TakoTsubo secondary to acute kidney disease

We report the case of a 62-year-old man who was admitted to the Cardiac Department for TakoTsubo and ACC by torsades de point, secondary to acute kidney disease. We decide to discharge with a portable defibrillator. One month after cardiac magnetic resonance showed a complete recovery of left ventricular function

COVID myocarditis: a review of the literature

Myocarditis is a potentially fatal complication of coronavirus disease 2019 (COVID‐19), which is caused by the severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) virus. COVID‐19 myocarditis appears to have distinct inflammatory characteristics that distinguish it from other viral etiologies. COVID‐19 myocarditis can present with symptoms ranging from dyspnea and chest pain to acute heart failure and death. It is critical to detect any cases of myocarditis, especially fulminant myocarditis, which can be characterized by signs of heart failure and arrhythmias. Serial troponins, echocardiography, and electrocardiograms should be performed as part of the initial workup for suspected myocarditis. The second step in detecting myocarditis is cardiac magnetic resonance imaging and endomyocardial biopsy. Treatment for COVID‐19 myocarditis is still debatable; however, combining intravenous immunoglobulins and corticosteroids may be effective, especially in cases of fulminant myocarditis. Overall, more research is needed to determine the incidence of COVID‐19 myocarditis , and the use of intravenous immunoglobulins and corticosteroids in combination requires large randomized controlled trials to determine efficacy. The purpose of this review is to summarize current evidence on the subject. This review aims to summarise current evidence on this topic

Riparazione valvolare mitralica percutanea: la Mitraclip

L'insufficienza mitralica (IM) è la valvulopatia cardiaca più comune, con una prevalenza stimata nella popolazione generale, aggiustata per età e sesso, pari all'1.7%, ma con un marcato incremento con l'aumentare dell'età, potendo colpire fino al 13.2% della popolazione al di sopra di 75 anni. La prevalenza non trascurabile dell'IM e l'importante impatto prognostico di questa malattia nei pazienti (pz.) affetti, sia nella sua forma degenerativa primitiva (IMP) che nella sua forma secondaria/funzionale (IMF), risultante dalla dilatazione e disfunzione del ventricolo sinistro (Vsx) nei pz con scompenso, ha portato all'elaborazione di nuove strategie di trattamento percutaneo minimamente invasivo, per consentire il trattamento di un maggior numero di pz. affetti. Fra esse la più frequentemente usata è la riparazione valvolare mitralica percutanea tramite impianto di clip con sistema Mitraclip (Abbott Laboratories, Menlo Park, California, USA). Considerato l'alto tasso di prevalenza di IM e di SC nella popolazione generale, la prognosi infausta di queste malattie, e l'alto tasso di comorbilità presente nei soggetti affetti da SC, che spesso rende i pz. stessi ineleggibili al trattamento chirurgico convenzionale, la riparazione valvolare percutanea mediante Mitraclip potrebbe rappresentare per molti individui un beneficio non solo sintomatologico, ma anche prognostico, andando ad interrompere il circolo vizioso che si crea fra disfunzione del Vsx e sovraccarico di volume, mediato proprio dall'IM stessa. In questa revisione della letteratura verranno discussi gli aspetti principali della riparazione valvolare mitralica percutanea con Mitraclip e l'importante impatto prognostico da essa derivante

Rapid progression of pulmonary artery dilatation in pulmonary hypertension

We report the case of a 47-year-old woman who was admitted to the cardiac department for worsening dyspnea. The last chest computed tomography (CT) showed a rapid increase in pulmonary artery dimension (65 mm in 2019, 76 mm in 2021). The symptoms reported by the patient were due to important extrinsic compression of the left main coronary artery (LMCA). In this case, it is very difficult to choose the best therapeutic strategy. In the end, we decided to treat the left main coronary for prevention. After 3 months no new clinical symptoms have developed

Hybrid transvenous and surgical approach for the extraction of coronary sinus leads: A case series

Transvenous lead extraction is the standard therapy for cardiac device-related infection. In some patients, however, a hybrid surgical and transvenous approach may be necessary

Varicella zoster virus and cardiovascular diseases

Varicella zoster virus (VZV) is a Herpesviridae family double-stranded DNA virus that only affects humans. The first clinical manifestation appears to be varicella, typical of childhood. VZV, on the other hand, becomes latent in ganglion neurons throughout the neuroaxis after primary infection. The VZV reactivates and travels along peripheral nerve fibers in the elderly and immunocompromised individuals, resulting in Zoster. It can, however, spread centrally and infect cerebral and extracranial arteries, resulting in vasculopathy, which can lead to transient ischemic attacks, strokes, aneurysms, cavernous sinus thrombosis, giant cell arteritis, and granulomatous aortitis. Although the mechanisms of virus-induced pathological vascular remodeling are not fully understood, recent research indicates that inflammation and dysregulation of ligand-1 programmed death play a significant role. Few studies, on the other hand, have looked into the role of VZV in cardiovascular disease. As a result, the purpose of this review is to examine the relationship between VZV and cardiovascular disease, the efficacy of the vaccine as a protective mechanism, and the target population of heart disease patients who could benefit from vaccination

Outcomes of leadless pacemaker implantation following transvenous lead extraction in high-volume referral centers: Real-world data from a large international registry

BACKGROUND Limited data on the real-world safety and efficacy of leadless pacemakers (LPMs) post-transvenous lead extraction (TLE) are available. OBJECTIVE The purpose of this study was to assess the long-term safety and effectiveness of LPMs following TLE in comparison with LPMs de novo implantation. METHODS Consecutive patients who underwent LPM implantation in 12 European centers joining the International LEAdless PacemakEr Registry were enrolled. The primary end point was the comparison of LPM-related complication rate at implantation and during follow-up (FU) between groups. Differences in electrical performance were deemed secondary outcomes. RESULTS Of the 1179 patients enrolled, 15.6% underwent a previous TLE. During a median FU of 33 (interquartile range 24-47) months, LPM-related major complications and all-cause mortality did not differ between groups (TLE group: 1.6% and 5.4% vs de novo group: 2.2% and 7.8%; P = .785 and P = .288, respectively). Pacing threshold (PT) was higher in the TLE group at implantation and during FU, with very high PT (>2 [email protected] ms) patients being more represented than in the de novo implantation group (5.4% vs 1.6 %; P = .004). When the LPM was deployed at a different right ventricular (RV) location than the one where the previous transvenous RV lead was extracted, a lower proportion of high PT (>1-2 [email protected] ms) patients at implantation, 1-month FU, and 12-month FU (5.9% vs 18.2%, P = .012; 3.4% vs 12.9%, P = .026; and 4.3% vs 14.5%, P = .037, respectively) was found. CONCLUSION LPMs showed a satisfactory safety and efficacy profile after TLE. Better electrical parameters were obtained when LPMs were implanted at a different RV location than the one where the previous transvenous RV lead was extracted