Revista portuguesa de cardiologia : orgão oficial da Sociedade Portuguesa de Cardiologia = Portuguese journal of cardiology : an official journal of the Portuguese Society of Cardiology
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The use of noninvasive methods to visualise the heart has had an extraordinary development over the last decade, with echocardiography demonstrating a particularly fast growth. Despite its unquestionable role in the diagnosis of heart disease and in the management of cardiac patients, it does have some limitations, both in the morphological visualisation, as well as in the functional assessment of the heart, such as blood flow, quantification of intracardiac volumes, etc. The recent development of dynamic three-dimensional (3D) echocardiography from two dimensional images has opened new perspectives in the study of cardiac pathophysiology. ⋯ The development of faster computers will shorten the time needed for image acquisition, postprocessing, and data analysis, contributing to the goal of easy access and wide use. With improvements in computer technology and production of interactive software, 3D echocardiography will provide a dynamic view of the surgical anatomy of the heart. Thus, the three-dimensional reconstruction concept has the potential to and diagnostic assessment of cardiac pathology in every facet.
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The aim of this study was to characterise the epidemiology of congestive heart failure namely assessing demographic, etiologic and prognostic aspects, and the hospital admission trends in the last 6 years. ⋯ The hospital prevalence of congestive heart failure is identical to other Western countries and is greater among the elderly patients. Valve disease, coronary artery disease and hypertension are the most frequent causes of congestive heart failure. An increasing trend in hospital admissions for congestive heart failure was observed. The hospital mortality was reduced in the last 6 years and was greater among the elderly patients. Age (> or = 70 years), the presence of comorbidity (infectious disease, central nervous system disease, acute renal failure, chronic renal disease and pulmonary embolism), hyponatremia, other electrolyte abnormalities and acid-base balance disturbances, resuscitated cardiac arrest and the presence of severe sodium and water retention have prognostic significance.
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The aim of this study was to evaluate our results of radiofrequency catheter ablation (RFCA) of ventricular tachycardia. ⋯ Radiofrequency catheter ablation of VT has shown a good success rate, and it is a valuable alternative in patients with hemodynamically tolerable VT, refractory to drug treatment, highly symptomatic and without surgical indication. In cases of idiopathic VT we had a high rate success and we think that RFCA will probably become the primary indication in symptomatic patients.
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Sudden death is a very important event in the natural history of hypertrophic cardiomyopathy. Although its physiopathology is not still fully understood, there are several potential mechanisms to explain it, such as electrical, ischemic and hemodynamic events. ⋯ Risk stratification implies aggressive investigation (electrophysiological study and/or forearm plethysmography during exercise and/or tilt test) in order to identify the most probable mechanism involved in each case and to select individualized preventive measures (pharmacological, surgical, implantable cardioverter defibrillator). The role of amiodarone is still controversial because of contradictory results with this drug in this illness.
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Comparative Study
[The contribution and usefulness of routine intraoperative transesophageal echocardiography in cardiac surgery. An analysis of 130 consecutive cases].
To assess the value of routine intraoperative transesophageal echocardiography (TEE) in unselected patients (P) undergoing cardiac surgery. ⋯ These data indicate that intraoperative TEE is useful in formulating the surgical plan and assessing immediate operative results as well as a guide to anesthetic procedures. Its high rentabillity in modifying the surgical and/or anesthetic plans lead us to believe that it must be used as a routine procedure in patients undergoing cardiac surgery.