Critical Care of Patients With Cardiopulmonary Complications of Sarcoidosis.

Sarcoidosis is a systemic inflammatory disease defined by the presence of aberrant granulomas affecting various organs. Due to its multisystem involvement, care of patients with established sarcoidosis becomes challenging, especially in the intensive care setting. While the lungs are typically involved, extrapulmonary manifestations also occur either concurrently or exclusively within a significant proportion of patients, complicating diagnostic and management decisions. The scope of this review is to focus on what considerations are necessary in the evaluation and management of patients with known sarcoidosis and their associated complications within a cardiopulmonary and critical care perspective.

[Sudden Cardiac Death in Patients With Chronic Obstructive Pulmonary Disease].

The article contains review of data on the problem of sudden cardiac death (SCD) in patients with chronic obstructive pulmonary disease (COPD). Large studies have shown that risk of cardiovascular mortality in patients with chronic obstructive pulmonary disease (COPD) is 2-3 times greater than in general population. The incidence of COPD and ischemic heart disease (IHD) progressively rises with age. Combination of these diseases is often observed in clinical practice among patients older than 40 years. According to the population study published in 2015 COPD has been associated with elevated risk of SCD especially in patients with frequent exacerbations within 5 years after diagnosis. SCD risk rises in patients with combination of COPD and cardiovascular diseases (myocardial infarction, hypertension, disturbances of cardiac rhythm), with severe clinical course, with frequent exacerbator phenotype. One of main factors underlying SCD is development of arrhythmia. According to 24-hour ECG monitoring supraventricular arrhythmias including atrial fibrillation prevail in COPD. Ventricular rhythm disturbances have been registered in patients with COPD mostly after large myocardial infarctions. Pathogenesis of arrhythmias in COPD if multifactorial. Targeted detection of comorbidities would allow to take into consideration individual characteristics while choosing pharmaotherapy. In patients with COPD and high SCD risk one should limit use of broncholytics especially short-acting, methylxanthines, drugs with potential to induce QT prolongation.

Anti-Ro/SSA antibodies and cardiac rhythm disturbances: Present and future perspectives.

Several case reports, small case series, and original research papers have recently suggested that the action of certain auto-antibodies related to connective tissue diseases may be responsible for significant cardiac rhythm disturbances in adults. The relationship between anti-Ro/SSA antibodies and congenital complete atrioventricular block is well recognized in the fetal heart. Herein we review the emerging evidences of the link to increased levels of anti-Ro/SSA antibodies with rhythm disorders of unknown origin in the adult. Confirmation of this distinct etiology may eventually be the basis for new therapies.