Clinical medicine (London, England)
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Isolated aortic infection is rare and is typically associated with an underlying aortic aneurysm or a prosthetic aortic graft. ⋯ This is an unusual case of acute upper limb ischaemia due to a mass infected with Citrobacter koseri in the ascending aorta without heart valve involvement.
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Infective endocarditis (IE) remains a rare condition but one with high associated morbidity and mortality. With an ageing population and increasing use of implantable cardiac devices and heart valves, the epidemiology of IE has changed. Early clinical suspicion and a rapid diagnosis are essential to enable the correct treatment pathways to be accessed and to reduce complication and mortality rates. In the current review, we detail the latest guidelines for the evaluation and management of patients with endocarditis and its prevention.
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Cardiovascular disease (CVD) remains one of the principal causes of morbidity and mortality in the world. International guidelines are being updated to take into account new evidence and improved health economics as drug patents expire. Recent studies have investigated the best lipid fractions to predict CVD, suggested additional CVD risk factors and a potential role for novel biomarkers while big data approaches have allowed improvements to be made to CVD risk calculators. ⋯ New data has been published on novel lipid-lowering therapies such as proprotein convertase subtilisin kexin 9 inhibitors but the role of these expensive drugs has yet to be fully settled and a diversity of approaches exists between guidelines. The role of lipid fractions outside LDL-C is unclear. There will be challenges in incorporating new non-linear data on omega-3 fatty acids that not only affect triglycerides but more directly CVD.