Assuntos
Fibrilação Atrial , Ablação por Cateter , Cicatriz , Humanos , Fibrilação Atrial/cirurgia , Ablação por Cateter/métodos , Cicatriz/etiologia , Cicatriz/diagnóstico , Masculino , Feminino , Pessoa de Meia-Idade , Átrios do Coração/diagnóstico por imagem , Mapeamento Potencial de Superfície Corporal/métodosRESUMO
Kidney injury may be a severe complication of acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and contributes to worsen the prognosis. Various pathophysiological mechanisms can contribute to organ damage and impair renal function, proving the complexity of the virus activity and the resulting immunity response. We summarized the evidence of the literature on the prevalence of kidney involvement, on the pathogenic pathways and on its management.
RESUMO
The actual Coronavirus Disease (COVID 19) pandemic is due to Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a member of the coronavirus family. Besides the respiratory involvement, COVID 19 patients frequently develop a pro-coagulative state caused by virus-induced endothelial dysfunction, cytokine storm and complement cascade hyperactivation. It is common to observe diffuse microvascular thrombi in multiple organs, mostly in pulmonary microvessels. Thrombotic risk seems to be directly related to disease severity and worsens patients' prognosis. Therefore, the correct understanding of the mechanisms underlying COVID-19 induced prothrombotic state can lead to a thorough assessment of the possible management strategies. Hence, we review the pathogenesis and therapy of COVID 19-related thrombosis disease, focusing on the available evidence on the possible treatment strategies and proposing an algorithm for the anticoagulation strategy based on disease severity.
Assuntos
Anticoagulantes/uso terapêutico , Tratamento Farmacológico da COVID-19 , COVID-19/complicações , SARS-CoV-2/fisiologia , Trombofilia/virologia , Algoritmos , Interações Hospedeiro-Patógeno , HumanosAssuntos
Cardiomiopatia Dilatada/etiologia , Isquemia Miocárdica/etiologia , Tetralogia de Fallot/complicações , Adulto , Cardiomiopatia Dilatada/diagnóstico , Angiografia Coronária , Ecocardiografia , Feminino , Humanos , Imagem Cinética por Ressonância Magnética , Isquemia Miocárdica/diagnóstico , Tetralogia de Fallot/diagnósticoAssuntos
Injúria Renal Aguda , Betacoronavirus/isolamento & purificação , Infecções por Coronavirus , Pandemias , Pneumonia Viral , Injúria Renal Aguda/diagnóstico , Injúria Renal Aguda/etiologia , Injúria Renal Aguda/terapia , Injúria Renal Aguda/virologia , Idoso de 80 Anos ou mais , COVID-19 , Teste para COVID-19 , Deterioração Clínica , Técnicas de Laboratório Clínico/métodos , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/tratamento farmacológico , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/fisiopatologia , Infecções por Coronavirus/terapia , Feminino , Humanos , Testes de Função Renal , Pulmão/diagnóstico por imagem , Pulmão/fisiopatologia , Oxigenoterapia/métodos , Administração dos Cuidados ao Paciente/métodos , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Pneumonia Viral/fisiopatologia , Pneumonia Viral/terapia , SARS-CoV-2 , Tomografia Computadorizada por Raios X/métodos , Resultado do Tratamento , Tratamento Farmacológico da COVID-19RESUMO
We report the case of a patient with recurrent episodes of postoperative intra-atrial reentrant tachycardia occurring after surgical patch closure of a sinus venosus atrial septal defect (SVASD). Arrhythmic episodes, as usually reported in scar-related arrhythmias, were resistant to antiarrhythmic therapy and worsened patient's quality of life. Therefore, we decided to perform an intracardiac electrophysiology study using a 3D-high definition mapping system to identify and treat the precise arrhythmic substrate with radiofrequency ablation. There is a growing evidence that this technique represents a valid therapeutic option in postoperative arrhythmias refractory to medical treatment in patients with repaired congenital heart disease.
Assuntos
Ablação por Cateter , Preparações Farmacêuticas , Taquicardia Supraventricular , Eletrocardiografia , Humanos , Qualidade de Vida , Taquicardia Supraventricular/cirurgiaRESUMO
As of January 2020, a new pandemic has spread from Wuhan and caused thousands of deaths worldwide. Several studies have observed a relationship between coronavirus disease (COVID-19) infection and the cardiovascular system with the appearance of myocardial damage, myocarditis, pericarditis, heart failure and various arrhythmic manifestations, as well as an increase in thromboembolic risk. Cardiovascular manifestations have been highlighted especially in older and more fragile patients and in those with multiple cardiovascular risk factors such as cancer, diabetes, obesity and hypertension. In this review, we will examine the cardiac involvement associated with SARS-CoV-2 infection, focusing on the pathophysiological mechanism underlying manifestations and their clinical implication, taking into account the main scientific papers published to date.