Penicillin-resistant gonorrheal endocarditis presenting with large annular abscess and aortic valve destruction.

Disseminated gonorrheal infections with cardiac involvement are rare, with fewer than 100 cases reported. The increasing prevalence of gonococcal infections and increasing antibiotic resistance represent a concerning challenge to public health. Here we report a case of antibiotic-resistant gonococcal endocarditis presenting with cardiogenic shock and discuss principles of diagnosis and treatment.

Echocardiographic Parameters and Outcomes in Methamphetamine-Associated Heart Failure: A Propensity Score-Weighted Analysis.

Background: Methamphetamines are a common cause of systolic heart failure (HF). There are limited data on the prognosis associated with hospitalizations for decompensated HF in the setting of methamphetamine use. We aimed to evaluate patient characteristics and outcomes among patients admitted with decompensated HF who had positive drug screens for amphetamines as well as to determine whether any parameters from transthoracic echocardiogram (TTE) can predict outcomes in this population.

Trial of Oral Diuretics Prior to Discharge Is Not Associated With Improved Outcomes in Decompensated Heart Failure.

Background: Current heart failure guidelines recommend transition of intravenous (IV) diuretics to oral > 24 h prior to hospital discharge. The aim of this study was to determine whether transition to oral diuretics prior to discharge in patients hospitalized with decompensated systolic heart failure (SHF) was associated with improved 30-day events.

Methods: This was a retrospective cohort study, in which adults admitted to the Loma Linda Medical Center for 3 - 14 days with a primary discharge diagnosis of acute on chronic SHF were included.

Impact of heart transplant allocation change on competing waitlist outcomes among listing strategies.

In 2018, the United Network for Organ Sharing (UNOS) adopted a 6-tier system for heart allocation which shifted patterns in listing strategies. The effects of the change on waitlist survival and transplantation rates have yet to be substantiated by analysis of competing outcomes among various listing strategies. This study included all adult patients listed for first-time heart transplantation in UNOS between 10/17/15 and 6/12/20.

The New Era of Cardiogenic Shock: Progress in Mechanical Circulatory Support.

Purpose Of Review: In recent decades, multiple left and right ventricular assist devices (VAD) have been developed, and the utilization of these devices has grown exponentially. We discuss the most common temporary mechanical circulatory support (tMCS) devices used for patients in cardiogenic shock, including the intra-aortic balloon pump (IABP), transvalvular axial flow support systems (Impella®), the Tandem™ collection, and extracorporeal membrane oxygenation (ECMO).

Recent Findings: In 2018 the United Network for Organ Sharing (UNOS) introduced new listing criteria for candidates awaiting heart transplantation in the USA.

Advanced heart failure with reduced ejection fraction.

Patients suffering advanced heart failure with reduced ejection fraction (HFrEF) account for a large portion of patients admitted to hospitals worldwide. Mortality and 30-day readmission rates for HFrEF are now a focus of value-based payment models, making management of this disease a priority for hospitals, physicians, and payers alike. Angiotensin-converting enzyme inhibitors have been the cornerstone of therapy for decades.

Differential responses to larger volume intra-aortic balloon counterpulsation: Hemodynamic and clinical outcomes.

Objectives: Examine hemodynamic and clinical correlates of use of an intra-aortic balloon pump catheter in a single center.

Background: The intra-aortic balloon pump catheter (IABC) has been used for 50 years but the clinical benefit is still debated. We reviewed 76 patients with right heart catheter measurements prior to IABC to assess response and outcomes.

A single center tertiary care experience utilizing the large volume mega 50cc intra-aortic balloon counterpulsation in contemporary clinical practice.

Objective: Clinical outcomes and adverse events utilizing the large volume 50cc intra-aortic balloon (IAB) in contemporary clinical practice.

Background: The newer large volume 50cc IAB, recently introduced into clinical practice offers improved diastolic augmentation and better left ventricular (LV) unloading compared to the older 40cc IAB.

Methods: In 150 consecutive patients who received intra-aortic balloon counterpulsation (IABC) with a 50cc balloon from 2011 to 2015, we retrospectively analyzed demographic, clinical, laboratory, and hemodynamic variables, adverse events and survival to discharge from index hospitalization.