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A Hidden Threat: Anomalous Aortic Origins of the Coronary Arteries in Athletes
AbstractPurpose of reviewAnomalous aortic origins of the coronary arteries (AAOCA) are a primary cause of sudden cardiac death in athletes. This review will detail the epidemiology, pathophysiology, and risk stratification of AAOCA, while also highlighting return-to-play considerations for athletes.Recent findingsSport pre-participation cardiovascular screening methods lack sensitivity and specificity in the identification of AAOCA. For the symptomatic athlete, clinicians must maintain a heightened clinical suspicion for AAOCA in order to proceed with appropriate cardiac imaging and functional assessments. Anomalous origin...
Source: Current Treatment Options in Cardiovascular Medicine - November 7, 2020 Category: Cardiology Source Type: research

“Hyperacute” Stroke Rehabilitation Care: Common Issues and Considerations
AbstractPurpose of reviewWe provide a comprehensive review of current issues and treatment guidelines for stroke rehabilitation in the acute care setting.Recent findingsNeuroplasticity and stroke recovery have been found to start at the onset of injury. As a result, neurorehabilitation beginning in the acute care setting has emerged as a promising management strategy to improve patient outcomes and quality of life. Specific treatment and rehabilitation protocols in the acute recovery phase include those that target motor recovery, spasticity, cognitive processes, nutrition, communication, and family dynamics.SummaryStroke ...
Source: Current Treatment Options in Cardiovascular Medicine - November 5, 2020 Category: Cardiology Source Type: research

Management and Treatment of Myocarditis in Athletes
AbstractPurpose of reviewMyocarditis is an inflammation of the myocardium that can often be associated with cardiac dysfunction and arrhythmias, and is even one of the leading causes for sudden cardiac death (SCD) in athletes. This review aims to summarize the current evidence and treatment guidelines for the management of myocarditis in the active population.Recent findingsPhysical exertion is likely a trigger for dangerous arrythmias and further propagates myocardial damage in athletes with myocarditis. For this reason, abstinence from sports is a critical facet of management in the initial inflammatory period. The use o...
Source: Current Treatment Options in Cardiovascular Medicine - November 4, 2020 Category: Cardiology Source Type: research

Differential Outcomes for African-American Women with Cardiovascular Complications of Pregnancy
AbstractPurpose of reviewMaternal mortality is rising in the USA, and cardiovascular disease is the leading cause of death. Black women are 3 times more likely to die than White women as a result of pregnancy-related causes. In this review, we describe the differential outcomes of Black women with cardiovascular conditions related to pregnancy.Recent findingsBlack women have a higher risk of developing peripartum cardiomyopathy (PPCM) and preeclampsia compared to White women. Black women with PPCM present with more severe disease and are less likely to experience myocardial recovery. Black women with preeclampsia are at hi...
Source: Current Treatment Options in Cardiovascular Medicine - November 3, 2020 Category: Cardiology Source Type: research

Cardiotoxicity of Contemporary Anticancer Immunotherapy
AbstractPurpose of reviewContemporary anticancer immunotherapy, particularly immune checkpoint inhibitors (ICI) and chimeric antigen receptor (CAR) T cell therapy, has changed the landscape of treatment for patients with a variety of malignancies who historically had a poor prognosis. However, both immune checkpoint inhibitors and CAR T cell therapy are associated with serious cardiovascular adverse effects. As immunotherapy evolves to include high-risk patients with preexisting cardiovascular risk factors and disease, the risk and relevance of its associated cardiotoxicity will be even higher.Recent findingsICI can cause ...
Source: Current Treatment Options in Cardiovascular Medicine - November 3, 2020 Category: Cardiology Source Type: research

Sex Differences in Young Adults Who Experience Myocardial Infarction
AbstractPurpose of reviewThe purpose of this review is to highlight sex differences in presentation, underlying mechanisms, treatment, and outcomes in young adults with myocardial infarction (MI).Recent findingsIn addition to traditional plaque rupture and plaque erosion, MI in young women can be caused by spontaneous coronary artery dissection (SCAD), MI with nonobstructive coronary arteries (MINOCA), and type 2 MI. MINOCA is more common in young women compared with young men, has a different epidemiology, and is associated with non-traditional cardiovascular risk factors. Additionally,  pregnancy-associated conditions (...
Source: Current Treatment Options in Cardiovascular Medicine - November 3, 2020 Category: Cardiology Source Type: research

The Association of Adverse Pregnancy Outcomes and Cardiovascular Disease: Current Knowledge and Future Directions
AbstractPurpose of reviewAdverse pregnancy outcomes are associated with increased risk for future cardiovascular disease. The goal of this review is to share what is currently known about the increased risk and to identify areas for future research.Recent findingsSevere studies have identified a strong association between adverse pregnancy outcomes and cardiovascular disease such as heart failure, valvular disease, ischemic heart disease, stroke, hypertension, and metabolic syndrome. The recognition of this increased risk is reflected in recent changes in prevention guidelines. The guidelines now recognize sex-specific ris...
Source: Current Treatment Options in Cardiovascular Medicine - October 31, 2020 Category: Cardiology Source Type: research

Workup and Management of Primary Mitral Regurgitation
AbstractPurpose of reviewWe summarize the current concepts and methods for diagnosis and management of primary mitral regurgitation due to leaflet prolapse or flail.Recent findingsCurrent practice guidelines emphasize accurate diagnosis of chronic primary severe MR, differentiating between symptomatic and asymptomatic states, and assessing both hemodynamic and functional impact, thereby ensuring timely surgical or transcatheter intervention for those who stand to benefit from it. No effective medical therapy for chronic severe mitral regurgitation has been found to date. Surgical repair has significant advantages over valv...
Source: Current Treatment Options in Cardiovascular Medicine - October 30, 2020 Category: Cardiology Source Type: research

Updates in the Definition, Diagnostic Work Up, and Therapeutic Strategies for MINOCA
AbstractPurpose of reviewMyocardial infarction with non-obstructive coronary arteries (MINOCA) is found in up to 6% of patients presenting with acute coronary syndrome. These patients represent a group with unique pathophysiology and treatment needs. This review summarizes recent advancement in the understanding of the causes and diagnostic work up of patients presenting with MINOCA.Recent findingsHistorically the importance of MINOCA has been under-recognized, and the condition was considered a more benign form of acute coronary syndrome. More recently consensus documents from major cardiac societies have highlighted the ...
Source: Current Treatment Options in Cardiovascular Medicine - October 28, 2020 Category: Cardiology Source Type: research

The Impact of Exercise and Athletic Training on Vascular Structure and Function
AbstractPurpose of reviewMyocardial adaptation to athletics and exercise training is a well-described process that has garnered much interest over the past decades. By contrast, our understanding of how the vascular system adapts in the trained athlete remains limited. The goal of this review is to provide a comprehensive overview of the impact of exercise on structure and function of the extra-cardiac vascular system.Recent findingsWhile structural changes in the size of the aorta are rare in young athletes, emerging data suggest that long-term athletic participation may be a risk factor for aortic dilation in middle-age ...
Source: Current Treatment Options in Cardiovascular Medicine - October 28, 2020 Category: Cardiology Source Type: research

Sex Differences in Cardiovascular Disease and Unique Pregnancy-Associated Risk Factors in Women
AbstractPurpose of reviewCardiovascular disease is the leading cause of mortality in women. Beyond conventional cardiovascular risk factors, women additionally face sex-specific cardiovascular disease risk factors, which include a history of adverse pregnancy outcomes. Adverse pregnancy outcomes include the hypertensive disorders of pregnancy, gestational diabetes mellitus, preterm delivery,  and small-for-gestational age delivery. Here, we review sex differences in cardiovascular disease with an emphasis on pregnancy-associated risk factors and discuss implications for the prevention and treatment of cardiovascular dise...
Source: Current Treatment Options in Cardiovascular Medicine - October 28, 2020 Category: Cardiology Source Type: research

Updates to a Modern Dilemma: a Practical Approach to the Workup and Management of Low-Gradient Severe Aortic Stenosis Using Transvalvular Flow Rate
AbstractPurpose of reviewTo provide a new and practical approach for clinicians assessing and managing patients with low-gradient severe aortic stenosis (AS) using recent data highlighting the importance of transvalvular flow rate in AS assessment.Recent findingsRecent data have highlighted the unifying underpinning of low-gradient severe AS to be low transvalvular flow rate, and shown the impact that flow rate has on diagnostic and prognostic utility in AS. Additional developments in echocardiographic measurement technique and non-echocardiographic modalities have also been made which can help tackle this clinical conundr...
Source: Current Treatment Options in Cardiovascular Medicine - October 28, 2020 Category: Cardiology Source Type: research

Pregnancy After Spontaneous Coronary Artery Dissection (SCAD): a 2020 Update
AbstractPurpose of reviewSpontaneous coronary artery dissection (SCAD) is a disease which affects a predominantly female and relatively young population, some of whom have not yet completed their reproductive lives. SCAD has traditionally been considered a contraindication to future pregnancy due to concerns about the risk of recurrence and the high-risk phenotype associated with pregnancy-associated SCAD (P-SCAD). This review summarizes recent advancements in the understanding of pregnancy and reproductive health after SCAD.Recent findingsAlthough traditionally under-recognized and underdiagnosed, the importance of SCAD a...
Source: Current Treatment Options in Cardiovascular Medicine - October 28, 2020 Category: Cardiology Source Type: research

Systematic Review: Does Balloon Pulmonary Angioplasty (BPA) Improve Right Ventricular Function in CTEPH Patients? Evaluation Based on Imaging Findings
AbstractPurpose of reviewChronic thromboembolic pulmonary hypertension (CTEPH) is a life-threatening disease with many complications, such as right heart failure. Therefore, a direct and efficient therapy is imperative. This review aims to determine the effectiveness of balloon pulmonary angioplasty (BPA) on right ventricular (RV) function among CTEPH patients, using imaging methods.Recent findingsFrom April 2019 to August 2019, PubMed database was searched for randomized control trials and cohort studies conducted until August 2019, evaluating the impact of BPA on RV function as assessed by non-invasive modalities. Data w...
Source: Current Treatment Options in Cardiovascular Medicine - October 21, 2020 Category: Cardiology Source Type: research

Doxorubicin Cardiotoxicity: Pathophysiology Updates
AbstractPurpose of reviewDoxorubicin has long been known to cause cardiotoxicity, yet our understanding of its pathophysiologic mechanisms remains incomplete. This review aims to update readers on the most recent evidence supporting candidate mechanisms and proposed treatments for doxorubicin cardiotoxicity.Recent findingsDoxorubicin causes cardiotoxicity via traditional mechanisms, such as oxidative stress, DNA and mitochondrial damage, and iron overload, as well as through novel pathways such as autophagy and CYP1 induction. The relative importance of each pathway and how these pathways interact with each other is not we...
Source: Current Treatment Options in Cardiovascular Medicine - October 14, 2020 Category: Cardiology Source Type: research