International journal of cardiology
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We evaluated correlates of prolonged use of evidence-based therapies in patients discharged after non-ST-segment elevation acute coronary syndrome (NSTE ACS). ⋯ After NSTE ACS, implementation of recommendations on long-term use of evidence-based therapies depends largely on in-hospital management. A variety of clinical characteristics are also predictive of long-term use.
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Letter Case Reports
Obstruction of the right coronary artery ostium due to acute aortic dissection.
Acute aortic dissection presents with a wide range of manifestations and it is frequently confused with acute coronary syndrome, leading to delayed diagnosis and inappropriate treatment. A high clinical index of suspicion is necessary. ⋯ We present a case of acute aortic dissection in a 68-year-old Italian woman with longstanding arterial hypertension, unknown ascending aortic aneurysm, normal D-dimer levels, new onset atypical chest pain and electrocardiographic images mimicking acute coronary syndrome. Also this case focuses attention on the importance of a correct evaluation of new onset chest pain.
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Given its linearity throughout exercise, oxygen uptake efficiency slope (OUES) obtained with a sub-maximal exercise is considered a reliable predictor of exercise capacity. We sought to assess the linearity of OUES across different exercise stages in adults with various forms of congenital heart disease. ⋯ In cyanotic Fontan patients, OUES(50) differs substantially from OUES(50-100) and OUES. Therefore, OUES(50) is unable to predict maximal exercise capacity in this population.
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The aim of the study was to report the impact of our hypothermia protocol on survival and neurological outcome. Furthermore, we were interested in the risk of bleeding complications in patients with acute myocardial infarction (AMI) being treated with percutaneous coronary revascularisation (PCI) and therapeutic hypothermia. ⋯ A major improvement in neurological outcome was observed in patients treated with hypothermia. Our results indicate that the combination of reperfusion strategies and the application of hypothermia do not carry an excessive risk of bleeding complications. Patients with AMI and out-of-hospital cardiac arrest should receive the optimal therapy for both conditions, that is, either thrombolysis or PCI and therapeutic hypothermia.
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Left ventricular hypertrabeculation/noncompaction is mainly detected by echocardiography. Left ventricular hypertrabeculation/noncompaction is commonly associated with cardiac and extra-cardiac disorders, preferentially neuromuscular disorders. Left ventricular hypertrabeculation/noncompaction is mainly located within the left ventricular apex, lateral, posterior and anterior wall but only rarely in the medial and basal portions of the interventricular septum. Aim of the present review is to summarize the knowledge about septal affection in left ventricular hypertrabeculation/noncompaction. ⋯ Septal affection in left ventricular hypertrabeculation/noncompaction is a finding in predominantly children and adolescents. Septal left ventricular hypertrabeculation/noncompaction occurs more in females than in males. Patients with septal left ventricular hypertrabeculation/noncompaction have a poor prognosis. Septal left ventricular hypertrabeculation/noncompaction is most likely congenital. The association of septal left ventricular hypertrabeculation/noncompaction with extracardiac abnormalities and neuromuscular disorders remains unclear. Presumably left ventricular hypertrabeculation/noncompaction affecting the septum does not represent a cardiac manifestation of a neuromuscular disorder.