Heart, lung & circulation
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Heart, lung & circulation · Jan 2013
Review Case ReportsRight-to-left atrial shunting associated with aortic root aneurysm: a case report of a rare cause of platypnea-orthodeoxia syndrome.
Platypnea-orthodeoxia is a rare syndrome characterised by dyspnoea and hypoxaemia worsened on upright posture. We report the case of a 76 year-old man treated for lung adenocarcinoma who had developed severe hypoxaemia due to right-to-left shunt through a patent foramen ovale (PFO). Diagnosis was suspected by systemic uptake of isotope during lung scintigraphy performed to exclude pulmonary embolism. ⋯ Chest computed tomography and echocardiography showed a 59-mm aneurysm of the thoracic aorta. The opening of the PFO seemed to be the result of mechanical deformation of the atrial septum by aortic root dilatation. Transcatheter closure of the atrial defect has provided excellent results, including a rapid increase in systemic saturation and improvement of symptoms without any complications.
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Heart, lung & circulation · Nov 2012
ReviewThe use of a PleurX catheter in the management of recurrent benign pleural effusion: a concise review.
Recurrent pleural effusion (RPE) can be encountered in various benign conditions such as inflammatory, infectious, or other systemic diseases (e.g., congestive heart failure (CHF), hepatic hydrothorax, post lung transplants, post coronary artery bypass graft (CABG) surgery, and chronic exudative pleurisy). Each condition is treated based on its unique pathophysiologic characteristics, and medical management is successful in the majority of patients. ⋯ We conducted a literature review using PubMed and Google Scholar, finding 33 articles that were relevant to our topic over the last 30 years. In patients with recurrent benign pleural effusion that is refractory to medical management, the PleurX catheter seems to be a useful tool in relieving respiratory symptoms, decreasing the rate of hospitalisation and achieving pleurodesis.
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Heart, lung & circulation · Oct 2012
ReviewAcute rheumatic fever and rheumatic heart disease--priorities in prevention, diagnosis and management. A report of the CSANZ Indigenous Cardiovascular Health Conference, Alice Springs 2011.
Three priority areas in the prevention, diagnosis and management of acute rheumatic fever (ARF) and rheumatic heart disease (RHD) were identified and discussed in detail: 1. Echocardiography and screening/diagnosis of RHD – Given the existing uncertainty it remains premature to advocate for or to incorporate echocardiographic screening for RHD into Australian clinical practice. Further research is currently being undertaken to evaluate the potential for echocardiography screening. 2. ⋯ Management of advanced RHD – National centres of excellence for the diagnosis, assessment and surgical management of RHD are required. Early referral for surgical input is necessary with multidisciplinary care and team-based decision making that includes patient, family, and local health providers. There is a need for a national RHD surgical register and research strategy for the assessment, intervention and long-term outcome of surgery and other interventions for RHD.
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Heart, lung & circulation · Jun 2012
ReviewRadiofrequency catheter ablation for ventricular tachycardia.
The management of ventricular tachycardia (VT) has evolved considerably in recent times. The majority of patients with VT have structural heart disease and often implantable defibrillators. ⋯ Radiofrequency catheter ablation has a definite role as an alternative to anti-arrhythmic therapy in both groups of patients. This review outlines the indications, techniques and outcomes of catheter ablation in the management of patients with ventricular tachycardia.