European heart journal. Acute cardiovascular care
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Eur Heart J Acute Cardiovasc Care · Dec 2016
Review Case ReportsST-segment elevation in V1-V4 in acute pulmonary embolism: a case presentation and review of literature.
Electrocardiographic (ECG) abnormalities are seen in 70%-80% of patients with acute pulmonary embolism (APE). Rarely, APE presents with ST-segment elevation (STE) in leads V1-V4, mimicking ST-segment elevation myocardial infarction (STEMI). Herein, we describe a case of APE presenting with STE in V1-V3, along with a comprehensive review of the literature. ⋯ STE in leads V1-V3/V4 in cases with APE identifies a subset of patients who are an intermediate to high risk category. In cases presenting with right precordial lead STE and clinical features that are more suggestive of APE rather than STEMI, a computed tomography pulmonary angiogram is warranted for earlier diagnosis of suspected APE, which allow for immediate-rather than delayed-initiation of therapeutic anticoagulant therapy if the diagnosis is confirmed and may avert the need for coronary angiography.
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Eur Heart J Acute Cardiovasc Care · Dec 2016
Prognostic value of different biomarkers for cardiovascular death in unselected older patients in the emergency department.
Risk stratification of elderly patients presenting with heart failure (HF) to an emergency department (ED) is an unmet challenge. We prospectively investigated the prognostic performance of different biomarkers in unselected older patients in the ED. ⋯ Within different biomarkers, MR-proADM was the only predictor of cardiovascular deaths in unselected older patients presenting to the ED.
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Eur Heart J Acute Cardiovasc Care · Dec 2016
Observational StudyMonitoring of left ventricular assist device implantation and set-up with miniaturized transoesophageal echocardiography: Initial experience at La Pitié-Salpêtrière Hospital and possible application fields.
Left ventricular assist devices are valuable options for mechanical circulatory support in patients with severe heart failure as a bridge to cardiac transplantation, to recovery, or as destination therapy. Transoesophageal echocardiography plays a key role in the management of left ventricular assist device patients; either in guiding the device implantation or in post-operative haemodynamic assessment. The aim of this observational study is to investigate the usefulness of a miniaturized transoesophageal echocardiography probe designed for continuous haemodynamic monitoring (haemodynamic transoesophageal echocardiography; ImaCor, Garden City, NY) in the haemodynamic assessment of patients undergoing left ventricular assist device implantation. ⋯ This observation suggests that haemodynamic monitoring using the haemodynamic transoesophageal echocardiography system in left ventricular assist device patients is feasible after a brief training period. The overall impact of haemodynamic transoesophageal echocardiography use in these patients is yet to be determined and further studies are still required.
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We present a rare image documenting direct transit of a thrombus originating from the venous circulation and passing through a patent foramen ovale linked to a malpositioned cannula in the setting of temporary mechanical circulatory assistance in a young patient who underwent a peripheral extra corporeal membrane oxygenation as a circulatory support.
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Eur Heart J Acute Cardiovasc Care · Nov 2016
Review Multicenter Study Observational StudyAssociation of anemia and renal dysfunction with in-hospital mortality among patients hospitalized for acute heart failure syndromes with preserved or reduced ejection fraction.
The aim of this study was to evaluate the association of anemia and renal dysfunction with in-hospital outcomes in acute heart failure syndromes patients with preserved or reduced ejection fraction. ⋯ Our findings demonstrate that anemia combined with renal dysfunction is not a risk factor for in-hospital mortality in patients with a preserved ejection fraction, whereas anemia is an independent predictor of in-hospital mortality risk in reduced ejection fraction patients regardless of renal dysfunction.