Cardiovascular Medications in Pregnancy
Cardiovascular disease and cardiovascular disease –related disorders remain among the most common causes of maternal morbidity and mortality in the United States. Due to increased rates of obesity, delayed childbearing, and improvements in medical technology, greater numbers of women are entering pregnancy with preexisting medical comorbidities. Use of cardiovascular medications in pregnancy continues to increase, and medical management of cardiovascular conditions in pregnancy will become increasingly common. Obstetricians and cardiologists must familiarize themselves with the pharmacokinetics of the most commonly used ...
Source: Cardiology Clinics - October 31, 2020 Category: Cardiology Authors: Karen L. Florio, Christopher DeZorzi, Emily Williams, Kathleen Swearingen, Anthony Magalski Source Type: research
Pregnancy in Women with Adult Congenital Heart Disease
Women with congenital heart disease are pursuing pregnancy in increasing numbers. Counseling about genetic transmission, medication management, maternal and fetal risks, and maternal longevity should be initiated well before pregnancy is considered. Although preconception medical and surgical optimization as well as coordinated multidisciplinary care throughout pregnancy decrease maternal and fetal risks, the rate of complications remains increased compared with the general population. Lesion-specific risk stratification and care throughout pregnancy further improve outcomes and decrease unnecessary interventions. (Source: Cardiology Clinics)
Source: Cardiology Clinics - October 30, 2020 Category: Cardiology Authors: Katherine B. Salciccioli, Timothy B. Cotts Source Type: research
Pulmonary Arterial Hypertension in Pregnancy
Pulmonary arterial hypertension is a rare disease that predominantly affects women. The pathophysiology of the disease is complex, with both genetic and hormonal influences. Pregnancy causes significant physiologic changes that may not be well tolerated with underlying pulmonary arterial hypertension, in particular leading to volume overload and increased pulmonary pressures. A multidisciplinary approach and careful monitoring are essential for appropriate management of pulmonary arterial hypertension during pregnancy. Nonetheless, outcomes are still poor, and pregnancy is considered a contraindication in patients with pul...
Source: Cardiology Clinics - October 29, 2020 Category: Cardiology Authors: Wenners Ballard, Brittany Dixon, Colleen A. McEvoy, Amanda K. Verma Source Type: research
Hypertrophic Cardiomyopathy in Pregnancy
Hypertrophic cardiomyopathy (HCM) is the most common genetic cardiac condition and highly heterogeneous. Echocardiography and genetic and clinical screening have led to detection in women of childbearing age. Maternal and fetal outcomes among women with HCM are favorable. Genetic counseling is recommended. Prepregnancy clinical evaluation and risk assessment are paramount in ensuring optimal outcomes. Most women carry moderate risk of morbidity, have clinical evaluations and echocardiography each trimester, and deliver vaginally. Those who are symptomatic or have significant left ventricular outflow obstruction or recurren...
Source: Cardiology Clinics - October 29, 2020 Category: Cardiology Authors: Sara Saberi Source Type: research
Cardio-Obstetrics: An Emerging Field to Improve Maternal Mortality
With steadily rising maternal morbidity and mortality in the United States, there is an urgent need to address the root causes. Cardiovascular disease is the leading cause of maternal deaths, many of which are preventable. Hemodynamic changes of pregnancy include significant increases in cardiac output, blood volume, and heart rate, as well as changes in systemic vascular resistance and increased oxygen consumption. This hemodynamic stress can unmask previously subclinical cardiovascular disease and contribute to complications, including arrhythmias, hypertensive disorders, heart failure, and ischemic events. (Source: Cardiology Clinics)
Source: Cardiology Clinics - October 29, 2020 Category: Cardiology Authors: Melinda B. Davis, Kathryn J. Lindley Tags: Preface Source Type: research
Currently Available Options for Mechanical Circulatory Support for the Management of Cardiogenic Shock
Cardiogenic shock (CS) is a complex condition with a high risk for morbidity and mortality. Mechanical circulatory support (MCS) devices were developed to support patients with CS in cases refractory to treatment with vasoactive medications. Current devices include intra-aortic balloon pumps, intravascular microaxial pumps, percutaneous LVAD, percutaneous RVAD, and VA ECMO. Data from limited observational studies and clinical trials show a clear difference in the level of hemodynamic support offered by each device. However, at this point, there are insufficient clinical trial data to guide MCS selection and, until ongoing ...
Source: Cardiology Clinics - October 7, 2020 Category: Cardiology Authors: Zachary K. Wegermann, Sunil V. Rao Source Type: research
Coronary Physiology Assessment for the Diagnosis and Treatment of Coronary Artery Disease
Functionally significant coronary lesions identification is necessary for appropriate revascularization. This review aims to provide an overview of the available options for coronary stenosis physiologic evaluation with a focus on the latest developments in the field. (Source: Cardiology Clinics)
Source: Cardiology Clinics - October 7, 2020 Category: Cardiology Authors: Elisabetta Moscarella, Felice Gragnano, Arturo Cesaro, Alfonso Ielasi, Vincenzo Diana, Matteo Conte, Alessandra Schiavo, Silvio Coletta, Dario Di Maio, Fabio Fimiani, Paolo Calabr ò Source Type: research
New Advances in the Treatment of Severe Coronary Artery Calcifications
Coronary artery calcifications are always challenging scenarios for interventional cardiologists. Calcium content in coronary tree directly correlates with male sex, age, Caucasian ethnicity, diabetes, and chronic kidney disease. Intracoronary imaging is useful and necessary to understand calcific lesion features and plan the best percutaneous coronary intervention strategy. Thus, accurate evaluation of patient and lesion characteristics is crucial. For this reason, definition of calcific arc, length, and thickness can suggest the best procedure before stenting and final optimization. In our modern era, different devices a...
Source: Cardiology Clinics - October 7, 2020 Category: Cardiology Authors: Pierluigi Demola, Francesca Ristalli, Brunilda Hamiti, Francesco Meucci, Carlo Di Mario, Alessio Mattesini Source Type: research
Coronary Artery Disease
CARDIOLOGY CLINICS (Source: Cardiology Clinics)
Source: Cardiology Clinics - October 7, 2020 Category: Cardiology Authors: Alberto Polimeni Source Type: research
Copyright
ELSEVIER (Source: Cardiology Clinics)
Source: Cardiology Clinics - October 7, 2020 Category: Cardiology Source Type: research
Contributors
JAMIL A. ABOULHOSN, MD, FACC, FSCAI (Source: Cardiology Clinics)
Source: Cardiology Clinics - October 7, 2020 Category: Cardiology Source Type: research
Contents
Alberto Polimeni (Source: Cardiology Clinics)
Source: Cardiology Clinics - October 7, 2020 Category: Cardiology Source Type: research
Forthcoming Issues
Pregnancy and Heart Disease (Source: Cardiology Clinics)
Source: Cardiology Clinics - October 7, 2020 Category: Cardiology Source Type: research
The High Bleeding Risk Patient with Coronary Artery Disease
Out-of-hospital bleeding is a common complication after percutaneous coronary intervention (PCI) due to the concomitant need for dual antiplatelet therapy. A significant proportion of patients undergoing PCI carry specific clinical characteristics posing them at high bleeding risk (HBR), increasing the risk of hemorrhagic complications secondary to antithrombotic therapy. Identifying patients at HBR and adjust antithrombotic therapy accordingly to optimize treatment benefits and risk is a challenge of modern cardiology. Recently, multiple definitions and tools have been provided to help clinicians with prognostic stratific...
Source: Cardiology Clinics - September 16, 2020 Category: Cardiology Authors: Francesco Costa, Victoria Garcia-Ruiz, Roberto Licordari, Luigi Fimiani Source Type: research
Echocardiographic Strain Imaging in Coronary Artery Disease
For more than 30 years, echocardiography, through the measurement of ejection fraction and wall motion assessment, has played a crucial role in the diagnosis and management of patients with acute and chronic ischemic heart disease. The introduction of myocardial strain, measured by speckle tracking echocardiograph y, is shifting this paradigm. Strain imaging catches something pathophysiologically deeper into myocardial function, facing a wide range of clinical applications. This review summarizes the basic concepts of strain imaging and its applicability in clinical practice for the evaluation of the ventricu lar and the...
Source: Cardiology Clinics - September 16, 2020 Category: Cardiology Authors: Alessandro Malagoli, Diego Fanti, Alessandro Albini, Andrea Rossi, Flavio L. Ribichini, Giovanni Benfari Source Type: research
