International journal of cardiology
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Letter Case Reports
Stroke and Takotsubo cardiomyopathy: is there more than just cause and effect?
Takotsubo cardiomyopathy has been described as a consequence of stroke or a cardioembolic source of stroke. We present the case of a 43 year-old woman who suffered from Takotsubo cardiomyopathy and subsequently developed a large left cerebellar infarct without significant neurological deficits nor evidence of a cardioembolic cause. Catecholamine excess has been postulated to cause myocardial stunning in Takotsubo cardiomyopathy and some cases of cerebral ischaemia. In this case, the concurrent occurrence of Takotsubo cardiomyopathy and stroke without an identifiable source suggests that there may be a possible unifying pathogenetic mechanism.
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Comparative Study
Long-term prognosis in stable angina; medical treatment or coronary revascularization in patients younger than 70 years?
Literature on the appropriateness of coronary revascularization in chronic angina is still scanty. The study aimed to compare long-term effects of revascularization with those of medical therapy in stable angina. ⋯ In low-risk chronic angina coronary revascularization does not improve long-term prognosis unless inducible myocardial ischemia is present. This suggests considering coronary revascularization as an effective tool in treating coronary artery disease only when myocardial ischemia has been documented.
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Comparative Study
Vagal impairment in elderly Chagas disease patients: a population-based study (the Bambuí study).
Chagas disease (ChD) will become predominantly a disease of the elderly, as a consequence of the effectiveness of control measures in many Latin American countries. The effects of the disease in old age have received little attention. We investigated the effects of ageing in the association between cardiac vagal impairment, a typical feature of ChD, and chronic Trypanosoma cruzi infection. ⋯ Disease-specific vagal cardiac dysfunction was observed in ChD individuals below 70. However, further ageing interferes significantly with vagal heart modulation, attenuating the difference of HRV indexes between ChD and non-ChD subjects.