14 research outputs found

    Valve Calcification in Aortic Stenosis: Etiology and Diagnostic Imaging Techniques

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    Aortic stenosis is the most common valvulopathy in the Western world. Its prevalence has increased significantly in recent years due to population aging; hence, up to 8% of westerners above the age of 84 now have severe aortic stenosis (Lindroos et al., 1993). This causes increased morbidity and mortality and therein lies the importance of adequate diagnosis and stratification of the degree of severity which allows planning the best therapeutic option in each case. Long understood as a passive age-related degenerative process, it is now considered a rather more complex entity involving mechanisms and factors similar to those of atherosclerosis (Stewart et al., 1997). In this review, we summarize the pathophysiological mechanisms underlying the onset and progression of the disease and analyze the current role of cardiac imaging techniques for diagnosis

    Role of echocardiography in a patient with suspected acute pulmonary embolism: a case report

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    Abstract Background Approximately half of pulmonary embolism cases are diagnosed in an emergency context. The classic symptoms of pulmonary embolism are absent in intensive care unit patients who are under sedation and on mechanical ventilation. In this scenario, after the development of sudden, severe hypotension, pulmonary embolism must be considered and included in a differential diagnosis according to the cause of admission. Echocardiography may be of further help in a differential diagnosis of the cause of shock. Case presentation We present a case of a 44-year-old Caucasian man who was admitted to the intensive care unit with a diagnosis of community-acquired pneumonia and respiratory failure and who required invasive mechanical ventilation. During admission, the patient developed sudden, severe hypotension that was refractory to treatment. An adequate diagnosis with transthoracic echocardiography was unachievable because of a poor echocardiographic window. However, the combined use of electrocardiography and transesophageal echocardiography established pulmonary embolism as a high-probability diagnosis based on findings of right ventricular pressure overload and right ventricular dysfunction. The unfavorable hemodynamic situation of the patient prevented his transfer to carry out other complementary tests that could confirm the diagnosis of pulmonary embolism. Fibrinolytic and anticoagulant therapies were administered immediately, and a favorable clinical outcome was achieved. Conclusion This case highlights the fundamental role that echocardiography played in a patient in the intensive care unit who presented with shock secondary to pulmonary embolism with an unfavorable hemodynamic situation and in whom an unnecessary transfer to perform other complementary diagnostic tests was avoided. The combined use of electrocardiography and echocardiography provided a complete differential diagnosis, identifying the cause of shock and allowing the initiation of specific treatment without further delay. Knowledge of the echocardiographic results that are characteristic of pulmonary embolism can aid in the diagnosis

    Electrocardiogram and left atrial abnormality: Design of an observational study to clarify diagnostic criteria

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    Background The criteria applied for diagnosis of left atrial (LA) abnormality using electrocardiogram (ECG) have high specificity but low sensitivity. In fact, some authors have suggested classifying P‐wave anomalies associated with LA abnormality and interatrial block as “atrial abnormalities.” The most widely known ECG criteria for LA abnormality include P‐wave duration, morphology and voltage of P wave in inferior leads, presence of P‐wave terminal force in V1 (PtfV1), and P‐wave axis and area. PtfV1 has also been reported to vary according to misplacement of the V1 and V2 electrodes. Methods The objective of this observational cohort study is to determine the degree of correlation between ECG criteria for LA abnormality and left atrium volume and functionality, as determined by speckle tracking echocardiography. The study also aims to investigate the correlation between these echocardiographic parameters and PtfV1 value by placing the V1 and V2 electrodes in the second, third, and fourth intercostal spaces. Results and Conclusions Our results could help to clarify whether the decrease in left atrial deformity, which is currently considered a surrogate target of fibrosis, correlates better with ECG criteria for LA abnormality than atrial volumes.Sin financiación1.468 JCR (2020) Q4, 130/142 Cardiac & Cardiovascular Systems0.494 SJR (2020) Q3, 190/349 Cardiology and Cardiovascular MedicineNo data IDR 2020UE
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