Acta cardiologica
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Experimental and clinical studies have proven the neuroprotective effects of hypothermia in unconscious patients with spontaneous circulation after out-of-hospital cardiac arrest. Based on this evidence, recommendations have been made to incorporate mild therapeutic hypothermia into practice. ECG changes are well documented in people with incidental hypothermia but there are only few studies on ECG abnormalities in patients undergoing mild therapeutic hypothermia after cardiac arrest due to ST-elevation myocardial infarction. ⋯ Although hypothermia is associated with typical ECG findings like Osborn wave, the electrocardiographic evolution of STEMI in patients receiving MTH is comparable with that in patients without it.
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Treatment with percutaneous edge-to-edge mitral valve repair (Mitraclip) has recently been recommended as an alternative to conventional mitral valve repair for high surgical risk patients with symptomatic severe mitral regurgitation (MR). In this study, we report the first use of Mitraclip therapy in Belgium. ⋯ In high-risk patients with functional MR, treatment with the Mitraclip-device is a feasible and safe option resulting in improvement of MR severity and clinical symptoms. However, as MACE is high in some subgroups (e.g. LVEF < 25%), careful patient selection is crucial to ensure the maximum benefit from this new technique.
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Observational Study
Non-invasive cardiac output assessment in critically ill paediatric patients.
Recently, non-invasive methods for cardiac output (CO) assessment have been developed including the ultrasonic cardiac output monitor (USCOM). This technique uses the same concept as Doppler echocardiography but differs in two aspects including continuous wave (CW) Doppler and estimated outflow tract diameter (OTD) used in USCOM compared to pulsed wave Doppler and directed measurement of OTD used in echocardiography. We sought to assess the agreement between CO assessment by USCOM and echocardiography in critically ill paediatric patients. ⋯ USCOM was an unreliable tool for absolute value measurement of CO and CI due to the errors of VTI by CW Doppler.
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Case Reports
Is recent cannabis use associated with acute coronary syndromes? An illustrative case series.
Cannabis is a frequently used recreational drug that potentially imposes serious health problems. We report three cases where recent and/or chronic use of marijuana led to severe cardiac dysfunction. All three patients collapsed at home and required cardiopulmonary resuscitation (CPR) with initial restoration of spontaneous circulation (ROSC). ⋯ Toxicological screening also showed no other substance abuse than cannabis. Using these three cases, we would like to illustrate that the widespread use of cannabis is not as innocent as is believed. Cannabis use can lead to severe cardiovascular problems and sudden death, not only in people at increased cardiovascular risk, but also in young people without any medical history or risk factors.
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Early repolarization (ERP) is a common electrocardiographic finding. Its potential to cause cardiac arrhythmias has been hypothesized from experimental studies, but it is not known whether there is a clinical association with sudden cardiac arrest. ⋯ ERP is a common finding in young teen athletes. In this population global ERP (both inferior and lateral) is more common than isolated inferior or lateral ERP. Young age might be a contributing factor in causing a more diffuse repolarization abnormality.