Deutsche medizinische Wochenschrift
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Dtsch. Med. Wochenschr. · Mar 2021
Review[Symptom control in heart failure patients - how to handle GFR decrease and hyperkalaemia].
For heart failure patients with reduced ejection fraction, optimised medication improves symptom control and reduces mortality. Substances influencing the renin-angiotensin-aldosteron-system, so-called RAAS-inhibitors, are the cornerstone of heart failure treatment. This article summarises a consensus between experts in cardiology and in nephrology on a pragmatic approach to manage a drop in glomerular filtration rate and incident hyperkalaemia - the two most common reasons for reducing or discontinuing heart failure medication.
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Since its beginning, 30 years ago, magnetic resonance imaging of the heart made tremendous progress. Starting from an almost experimental level in the 90 s it has now become a routine tool within cardiac diagnostics. This article presents a selection of present applications of cardiac magnetic resonance imaging. ⋯ Perfusion imaging allows detection of ischemia, and measurement of blood flow quantifies cardiac shunts and valve disorders. In combination with Positron Emission Tomography, the relationship of molecular/cellular processes and functional, microstructural alterations become visible in myocarditis and amyloidosis. Recent contraindications of cMRI/MRI as cardiac devices MRI have been resolved; however, image quality of the heart is still a challenge.
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Dtsch. Med. Wochenschr. · Mar 2021
Case Reports[Taxus poisoning: an unusual cause of acute heart failure].
Taxines are the active, poisonous constituents in yew plants (Taxus spp.) and can result in life-threatening cardiac toxicity. Rapid elimination of yew plant material and administration of active charcoal can limit absorption of toxins. ⋯ Therapeutic interventions such as utilization of digoxin immune fab, hemodialysis and temporary cardiac pacing may be utilized. Extracorporeal life support should be considered for severe cases.