Localisation de l'obstruction coronaire en cas d'infarctus myocardique postéro-inférieur.

SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Comment améliorer la prise en charge de l'insuffisance cardiaque par le médecin généraliste?

Current treatment of heart failure remains suboptimally implemented, leading to less favorable outcome. Readmission due to decompensation, remains frequent, in about 20% of patients at one month and 50% at six months. Precipitating factors of deterioration are known, including inappropriate drug interactions, and the early detection can be facilitated by simple clinical features (weight, heart rate, dyspnea) that can be confirmed by biomarkers (BNP, Nt-ProBNP). Medical treatment relies upon the proper use of drugs that have been demonstrated efficacious in the randomized clinical trials, and have been proposed in the international clinical guidelines. The basic principle of their titration consists on a gradual increase of the dosage, up to the target dosages, or maximal clinically tolerated dosages. Particular attention shall be paid to renal function and kaliemia, besides clinical parameters ;close monitoring is mandatory along the treatment.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Place des β-bloquants dans le traintement de l'insuffisance cardiaque

Despite Beta-blockade therapy has been considered as an absolute contraindication in the treatment of heart failure, it has been shown that they could have a beneficial effect, provided that they were introduced at very low dose, and very progressively in addition of the traditional treatment. The advances in the understanding of the neuro-hormonal mechanisms of heart failure have modified the therapeutic strategy: the deleterious effect of the activation of the sympathetic nervous system on the myocardium has served as the rationale for randomized clinical trials comparing beta- blockade to placebo: the current data are promising, suggesting a beneficial effect on survival as well as on quality of life. However, these results have to be confirmed by larger trials, currently underway, before to consider that beta-blockade should definitely be incorporated in the treatment of heart failure.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Angor récent.

SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Le risque thrombo-embolique de la fibrillation auriculaire

The assessment of the thrombo-embolic risk is currently well defined in case of atriai fibrillation, in the general population as well as in several subgroups. Predictive factors of thrombo-embolism have been identified, they are clinical and echocardiographic criteria. They allow to stratify the individual risk of each patient and to establish the therapeutic attitude best suited to its thrombo-embolic and haemorrhagic risk profile. Recent clinical trials have demonstrated that oral anticoagulation with coumarinics, adjusted at an INR between 2 and 3, provided a greater protection for patients at higher risk, compared to aspirin, with an acceptable low rate of haemorrhagic complications. When atrial fibrillation is of recent onset, the therapeutic attitude will take into account the time delay between onset of the arrhythmia and the medical consultation, 48 h representing the maximal delay allowed to perform cardioversion without prolonged anticoagulation.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

La cardiomyopathie congestive.

Idiopathic congestive cardiomyopathy, which is often the result of a silent viral myocarditis, will occur in about 400 patients per year in Belgium. However, a comparable clinical and paraclinical picture, characterized by dilatation of the cardiac chambers and diffuse and profound hypocontractility of the myocardium, can be the common consequence of a large number of cardiac diseases. In front of a clinical presentation of heart failure, the physician will aim to identify the global myocardial insult and to rule out etiologies which, corrected, do not necessarily produce irreversible myocardial damage. This differential diagnosis will be based on medical history, physical examination, echocardiography and coronary angiography. Prognosis of congestive cardiomyopathy, although generally poor, can be greatly improved by a rational pharmacological therapy as well as new interventions (implantable defibrillator, cardiac transplantation) whose correct indications rely on technological advances and a better knowledge of the natural history of the disease.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Applications de l'échocardiographie bidimensionnelle et de la vélocimétrie doppler à l'évaluation hémodynamique des valvulopathies

Doctorat en sciences médicalesinfo:eu-repo/semantics/nonPublishe

Effects of respiration on an atrial septal aneurysm of the fossa ovale shown by echographic study

This report delineates a case of atrial septal aneurysm in which the motion of the aneurysmal septum was related to phasic respiratory variations. Although atrial septal aneurysm is a well-recognized morphologic entity, its rarity explains the lack of echocardiographic reports. There is only one recent study that described such an aneurysm associated with normal atrial pressures, with data concerning the relationship of its motion with cardiac cycle and respiration.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Doppler demonstration of systolic aortic regurgitation

SCOPUS: ar.jinfo:eu-repo/semantics/publishe