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1.
J Formos Med Assoc ; 120(1 Pt 1): 78-82, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32682701

RESUMO

Coronavirus disease 2019 (COVID-19) is a highly contagious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Infection with SARS-CoV may cause coronary plaque instability and lead to acute coronary syndrome (ACS). Management of ACS in patients with COVID-19 needs more consideration of the balance between clinical benefit and transmission risk of virus. This review provides recommendations of management strategies for ACS in patients with suspected or confirmed COVID-19 in Taiwan.


Assuntos
Síndrome Coronariana Aguda , Transmissão de Doença Infecciosa/prevenção & controle , Infarto do Miocárdio , Síndrome Coronariana Aguda/epidemiologia , Síndrome Coronariana Aguda/terapia , /prevenção & controle , Cardiologia/métodos , Cardiologia/normas , Comorbidade , Consenso , Humanos , Infarto do Miocárdio/epidemiologia , Infarto do Miocárdio/terapia , Administração dos Cuidados ao Paciente/métodos , Medição de Risco , Sociedades Médicas/normas , Taiwan
2.
Rev. esp. cardiol. Supl. (Ed. impresa) ; 20(supl.E): 14-20, dic. 2020. ilus, tab, graf
Artigo em Espanhol | IBECS | ID: ibc-195342

RESUMO

La pandemia por COVID-19 ha puesto a prueba a toda la población de nuestro país y en particular a los profesionales sanitarios en una situación en que la capacidad de adaptación y rapidez de la respuesta son cruciales para ayudar a frenar la expansión del virus. En un entorno de incertidumbre con necesidad acuciante de Información para tratar de proporcionar la mejor atención a los pacientes afectos de enfermedades cardiovasculares, la Sociedad Española de Cardiología ha elaborado una serie de documentos que ayudan a la toma de decisiones


The COVID-19 pandemic has posed a challenge to the entire Spanish population and, in particular, to medical professionals who are dealing with a situación in which adaptability and rapid reactions are crucial for helping to slow the spread of the virus. At a time of uncertainty when there is an urgent need for Información to ensure that patients with cardiovascular disease receive the best care, the Spanish Society of Cardiology has produced a series of documents to aid decision-making


Assuntos
Humanos , Sociedades Médicas , Cardiologia/normas , Serviço Hospitalar de Cardiologia/normas , Infecções por Coronavirus/prevenção & controle , Pneumonia Viral/virologia , Pandemias , Espanha
3.
J Vasc Nurs ; 38(4): 176-179, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33279106

RESUMO

Coronavirus disease of 2019 poses significant risks for patients with vascular disease. Telemedicine can help clinicians provide care for patients with vascular disease while adhering to social-distancing guidelines. In this article, we review the components of telemedicine used in the vascular medicine practice at the Vanderbilt University Medical Center. In addition, we describe inpatient and outpatient diagnosis-based algorithms to help select patients for telemedicine versus in-person evaluation.


Assuntos
/prevenção & controle , Cardiologia/normas , Assistência à Saúde/normas , Pandemias/prevenção & controle , Guias de Prática Clínica como Assunto , Serviços Preventivos de Saúde/normas , Telemedicina/normas , Cardiologia/métodos , Assistência à Saúde/métodos , Humanos , Serviços Preventivos de Saúde/métodos , Telemedicina/métodos , Tennessee
4.
J Cardiovasc Magn Reson ; 22(1): 76, 2020 11 09.
Artigo em Inglês | MEDLINE | ID: mdl-33161900

RESUMO

The Society for Cardiovascular Magnetic Resonance (SCMR) last published its comprehensive expert panel report of clinical indications for CMR in 2004. This new Consensus Panel report brings those indications up to date for 2020 and includes the very substantial increase in scanning techniques, clinical applicability and adoption of CMR worldwide. We have used a nearly identical grading system for indications as in 2004 to ensure comparability with the previous report but have added the presence of randomized controlled trials as evidence for level 1 indications. In addition to the text, tables of the consensus indication levels are included for rapid assimilation and illustrative figures of some key techniques are provided.


Assuntos
Cardiologia/normas , Doenças Cardiovasculares/diagnóstico por imagem , Imagem por Ressonância Magnética/normas , Tomada de Decisão Clínica , Consenso , Técnica Delfos , Humanos , Valor Preditivo dos Testes
5.
Methodist Debakey Cardiovasc J ; 16(3): 199-204, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33133355

RESUMO

Americans expect their doctors to have the competence to deliver high-quality care and expect safeguards to be in place that assure their doctors are competent. However, competence requires knowledge, and people have trouble assessing their own knowledge and level of competence. Because external assessment is required, several organizations have taken on the roles of defining and assuring medical competence. For example, professional organizations such as the American College of Cardiology (ACC) have developed consensus documents that define core competencies for cardiologists. External organizations such as the Accreditation Council for Graduate Medical Education and the American Board of Internal Medicine (ABIM) have defined training requirements for cardiologists, and the ABIM has developed a process to certify that physicians maintain their competence, although the process has generated considerable criticism from the profession. Recently, the ACC and ABIM have worked together to make the certification process less onerous and more meaningful. This paper provides a brief summary of the history and ongoing efforts to assure the competence of cardiologists.


Assuntos
Acreditação , Cardiologistas/educação , Cardiologia/educação , Certificação , Competência Clínica , Educação de Pós-Graduação em Medicina , Acreditação/normas , Cardiologistas/normas , Cardiologia/normas , Certificação/normas , Competência Clínica/normas , Currículo , Educação de Pós-Graduação em Medicina/normas , Humanos
6.
Methodist Debakey Cardiovasc J ; 16(3): 205-211, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33133356

RESUMO

Cardiovascular registries play an integral role in providing real-world data on a number of cardiovascular conditions and allowing measurement of quality metrics across a large cohort of patients. Over the past 35 years, the number of cardiovascular registries has skyrocketed, and their use will only continue to grow as data on novel procedures and devices will need to be collected and analyzed. The American College of Cardiology and Society of Thoracic Surgeons Transcatheter Valve Therapy Registry is just one example of a modern registry that plays a crucial role in collecting data on patients undergoing transcatheter valvular procedures. Through public reporting registries, data can be shared on a hospital and provider level for many quality performance measures. There remains much work to be done on allowing automated data extraction from the electronic medical record directly into registries. No matter how sophisticated and complete a registry is, it can never overcome the problem of treatment selection bias that is inherent in observational data. This review discusses the growth, benefits, and limitations of national registries and their role in developing evidence for best clinical practice, measuring outcomes, providing feedback to clinicians, and improving quality of care.


Assuntos
Cardiologia/normas , Doenças Cardiovasculares/terapia , Avaliação de Processos e Resultados em Cuidados de Saúde/normas , Melhoria de Qualidade/normas , Indicadores de Qualidade em Assistência à Saúde/normas , Sistema de Registros/normas , Big Data , Doenças Cardiovasculares/diagnóstico , Humanos , Registros Públicos de Dados de Cuidados de Saúde , Resultado do Tratamento
7.
Methodist Debakey Cardiovasc J ; 16(3): 225-231, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33133359

RESUMO

Over the past two decades, Medicare and other payers have been looking at ways to base payment for cardiovascular care on the quality and outcomes of care delivered. Public reporting of hospital performance on a series of quality measures began in 2004 with basic processes of care such as aspirin use and influenza vaccination, and it expanded in later years to include outcomes such as mortality and readmission rates. Following the passage of the Affordable Care Act in March 2010, Medicare and other payers moved forward with pay-for-performance programs, more commonly referred to as value-based purchasing (VBP) programs. These programs are largely based on an underlying fee-for-service payment infrastructure and give hospitals and clinicians bonuses or penalties based on their performance. Another new payment mechanism, called alternative payment models (APMs), aims to move towards episode-based or global payments to improve quality and efficiency. The two most relevant APMs for cardiovascular care include Accountable Care Organizations and bundled payments. Both VBP programs and APMs have challenges related to program efficacy, accuracy, and equity. In fact, despite over a decade of progress in measuring and incentivizing high-quality care delivery within cardiology, major limitations remain. Many of the programs have had little benefit in terms of clinical outcomes yet have led to marked administrative burden for participants. However, there are several encouraging prospects to aid the successful implementation of value-based high-quality cardiovascular care, such as more sophisticated data science to improve risk adjustment and flexible electronic health records to decrease administrative burden. Furthermore, payment models designed specifically for cardiovascular care could incentivize innovative care delivery models that could improve quality and outcomes for patients. This review provides an overview of current efforts, largely at the federal level, to pay for high-quality cardiovascular care and discusses the challenges and prospects related to doing so.


Assuntos
Cardiologia/economia , Doenças Cardiovasculares/economia , Doenças Cardiovasculares/terapia , Custos de Cuidados de Saúde , Avaliação de Processos e Resultados em Cuidados de Saúde/economia , Reembolso de Incentivo/economia , Cardiologia/normas , Doenças Cardiovasculares/diagnóstico , Custos de Cuidados de Saúde/normas , Humanos , Avaliação de Processos e Resultados em Cuidados de Saúde/normas , Pacotes de Assistência ao Paciente/economia , Melhoria de Qualidade/economia , Indicadores de Qualidade em Assistência à Saúde/economia , Reembolso de Incentivo/normas , Resultado do Tratamento , Seguro de Saúde Baseado em Valor/economia , Aquisição Baseada em Valor/economia
10.
BMC Cardiovasc Disord ; 20(1): 448, 2020 10 19.
Artigo em Inglês | MEDLINE | ID: mdl-33070781

RESUMO

The 2020 annual Congress of the European Society of Cardiology (ESC) was the first ever to be held virtually. Under the spotlight of 'the cutting edge of cardiology', exciting and ground-breaking cardiovascular (CV) science was presented both in basic and clinical research. This commentary summarizes essential updates from ESC 2020-The Digital Experience. Despite the challenges that coronavirus disease 2019 (COVID-19) has posed on the conduct of clinical trials, the ESC Congress launched the results of major studies bringing innovation to the field of general cardiology, cardiac surgery, heart failure, interventional cardiology, and atrial fibrillation. In addition to three new ESC guidelines updates, the first ESC Guidelines on Sports Cardiology and Exercise in Patients with Cardiovascular Disease were presented. As former ESC president, Professor Casadei undoubtedly pointed out the ESC Congress 2020 was a great success. During the ESC 2020 Congress, BMC Cardiovascular Disorders updated to seven journal sections including Arrhythmias and Electrophysiology, CV Surgery, Coronary Artery Disease, Epidemiology and Digital health, Hypertension and Vascular biology, Primary prevention and CV Risk, and Structural Diseases, Heart Failure, and Congenital Disorders. To conclude, an important take-home message for all CV health care professionals engaged in the COVID-19 pandemic is that we must foresee and be prepared to tackle the dramatic, long-term CV complications of COVID-19 patients.


Assuntos
Cardiologia , Doenças Cardiovasculares , Infecções por Coronavirus , Controle de Infecções/métodos , Pandemias , Pneumonia Viral , Telecomunicações/organização & administração , Relatórios Anuais como Assunto , Betacoronavirus , Cardiologia/métodos , Cardiologia/normas , Cardiologia/tendências , Doenças Cardiovasculares/classificação , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/terapia , Congressos como Assunto , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Europa (Continente) , Humanos , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Guias de Prática Clínica como Assunto , Sociedades Médicas
11.
Open Heart ; 7(2)2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-33020254

RESUMO

Disseminating the practice of minimally invasive mitral surgery (mini-MVS) can be challenging, despite its original case reports a few decades ago. The penetration of this technology into clinical practice has been limited to centres of excellence, and mitral surgery in most general cardiothoracic centres remains to be conducted via sternotomy access as a first line. The process for the uptake of mini-MVS requires clearer guidance and standardisation for the processes involved in its implementation. In this statement, a consensus agreement is outlined that describes the benefits of mini-MVS, including reduced postoperative bleeding, reduced wound infection, enhanced recovery and patient satisfaction. Technical considerations require specific attention and can be introduced through simulation and/or use in conventional cases. Either endoballoon or aortic cross clamping is recommended, as well as femoral or central aortic cannulation, with the use of appropriate adjuncts and instruments. A coordinated team-based approach that encourages ownership of the programme by the team members is critical. A designated proctor is also recommended. The organisation of structured training and simulation, as well as planning the initial cases, is an important step to consider. The importance of pre-empting complications and dealing with adverse events is described, including re-exploration, conversion to sternotomy, unilateral pulmonary oedema and phrenic nerve injury. Accounting for both institutional and team considerations can effectively facilitate the introduction of a mini-MVS service. This involves simulation, team-based training, visits to specialist centres and involvement of a designated proctor to oversee the initial cases.


Assuntos
Procedimentos Cirúrgicos Cardíacos/normas , Cardiologia/normas , Doenças das Valvas Cardíacas/cirurgia , Procedimentos Cirúrgicos Minimamente Invasivos/normas , Valva Mitral/cirurgia , Medicina Estatal/normas , Procedimentos Cirúrgicos Cardíacos/efeitos adversos , Consenso , Doenças das Valvas Cardíacas/diagnóstico por imagem , Doenças das Valvas Cardíacas/fisiopatologia , Humanos , Procedimentos Cirúrgicos Minimamente Invasivos/efeitos adversos , Valva Mitral/diagnóstico por imagem , Valva Mitral/fisiopatologia , Equipe de Assistência ao Paciente , Satisfação do Paciente , Complicações Pós-Operatórias/etiologia , Desenvolvimento de Programas , Resultado do Tratamento , Reino Unido
12.
Radiol Med ; 125(11): 1013-1023, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32964326

RESUMO

The purpose of this article is to provide an overview on the role of CT scan and MRI according to selected guidelines by the European Society of Cardiology (ESC) and the American College of Cardiology/American Heart Association (ACC/AHA). ESC and ACC/AHA guidelines were systematically reviewed for recommendations to CT and MRI use in specific cardiovascular (CV) clinical categories. All recommendations were collected in a dataset, including the class of recommendation, the level of evidence (LOE), the specific imaging technique, the clinical purpose of the recommendation and the recommending Society. Among the 43 included guidelines (ESC: n = 18, ACC/AHA: n = 25), 26 (60.4%) contained recommendations for CT scan or MRI (146 recommendations: 62 for CT and 84 for MRI). Class of recommendation IIa (32.9%) was the most represented, followed by I (28.1%), IIb (24%) and III (11.9%). MRI recommendations more frequently being of higher class (I: 36.9%, IIa: 29.8%, IIb: 21.4%, III: 11.9%) as compared to CT (I: 16.1%, IIa: 37.1%, IIb: 27.4%, III: 19.4%). Most of recommendation (55.5%) were based on expert opinion (LOE C). The use of cardiac CT and cardiac MR in the risk assessment, diagnosis, therapeutic and procedural planning is in continuous development, driven by an increasing need to evolve toward an imaging-guided precision medicine, combined with cost-effectiveness and healthcare sustainability. These developments must be accompanied by an increased availability of high-performance scanners in healthcare facilities and should emphasize the need of increasing the number of radiologists fully trained in cardiac imaging.


Assuntos
Cardiologia/normas , Doenças Cardiovasculares/diagnóstico por imagem , Angiografia por Tomografia Computadorizada , Imagem por Ressonância Magnética , Guias de Prática Clínica como Assunto , Medicina de Precisão/métodos , Doenças Cardiovasculares/prevenção & controle , Angiografia por Tomografia Computadorizada/métodos , Angiografia Coronária/métodos , Vasos Coronários/diagnóstico por imagem , Europa (Continente) , Coração/diagnóstico por imagem , Humanos , Imagem por Ressonância Magnética/métodos , Prevenção Primária , Sociedades Médicas , Estados Unidos
13.
Vnitr Lek ; 66(2): 111-115, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32942896

RESUMO

A brief summarization of European Society of Cardiology 2019 Guidelines on diabete{s, pre-diabetes, and cardiovascular diseases.


Assuntos
Cardiologia , Doenças Cardiovasculares , Diabetes Mellitus , Estado Pré-Diabético , Cardiologia/normas , Doenças Cardiovasculares/prevenção & controle , Diabetes Mellitus/terapia , Europa (Continente) , Humanos , Guias de Prática Clínica como Assunto , Sociedades Médicas
14.
Arch Cardiovasc Dis ; 113(11): 749-759, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32978090

RESUMO

Acute pulmonary embolism is a frequent cardiovascular emergency with an increasing incidence. The prognosis of patients with high-risk and intermediate-high-risk pulmonary embolism has not improved over the last decade. The current treatment strategies are mainly based on anticoagulation to prevent recurrence and reduce pulmonary vasculature obstruction. However, the slow rate of thrombus lysis under anticoagulation is unable to acutely decrease right ventricle overload and pulmonary vasculature resistance in patients with severe obstruction and right ventricle dysfunction. Therefore, patients with high-risk and intermediate-high-risk pulmonary embolism remain a therapeutic challenge. Reperfusion therapies may be discussed for these patients, and include systemic thrombolysis, catheter-directed therapies and surgical thrombectomy. High-risk patients require systemic thrombolysis, but may have contraindications as a result of the high risk of bleeding. In addition, intermediate-high-risk patients should not receive systemic thrombolysis, despite its high efficacy, because of prohibitive bleeding complications. Recently, percutaneous reperfusion techniques have been developed to acutely decrease pulmonary vascular obstruction with lower-dose or no thrombolytic agents and, thus, potentially higher safety than systemic thrombolysis. Some of these techniques improve key haemodynamic variables. Cardiac surgical techniques and venoarterial extracorporeal membrane oxygenation as temporary circulatory support may be useful in selected cases. The development of pulmonary embolism centres with multidisciplinary pulmonary embolism teams is mandatory to enable adequate use of reperfusion and improve outcomes. We aim to present the state of the art regarding reperfusion therapies in pulmonary embolism, but also to provide guidance on their indications and patient selection.


Assuntos
Cardiologia/normas , Procedimentos Endovasculares/normas , Embolia Pulmonar/terapia , Reperfusão/normas , Trombectomia/normas , Terapia Trombolítica/normas , Tomada de Decisão Clínica , Consenso , Procedimentos Endovasculares/efeitos adversos , Oxigenação por Membrana Extracorpórea/normas , Humanos , Seleção de Pacientes , Embolia Pulmonar/diagnóstico , Embolia Pulmonar/fisiopatologia , Reperfusão/efeitos adversos , Fatores de Risco , Trombectomia/efeitos adversos , Terapia Trombolítica/efeitos adversos , Resultado do Tratamento
15.
Med J Aust ; 213(4): 182-187, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32734645

RESUMO

INTRODUCTION: The coronavirus 2019 disease (COVID-19) pandemic is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Pre-existing cardiovascular disease (CVD) increases the morbidity and mortality of COVID-19, and COVID-19 itself causes serious cardiac sequelae. Strategies to minimise the risk of viral transmission to health care workers and uninfected cardiac patients while prioritising high quality cardiac care are urgently needed. We conducted a rapid literature appraisal and review of key documents identified by the Cardiac Society of Australia and New Zealand Board and Council members, the Australian and New Zealand Society of Cardiac and Thoracic Surgeons, and key cardiology, surgical and public health opinion leaders. MAIN RECOMMENDATIONS: Common acute cardiac manifestations of COVID-19 include left ventricular dysfunction, heart failure, arrhythmias and acute coronary syndromes. The presence of underlying CVD confers a five- to tenfold higher case fatality rate with COVID-19 disease. Special precautions are needed to avoid viral transmission to this population at risk. Adaptive health care delivery models and resource allocation are required throughout the health care system to address this need. CHANGES IN MANAGEMENT AS A RESULT OF THIS STATEMENT: Cardiovascular health services and cardiovascular health care providers need to recognise the increased risk of COVID-19 among CVD patients, upskill in the management of COVID-19 cardiac manifestations, and reorganise and innovate in service delivery models to meet demands. This consensus statement, endorsed by the Cardiac Society of Australia and New Zealand, the Australian and New Zealand Society of Cardiac and Thoracic Surgeons, the National Heart Foundation of Australia and the High Blood Pressure Research Council of Australia summarises important issues and proposes practical approaches to cardiovascular health care delivery to patients with and without SARS-CoV-2 infection.


Assuntos
/complicações , Cardiologia/normas , Doenças Cardiovasculares/virologia , Cirurgia Torácica/normas , Austrália/epidemiologia , Consenso , Humanos , Nova Zelândia/epidemiologia , Sociedades Médicas
16.
Pediatr Cardiol ; 41(8): 1645-1650, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32851436

RESUMO

Bicuspid aortic valve (BAV) is the most common congenital heart disease. Since heritability is suspected, actual guidelines recommend to perform an echocardiographic assessment for first-degree relatives (FDR) of patient with BAV. This study aimed to assess the effectiveness and the feasibility of the current guidelines for the screening of FDR of patient with BAV in a pediatric cardiology daily practice. Consecutive patients with BAV and their FDR were prospectively included from January 2015 to March 2018 at Centre Hospitalier Universitaire de Laval, Quebec City (Canada). Data were retrospectively collected and analyzed. A total of 713 FDR of 213 consecutives index cases [median age: 11 (6-20) years] were studied. Up to 32 (6.6%) FDR had a BAV and 26 (5.4%) had an aortic valve dysfunction. A total of 14 (2.9%) FDR had an ascending aorta dilatation according to Z-score including 6 (1.2%) patients with an ascending aorta ≥ 45 mm. No statistically significant differences regarding BAV, aortic valve dysfunction and ascending aorta dilatation prevalence were identified between generations. Screening was done in 482 (67.6%), prescribed but not done in 134 (19%), not prescribed in 92 (13%) and declined in 5 (1%) FDR. The prevalence of BAV in FDR was similar to prospective adult studies and supports actual guidelines in pediatric cardiology practice. Ascending aorta dilatation was rare in our young population. Exhaustiveness and additional burden to implement current guidelines remain a challenge in daily practice.


Assuntos
/diagnóstico , Programas de Rastreamento/métodos , Pediatria/normas , Guias de Prática Clínica como Assunto , Adolescente , Aorta/diagnóstico por imagem , Aorta/patologia , Doenças da Aorta/diagnóstico , Doenças da Aorta/epidemiologia , Valva Aórtica/diagnóstico por imagem , Valva Aórtica/patologia , Canadá , Cardiologia/normas , Criança , Ecocardiografia , Família , Estudos de Viabilidade , Feminino , Humanos , Masculino , Prevalência , Estudos Retrospectivos , Adulto Jovem
17.
Prog Cardiovasc Dis ; 63(5): 662-670, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32795462

RESUMO

Resistant hypertension (RH) induces higher morbidity and mortality due to cardiovascular disease and stroke than hypertension without treatment resistance. New guidelines define RH as blood pressure (BP) ≥130/80 mmHg in a patient taking ≥3 antihypertensive agents of different classes or BP <130/80 mmHg in a patient taking ≥4 antihypertensive drugs. According to the new definition, pseudo-resistance due to error in BP measurement, white coat effect and medication nonadherence must be excluded to make the diagnosis of RH. This 2020 update focuses on the lifestyle and antihypertensive drug management of RH and includes recent proof-of-principle trials of renal nerve ablation in hypertension. Stepwise evidence-based pharmacologic treatment of RH includes optimization of the 3-drug regimen, substitution of a thiazide-like for a thiazide diuretic and addition of a mineralocorticoid receptor antagonist as the fourth drug. Non-evidence-based recommendations include addition of a ß-blocker as the fifth drug and switching to a minoxidil-based regimen as the final step in achieving BP control.


Assuntos
Anti-Hipertensivos/uso terapêutico , Pressão Sanguínea , Cardiologia/normas , Resistência a Medicamentos , Estilo de Vida Saudável , Hipertensão/terapia , Guias de Prática Clínica como Assunto/normas , Comportamento de Redução do Risco , Simpatectomia , Pressão Sanguínea/efeitos dos fármacos , Consenso , Quimioterapia Combinada , Humanos , Hipertensão/diagnóstico , Hipertensão/fisiopatologia , Fatores de Proteção , Medição de Risco , Fatores de Risco , Simpatectomia/efeitos adversos , Resultado do Tratamento
19.
High Blood Press Cardiovasc Prev ; 27(5): 373-377, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32734561

RESUMO

In 2020, the Sars-Cov-2 pandemic is causing a huge and dramatic impact on healthcare systems worldwide. During this emergency, fragile patients suffering from other comorbidities, especially patients susceptible to or affected by cardiovascular disease, are the ones most exposed to the poorer outcomes. Therefore, it is still mandatory to continue to strictly adhere to the rules of cardiovascular prevention. This document aims to provide all doctors with simple and clear recommendations in order to spread useful messages to the widest number of subjects in order to continue the battle against cardiovascular diseases even in times of pandemic.


Assuntos
Betacoronavirus/patogenicidade , Cardiologia/normas , Fármacos Cardiovasculares/uso terapêutico , Doenças Cardiovasculares/prevenção & controle , Infecções por Coronavirus/terapia , Pneumonia Viral/terapia , Serviços Preventivos de Saúde/normas , Comportamento de Redução do Risco , Fármacos Cardiovasculares/efeitos adversos , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/epidemiologia , Consenso , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/virologia , Interações Hospedeiro-Patógeno , Humanos , Pandemias , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Pneumonia Viral/virologia , Medição de Risco , Fatores de Risco
20.
Cardiovasc Revasc Med ; 21(8): 1030-1033, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32736981

RESUMO

During the novel coronavirus disease 2019 (COVID-19) pandemic, many hospitals have been asked to postpone elective and surgical cases. This begs the question, "What is elective in structural heart disease intervention?" The recently proposed Society for Cardiovascular Angiography and Interventions/American College of Cardiology consensus statement is, unfortunately, non-specific and insufficient in its scope and scale of response to the COVID-19 pandemic. We propose guidelines that are practical, multidisciplinary, implementable, and urgent. We believe that this will provide a helpful framework for our colleagues to manage their practices during the surge and peak phases of the pandemic. General principles that apply across structural heart disease interventions include tracking and reporting cardiovascular outcomes, "healthcare distancing," preserving vital resources and personnel, shared decision-making between the heart team and hospital administration on resource-intensive cases, and considering delaying research cases. Specific guidance for transcatheter aortic valve replacement and MitraClip procedures varies according to pandemic phase. During the surge phase, treatment should broadly be limited to those at increased risk of complications in the near term. During the peak phase, treatment should be limited to inpatients for whom it may facilitate discharge. Keeping our patients and ourselves safe is paramount, as well as justly rationing resources.


Assuntos
Betacoronavirus , Cardiologia/normas , Infecções por Coronavirus/epidemiologia , Gerenciamento Clínico , Cardiopatias/terapia , Pandemias , Pneumonia Viral/epidemiologia , Guias de Prática Clínica como Assunto , Sociedades Médicas , Comorbidade , Saúde Global , Cardiopatias/epidemiologia , Humanos
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