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1.
Rev Port Cir Cardiotorac Vasc ; 28(1): 53-55, 2021 Apr 08.
Artículo en Inglés | MEDLINE | ID: mdl-33834651

RESUMEN

Myxomas are the most common cardiac tumors; however right ventricular myxomas are very rare. We present the case of an asymptomatic 74 year old female with a right ventricular myxoma originating from the interventricular septum diagnosed during a routine echocardiographic examination. Initially the patient refused surgery due to being asymptomatic, but agreed to be operated two months later. Surgical removal was uneventful, as was the postoperative course. Histopathological analysis confirmed the suspected diagnosis of cardiac myxoma.


Asunto(s)
Neoplasias Cardíacas , Mixoma , Anciano , Ecocardiografía , Femenino , Neoplasias Cardíacas/diagnóstico por imagen , Neoplasias Cardíacas/cirugía , Ventrículos Cardíacos/diagnóstico por imagen , Humanos , Mixoma/diagnóstico por imagen , Mixoma/cirugía , Periodo Posoperatorio
2.
Angiol Sosud Khir ; 27(1): 39-47, 2021.
Artículo en Ruso | MEDLINE | ID: mdl-33825727

RESUMEN

BACKGROUND: The problems concerning assessment of the state of myocardial perfusion in patients with acute ST elevation myocardial infarction after successful revascularization still remain of current importance. Contrast-enhanced echocardiography remains the least studied and most promising ultrasound technology for the diagnosis of the no-reflow phenomenon. AIM: The study was aimed at evaluating echocardiographic and angiographic characteristics of the no-reflow phenomenon detected by means of contrast-enhanced echocardiography in patients with ST-segment elevation myocardial infarction. PATIENTS AND METHODS: The study included a total of forty-three 40-to-82-year-old patients in acute period of myocardial infarction. The patients were divided into two groups: 32 patients with satisfactory myocardial reperfusion after revascularization according to the findings of contrast-enhanced echocardiography and 11 patients with impaired perfusion. RESULTS: The patients in the group with impaired perfusion demonstrated a greater size of the left ventricular (LV) asynergy (40.1±2.2% vs 27.4±8.5%, p<0.001), more frequent LV dilatation (LV end-systolic volume 67.3±20.3 ml vs 51.8±17.2 ml, p=0.015), decreased LV contractility (LV ejection fraction 39.5±3.4% vs 47.2±4.9%, p < 0.001), and significant mitral regurgitation (45.5% vs 3.1%, p=0.011) with a decrease in DP/DT (979.9±363.4 mmHg/s vs 1565.7±502.8 mmHg/s, p<0.001) were more often detected in this group. Coronary angiography showed no perfusion disorders after revascularization in more than a quarter of these patients. In the group with impaired perfusion, more frequently revealed were single-vascular lesions (46.9% vs 9.1%, p=0.033), lesions of the anterior interventricular artery (90.9% vs 40.6%, p=0.004), and acute occlusion (100% vs 68.8%, p=0.043); compliance by the SYNTAX score in this group was higher (18.9±3.7 vs 9.9±5.7, p<0.001). CONCLUSION: In patients with acute myocardial infarction after successfully performed revascularization, perfusion disorders revealed by the findings of contrast-enhanced echocardiography were accompanied by more pronounced echo signs of left-ventricular dysfunction, higher values of the SYNTAX score and significantly more frequently revealed lesions of the anterior interventricular septum as compared with the patients with recovered perfusion.


Asunto(s)
Infarto del Miocardio , Fenómeno de no Reflujo , Infarto del Miocardio con Elevación del ST , Angiografía Coronaria , Ecocardiografía , Humanos , Infarto del Miocardio/diagnóstico , Fenómeno de no Reflujo/diagnóstico , Fenómeno de no Reflujo/etiología , Infarto del Miocardio con Elevación del ST/diagnóstico , Infarto del Miocardio con Elevación del ST/diagnóstico por imagen
3.
Mymensingh Med J ; 30(2): 281-291, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33830104

RESUMEN

Rheumatic heart disease causes a substantial number of morbidity and mortality in South Asia. With the increasing urbanization & antibiotic availability, it is now in declining trends. The prevalence of Rheumatic Fever and Chronic Rheumatic Heart Disease in Bangladesh is 0.6 and 0.3 per thousand populations, respectively. Mitral valve is mostly involved in the rheumatic process, particularly in the form of mitral stenosis. Treatment options of mitral stenosis depend upon the severity of the disease. Echocardiography has a key role in determining the pattern, extent and severity of the involvement of the mitral valve apparatus. 2D and Doppler echocardiography are conventionally used. 3D echocardiography is more available nowadays. The heart being a complex three-dimensional structure, a 3D evaluation would definitely offer better visualization for accurate assessment of the severity of rheumatic mitral stenosis. There are many echocardiography based scoring systems are available for the assessment of the severity of rheumatic MS. Those are mostly 2DE based; among them, Wilkins is widely practiced. Real-time 3DE based score for mitral stenosis is developed recently. This cross-sectional observational study was done in the University Cardiac Centre, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from May 2012 to October 2012. Considering all ethical issues, data were collected from 50 subjects who underwent transthoracic 2D and 3D Echocardiography for the assessment of the extent and severity of mitral stenosis. Precise measurement of the mitral valvular area is of a pivotal role in the assessment of severity, which is found almost similar by both 2DE (0.98±0.24cm²) and 3DE (0.92±0.23cm²). But in identifying calcification and its extent specifically commissural involvement is better detected by 3DE (p=0.002). Detail assessment of subvalvular involvement particularly chordal adhesion can better be done by 3DE (p<0.001). All of these have important contributions in formulating the most favorable therapeutic roadmap in chronic rheumatic MS. To make an efficient management plan and also for the confident prediction of complications, three-dimensional echocardiography has promising prospects and should be considered as an important adjuvant to the conventional two-dimensional echocardiography.


Asunto(s)
Ecocardiografía Tridimensional , Estenosis de la Válvula Mitral , Cardiopatía Reumática , Bangladesh/epidemiología , Estudios Transversales , Ecocardiografía , Humanos , Estenosis de la Válvula Mitral/diagnóstico por imagen , Cardiopatía Reumática/diagnóstico , Cardiopatía Reumática/diagnóstico por imagen
4.
Mymensingh Med J ; 30(2): 292-300, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33830105

RESUMEN

This study is aimed to find out various clinical, radio-graphical and echocardiographic variables to predict mitral valvular disease and their correlation with Echocardiography. This cross-sectional observational study was conducted in the Department of Radiology and Imaging, in collaboration with Department of Cardiology, Mymensingh Medical College Hospital (MMCH), Mymensingh, Bangladesh from January 2017 to December 2018. Total 50 consecutive cases enrolled in this study who was the patients of mitral valvular disease. Both chest radiograph and echocardiograph were done for each patient. There were 76% female and 26% male with a female-male ratio 3.16:1 with mean±SD (41.54±12.44). About 42% patients had previous history of rheumatic fever. The most common x-ray findings of heart were increased central density (90%) followed by enlargement in transverse diameter (88%), straightening of the left border (88%), widening of the carina (86%), full pulmonary conus (84%) and double contour of right border (76%). About 47(94%) patients confirmed mitral valvular heart disease on echocardiography. The prominent findings included left atrium was predominantly severely dilated (50%), severely reduced mitral valve orifice area (68%), mild mitral regurgitation (46%) and mild pulmonary hypertension (38%). And overall sensitivity, specificity, PPV, NPV and accuracy of chest radiograph in the detection of mitral valvular heart disease were 85.11%, 66.67%, 97.56%, 14.89% and 84%, respectively. These findings suggest that chest radiograph could be used as an adjunct tool with echocardiography.


Asunto(s)
Enfermedades de las Válvulas Cardíacas , Insuficiencia de la Válvula Mitral , Bangladesh/epidemiología , Estudios Transversales , Ecocardiografía , Femenino , Enfermedades de las Válvulas Cardíacas/diagnóstico por imagen , Enfermedades de las Válvulas Cardíacas/epidemiología , Humanos , Masculino , Válvula Mitral/diagnóstico por imagen , Insuficiencia de la Válvula Mitral/diagnóstico por imagen , Radiografía
5.
Wiad Lek ; 74(3 cz 1): 395-398, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33813439

RESUMEN

OBJECTIVE: The aim: The purpose of the present research was to study the results of coronary artery bypass graft (CABG) surgery depending on the degree of left ventricular ejection fraction (LVEF) reduction with the aim to identify additional echocardiographic predictors of the early postoperative period. PATIENTS AND METHODS: Materials and methods: Were fixed, the results of CABG in 97 patients operated on in the "Bikard" private clinic from March 2016 to December 2018 were the material of the research. All patients underwent CABG surgery under cardiopulmonary bypass and cardioplegia, and in the preoperative period underwent echocardiographic examination according to the standard technique on the Vivid 7 machine. Patients, in dependent of the LVEF, were divided into 3 groups: group 1 35 people (LVEF < 40%), group 2 32 people ( 40% < LVEF < 50%), group 3 30 people (LVEF > 50%). RESULTS: Results: Our studies showed that the most important echocardiographic predictors of a complicated development of the disease in the early postoperative period, in addition to LVEF of the heart, can be the size of the left ventricle and left atrial, the presence and severity of mitral regurgitation and diastolic dysfunction of the left ventricle of the heart. CONCLUSION: Conclusions: Comprehensive measurement of these echocardiographic parameters will allow more accurately predict the results of coronary artery bypass grafting in the early postoperative period.


Asunto(s)
Disfunción Ventricular Izquierda , Función Ventricular Izquierda , Puente de Arteria Coronaria , Ecocardiografía , Humanos , Periodo Posoperatorio , Volumen Sistólico , Resultado del Tratamiento , Disfunción Ventricular Izquierda/diagnóstico por imagen
6.
Diving Hyperb Med ; 51(1): 98-102, 2021 Mar 31.
Artículo en Inglés | MEDLINE | ID: mdl-33761549

RESUMEN

The case of a diver with a history of decompression sickness (DCS) after recreational scuba diving is presented. Cutis marmorata, a subtype of cutaneous DCS, has been consistently associated with the presence of a persistent (patent) foramen ovale (PFO) as a risk factor. Diagnostic uncertainty arose when transthoracic echocardiography with antecubital injection of agitated saline bubbles (ASBs) did not show any significant shunt, but the presence of a large Eustachian valve was counteracted by intra-femoral injection of ASBs, showing a large PFO with spontaneous shunting. The importance of proper echocardiography techniques prior to resorting to intra-femoral injection of ASBs to counteract the haemodynamic effects of the Eustachian valve is emphasised.


Asunto(s)
Enfermedad de Descompresión , Buceo , Foramen Oval Permeable , Foramen Oval , Enfermedad de Descompresión/diagnóstico por imagen , Enfermedad de Descompresión/etiología , Buceo/efectos adversos , Ecocardiografía , Foramen Oval/diagnóstico por imagen , Foramen Oval Permeable/complicaciones , Foramen Oval Permeable/diagnóstico por imagen , Humanos , Factores de Riesgo
7.
J Med Case Rep ; 15(1): 143, 2021 Mar 19.
Artículo en Inglés | MEDLINE | ID: mdl-33741059

RESUMEN

BACKGROUND: There are limited data on cardiovascular complications of coronavirus disease 2019 in pregnancy, and there are only a few case reports on coronavirus disease 2019 related cardiomyopathy in pregnancy. Differentiation between postpartum cardiomyopathy and coronavirus disease 2019 related cardiomyopathy in pregnant women who develop severe acute respiratory syndrome coronavirus-2 infection during peripartum could be challenging. Here, we present a case of possible coronavirus disease 2019 related cardiomyopathy in a pregnant patient, followed by a discussion of potential differential diagnosis. CASE PRESENTATION: In this case report, we present the case of a young pregnant Iranian woman who developed heart failure with pulmonary edema after cesarean section. She was treated because of low left ventricular ejection fraction and impression of postpartum cardiomyopathy, and her severe dyspnea improved by intravenous furosemide. On day 3, she exhibited no orthopnea or leg edema, but she was complaining of severe and dry cough. Further evaluation showed severe acute respiratory syndrome coronavirus-2 infection. CONCLUSIONS: The possibility of severe acute respiratory syndrome coronavirus-2 infection should be considered in any pregnant woman who develops cardiomyopathy and pulmonary edema.


Asunto(s)
/diagnóstico , Cardiomiopatías/diagnóstico , Insuficiencia Cardíaca/diagnóstico , Trastornos Puerperales/diagnóstico , Edema Pulmonar/diagnóstico , Adulto , Antibacterianos/uso terapéutico , Antivirales/uso terapéutico , Azitromicina/uso terapéutico , /terapia , Cardiomiopatías/tratamiento farmacológico , Cardiomiopatías/fisiopatología , Cesárea , Tos/fisiopatología , Diagnóstico Diferencial , Diuréticos/uso terapéutico , Disnea/fisiopatología , Ecocardiografía , Electrocardiografía , Femenino , Furosemida/uso terapéutico , Insuficiencia Cardíaca/tratamiento farmacológico , Insuficiencia Cardíaca/fisiopatología , Humanos , Inmunoglobulinas Intravenosas/uso terapéutico , Factores Inmunológicos/uso terapéutico , Interferón beta/uso terapéutico , Pulmón/diagnóstico por imagen , Preeclampsia , Embarazo , Trastornos Puerperales/tratamiento farmacológico , Trastornos Puerperales/fisiopatología , Edema Pulmonar/tratamiento farmacológico , Edema Pulmonar/fisiopatología , Volumen Sistólico , Tomografía Computarizada por Rayos X
8.
Am J Vet Res ; 82(4): 274-279, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33764827

RESUMEN

OBJECTIVE: To determine repeatability, reproducibility, and reference intervals of indices of right atrial longitudinal strain (RALS) derived from speckle-tracking echocardiography (STE) in dogs without heart disease. ANIMALS: 110 client-owned dogs and 10 laboratory Beagles. PROCEDURES: To determine intraobserver within-day (repeatability) and interobserver (reproducibility) coefficients of variation, RALS during ventricular systole (ϵS), ventricular early diastole (ϵE), and atrial systole (ϵA), as derived with STE, were obtained by 2 investigators for 5 randomly selected client-owned dogs and analyzed by linear regression. Reference intervals were estimated from the results of all dogs. Correlations between RALS indices (ϵS, ϵE, and ϵA) and sex, age, body weight, heart rate, and blood pressure were determined. RESULTS: RALS derived from STE showed good intraobserver within-day repeatability and interobserver reproducibility, with coefficients of variation of < 20%. Both ϵS and ϵE were significantly negatively correlated with age, but ϵA was not correlated with age. Indices were not correlated with sex, body weight, or blood pressure. CONCLUSIONS AND CLINICAL RELEVANCE: RALS indices derived from STE were repeatable and reproducible and were affected by the age of dogs without heart disease. Age should be considered in the interpretation of RALS indices in clinical settings. Further studies are needed to apply RALS indices for assessing dogs with heart disease.


Asunto(s)
Ecocardiografía , Atrios Cardíacos , Animales , Perros , Ecocardiografía/veterinaria , Atrios Cardíacos/diagnóstico por imagen , Ventrículos Cardíacos/diagnóstico por imagen , Reproducibilidad de los Resultados , Sístole
9.
Medicine (Baltimore) ; 100(8): e24896, 2021 Feb 26.
Artículo en Inglés | MEDLINE | ID: mdl-33663121

RESUMEN

INTRODUCTION: Hemodynamically-instable ventricular arrhythmias (VAs) are rare in patients with pulmonary hypertension (PH). To the best of our knowledge, only 1 case has been reported so far. Moreover, the pathogenesis of this kind of arrhythmia remains obscured and its treatment is challenging. Here we report another case and presented the substrate for VAs initiation and therapeutic effect of radiofrequency ablation. PATIENT CONCERNS: This is a 57-year-old man who presented paroxysmal palpitation associated with presyncope at rest. Surface electrocardiogram (ECG) revealed frequent ventricular premature contractions and non-sustained ventricular tachycardia when symptoms occurred. He also had a history of severe PH which was secondary to atrial septal defect and partial anomalous pulmonary venous drainage and suffered from obvious dyspnea when climbing stairs World Health Organization Class III (WHO Class III). DIAGNOSIS: Hemodynamically-instable VAs associated with severe PH. INTERVENTION: Echocardiography revealed enlargement of right ventricle (right ventricle [RV]: 43 mm). Electrophysiological examination showed the origin of VAs is next to a small low-voltage zone of RV. Radiofrequency delivery at the origin successfully terminated VAs without occurrence of complication. OUTCOME: The patient was free from arrhythmias and got an improvement of exercise tolerance, just with mild dyspnea when climbing stairs World Health Organization Class II (WHO class II), during six-month follow up. LESSONS: This case suggests the low-voltage zone of remodeled RV, which may be secondary to increased pulmonary artery pressure, serves as the substrate for VAs initiation in patient with PH. Radiofrequency ablation can successfully terminate VAs and the termination of VAs can significantly improve the patient's impaired exercise tolerance.


Asunto(s)
Hipertensión Pulmonar/complicaciones , Ablación por Radiofrecuencia/métodos , Complejos Prematuros Ventriculares/complicaciones , Ecocardiografía , Técnicas Electrofisiológicas Cardíacas/métodos , Ventrículos Cardíacos/diagnóstico por imagen , Ventrículos Cardíacos/fisiopatología , Humanos , Hipertensión Pulmonar/fisiopatología , Masculino , Persona de Mediana Edad , Complejos Prematuros Ventriculares/fisiopatología , Complejos Prematuros Ventriculares/terapia , Remodelación Ventricular
10.
Heart Fail Clin ; 17(2): 179-186, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33673943

RESUMEN

Stage A and B heart failure (HF) include asymptomatic patients without and with structural cardiac disorder, respectively. Asymptomatic left ventricular (LV) dysfunction represents an early stage of HF that should be recognized to prevent overt HF development. Echocardiography plays a pivotal role in assessment of cardiac structure and function and represents the ideal imaging technique for screening in the general population, thanks to its availability, feasibility, and low cost. Traditional echocardiography, with LV systolic and diastolic function and cardiac remodeling assessment, is usually performed. Development of new technologies may offer additional information and insights in detection of early LV dysfunction.


Asunto(s)
Enfermedades Asintomáticas , Ecocardiografía/métodos , Tamizaje Masivo/métodos , Salud Pública , Disfunción Ventricular Izquierda/diagnóstico , Humanos , Disfunción Ventricular Izquierda/fisiopatología
11.
Acute Med ; 20(1): 15-17, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33749690

RESUMEN

We assessed the efficacy of thrombolysis in avoiding long-term complications. Notes of patients thrombolysed for PE in the 2-year period were reviewed. The initial CTPA and echocardiogram results before thrombolysis were compared to the results of follow up imaging repeated after 6 months. Twenty-two patients were thrombolysed for PE. 14 patients had sub-massive PE and 8 patients had massive PE. The right ventricle (RV) was dilated on pre-thrombolysis echocardiogram in 16 patients. On follow up echocardiography all patients with massive PE (6 studies) had a normal RV size, with pulmonary artery pressures (PAP) of 29mmHg. Follow up echocardiography of patients with submassive PE (13 studies) showed 11 patients with a normal RV, with PAP of 28 mmHg.


Asunto(s)
Embolia Pulmonar , Terapia Trombolítica , Ecocardiografía , Humanos , Embolia Pulmonar/tratamiento farmacológico , Estudios Retrospectivos , Resultado del Tratamiento
12.
World J Pediatr Congenit Heart Surg ; 12(2): 293-296, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33684003

RESUMEN

Interruption of the ascending aorta is an extremely rare anomaly defined by a point of interruption between the intrapericardial and extrapericardial aorta and can be explained by developmental errors proximal to the embryologic right aortic sac. Herein, we present a case of interruption of the ascending aorta and describe a successful biventricular surgical repair of this unique anomaly.


Asunto(s)
Aorta Torácica/cirugía , Tronco Braquiocefálico/cirugía , Procedimientos Quirúrgicos Cardíacos/métodos , Malformaciones Vasculares/cirugía , Aorta Torácica/diagnóstico por imagen , Tronco Braquiocefálico/diagnóstico por imagen , Ecocardiografía/métodos , Femenino , Humanos , Lactante , Malformaciones Vasculares/diagnóstico
13.
Isr Med Assoc J ; 23(3): 149-152, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33734626

RESUMEN

BACKGROUND: Takotsubo syndrome (TTS) is a non-ischemic cardiomyopathy characterized by an acute reversible left ventricular dysfunction with typical apical ballooning, usually with subsequent complete spontaneous recovery. TTS may be triggered by several physical and emotional stressors. The name Covidsubo was recently adopted to describe this emerging entity. TTS during quarantine may be a reasonable outcome of the overwhelming stress and fear of this pandemic. However, according to the current literature, conflicting results have been reported regarding the incidence of this syndrome during the first wave of the pandemic, and further studies are needed. High index of suspicion is needed to identify patients during the next waves of the pandemic, particularly given the need for minimizing imaging modalities and contact with the patients. OBJECTIVES: To describe two cases of TTS triggered by quarantine during the coronavirus disease-2019 (COVID-19) pandemic. METHODS: Two patients (age 81 years and 70 years) were admitted to our medical center with severe chest pain with normal blood pressure and heart rate. RESULTS: TTS should always be in the differential diagnosis in patients presenting with chest pain suspected to be from coronary origin. Based on the typical clinical, echocardiographic, and angiographic findings, we assumed TTS. CONCLUSIONS: The only prominent stressor in the two cases in this article was the stress accompanying quarantine.


Asunto(s)
/psicología , Ecocardiografía/métodos , Ventrículos Cardíacos , Estrés Psicológico , Cardiomiopatía de Takotsubo , Anciano , Anciano de 80 o más Años , Angiografía Coronaria/métodos , Diagnóstico Diferencial , Electrocardiografía/métodos , Femenino , Ventrículos Cardíacos/diagnóstico por imagen , Ventrículos Cardíacos/fisiopatología , Humanos , Manejo de Atención al Paciente/métodos , Cuarentena/psicología , Estrés Psicológico/epidemiología , Estrés Psicológico/etiología , Estrés Psicológico/fisiopatología , Estrés Psicológico/prevención & control , Cardiomiopatía de Takotsubo/diagnóstico , Cardiomiopatía de Takotsubo/fisiopatología , Cardiomiopatía de Takotsubo/psicología , Cardiomiopatía de Takotsubo/terapia , Resultado del Tratamiento
14.
Medicine (Baltimore) ; 100(12): e25151, 2021 Mar 26.
Artículo en Inglés | MEDLINE | ID: mdl-33761684

RESUMEN

ABSTRACT: In 2014, the American College of Cardiology/American Heart Association (ACC/AHA) released guidelines for ordering pre-operative echocardiograms in patients undergoing non-cardiac surgery. The purpose of this study is to determine if pre-operative echocardiograms ordered prior to fragility hip fracture repair are ordered according to these guidelines, change anesthetic management or affect patient outcomes. In addition, we attempted to evaluate the efficacy of the ACC/AHA guidelines.We conducted a 4-year retrospective chart review of acute fragility hip fractures at a single institution. Charts were reviewed to determine which patients met criteria for a pre-operative echocardiogram. Within this group we then compared patients who received a pre-operative echocardiogram to those who did not. Comparisons were made with regard to time to surgery, changes from standard anesthetic management, major adverse cardiac events, length of hospital stay, and 1-year mortality. We also examined which patients received postoperative echocardiograms and the incidence of adverse cardiac events in this group.Of 402 patients, 87 (22%) had ACC/AHA indications for pre-operative echocardiogram, and 42 (48%) of them received one. The indication to order a pre-operative echocardiogram in stable heart failure or valve disease patients if their last echo was greater than 1 year was only followed 23% of the time. In the pre-operative echocardiogram group, anesthetic management was adjusted more frequently (P = .025), and average time to surgery was greater (P < .001). The incidence of a major adverse cardiac event was 10% in the ACC/AHA echocardiogram indicated group and 3% in the non-indicated echocardiogram group. An equal number of echocardiograms were completed postoperatively as were completed under ACC/AHA pre-operative guidelines. Sixty-seven percent of the postoperative echocardiograms did not have ACC/AHA pre-operative indications.Our data demonstrates that pre-operative echocardiograms for "stable heart failure and valvular disease with greater than 1 year from last echocardiogram" is infrequently performed without significant adverse cardiac outcomes. Pre-operative echocardiography was associated with more anesthetic adjustments and longer time to surgery. Postoperative echocardiograms were done for cardiopulmonary complications. Studies need to examine and refine clinical parameters that would improve the selection of patients who would benefit from pre-operative echocardiograms.


Asunto(s)
Ecocardiografía/normas , Cardiopatías/prevención & control , Fracturas de Cadera/diagnóstico por imagen , Fracturas Osteoporóticas/diagnóstico por imagen , Complicaciones Posoperatorias/prevención & control , Cuidados Preoperatorios/normas , Anciano de 80 o más Años , Femenino , Fijación de Fractura/efectos adversos , Fijación de Fractura/normas , Adhesión a Directriz/estadística & datos numéricos , Cardiopatías/epidemiología , Cardiopatías/etiología , Fracturas de Cadera/cirugía , Humanos , Incidencia , Masculino , Fracturas Osteoporóticas/cirugía , Complicaciones Posoperatorias/epidemiología , Complicaciones Posoperatorias/etiología , Estudios Retrospectivos , Medición de Riesgo
15.
Kardiologiia ; 61(1): 66-71, 2021 Feb 10.
Artículo en Inglés | MEDLINE | ID: mdl-33706689

RESUMEN

Goals Discrimination of the time course of functional recovery in early period following ST elevation myocardial infarction (STEMI) has prognostic importance. This study aims to establish the ability of the combined systolic-diastolic index (E / (Ea x Sa), for differentiating recoverable myocardium or persistent non-viability in subjects with STEMI.Material and methods 77 patients with first acute STEMI were enrolled to the study. Serial transthoracic echocardiography (TTE) examinations were performed at the time of the admission (immediately after reperfusion), hospital discharge (5±1 days) and control examination (30±2 days). To assess the association between E / (Ea×Sa) index and myocardial recovery, two categories (Transient stunning and persistent non-viability) were defined on basis of improvement of left ventricle ejection fraction (LV EF) (Improvement was defined as an increase more than 10 % in LV EF at day 30 compared to baseline).Results 55 patients (71.4 %) had improvement of LV EF and 24 patients (28.6 %) had no recovery of systolic function (30 days LV EF 48.78±6.1 vs. 39.31±8.1 %, p=0.01). The E / (Ea×Sa) index were significantly higher in the "non-viability" than in stunning group on predischarge and 1 month (1.61±0.64 vs 1.25±0.43, p=0.01 and 1.33±0.25 vs 1.14±0.21, p=0.01, respectively). The change in the E / (Ea×Sa) index in early period (within 5±1 days) was higher in the stunning group (26 %) compared to non-viability group (15 %) (p=0.033). E / (Ea×Sa) index was found to be a significant predictor of myocardial recovery in multivariable logistic regression (OR 0.91, 95 % CI 0.83-0.98, p=0.001). Roc curve showed that the cutoff value of E / (Ea×Sa) index is 1.29 with 73 % of sensitivity and 61 % of specificity (AUC: 0.71, p=0.01, CI: 0.54-0.89).Conclusions Our findings suggest that E / (Ea×Sa) index is a strong predictor of functional recovery; the odds of recovery decreases as E / (Ea×Sa) index value increases.


Asunto(s)
Infarto del Miocardio con Elevación del ST , Diástole , Ecocardiografía , Humanos , Miocardio , Valor Predictivo de las Pruebas , Infarto del Miocardio con Elevación del ST/diagnóstico , Función Ventricular Izquierda
16.
Undersea Hyperb Med ; 48(1): 73-80, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33648036

RESUMEN

Venous gas emboli (VGE) are often quantified as a marker of decompression stress on echocardiograms. Bubble-counting has been proposed as an easy to learn method, but remains time-consuming, rendering large dataset analysis impractical. Computer automation of VGE counting following this method has therefore been suggested as a means to eliminate rater bias and save time. A necessary step for this automation relies on the selection of a frame during late ventricular diastole (LVD) for each cardiac cycle of the recording. Since electrocardiograms (ECG) are not always recorded in field experiments, here we propose a fully automated method for LVD frame selection based on regional intensity minimization. The algorithm is tested on 20 previously acquired echocardiography recordings (from the original bubble-counting publication), half of which were acquired at rest (Rest) and the other half after leg flexions (Flex). From the 7,140 frames analyzed, sensitivity was found to be 0.913 [95% CI: 0.875-0.940] and specificity 0.997 [95% CI: 0.996-0.998]. The method's performance is also compared to that of random chance selection and found to perform significantly better (p≺0.0001). No trend in algorithm performance was found with respect to VGE counts, and no significant difference was found between Flex and Rest (p>0.05). In conclusion, full automation of LVD frame selection for the purpose of bubble counting in post-dive echocardiography has been established with excellent accuracy, although we caution that high quality acquisitions remain paramount in retaining high reliability.


Asunto(s)
Algoritmos , Diagnóstico por Computador/métodos , Buceo/fisiología , Ecocardiografía/métodos , Embolia Aérea/diagnóstico por imagen , Función Ventricular/fisiología , Enfermedad de Descompresión/diagnóstico por imagen , Diagnóstico por Computador/estadística & datos numéricos , Diástole/fisiología , Ecocardiografía/estadística & datos numéricos , Ventrículos Cardíacos/diagnóstico por imagen , Humanos , Contracción Miocárdica/fisiología , Sensibilidad y Especificidad
17.
GMS J Med Educ ; 38(1): Doc5, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33659610

RESUMEN

Background: Facing the global COVID-19 pandemic University teaching has been digitalized and German medical faculties took great effort to offer curricular contents online as they agreed that semesters during pandemic should not be suspended. Skill training is an essential part of medical education and cannot be fully digitalized nor should it be omitted. The pandemic demonstrates that skills like ultrasound are essential when treating critical ill patients. Medical faculties use peer assisted learning (PAL) concepts to teach skills, like ultrasound through specially trained student tutors. Aim: Here, we would like to share our experiences and elaborate how ultrasound teaching can be safely performed during the pandemic with an emphasis on adjustment of an existing PAL teaching concept. Method: At the hospital of Saarland University, we implemented a PAL teaching concept for abdominal, including emergency, ultrasound, and echocardiography, called "sonoBYstudents" to teach sonography to undergraduate medical students. Students are generally taught in small groups of 5 people in 90min sessions over a time of 8 weeks with an objective structured clinical exam (OSCE) at the end of the course program. Each semester nearly 50 students are taught in abdominal and emergency ultrasound and 30 students in echocardiography. Over five years, more than 600 students have been taught with at least 30 students being trained as student tutors. Given the pandemic, course size, course interval and total course time and total course time were adapted to the hygienic precautions. Results: 45 and 30 students were taught in abdominal ultrasound and echocardiography respectively achieving their learning goals measured via OSCE at the end of the courses. OSCE results were the same when compared to previous semesters. Conclusion: PAL as a teaching concept lives out of sustained educational strategies like practical and didactical trainings and an ongoing recruitment of new student tutors. Suspending PAL and its skill teaching would require starting from the beginning which is a time and cost consuming process. With sonoBYstudents we were able to demonstrate that an existing PAL concept can, with some effort, be adjusted to changing teaching circumstances. Apart from this ultrasound is a non-omittable part of medical skill training with easily appliable hygienic precautions during teaching sessions.


Asunto(s)
/epidemiología , Educación de Pregrado en Medicina/organización & administración , Grupo Paritario , Enseñanza/organización & administración , Ultrasonografía/métodos , Actitud del Personal de Salud , Ecocardiografía/métodos , Humanos , Pandemias , Estudiantes de Medicina/psicología
19.
Pol Merkur Lekarski ; 49(289): 54-56, 2021 Feb 24.
Artículo en Polaco | MEDLINE | ID: mdl-33713094

RESUMEN

In recent years the number of complications related to implantation of cardiac stimulating systems is increasing. Life-threatening myocardial perforation leading to cardiac tamponade is one of the rarest complications. In that case it is necessary to take the immediate lifesaving procedures. A CASE REPORT: 61-year-old woman ended up in the cardiac surgery department with progressive cardiac tamponade and cardiogenic shock symptoms. Three weeks earlier due to the tachycardia-bradycardia syndrome with second-degree atrioventricular block diagnosis, the cardiac stimulating system was implanted into the heart at the cardiology department. Two days after the discharge from hospital the patient appeared in the emergency department with non-specific chest symptoms, which disappeared after analgesic drugs. After another two weeks the patient returned to the emergency department in general poor condition. Echocardiographic examination showed fluid in both pleural cavities, a dense layer around heart and fluid out wards from the layer in the pericardial space. Furthermore, CT scan showed unobvious shape crossing the heart muscle. Firstly, the patient was admitted to the cardiology department and next transferred to the cardio surgery where on account of deteriorating condition was made a decision urgent sternotomy and revision pericardial sac. Intraoperatively were found perforation of right ventricular free wall caused by stimulation electrode and hole communicating pericardial space with left pleural cavity. The operation went well, without any complications. The patient was discharged from hospital 12 days after surgery. CONCLUSIONS: In the case of suspected complications related to the implantation of electrostimulation equipment, it is necessary to perform appropriate diagnostics and implement urgent procedures, including surgery.


Asunto(s)
Taponamiento Cardíaco , Marcapaso Artificial , Taponamiento Cardíaco/diagnóstico por imagen , Taponamiento Cardíaco/etiología , Taponamiento Cardíaco/terapia , Ecocardiografía , Femenino , Humanos , Persona de Mediana Edad , Marcapaso Artificial/efectos adversos , Pericardio
20.
Pol Merkur Lekarski ; 49(289): 57-59, 2021 Feb 24.
Artículo en Inglés | MEDLINE | ID: mdl-33713095

RESUMEN

In the course of COVID-19 pandemic, many patients with diagnosed or suspected disease do require echocardiography. At the same time, when it comes to the echocardiographers, there is a fear of their being exposed to contamination. At COVID-19-dedicated hospital examinations are bedside, and in some patients hand-held or tablet-based echocardiography should be preferred; the echocardiographer routinely puts on a complete protective uniform. The prevalence of stress-induced takotsubo syndrome (TTS) during the Covid-19 pandemic is higher than previously reported. The authors present the images obtained using tabletbased limited echocardiography in patients with different forms of TTS. The time of the examination of patients and decontamination of the equipment was short (5-7 min and less than 2 min, respectively); the images were of fairly good quality.


Asunto(s)
Cardiomiopatía de Takotsubo , Ecocardiografía , Hospitales , Humanos , Pandemias , Cardiomiopatía de Takotsubo/diagnóstico por imagen , Cardiomiopatía de Takotsubo/epidemiología
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