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Quiz case: a clinical reasoning challenge in the emergency stroke setting
AbstractA right-handed woman in her 80s was admitted to the emergency department 1 h after sudden-onset global aphasia and right-sided hemiparesis. Medical history included arterial hypertension, dyslipidemia, hyperuricemia, aortic stenosis, osteoporosis, and recent pulmonary embolism. Medication consisted of apixaban, bisoprolol, hydrochlorothiazide, allopurinol, fenofibrate, and vitamin D. Vital parameters (blood pressure, heart rate, body temperature, oxygen saturation) and glycemia were all within normal range. Electrocardiogram showed a first-degree atrioventricular block. The patient was promptly transported to the e...
Source: Neurological Sciences - August 5, 2023 Category: Neurology Source Type: research

Zero-contrast imaging for the assessment of transcatheter aortic valve implantation in candidates with renal dysfunction
CONCLUSION: The proposed contrast-free imaging protocol appears to be a promising clinical tool for pre-TAVI evaluation in patients with severe renal dysfunction.PMID:37350345 | DOI:10.1080/0886022X.2023.2224888
Source: Renal Failure - June 23, 2023 Category: Urology & Nephrology Authors: Guy F A Prado Stefano Garzon Jose Mariani Adriano Caixeta Breno O Almeida Felipe O Ramalho Marcelo L C Vieira Claudio H Fischer Gilberto Szarf Walther Ishikawa Pedro A Lemos Source Type: research

Hemodynamic changes during aortic valve surgery among patients with aortic stenosis
Conclusion. In patients with AS, CI can be increased with both dobutamine and fluid during surgery. Dobutamine's effect on SVI was highly variable and associated with baseline LVEF, and an increase in CI was mostly driven by an increase in heart rate. Fluid increased SVi at the cost of an increase in PCWP.PMID:35848519 | DOI:10.1080/14017431.2022.2099008
Source: Scandinavian Cardiovascular Journal - July 18, 2022 Category: Cardiology Authors: Rasmus Carter-Storch S øren Mose Hansen Jordi S Dahl Kasper Enevold Nils Sofus Borg Mogensen Henrik Berg Marie-Annick Clavel Jacob E M øller Source Type: research

Thoracic Aortic < sup > 18 < /sup > F-Sodium Fluoride Activity and Ischemic Stroke in Patients With Established Cardiovascular Disease
CONCLUSIONS: In patients with established cardiovascular disease, thoracic aortic 18F-sodium fluoride activity is associated with the progression of atherosclerosis and future ischemic stroke. Arterial 18F-sodium fluoride activity identifies localized areas of atherosclerotic disease activity that are directly linked to disease progression and downstream regional clinical atherothrombotic events. (DIAMOND - Dual Antiplatelet Therapy to Reduce Myocardial Injury [DIAMOND], NCT02110303; Study Investigating the Effect of Drugs Used to Treat Osteoporosis on the Progression of Calcific Aortic Stenosis [SALTIRE II], NCT02132026; ...
Source: Atherosclerosis - February 20, 2022 Category: Cardiology Authors: Alexander J Fletcher Yong Y Tew Evangelos Tzolos Shruti S Joshi Jakub Kaczynski Jennifer Nash Samuel Debono Maria Lembo Jacek Kwiecinski Rong Bing Maaz B J Syed Mhairi K Doris Edwin J R van Beek Alistair J Moss William S Jenkins Niki L Walker Nikhil V Jos Source Type: research

Carotid Duplex Poorly Predicts Stroke Risk During Transcatheter Aortic Valve Replacement
Patients undergoing surgical aortic valve replacement, in isolation or with concomitant coronary artery bypass grafting, have historically been screened for carotid artery disease prior to surgery. Over the past decade, transcatheter aortic valve replacement (TAVR) has incrementally become the predominant technique for the treatment of severe aortic stenosis. The relationship between internal carotid artery stenosis (ICAS) and risk of periprocedural stroke in the TAVR population is uncertain. We sought to evaluate our institution's outcomes with the TAVR procedure and the association with preoperative carotid duplex scan (CDS) results.
Source: Annals of Vascular Surgery - January 4, 2022 Category: Surgery Authors: Cameron St. Hilaire, Jaclyn DeRieux, Michael Shenoda, Kevin Casey Tags: Clinical Research Source Type: research

Spontaneous Spinal Epidural Hematoma in an Adult Patient with Complex Congenital Heart Disease
We report the case of a 27-year-old man who developed sudden upper back pain with no specific precipitant. Five days later, he visited our emergency department complaining of weakness in both lower limbs and dysuria. He had a history of intracardiac repair and a Blalock-Park procedure for an interrupted aortic arch and ventricular septal defect in infancy. Additionally, he had undergone an aortic root dilatation and aortic valve replacement at the age of 10 because of progression of aortic and supra-aortic stenosis and had received chronic anticoagulation and antiplatelet therapy with warfarin and aspirin, respectively. An...
Source: International Heart Journal - July 8, 2021 Category: Cardiology Authors: Toshinobu Ifuku Toshihiro Nishiguchi Source Type: research

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