Kardiol Pol
-
In systemic sclerosis (SSc), changes in the lungs and pulmonary hypertension (PH) are complications most adversely affecting the prognosis. Given the availability of specific treatment, early diagnosis of PH is very important. Exercise echocardiography, by increasing the patient's cardiac output, makes it possible to identify patients with elevated pulmonary artery pressure (PAP) during exercise. The diagnostic role of exercise echocardiography is still unclear, mainly because of the lack of prospective studies. ⋯ Exercise echocardiography is a safe and useful screening tool for PH diagnosis in patients with SSc. It enables to identify patients with normal systolic PAP at rest but a significant increase during exercise. The final confirmation of PH and differentiation between precapillary arterial and postcapillary venous PH requires RHC.
-
The electrocardiogram (ECG) is characterised by little sensitivity and specificity in the diagnostic evaluation of acute pulmonary embolism (APE). ⋯ ECG parameters are useful in predicting myocardial injury and assessing prognosis in patients with APE.
-
Acute hyperglycaemia is an adverse prognostic factor in patients with acute coronary syndrome (ACS). It is unclear whether these negative effects apply equally to patients with diabetes mellitus (DM) and non-DM patients. ⋯ Acute hyperglycaemia in non-DM patients hospitalised due to ACS was found to be an unfavourable long-term (four-year) risk factor, and may also be an unfavourable in-hospital risk factor. In contrast, acute hyperglycaemia did not affect cardiovascular outcomes in DM patients.
-
Therapeutic hypothermia is currently the best-documented method of improving neurological outcomes in patients after cardiac arrest and successful resuscitation. There is a variety of methods for lowering body temperature. However, there are no data showing that any specific method of cooling improves the results or increases survival. A simple method involving surface cooling and ice-cold intravenous fluids, as well as more technologically advanced methods, are used in clinical practice. One of the more advanced methods is intravascular hypothermia, during which cooling is carried out with the use of a special catheter located in the central vein. ⋯ The presented technique of intravascular hypothermia provides more precise temperature control in comparison with the traditional method.
-
Spinal cord stimulation (SCS) is a well known method of treatment used worldwide since the 80's of the last century. High efficiency of SCS was observed in the treatment of various types of pain. Promising clinical results were observed in the treatment of patients with refractory angina (RA). ⋯ The mechanism of action in RA is not well understood. It is known that SCS reduces the activity of the sympathetic nervous system, by which improves the coronary perfusion and oxygenation of the heart muscle. It is important that SCS does not mask the pain related to the infarct.