noninfectious pericarditis (pericarditis in systemic autoimmune diseases and neoplastic pericardial disease), pericardial effusion, and constrictive pericarditis is reviewed.
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J Cardiovasc Med (Hagerstown) · Nov 2010
Plasma glucose and not hemoglobin or renal function predicts mortality in patients with STEMI complicated with cardiogenic shock.
To assess the predictive value of three biomarkers for mortality in ST-segment elevation myocardial infarction (STEMI) with cardiogenic shock. ⋯ Hemoglobin and creatinine clearance bear no prognostic value. Only admission glucose levels strongly and independently predict 1-year mortality in STEMI patients with cardiogenic shock and treated with PCI.
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J Cardiovasc Med (Hagerstown) · Nov 2010
Case ReportsDominant right coronary artery occlusion entailing diffuse ST-segment elevation in the precordial leads.
Right ventricular infarction (RVI) during inferior myocardial infarction (MI) is readily diagnosed when ST-segment elevation (STE) is recorded in lead V4R. RVI may also yield precordial STE and such an electrocardiographic (ECG) pattern may be misinterpreted as a sign of anterior MI. ⋯ This case illustrates that dilation of an infarcted RV should be considered when such an ECG pattern is encountered during inferior MI, specifically a dominant one. Awareness of the circumstances under which this ECG pattern develops facilitates avoidance of misinterpretation as a sign of anterior MI and proper management.
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J Cardiovasc Med (Hagerstown) · Nov 2010
Arterial duct stenting: Do we still need surgical shunt in congenital heart malformations with duct-dependent pulmonary circulation?
Despite current trends toward primary repair, surgical systemic-to-pulmonary shunt is still an invaluable palliative option in some patients with congenital heart defects and duct-dependent pulmonary circulation. However, arterial duct stabilization with a high-flexibility coronary stent could be an effective alternative in high-risk surgical candidates or whenever short-term pulmonary blood flow support is anticipated. ⋯ Arterial duct stenting is a technically feasible, well tolerated and effective palliation in congenital heart disease with duct-dependent pulmonary circulation. It is advisable either in high-risk neonates or whenever a short-term pulmonary blood flow support is anticipated. The stented duct appears less durable than a conventional surgical shunt although it is highly effective in promoting a global and uniform pulmonary artery growth.