Angiotensin II: A Review of Current Literature.

Up to one-third of all patients admitted to intensive care units carry a diagnosis of shock. The use of angiotensin II is becoming widespread in all forms of shock, including cardiogenic, after the U.S. Food and Drug Administration's (FDA's) initial approval for vasoplegic shock in 2017. Here, the authors review the literature on angiotensin II's mechanism of action, benefits, and future therapeutic opportunities.

Angiotensin II: A Multimodal Approach to Vasoplegia in a Cardiac Setting.

Patients experiencing vasoplegia, a type of distributive shock, have limited options when conventional vasopressors are not appropriate or sufficient. This is especially true for patients with cardiac dysfunction, whether after heart transplant or ventricular assist device (VAD) implantation. Angiotensin II has been used in various clinical settings for distributive shock; however, its role in patients after orthotopic heart transplant or VAD implantation is not well studied. We present two cases where angiotensin II played a vital role in correcting vasoplegia for critical cardiac patients.

Papillary fibroelastoma in the left ventricle.

We present a 61-year-old woman with a recent transient ischemic attack who presented with presyncope and was ultimately found to have a papillary fibroelastoma at the apex of her left ventricle. She underwent minimally invasive excision of the tumor.

Isolated mitral valve endocarditis with ring abscess and pericarditis in end-stage renal disease.

Described herein is a 68-year-old man with end-stage renal disease on hemodialysis who was found to have methicillin-sensitive Staphylococcus aureus endocarditis with an associated ring abscess that extended into the left atrioventricular sulcus and ruptured into the pericardial space causing pericardial effusion. In contrast to the frequency of infective endocarditis involving the aortic valve, ring abscess associated with infection of the mitral valve is uncommon.