Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Idoso , Cardiomiopatia Hipertrófica/diagnóstico por imagem , Acidente Vascular Cerebral/tratamento farmacológico , Embolia Intracraniana/etiologia , Doença de Moyamoya/terapia , Doença de Moyamoya/diagnóstico por imagem , Fibrilação Atrial/complicações , Tomografia Computadorizada por Raios X/métodos , Ecocardiografia Doppler em Cores , Inibidores de Hidroximetilglutaril-CoA Redutases/farmacologia , Acidente Vascular Cerebral/complicações , Eletrocardiografia , Valsartana/farmacologia , Terapia Antiplaquetária Dupla/métodos , Anticoagulantes/farmacologiaRESUMO
SARS-CoV-2, along with SARS-CoV and MERS-CoV, forms part of the three highly pathogenic coronaviruses identified since the start of the millennium.1,2 While SARS-CoV was identified on 2003 and MERS-CoV on 2012, the initial reports of SARS-CoV-2 (the etiological agent of COVID-19) were first released at the end of December 2019.3,4 Now, after less than four months, the virus has distributed globally and has become the focus of extensive medical research, as the number of cases keeps rising.A significant part of the investigative effort has been directed to the search for an effective therapy or intervention that could stop the spread of the disease or be used to effectively treat infected patients. Likewise, potential predisposing factors to develop a more severe clinical presentation are progressively being identified. Some of the more relevant are older age and the presence of certain comorbidities, such as cerebrovascular and coronary heart disease, hypertension and diabetes.58 It is important to highlight that the last two are chronic conditions commonly treated with ACE-inhibitors and angiotensin II type-I receptor blockers.911 However, the evidence suggests that these medications can upregulate the expression of angiotensin converting enzyme 2 (ACE2), the cellular receptor for both SARS-CoV and SARS-CoV-2.1116 Thus, a group of researchers hypothesized that ACE2-increasing drugs could raise the risk of infection and prompt a more severe clinical course or a fatal outcome in diabetic and hypertensive patients.
Assuntos
Humanos , Lesão Pulmonar Aguda , Inibidores da Liberação da Acetilcolina , SARS-CoV-2 , COVID-19 , Infecções , Angiotensinas , Receptores de Angiotensina , Doença das Coronárias , Coronavírus da Síndrome Respiratória do Oriente MédioRESUMO
Hepatocellular carcinoma is a tumor that rarely invades the inferior vena cava and right heart. We describe the case of a 63-year-old man with jaundice and a history of cryptogenic hepatic cirrhosis with diagnosis of hepatocellular carcinoma. He was referred to the echocardiography laboratory for sudden dyspnea and suggestion of pulmonary thromboembolism. Echocardiographic study reported a mass in the right atrium proceeding from the inferior vena cava.