Abstract Background It is estimated that 2 to 8% of pregnancies are complicated by gestational hypertension and preeclampsia, the latter being considered a major cardiovascular emergency due to its possible progression to severe eclampsia and HELLP syndrome. New inflammatory biomarkers, such as the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR), may predict the progression of gestational hypertension. Aim of the study The aim of this study was to assess whether NLR, PLR, and uric acid play a role in predicting preeclampsia and its severe forms. Methods This prospective, single-center cohort study, conducted between January 1, 2020 and December 31, 2022, included 107 pregnant women with gestational hypertension, preeclampsia and its severe forms, HELLP syndrome and eclampsia. Patients were divided into two groups: the first group included 88 patients with gestational hypertension (GH group), and the second group included 19 patients with preeclampsia and its severe forms (PE group). We compared demographic, clinical and biochemistry data between the two groups. Results PLR was significantly lower in women with preeclampsia (85.47 ± 7.91 vs. 115.90 ± 4.63, p = 0.005). The mean serum uric acid level in the PE group was significantly higher than in the GH group (6.71 ± 0.44 mg/dL vs. 4.59 ± 0.12 mg/dL, p <0.0001). Conclusion In this study, low-cost biomarkers PLR and serum uric acid were associated with a higher risk of PE and its severe forms and may be used to predict the progression of gestational hypertension.
据估计，2 - 8%的妊娠合并妊娠高血压和先兆子痫，后者被认为是一个主要的心血管急症，因为它可能发展为严重子痫和HELLP综合征。新的炎症生物标志物，如中性粒细胞与淋巴细胞比值(NLR)和血小板与淋巴细胞比值(PLR)，可能预测妊娠期高血压的进展。研究目的本研究的目的是评估NLR、PLR和尿酸是否在预测子痫前期及其严重形式中起作用。方法本前瞻性单中心队列研究于2020年1月1日至2022年12月31日进行，纳入107例妊娠期高血压、先兆子痫及其严重形式、HELLP综合征和子痫的孕妇。患者分为两组:第一组为88例妊娠期高血压患者(GH组)，第二组为19例先兆子痫及其严重形式患者(PE组)。我们比较了两组患者的人口学、临床和生物化学数据。结果子痫前期妇女的PLR明显低于对照组(85.47±7.91∶115.90±4.63,p = 0.005)。PE组平均血尿酸水平显著高于GH组(6.71±0.44 mg/dL vs. 4.59±0.12 mg/dL, p <0.0001)。结论:低成本生物标志物PLR和血清尿酸与PE及其严重形式的高风险相关，可用于预测妊娠期高血压的进展。
{"title":"Are NLR, PLR, and Elevated Uric Acid Levels Predictive of Preeclampsia?","authors":"Alina-Georgiana Corduneanu, Mihai Emil Căpîlna","doi":"10.2478/jce-2023-0009","DOIUrl":"https://doi.org/10.2478/jce-2023-0009","url":null,"abstract":"Abstract Background It is estimated that 2 to 8% of pregnancies are complicated by gestational hypertension and preeclampsia, the latter being considered a major cardiovascular emergency due to its possible progression to severe eclampsia and HELLP syndrome. New inflammatory biomarkers, such as the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR), may predict the progression of gestational hypertension. Aim of the study The aim of this study was to assess whether NLR, PLR, and uric acid play a role in predicting preeclampsia and its severe forms. Methods This prospective, single-center cohort study, conducted between January 1, 2020 and December 31, 2022, included 107 pregnant women with gestational hypertension, preeclampsia and its severe forms, HELLP syndrome and eclampsia. Patients were divided into two groups: the first group included 88 patients with gestational hypertension (GH group), and the second group included 19 patients with preeclampsia and its severe forms (PE group). We compared demographic, clinical and biochemistry data between the two groups. Results PLR was significantly lower in women with preeclampsia (85.47 ± 7.91 vs. 115.90 ± 4.63, p = 0.005). The mean serum uric acid level in the PE group was significantly higher than in the GH group (6.71 ± 0.44 mg/dL vs. 4.59 ± 0.12 mg/dL, p <0.0001). Conclusion In this study, low-cost biomarkers PLR and serum uric acid were associated with a higher risk of PE and its severe forms and may be used to predict the progression of gestational hypertension.","PeriodicalId":15210,"journal":{"name":"Journal Of Cardiovascular Emergencies","volume":"58 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135428478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Constantin Tolescu, Violeta Masca, Balazs Bajka, Imre Benedek
Abstract The link between COVID-19 and cardiovascular diseases, specifically myocardial infarction, has been well documented, but the interactions between these comorbidities in the context of pregnancy has not been elucidated so far. We report an intriguing case of a 35-year-old woman in her 35th week of pregnancy, with SARS-CoV-2 infection, who developed an acute coronary syndrome caused by a spontaneous coronary dissection. To our knowledge, this paper presents one of the first cases reported in the literature of acute coronary syndrome and COVID-19 infection in a pregnant patient.
{"title":"COVID Infection and Spontaneous Coronary Dissection in a Pregnant Woman — a Therapeutic Challenge","authors":"Constantin Tolescu, Violeta Masca, Balazs Bajka, Imre Benedek","doi":"10.2478/jce-2023-0010","DOIUrl":"https://doi.org/10.2478/jce-2023-0010","url":null,"abstract":"Abstract The link between COVID-19 and cardiovascular diseases, specifically myocardial infarction, has been well documented, but the interactions between these comorbidities in the context of pregnancy has not been elucidated so far. We report an intriguing case of a 35-year-old woman in her 35th week of pregnancy, with SARS-CoV-2 infection, who developed an acute coronary syndrome caused by a spontaneous coronary dissection. To our knowledge, this paper presents one of the first cases reported in the literature of acute coronary syndrome and COVID-19 infection in a pregnant patient.","PeriodicalId":15210,"journal":{"name":"Journal Of Cardiovascular Emergencies","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135427669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
László-Lehel Bordi, D. Opincariu, T. Benedek, I. Kovács, Z. Parajkó, E. Márton, R. Gerculy, I. Benedek
Abstract Introduction This study aimed to investigate the correlation between multislice computed tomography (MSCT)-derived parameters characterizing atrial enlargement and the frequency of emergency hospitalizations after catheter ablation for atrial fibrillation (AF). Methods The study included 52 patients with paroxysmal or persistent AF, who presented criteria for interventional rhythm control strategies and underwent MSCT evaluation prior to ablation. Results The majority of emergency hospital admissions were due to heart failure caused by high-frequency arrhythmia (90.33%), or by cardioembolic complications, causing acute stroke (9.67%). The number of emergency referrals was significantly increased in cases of moderately enlarged left atrial volume (69.23%), and re-admission was necessary for over three quarters of the patients with highly enlarged left atrial volume (76.92%, p = 0.02). The average recurrence rate of AF following ablation therapy was 28.84% during the one-year follow-up, being 0% for volumes <71.33 mL, 32% for volumes between 71.33 mL and 109.5 mL, and 53.84% for volumes >109.5 mL (p = 0.01). Conclusion A large volume of the left atrium, determined by MSCT, is associated with a higher risk of emergency rehospitalizations following catheter ablation of AF.
{"title":"Left Atrial Volume Quantified by MSCT Predicts Emergency Hospitalizations for AF and Arrhythmia Recurrence after Catheter Ablation","authors":"László-Lehel Bordi, D. Opincariu, T. Benedek, I. Kovács, Z. Parajkó, E. Márton, R. Gerculy, I. Benedek","doi":"10.2478/jce-2023-0004","DOIUrl":"https://doi.org/10.2478/jce-2023-0004","url":null,"abstract":"Abstract Introduction This study aimed to investigate the correlation between multislice computed tomography (MSCT)-derived parameters characterizing atrial enlargement and the frequency of emergency hospitalizations after catheter ablation for atrial fibrillation (AF). Methods The study included 52 patients with paroxysmal or persistent AF, who presented criteria for interventional rhythm control strategies and underwent MSCT evaluation prior to ablation. Results The majority of emergency hospital admissions were due to heart failure caused by high-frequency arrhythmia (90.33%), or by cardioembolic complications, causing acute stroke (9.67%). The number of emergency referrals was significantly increased in cases of moderately enlarged left atrial volume (69.23%), and re-admission was necessary for over three quarters of the patients with highly enlarged left atrial volume (76.92%, p = 0.02). The average recurrence rate of AF following ablation therapy was 28.84% during the one-year follow-up, being 0% for volumes <71.33 mL, 32% for volumes between 71.33 mL and 109.5 mL, and 53.84% for volumes >109.5 mL (p = 0.01). Conclusion A large volume of the left atrium, determined by MSCT, is associated with a higher risk of emergency rehospitalizations following catheter ablation of AF.","PeriodicalId":15210,"journal":{"name":"Journal Of Cardiovascular Emergencies","volume":"3 1","pages":"24 - 31"},"PeriodicalIF":0.4,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73479753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Introduction In patients with ischemic heart disease and coronary chronic total occlusion, it is extremely important to assess the presence of myocardial viability via different cardiac imaging techniques in order to predict a potential functional recovery following revascularization. Multimodality cardiac imaging techniques estimate the risk of sudden cardiac death and personalize patient selection for primary prevention implantable cardioverterdefibrillator therapy. Case presentation A 61-year-old patient with a history of an extensive anterior myocardial infarction with conservative management (8 years before the current presentation, when the coronary angiography revealed two-vessel chronic total occlusion) presented to our outpatient service for fast-paced palpitations at home and fatigue. At the time of the index hospitalization, the patient refused coronary artery bypass grafting. During this period, he did not undergo any cardiovascular evaluation, but he did follow the pharmacological recommendations from the initial hospital discharge. Given the detection of multiple premature ventricular contractions and numerous episodes of nonsustained ventricular tachycardia during this medical visit, a multimodal imaging evaluation was conducted, which further guided the implementation of a personalized therapy. Conclusions In patients with ischemic heart failure and coronary chronic total occlusion, presenting with ventricular tachycardia, the therapeutic decision should be based on the results of a multi-modality cardiac imaging evaluation.
{"title":"Multimodality Imaging-Based Therapeutic Decision in Ischemic Cardiomyopathy and Ventricular Tachycardia – a Case Report","authors":"R. Sascău, A. Clément, C. Stătescu","doi":"10.2478/jce-2023-0006","DOIUrl":"https://doi.org/10.2478/jce-2023-0006","url":null,"abstract":"Abstract Introduction In patients with ischemic heart disease and coronary chronic total occlusion, it is extremely important to assess the presence of myocardial viability via different cardiac imaging techniques in order to predict a potential functional recovery following revascularization. Multimodality cardiac imaging techniques estimate the risk of sudden cardiac death and personalize patient selection for primary prevention implantable cardioverterdefibrillator therapy. Case presentation A 61-year-old patient with a history of an extensive anterior myocardial infarction with conservative management (8 years before the current presentation, when the coronary angiography revealed two-vessel chronic total occlusion) presented to our outpatient service for fast-paced palpitations at home and fatigue. At the time of the index hospitalization, the patient refused coronary artery bypass grafting. During this period, he did not undergo any cardiovascular evaluation, but he did follow the pharmacological recommendations from the initial hospital discharge. Given the detection of multiple premature ventricular contractions and numerous episodes of nonsustained ventricular tachycardia during this medical visit, a multimodal imaging evaluation was conducted, which further guided the implementation of a personalized therapy. Conclusions In patients with ischemic heart failure and coronary chronic total occlusion, presenting with ventricular tachycardia, the therapeutic decision should be based on the results of a multi-modality cardiac imaging evaluation.","PeriodicalId":15210,"journal":{"name":"Journal Of Cardiovascular Emergencies","volume":"12 1","pages":"43 - 48"},"PeriodicalIF":0.4,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77739063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Cardiac resynchronization therapy is an essential tool for treating patients with heart failure in different types of dilatative cardiomyopathy with bundle branch block. This technique is wildly used with significant benefits in terms of quality of life and effort tolerability along with optimized medical therapy. In spite of its benefits, several factors may influence its efficacy such as etiology, lead position, or device settings. In some cases, the anatomical variance of the coronary sinus could create technical difficulties for advancing the left ventricular lead. This case report describes a female patient presenting with decompensated heart failure, known with complicated sclerosis multiplex and a fibrous tissue in the coronary sinus, which created a critical obstruction leading to impossibility to advance the left ventricular lead. This case underlines the importance of appropriate imaging investigation for optimal interventional approach in these difficult cases.
{"title":"Cardiac Resynchronization in the Acute Phase of Decompensated Heart Failure in a Young Patient with Systemic Sclerosis","authors":"Z. Parajkó, I. Kovács, M. Chițu, I. Benedek","doi":"10.2478/jce-2023-0005","DOIUrl":"https://doi.org/10.2478/jce-2023-0005","url":null,"abstract":"Abstract Cardiac resynchronization therapy is an essential tool for treating patients with heart failure in different types of dilatative cardiomyopathy with bundle branch block. This technique is wildly used with significant benefits in terms of quality of life and effort tolerability along with optimized medical therapy. In spite of its benefits, several factors may influence its efficacy such as etiology, lead position, or device settings. In some cases, the anatomical variance of the coronary sinus could create technical difficulties for advancing the left ventricular lead. This case report describes a female patient presenting with decompensated heart failure, known with complicated sclerosis multiplex and a fibrous tissue in the coronary sinus, which created a critical obstruction leading to impossibility to advance the left ventricular lead. This case underlines the importance of appropriate imaging investigation for optimal interventional approach in these difficult cases.","PeriodicalId":15210,"journal":{"name":"Journal Of Cardiovascular Emergencies","volume":"73 1","pages":"38 - 42"},"PeriodicalIF":0.4,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78576544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
L. Mǎrginean, Vlad Vunvulea, Claudiu Constantin Ciucanu, T. Jovin, B. Suciu
Abstract Introduction The current paper presents an examination of the emerging role of deep learning-based simulation software in enhancing preprocedural planning for intracranial aneurysm treatment using flow diverters. Intracranial aneurysms pose significant risk due to their potential rupture leading to life-threatening subarachnoid hemorrhage. Innovative endovascular treatment options like flow diverters, which redirect blood flow and promote healing, are gaining attention. The role of simulation software in optimizing these procedures is becoming increasingly crucial. Case presentation This study involves a 47-year-old female patient diagnosed with an intracranial aneurysm. Through diagnostic angiography and 3D rotational angiography imaging, the complex aneurysm anatomy was determined and the need for flow diverter placement ascertained. The Sim&Size™ software was used to simulate the size and placement of the flow diverter, based on the patient’s specific vascular anatomy. The procedure, including the placement of the flow diverter as per the simulation, was successful. Conclusion The Sim&Size™ simulation software significantly contributes to the enhancement of intracranial aneurysm treatment planning. By providing patient-specific simulations, it improves procedural precision and reduces the risk of complications, thus potentially optimizing patient outcomes. However, the quality of the simulation is contingent on the accuracy of the input data, and it does not account for physiological dynamics. Despite these limitations, this tool represents a promising development in neurointerventional practice.
{"title":"The Use of Simulation and Deep Learning Models in the Endovascular Treatment of Ruptured Intracranial Aneurysms: A Case Report","authors":"L. Mǎrginean, Vlad Vunvulea, Claudiu Constantin Ciucanu, T. Jovin, B. Suciu","doi":"10.2478/jce-2023-0007","DOIUrl":"https://doi.org/10.2478/jce-2023-0007","url":null,"abstract":"Abstract Introduction The current paper presents an examination of the emerging role of deep learning-based simulation software in enhancing preprocedural planning for intracranial aneurysm treatment using flow diverters. Intracranial aneurysms pose significant risk due to their potential rupture leading to life-threatening subarachnoid hemorrhage. Innovative endovascular treatment options like flow diverters, which redirect blood flow and promote healing, are gaining attention. The role of simulation software in optimizing these procedures is becoming increasingly crucial. Case presentation This study involves a 47-year-old female patient diagnosed with an intracranial aneurysm. Through diagnostic angiography and 3D rotational angiography imaging, the complex aneurysm anatomy was determined and the need for flow diverter placement ascertained. The Sim&Size™ software was used to simulate the size and placement of the flow diverter, based on the patient’s specific vascular anatomy. The procedure, including the placement of the flow diverter as per the simulation, was successful. Conclusion The Sim&Size™ simulation software significantly contributes to the enhancement of intracranial aneurysm treatment planning. By providing patient-specific simulations, it improves procedural precision and reduces the risk of complications, thus potentially optimizing patient outcomes. However, the quality of the simulation is contingent on the accuracy of the input data, and it does not account for physiological dynamics. Despite these limitations, this tool represents a promising development in neurointerventional practice.","PeriodicalId":15210,"journal":{"name":"Journal Of Cardiovascular Emergencies","volume":"107 1","pages":"32 - 37"},"PeriodicalIF":0.4,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85572922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Atrial fibrillation (AF) is a cardiac condition that may cause severe complications, eventually leading to the death of the patient. As the disease progresses, fibrillation periods become more frequent and last longer. Patient outcomes show a strong correlation with the duration of each episode, and persistent AF responds increasingly poorly to antiarrhythmic medication.1 Therefore, catheter ablation has become one of the most important therapeutic methods in the treatment of AF. Studies show a positive correlation between the size of the left atrium (LA) and the incidence of AF,2 heart failure,3 and ischemic stroke.4 In an enlarged LA, the myocardium has time for repolarization, and the electrical impulse depolarizes the myocardium again, causing AF. It is important to determine the correlation between the size of the LA and the incidence of AF and other complications that are associated with AF or the size of the LA. Multislice computed tomography (MSCT) creates a 3D image of the heart and has the ability to calculate the size and volume of the LA.5–7 An enlarged LA can also lead to heart failure and an increased risk of cardio-embolic events such as stroke or end-artery organ damage. It can also be the starting point of cardiomyopathy or the consequence of other diseases such as left ventricular failure or hypertension.8 Identifying the cause of LA enlargement is important for treatment and the prognosis of the patient. In a study published in this issue of the Journal of Cardiovascular Emergencies,9 Bordi et al. demonstrate a relationship between the size of the LA and the occurrence of AF. The study enrolled patients with previous episodes of AF, treated with catheter ablation, with the aim to assess the rate of emergency hospitalization due to symptoms related to enlarged LA and to examine whether these rates can be predicted with volume measurement using MSCT. The results clearly depict a direct relationship between the size of the LA and the reoccurrence of AF. The study has also found emergency admissions due to heart failure to be correlated with LA enlargement in these patients. Mmode echocardiography is also frequently used to determine the volume of cardiac chambers and there is a debate regarding its benefits compared to MSCT.10,11 It is conclusive to say that LA volume determination in patients treated with catheter ablation for AF plays an important role in the long-term outcomes of AF and affects the frequency of emergency hospitalizations. Catheter ablation improves the quality of life and has economic benefits in the form of reduced need for hospitalization, but attention needs to be paid to risk factors such as CCS and RAV, which influence the prognosis of the patient.
{"title":"Left Atrial Volume to Predict the Recurrence of Atrial Fibrillation in Patients Treated with Catheter Ablation","authors":"Dev M. Desai, N. Suthar","doi":"10.2478/jce-2023-0008","DOIUrl":"https://doi.org/10.2478/jce-2023-0008","url":null,"abstract":"Atrial fibrillation (AF) is a cardiac condition that may cause severe complications, eventually leading to the death of the patient. As the disease progresses, fibrillation periods become more frequent and last longer. Patient outcomes show a strong correlation with the duration of each episode, and persistent AF responds increasingly poorly to antiarrhythmic medication.1 Therefore, catheter ablation has become one of the most important therapeutic methods in the treatment of AF. Studies show a positive correlation between the size of the left atrium (LA) and the incidence of AF,2 heart failure,3 and ischemic stroke.4 In an enlarged LA, the myocardium has time for repolarization, and the electrical impulse depolarizes the myocardium again, causing AF. It is important to determine the correlation between the size of the LA and the incidence of AF and other complications that are associated with AF or the size of the LA. Multislice computed tomography (MSCT) creates a 3D image of the heart and has the ability to calculate the size and volume of the LA.5–7 An enlarged LA can also lead to heart failure and an increased risk of cardio-embolic events such as stroke or end-artery organ damage. It can also be the starting point of cardiomyopathy or the consequence of other diseases such as left ventricular failure or hypertension.8 Identifying the cause of LA enlargement is important for treatment and the prognosis of the patient. In a study published in this issue of the Journal of Cardiovascular Emergencies,9 Bordi et al. demonstrate a relationship between the size of the LA and the occurrence of AF. The study enrolled patients with previous episodes of AF, treated with catheter ablation, with the aim to assess the rate of emergency hospitalization due to symptoms related to enlarged LA and to examine whether these rates can be predicted with volume measurement using MSCT. The results clearly depict a direct relationship between the size of the LA and the reoccurrence of AF. The study has also found emergency admissions due to heart failure to be correlated with LA enlargement in these patients. Mmode echocardiography is also frequently used to determine the volume of cardiac chambers and there is a debate regarding its benefits compared to MSCT.10,11 It is conclusive to say that LA volume determination in patients treated with catheter ablation for AF plays an important role in the long-term outcomes of AF and affects the frequency of emergency hospitalizations. Catheter ablation improves the quality of life and has economic benefits in the form of reduced need for hospitalization, but attention needs to be paid to risk factors such as CCS and RAV, which influence the prognosis of the patient.","PeriodicalId":15210,"journal":{"name":"Journal Of Cardiovascular Emergencies","volume":"9 1","pages":"22 - 23"},"PeriodicalIF":0.4,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82102605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Gestational hypertension and preeclampsia complicate 2–8% of pregnancies, with a great impact on the fetuses, as well as on maternal well-being. Preeclampsia is considered a major cardiovascular emergency due to its potential to evolve to severe eclampsia, a devastating life-threatening condition. Worldwide, preeclampsia is considered to be one of the major factors that lead to maternal and fetal death. On average, hypertensive disorders are responsible for approximately 16% of maternal deaths, and every year, preeclampsia is estimated to cause more than 500,000 deaths of the fetus and 70,000 maternal deaths all over the world. While different studies published so far have not succeeded in identifying the exact mechanisms that cause preeclampsia, ischemic vascular phenomena, immunological disorders, and inflammation have been reported as important factors involved in its pathogenesis. The current review aims to provide updated, relevant literature data regarding the potential link between elevated inflammatory status and preeclampsia, at the same time underlining the role of emerging imaging techniques for the early detection of preeclamptic risk.
{"title":"Inflammation, Gestational Hypertension, and Preeclampsia – a Dangerous Association","authors":"A. Corduneanu, Ioana Păvăleanu, M. Căpîlna","doi":"10.2478/jce-2023-0002","DOIUrl":"https://doi.org/10.2478/jce-2023-0002","url":null,"abstract":"Abstract Gestational hypertension and preeclampsia complicate 2–8% of pregnancies, with a great impact on the fetuses, as well as on maternal well-being. Preeclampsia is considered a major cardiovascular emergency due to its potential to evolve to severe eclampsia, a devastating life-threatening condition. Worldwide, preeclampsia is considered to be one of the major factors that lead to maternal and fetal death. On average, hypertensive disorders are responsible for approximately 16% of maternal deaths, and every year, preeclampsia is estimated to cause more than 500,000 deaths of the fetus and 70,000 maternal deaths all over the world. While different studies published so far have not succeeded in identifying the exact mechanisms that cause preeclampsia, ischemic vascular phenomena, immunological disorders, and inflammation have been reported as important factors involved in its pathogenesis. The current review aims to provide updated, relevant literature data regarding the potential link between elevated inflammatory status and preeclampsia, at the same time underlining the role of emerging imaging techniques for the early detection of preeclamptic risk.","PeriodicalId":15210,"journal":{"name":"Journal Of Cardiovascular Emergencies","volume":"175 1","pages":"1 - 8"},"PeriodicalIF":0.4,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79768645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Introduction Cardiac masses are at the attention of health specialists since the development of echocardiography. Even though imaging is an excellent tool for diagnosis, the clinical presentation, risk factors, and hemodynamic status of the patients are important in establishing the diagnosis and subsequent management. The purpose of this presentation is to assess the difficulty of diagnosis in the case of an intracardiac mass and its therapeutic management. Case report A 29-year-old female with paresthesia in the left arm and a systolic tricuspid murmur underwent echocardiography, which revealed a mass of 35/20 mm in the right atrium. Due to the high embolic risk, the patient was referred to the cardiac surgery department and underwent surgical removal of the cardiac mass, which presented the macroscopical aspect of a myxoma. However, the histopathological examination revealed a right atrial thrombus. Conclusion Right heart thrombi represent a challenging diagnosis that involves a multidisciplinary team for the diagnosis and treatment of the patient.
{"title":"Incidental Discovery of a Cardiac Thrombus Mimicking a Right Atrial Myxoma in a Young Female Patient – A Case Report","authors":"M. Oltean, B. Caloian, D. Irimie, D. Pop","doi":"10.2478/jce-2023-0001","DOIUrl":"https://doi.org/10.2478/jce-2023-0001","url":null,"abstract":"Abstract Introduction Cardiac masses are at the attention of health specialists since the development of echocardiography. Even though imaging is an excellent tool for diagnosis, the clinical presentation, risk factors, and hemodynamic status of the patients are important in establishing the diagnosis and subsequent management. The purpose of this presentation is to assess the difficulty of diagnosis in the case of an intracardiac mass and its therapeutic management. Case report A 29-year-old female with paresthesia in the left arm and a systolic tricuspid murmur underwent echocardiography, which revealed a mass of 35/20 mm in the right atrium. Due to the high embolic risk, the patient was referred to the cardiac surgery department and underwent surgical removal of the cardiac mass, which presented the macroscopical aspect of a myxoma. However, the histopathological examination revealed a right atrial thrombus. Conclusion Right heart thrombi represent a challenging diagnosis that involves a multidisciplinary team for the diagnosis and treatment of the patient.","PeriodicalId":15210,"journal":{"name":"Journal Of Cardiovascular Emergencies","volume":"7 1","pages":"17 - 21"},"PeriodicalIF":0.4,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89553820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
I. Balmoș, M. Mureșan, K. Brinzaniuc, H. Suciu, E. Horváth, Réka Kaller, C. Banceu, A. Mureṣan
Abstract Background This study aimed to identify early postoperative complications after carotid endarterectomy and the factors that may influence their occurrence. Methods This was an observational, analytical, prospective study conducted over a period of 3 years in 2 university hospitals in Târgu Mureș, Romania. One hundred nineteen patients who underwent carotid endarterectomy for severe carotid stenosis were included. Statistical analysis was used to identify the independent factors with a direct influence on the acute complications in the first 48 h after carotid endarterectomy. Results We followed up on the acute postoperative complications occurring in the first 2 days after surgery. These were represented by a limited number of neurological complications and major neck hematomas. Among all comorbidities and risk factors, only advanced coronary artery disease (p = 0.05) and smoking (p = 0.03) were independent factors that directly influenced the occurrence of major neck hematomas. Operative time exceeding the median time of 90 minutes increased the risk of neurological complications (p = 0.02). The risk of major neck hematomas was also increased by preoperative treatment with anticoagulants (p = 0.01) and anticoagulants associated with antiplatelet therapy (p = 0.009). Conclusions This study has identified factors such as advanced coronary artery disease, smoking, operative time, and anticoagulant therapy that may be independently associated with an increased risk of acute postoperative complications after carotid endarterectomy.
{"title":"Factors That Influence the Occurrence of Acute Postoperative Complications after Carotid Endarterectomy","authors":"I. Balmoș, M. Mureșan, K. Brinzaniuc, H. Suciu, E. Horváth, Réka Kaller, C. Banceu, A. Mureṣan","doi":"10.2478/jce-2023-0003","DOIUrl":"https://doi.org/10.2478/jce-2023-0003","url":null,"abstract":"Abstract Background This study aimed to identify early postoperative complications after carotid endarterectomy and the factors that may influence their occurrence. Methods This was an observational, analytical, prospective study conducted over a period of 3 years in 2 university hospitals in Târgu Mureș, Romania. One hundred nineteen patients who underwent carotid endarterectomy for severe carotid stenosis were included. Statistical analysis was used to identify the independent factors with a direct influence on the acute complications in the first 48 h after carotid endarterectomy. Results We followed up on the acute postoperative complications occurring in the first 2 days after surgery. These were represented by a limited number of neurological complications and major neck hematomas. Among all comorbidities and risk factors, only advanced coronary artery disease (p = 0.05) and smoking (p = 0.03) were independent factors that directly influenced the occurrence of major neck hematomas. Operative time exceeding the median time of 90 minutes increased the risk of neurological complications (p = 0.02). The risk of major neck hematomas was also increased by preoperative treatment with anticoagulants (p = 0.01) and anticoagulants associated with antiplatelet therapy (p = 0.009). Conclusions This study has identified factors such as advanced coronary artery disease, smoking, operative time, and anticoagulant therapy that may be independently associated with an increased risk of acute postoperative complications after carotid endarterectomy.","PeriodicalId":15210,"journal":{"name":"Journal Of Cardiovascular Emergencies","volume":"96 1","pages":"9 - 16"},"PeriodicalIF":0.4,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73451793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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