Mechanical Complication of Acute Myocardial Infarction Secondary to COVID-19 Disease
The aggressive inflammatory response to COVID-19 can result in airway damage, respiratory failure, cardiac injury, and multiorgan failure, which lead to death in susceptible patients.1,2 Cardiac injury and acute myocardial infarction (AMI) secondary to COVID-19 disease can lead to hospitalization, heart failure, and sudden cardiac death.3 When serious collateral damage from tissue necrosis or bleeding occurs, mechanical complications of myocardial infarction and cardiogenic shock can ensue. While prompt reperfusion therapies have decreased the incidence of these serious complications, patients who present late following th...
Source: Cardiology Clinics - May 16, 2022 Category: Cardiology Authors: Abdulla A. Damluji, Nikhil R. Gangasani, Cindy L. Grines Source Type: research
COVID-19 Pandemic: Direct and Indirect Cardiovascular Effects
The COVID-19 pandemic has had a dramatic impact on the care of patients with cardiovascular disease throughout the world. COVID-19 has a myriad of direct effects on the myocardium, vasculature, and coagulation cascade, related to the proinflammatory and prothrombotic effects of the virus, leading to an increased risk of myocardial infarction, stroke, deep venous thrombosis, and pulmonary emboli within the first 2 to 4 weeks of contracting the disease. Patients with preexistent cardiovascular disease and/or cardiovascular risk factors, such as hypertension and diabetes, are particularly susceptible to suffer complications f...
Source: Cardiology Clinics - May 11, 2022 Category: Cardiology Authors: Timothy D. Henry, Santiago Garcia Tags: Preface Source Type: research
Preface: COVID-19 Pandemic: Direct and Indirect Cardiovascular Effects
The COVID-19 pandemic has had a dramatic impact on the care of patients with cardiovascular disease throughout the world. COVID-19 has a myriad of direct effects on the myocardium, vasculature and coagulation cascade, related to the pro-inflammatory and prothrombotic effects of the virus, leading to an increase risk of myocardial infarction, stroke, deep venous thrombosis (DVT), and pulmonary emboli within the first 2-4 weeks of contracting the disease. Patients with pre-existent cardiovascular disease and/or cardiovascular risk factors such as hypertension and diabetes are particularly susceptible to suffer complications ...
Source: Cardiology Clinics - May 11, 2022 Category: Cardiology Authors: Timothy D. Henry, Santiago Garcia Source Type: research
Myocarditis Following COVID-19 Vaccination
Myocarditis is an established but rare adverse event following administration of messenger ribonucleic acid (mRNA)-based coronavirus disease 2019 (COVID-19) vaccines, and is most common in male adolescents and young adults. Symptoms typically develop within a few days of vaccine administration. Most patients have mild abnormalities on cardiac imaging with rapid clinical improvement with standard treatment. However, longer term follow-up is needed to determine whether imaging abnormalities persist, to evaluate for adverse outcomes, and to understand the risk associated with subsequent vaccination. The purpose of the review ...
Source: Cardiology Clinics - May 5, 2022 Category: Cardiology Authors: Constantin A. Marschner, Kirsten E. Shaw, Felipe Sanchez Tijmes, Matteo Fronza, Sharmila Khullar, Michael A. Seidman, Paaladinesh Thavendiranathan, Jacob A. Udell, Rachel M. Wald, Kate Hanneman Source Type: research
Thyroid Abnormalities in Heart Failure
This article discusses the basic science and clinical data that support the hypothesis that these changes pose pathophysiologic and potential novel therapeutic challenges. (Source: Cardiology Clinics)
Source: Cardiology Clinics - April 22, 2022 Category: Cardiology Authors: Sara Danzi, Irwin Klein Source Type: research
Anabolic Deficiencies in Heart Failure
“Chronic heart failure (CHF) is a complex syndrome characterized by symptoms and signs supported by different forms of cardiac impairment. The link between multiple hormonal and metabolic derangements and the development of CHF and the beneficial effects seen with hormonal replacement therapy sugg est that a reduction of anabolic pathways might contribute to the onset of CHF. Therefore, an imbalance between anabolic and catabolic forces could be responsible for the development of CHF. There are sufficient evidence to support the screening in patients with CHF of hormonal deficiencies and thei r correction with replacemen...
Source: Cardiology Clinics - April 22, 2022 Category: Cardiology Authors: Raffaele Napoli, Roberta D ’Assante, Martina Miniero, Andrea Salzano, Antonio Cittadini Source Type: research
The Gut Axis Involvement in Heart Failure
A novel pathophysiological model of interest is the association between heart failure (HF) and the gastrointestinal system, the ‘gut hypothesis’. The choline and carnitine metabolic by-product, Trimethylamine N-oxide (TMAO) is one of the more prominent molecules associated with the link between HF and the gut. Indeed, TMAO levels are increased in HF populations and higher TMAO levels are associated with poor prognosis, w hereas low TMAO levels either at baseline/follow up confer better prognosis. Considering that TMAO levels seem not to be affected by guideline-HF treatment, this model could represent a novel and indep...
Source: Cardiology Clinics - April 22, 2022 Category: Cardiology Authors: Andrea Salzano, Shabana Cassambai, Yoshiyuki Yazaki, Muhammad Zubair Israr, Dennis Bernieh, Max Wong, Toru Suzuki Source Type: research
Chronic Obstructive Pulmonary Disease and Heart Failure
Heart failure (HF) and chronic obstructive pulmonary disease (COPD) are both common causes of breathlessness and often conspire to confound accurate diagnosis and optimal therapy. Risk factors (such as aging, smoking, and obesity) and clinical presentation (eg, cough and breathlessness on exertion) can be very similar, but the treatment and prognostic implications are very different. This review discusses the diagnostic challenges in individuals with exertional dyspnea. We also highlight the prevalence, clinical relevance and therapeutic implications of a concurrent diagnosis of COPD and HF. (Source: Cardiology Clinics)
Source: Cardiology Clinics - April 22, 2022 Category: Cardiology Authors: Pierpaolo Pellicori, John G.F. Cleland, Andrew L. Clark Source Type: research
Sleep Breathing Disorders in Heart Failure
Sleep-disordered breathing (SDB), including obstructive sleep apnea, central sleep apnea (CSA), and Cheyne-Stokes respiration, is common in patients with heart failure (HF) and associated with lower left ventricular ejection fraction (EF), increased arrhythmia burden, and increased mortality. Continuous positive airway pressure therapy improves short-term and long-term outcomes in HF patients. Adaptive servoventilation (ASV) therapy in patients with low-EF HF with predominant CSA is not recommended. Ongoing trials are evaluating whether ASV will have a role in SDB treatment. Phrenic nerve stimulation is an emerging treatme...
Source: Cardiology Clinics - April 22, 2022 Category: Cardiology Authors: Amanda C. Coniglio, Robert J. Mentz Source Type: research
When Pulmonary Hypertension Complicates Heart Failure
Pulmonary hypertension (PH) often complicates chronic left-sided heart failure, with a remarkable impact on quality of life, exercise capacity, and survival. PH in chronic left-sided heart failure (PH-LHD) is not only caused by backward transmission of pressures but also involves impairment of atrial function, inflammation, and vasoconstriction. Once the left atrium loses its reservoir capacity, usually pulmonary vascular resistances increase. Right atrial dilation commonly represents the first sign of PH-LHD, before right ventricle dilatation and systolic dysfunction develop, leading to right heart insufficiency, and ulti...
Source: Cardiology Clinics - April 22, 2022 Category: Cardiology Authors: Alberto-Maria Marra, Nicola Benjamin, Antonio Cittadini, Eduardo Bossone, Ekkehard Gr ünig Source Type: research
Cardiac Cachexia Revisited
Cardiac cachexia is a co-morbidity of heart failure (HF) defined by a non-edematous weight loss of ≥6% within the previous 6–12 months. Cachexia affects about 10-39% patients with HF and occurs typically in advanced stages of HF, especially in the presence of congestive right ventricular dysfunction. This review elucidates the approaches and pitfalls in the diagnosis of cachexia. It summarize s the prevalence and impact of cardiac cachexia. It also discusses changes in body composition over the course of HF and provides an overview of the mechanisms involved in wasting in HF. (Source: Cardiology Clinics)
Source: Cardiology Clinics - April 22, 2022 Category: Cardiology Authors: Miroslava Valentova, Stefan D. Anker, Stephan von Haehling Source Type: research
The Impact of Obesity in Heart Failure
Overweight and obesity adversely impact cardiac structure and function, affecting systolic and diastolic ventricular function. Epidemiologic studies have documented an obesity paradox in large heart failure cohorts, where overweight and obese individuals with established heart failure have a better short- and medium-term prognosis compared with leaner patients; this relationship is strongly impacted by level of cardiorespiratory fitness. There are implications for therapies aimed at increasing lean mass as well as weight loss and improvements in quality of diet for the prevention and treatment of heart failure and concomit...
Source: Cardiology Clinics - April 22, 2022 Category: Cardiology Authors: Salvatore Carbone, Carl J. Lavie, Andrew Elagizi, Ross Arena, Hector O. Ventura Source Type: research
The Cardiorenal Syndrome in Heart Failure
Abnormal fluid handling leads to physiologic abnormalities in multiple organ systems. Deranged hemodynamics, neurohormonal activation, excessive tubular sodium reabsorption, inflammation, oxidative stress, and nephrotoxic medications are important drivers of harmful cardiorenal interactions in patients with heart failure. Accurate quantitative measurement of fluid volume is vital to individualizing therapy for such patients. Blood volume analysis and pulmonary artery pressure monitoring seem the most reliable methods for assessing fluid volume and guiding decongestive therapies. Still the cornerstone of decongestive therap...
Source: Cardiology Clinics - April 22, 2022 Category: Cardiology Authors: Maria Rosa Costanzo Source Type: research
Hypertension and Heart Failure
Hypertension is possibly the most powerful, modifiable risk factor for the development of heart failure. Chronic hypertension drives cardiac remodeling within the left ventricle resulting in hypertensive heart disease, which ultimately manifests as heart failure. Early detection and appropriate management are necessary to prevent heart failure as well as other cardiovascular diseases. Achieving blood pressure goals in conjunction with using evidence-based treatments can improve clinical outcomes for patients with comorbid hypertension and heart failure. (Source: Cardiology Clinics)
Source: Cardiology Clinics - April 22, 2022 Category: Cardiology Authors: Katherine E. Di Palo, Nicholas J. Barone Source Type: research
Atrial Fibrillation in Heart Failure
This article explores the relationship between AF and HF and the thromboembolic effect of these diseases. Morbidity and mortality are increased when the 2 conditions are seen together. Stroke risks are significant with AF and all subtypes of HF. This article suggests that all patients with AF and HF should be considered for anticoagulation. Current evidence suggests that non –vitamin K antagonist oral anticoagulants are effective and safe in AF and HF in comparison with warfarin. (Source: Cardiology Clinics)
Source: Cardiology Clinics - April 22, 2022 Category: Cardiology Authors: Mohammed Obeidat, Malcolm Burgess, Gregory Y.H. Lip Source Type: research
