Cardiology in review
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Coronavirus disease 2019 (COVID-19) is characterized by a clinical spectrum of diseases ranging from asymptomatic or mild cases to severe pneumonia with acute respiratory distress syndrome (ARDS) requiring mechanical ventilation. Extracorporeal membrane oxygenation (ECMO) has been used as rescue therapy in appropriate patients with COVID-19 complicated by ARDS refractory to mechanical ventilation. In this study, we review the indications, challenges, complications and clinical outcomes of ECMO utilization in critically ill patients with COVID-19 related ARDS. ⋯ Although the risk of mortality and complications is very high among patients with COVID-19 requiring ECMO, it is similar to that of non-COVID-19 patients with ARDS requiring ECMO. ECMO is a resource-intensive therapy, with an inherent risk of complications, which makes its availability limited and its use challenging in the midst of a pandemic. Well-maintained data registries, with timely reporting of outcomes and evidence-based clinical guidelines, are necessary for the careful allocation of resources and for the development of standardized utilization protocols.
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Cardiology in review · Jun 2021
A Review of the Role of Type 2 Diabetes and SGLT2 Inhibitors in Heart Failure with Preserved Ejection Fraction.
Previous research has demonstrated that patients with Type 2 Diabetes (T2DM) are at an increased risk for cardiovascular events, including heart failure. Moreover, there's a higher risk of mortality in individuals who have both T2DM and heart failure with preserved ejection fraction (HFpEF). Although there are antidiabetic agents that have shown both cardiovascular safety and improved cardiovascular outcomes, only certain agents have been associated with heart failure benefits, such as sodium-glucose cotransporter-2 (SGLT2) inhibitors. This study aims to review the pathophysiology of HFpEF in the setting of T2DM, and more specifically the role of SGLT2 inhibitors in HFpEF outcomes.
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The novel coronavirus (severe acute respiratory syndrome CoV-2 [SARS-CoV-2]), also known as COVID-19, is a single-stranded enveloped RNA virus that created a Public Health Emergency of International Concern in January 2020, with a global case burden of over 15 million in just 7 months. Infected patients develop a wide range of clinical manifestations-typically presenting with fever, cough, myalgia, and fatigue. Severely ill patients may fall victim to acute respiratory distress syndrome, acute heart injuries, neurological manifestations, or complications due to secondary infections. ⋯ Evidence suggests that prophylaxis with anticoagulation may lead to a lower risk of mortality, although it does not eliminate the possibility. The risks and benefits of anticoagulation treatment should be considered in each case. Patients should be regularly evaluated for bleeding risks and thrombotic complications.
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Severe acute respiratory coronavirus-2 (SARS-CoV-2) is responsible for one of the greatest public health challenges of our lifetime, the coronavirus disease 2019 (COVID-19) pandemic. Because of the complicated postinfection sequelae and grave consequences, the search for effective therapies has become a worldwide priority. The antiviral agent remdesivir has become a viable option and is now available in the United States for hospitalized patients through an emergency use authorization. This article describes remdesivir's historical background, pharmacology, key trials, adverse events, and issues regarding accessibility.
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Cardiology in review · Nov 2020
Review Case ReportsMyocarditis in Multisystem Inflammatory Syndrome in Children Associated With Coronavirus Disease 2019.
Cardiac involvement as a complication of severe acute respiratory syndrome coronavirus 2 infection in children is a relatively new entity. We present our initial experience managing children with coronavirus disease 2019-related acute myocardial injury. The 3 patients presented here represent a spectrum of the cardiac involvement noted in children with coronavirus disease 2019-related multisystem inflammatory syndrome, including myocarditis presenting as cardiogenic shock or heart failure with biventricular dysfunction, valvulitis, coronary artery changes, and pericardial effusion.