Journal of cardiovascular medicine
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J Cardiovasc Med (Hagerstown) · Jan 2009
Natriuretic peptide system is not exhausted in severe heart failure.
We aimed to investigate the prognostic value of amino-terminal B-type natriuretic peptide (NT-pro-BNP) in severe heart failure. ⋯ We conclude that in patients with severe heart failure, NT-pro-BNP has a powerful prognostic value. Patients with high NT-pro-BNP had more than five-fold increase in the 6-month risk of death. Our results do not support the hypothesis that ventricular exhaustion with inability to synthesize and secrete natriuretic peptides is the mechanism underlying decompensation. Attenuation mechanisms of compensatory systems ought to be further studied.
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J Cardiovasc Med (Hagerstown) · Jan 2009
Case ReportsGiant left ventricular pseudoaneurysm complicating an acute myocardial infarction in patient with previous cardiac surgery: a case report.
Left ventricular pseudoaneurysm is a nonfrequent complication of acute myocardial infarction. We describe a case of a patient with previous cardiac surgery and recent inferior myocardial infarction, who developed severe congestive heart failure due to a giant pseudoaneurysm of the inferoposterior wall.
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J Cardiovasc Med (Hagerstown) · Dec 2008
Time of onset and outcome of cardiogenic shock in acute coronary syndromes.
The aim of our study was to evaluate the incidence, timing of the onset and outcome of cardiogenic shock in a group of 865 patients with acute coronary syndromes who were consecutively admitted to our Intensive Cardiac Care Unit (ICCU) from January 2004 to December 2005. ⋯ Primary percutaneous coronary intervention has reduced the number of patients who develop cardiogenic shock after ICCU admission. According to our results, cardiogenic shock in patients with ST-elevation myocardial infarction developed early after symptoms' onset and, despite optimal treatment, mortality in these patients remains high (about 50%). Delayed cardiogenic shock is mainly due to mechanical complications as well as due to PCI complications.
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J Cardiovasc Med (Hagerstown) · Nov 2008
Case ReportsAtrial septal defect combined with partial anomalous pulmonary venous return: complete anatomic and functional characterization by cardiac magnetic resonance.
The presented case regards a 17-year-old male with new-onset right bundle branch block and significantly enlarged right-heart sections as the only pathologic finding on transthoracic echocardiography. Cardiac magnetic resonance (CMR) revealed the presence of a superior sinus venosus atrial septal defect associated with a partial anomalous pulmonary venous return, with the right upper lobe pulmonary vein draining into the superior vena cava. ⋯ With echocardiography, sinus venosus defects and anomalous pulmonary vein drainage may be more easily detected by a transoesophageal approach because of the proximity of the transducer to the atrial septum. CMR may be specifically recommended as an alternative to transoesophageal echocardiography in any patient with an unexplained dilatation of the right ventricle.
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J Cardiovasc Med (Hagerstown) · Nov 2008
Case ReportsWitnessing a rare event - thrombus seeking its route in the right atrium: 'thrombus-in-transit'.
Pulmonary embolus and right atrial thrombus trapped in a patent foramen ovale is an unusual, rare condition. We report a case of impending paradoxical embolism with pulmonary embolism, in which a thrombus entrapped in a patent foramen ovale was detected. To our knowledge, this is the first case in the literature in which 'thrombus-in-transit' was detected in the right atrium both before and after entrapment in a patent foramen ovale.