European heart journal. Acute cardiovascular care
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Eur Heart J Acute Cardiovasc Care · Oct 2015
Case ReportsFirst case of atypical takotsubo cardiomyopathy in a bilateral lung-transplanted patient due to acute respiratory failure.
Takotsubo cardiomyopathy which is characterised by a transient left ventricular wall motion abnormality was first described in 1990. The disease is still not well known, and as such it is suggested that an emotional trigger is mandatory in this disease. ⋯ Little is known about the association of hypoxia and takotsubo cardiomyopathy which can elicit a life-threatening condition requiring acute intensive care. Therefore, experimental studies are needed to investigate the role of hypoxia in takotsubo cardiomyopathy.
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Eur Heart J Acute Cardiovasc Care · Oct 2015
Observational StudyEarly rule-out of acute coronary syndrome using undetectable levels of high sensitivity troponin T.
To examine whether undetectable high sensitivity troponin T (hsTnT) can be used to safely rule out non-ST-elevation acute coronary syndrome (NSTE-ACS) (using the limit of detection (LOD) as the cut-off) and to compare this strategy to serial hsTnT and the use of combined hsTnT and copeptin. ⋯ A single hsTnT test at presentation, using the LOD as the cut-off, appears to be a safe and time-saving strategy to rule out NSTE-ACS. Further, undetectable levels of hsTnT were associated with an excellent prognosis and none of the patients with undetectable hsTnT were diagnosed with NSTEMI. Together with ECG and clinical assessment this biomarker strategy might permit outpatient treatment of almost one third of the patients we currently admit for observation.
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Eur Heart J Acute Cardiovasc Care · Aug 2015
Value of syncope in patients with high-to-intermediate risk pulmonary artery embolism.
Syncope may develop in 9-35% of patients with pulmonary embolism (PE). Despite its severity and importance, the prognostic value of syncope in PE is unclear. We aimed to assess the value of syncope in patients with high-to-intermediate risk PE. ⋯ The history of syncope in patients with suspected PE should be considered as a possible criterion of high risk of fatal complications of in-hospital period due to frequent embolism of the pulmonary trunk and its main branches. The use of thrombolytic therapy showed a tendency in improving outcomes.
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Eur Heart J Acute Cardiovasc Care · Aug 2015
Randomized Controlled TrialAcute intraoperative effect of intravenous amiodarone on right ventricular function in patients undergoing valvular surgery.
Amiodarone is commonly used in the acute care setting. However the acute hemodynamic and echocardiographic effect of intravenous amiodarone administered intraoperatively on right ventricular (RV) systolic and diastolic function using transesophageal echocardiography (TEE) has not been described. ⋯ Acute administration of amiodarone is associated with alteration in RV diastolic properties and has minimal negative inotropic effect on RV systolic function in cardiac surgical patients with valvular disease.
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Eur Heart J Acute Cardiovasc Care · Aug 2015
Impact of patient positioning on lung ultrasound findings in acute heart failure.
The purpose of this study was to compare lung ultrasound findings in both the supine and upright positions in heart failure patients presenting with dyspnea or chest pain. ⋯ Our findings suggest that patient positioning may impact the number of B-lines on lung ultrasound in a heart failure population. A consistent approach to patient positioning during lung ultrasonography may be necessary in order to monitor dynamic changes in heart failure.