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1.
Cureus ; 16(5): e61107, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38919228

RESUMO

Cardiac arrest is a leading cause of mortality globally, and mechanical CPR devices like the LUCAS system are designed to improve outcomes by enhancing consistency and reducing rescuer fatigue. However, this case report of a 76-year-old female who suffered cardiac arrest post-flight reveals significant complications associated with mechanical CPR. Despite achieving initial resuscitation, she developed extensive liver damage and additional complications, which ultimately led to her death. This case underscores the importance of precise training and strict adherence to guidelines when using mechanical CPR devices. It highlights that while these devices offer potential benefits, they also pose risks, especially for vulnerable patients, necessitating careful consideration and ongoing evaluation to optimize safety and effectiveness.

2.
Clin Cardiol ; 47(6): e24298, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38873847

RESUMO

BACKGROUND: In patients with transthyretin cardiac amyloidosis (ATTR-CA), renal dysfunction is a poor prognostic indicator. Limited data are available on variables that portend worsening renal function (wRF) among ATTR-CA patients. OBJECTIVES: This study assesses which characteristics place patients at higher risk for the development of wRF (defined as a drop of ≥10% in glomerular filtration rate [GFR]) within the first year following diagnosis of ATTR-CA. METHODS: We included patients with ATTR-CA (n = 134) evaluated between 2/2016 and 12/2022 and followed for up to 1 year at our amyloid clinic. Patients were stratified into two groups: a group with maintained renal function (mRF) and a group with wRF and compared using appropriate testing. Significant variables in the univariate analysis were included in the multivariable logistic regression model to determine characteristics associated with wRF. RESULTS: Within a follow-up period of 326 ± 118 days, the median GFR% change measured -6% [-18%, +8]. About 41.8% (n = 56) had wRF, while the remainder had mRF. In addition, in patients with no prior history of chronic kidney disease (CKD), 25.5% developed de novo CKD. On multivariable logistic regression, only New York Heart Association (NYHA) class ≥III (odds ratio [OR]: 3.9, 95% confidence interval [CI]: [1.6-9.3]), history of ischemic heart disease (IHD) (OR: 0.3, 95% CI: [0.1-0.7]), and not receiving SGLT-2i (OR: 0.1, 95% CI: [0.02-0.5]) were significant predictors of wRF. CONCLUSION: Our study demonstrated that the development of de novo renal dysfunction or wRF is common following the diagnosis of ATTR-CA. Additionally, we identified worse NYHA class and no prior history of IHD as significant predictors associated with developing wRF, while receiving SGLT-2i therapy appeared to be protective in this population.


Assuntos
Neuropatias Amiloides Familiares , Cardiomiopatias , Taxa de Filtração Glomerular , Humanos , Masculino , Feminino , Neuropatias Amiloides Familiares/complicações , Neuropatias Amiloides Familiares/diagnóstico , Neuropatias Amiloides Familiares/fisiopatologia , Idoso , Cardiomiopatias/diagnóstico , Cardiomiopatias/fisiopatologia , Cardiomiopatias/etiologia , Prognóstico , Estudos Retrospectivos , Fatores de Risco , Pessoa de Meia-Idade , Seguimentos , Insuficiência Renal Crônica/diagnóstico , Insuficiência Renal Crônica/fisiopatologia , Insuficiência Renal Crônica/complicações , Insuficiência Renal Crônica/epidemiologia , Progressão da Doença , Rim/fisiopatologia , Fatores de Tempo , Incidência , Medição de Risco/métodos
3.
Curr Probl Cardiol ; 48(9): 101791, 2023 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-37172870

RESUMO

The diagnosis of infective endocarditis (IE) can pose a significant challenge, particularly in cases of prosthetic valve endocarditis (PVE) or cardiac device-related endocarditis (CDIE) (1). While echocardiography remains a crucial diagnostic tool for identifying IE, including PVE and CDIE, there are certain circumstances where transesophageal echocardiography (TEE) may not be conclusive or practically feasible (2). Recently, intracardiac echocardiography (ICE) has emerged as a promising alternative for diagnosing IE and evaluating intracardiac infections, especially in cases where transthoracic echocardiography (TTE) has not been revealing, and TEE has been contraindicated. Furthermore, ICE has been found to be useful in guiding transvenous lead extractions in infected implantable cardiac devices (3). This systematic review aims to comprehensively explore the various applications of ICE in the diagnosis of IE and assess its efficacy in comparison to traditional diagnostic methods.


Assuntos
Endocardite Bacteriana , Endocardite , Próteses Valvulares Cardíacas , Humanos , Endocardite Bacteriana/diagnóstico por imagem , Endocardite/diagnóstico por imagem , Endocardite/etiologia , Ecocardiografia/métodos , Ecocardiografia Transesofagiana/métodos
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