Kardiol Pol
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Tako-tsubo cardiomyopathy (TTC) is an uncommon transient cardiomyopathy with a clinical and electrocardiographic (ECG) presentation similar to that of ST-elevation myocardial infarction (STEMI). ⋯ Although there is some diversity in ECG, laboratory, and ECHO parameters, none of these patterns alone can reliably distinguish TTC from MI in female patients. TTC and STEMI females have similar in-hospital and long-term outcomes.
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To evaluate long-term outcomes of surgical aortic valve replacement (AVR) due to significant aortic stenosis (AS) and assess changes in factors affecting survival during a 10-year period in patients referred for surgery from a single centre. ⋯ Long-term surgical outcomes in patients with significant AS are very good, with better survival in women compared to men, although these differences attenuated after 3 years. Factors affecting 10-year survival are different in women and men: a significant effect in women was noted only for age and preoperative NYHA class, while in men for age, NYHA class, hypertension, reduced LVEF, and the presence of significant coronary artery stenoses. During 10-year follow-up, longitudinal changes can be noted in factors affecting survival after AVR.
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Postoperative complications are integral to cardiac surgery. The most serious ones are stroke, which develops in about 7.5% of the patients, and postoperative encephalopathy, which affects 10-30% of the patients. According to bibliographical data, the number of complications is increasing. ⋯ In patients undergoing heart surgery, the independent risk factors of neurological complications in the first 30 days include: long duration of ventilation, a history of stroke with paresis, AF, haemodilution manifested by an HCT of <28% and long duration of aortic cross-clamping. Neurological complications are associated with high postoperative mortality.
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New generation cardiac troponin assays have sufficient precision to detect and quantify plasma troponin concentrations below the lower threshold of detection of the currently employed troponin tests. However, diagnostic performance of the newer generation assays in daily clinical practice is not well established. ⋯ The newer generation sensitive cardiac troponin assay presented superior diagnostic accuracy in the diagnosis of AMI compared to the standard troponin test in a single reading at admission with improved sensitivity and specificity. The sensitive troponin assay has the potential to improve early detection and/or exclusion of AMI.