Journal of cardiology
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Although its prevalence is relatively low in pregnant women, heart disease is the most important cause of maternal mortality. Problems may arise due to hemodynamic burden and the hypercoagulable state of pregnancy. Heart disease may be congenital or acquired. ⋯ Treatment options should be discussed with the future parents, as they may affect both mother and child. In general, the preferred route of delivery is vaginal. The optimal care for pregnant women with heart disease requires multidisciplinary involvement and is best concentrated in tertiary centers.
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Journal of cardiology · Dec 2012
Usefulness of cardiac biomarkers in the prediction of right ventricular dysfunction before echocardiography in acute pulmonary embolism.
The aim of this study was to investigate a useful cardiac biomarker for predicting echocardiographic right ventricular (RV) dysfunction in patients with acute pulmonary embolism (APE). ⋯ NT-proBNP, cTnt, and cTni were significant serologic predictors of RV dysfunction in APE. Measurements of NT-proBNP, cTnt, and cTni are simple and useful in the risk stratification or treatment of APE.
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Journal of cardiology · Dec 2012
ReviewTako-tsubo cardiomyopathy: clinical presentation and underlying mechanism.
Since Dr Sato at Hiroshima City Hospital first recognized and reported the concept of tako-tsubo cardiomyopathy in 1990, this disorder has become accepted worldwide as a distinct clinical entity. Tako-tsubo cardiomyopathy is an important disorder as a differential diagnosis of acute myocardial infarction. This disorder usually occurs in postmenopausal women of an advanced age, and is characterized by transient left ventricular apical wall motion abnormalities associated with emotional or physical stress. ⋯ The prognosis is generally favorable. However, several acute complications have been reported such as congestive heart failure, cardiac rupture, hypotension, left ventricular apical thrombosis, or Torsade de Pointes. Several possible mechanisms such as multivessel coronary artery spasm, coronary microvascular dysfunction, myocarditis, or catecholamine toxicity have been proposed to explain tako-tsubo cardiomyopathy, but its pathophysiology is not well understood.
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Journal of cardiology · Dec 2012
Effect of intravenous adrenaline before arrival at the hospital in out-of-hospital cardiac arrest.
There is some evidence in prospective randomized clinical trials that the administration of adrenaline (AD) before admission for the treatment of out-of-hospital cardiac arrest did not improve survival to hospital discharge. The aim of this study was to evaluate our real-world experience regarding the efficacy of intravenous AD in out-of-hospital cardiac arrest at our university hospital. In this retrospective study, we enrolled and divided 644 patients into AD (AD administration before arrival at the hospital) and non-AD (no AD administration before arrival at the hospital) groups. ⋯ We analyzed whether intravenous AD before arrival in patients with intrinsic cause was effective. The outcomes in the AD group were similar to those in the non-AD group. In conclusion, our study indicated that AD administration before arrival at the hospital for the treatment of out-of-hospital cardiac arrest did not improve the clinical outcome.