Relevance of cardiac imaging in the evolving landscape of infective endocarditis management.

Infective endocarditis (IE) is an increasingly recognized condition with high morbidity. Patients with atypical symptoms, culture-negative infections, and prosthetic cardiac devices and implants represent challenging populations to evaluate and manage. Recent major society guidelines have recommended the appropriate incorporation of multimodality imaging in the evaluation of these more complex IE cases.

Role of multimodality imaging in infective endocarditis: A comparison of the major society guidelines in the United States and Europe.

Infective endocarditis (IE) is a life-threatening condition, and early diagnosis and management are critical. There is emerging evidence on the role of advanced imaging modalities including dedicated cardiac computed tomography (CCT), and F-fluorodeoxyglucose positron emission tomography (PET). The updated 2023 European Society of Cardiology (ESC) guidelines have emphasized increased utilization of multimodality imaging in the diagnosis and management of IE.

Do the Few Dictate Care for the Many? Revascularisation Considerations That Go Beyond the Guidelines.

The burden of coronary artery disease (CAD) is large and growing, commonly presenting with comorbidities and older age. Patients may benefit from coronary revascularisation with percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG), yet half of patients with CAD who would benefit from revascularisation fall outside the eligibility criteria of trials to date. As such, the choice of revascularisation procedures varies depending on the CAD anatomy and complexity, surgical risk and comorbidities, the patient's preferences and values, and the treating team's expertise.

Multimodality Imaging Approach Evaluation of the Congenital Pericardial Defect: a Contemporary Review.

Purpose Of Review: This review presents the etiology, clinical manifestations, diagnostic approach, and treatment of congenital pericardial defects. It also highlights the critical role of echocardiography, cardiac computed tomography (CCT), and cardiac magnetic resonance (CMR) in the diagnosis and management approach.

Recent Findings: Congenital pericardial defects are rare.

Clinical management of conduction abnormalities following transcatheter aortic valve replacement: prospective evaluation of a standardized management pathway.

Purpose: Limited evidence guides management of conduction abnormalities following TAVR. Standardized clinical pathways may reduce variability in care while minimizing bradyarrhythmic morbidity, length of stay (LOS), and pacemaker (PPM) implantation rates.

Methods: A multidisciplinary consensus pathway to standardize post-TAVR management was developed.

A case report of cardiac toxicity from barracuda ingestion in Mexico.

Background: Ciguatera toxicity is a fish-borne illness that initially manifests with gastrointestinal symptoms, followed by bizarre neurological symptoms including heat-cold sensation alteration, peculiar feeling of loose teeth, and peripheral neuropathy. However, cardiac manifestations are rare and underreported in the literature.

Case Summary: A 73-year-old man presented with symptomatic bradycardia and hypotension after ingestion of barracuda fish in Mexico.

Biomarker profile in stable Fontan patients.

Background: As the population of adults with congenital heart disease (CHD) grows, cardiologists continue to encounter patients with complex anatomies that challenge the standard treatment of care. Single ventricle Fontan palliated patients are the most complex within CHD, with a high morbidity and mortality burden. Factors driving this early demise are largely unknown.

Sequence and Nuclease Requirements for Breakage and Healing of a Structure-Forming (AT)n Sequence within Fragile Site FRA16D.

Common fragile sites (CFSs) are genomic regions that display gaps and breaks in human metaphase chromosomes under replication stress and are often deleted in cancer cells. We studied an ∼300-bp subregion (Flex1) of human CFS FRA16D in yeast and found that it recapitulates characteristics of CFS fragility in human cells. Flex1 fragility is dependent on the ability of a variable-length AT repeat to form a cruciform structure that stalls replication.

Hands-on defibrillation with a safety barrier: An analysis of potential risk to rescuers.

Background: Interruptions in compressions reducethe efficacy of cardiopulmonary resuscitation (CPR) and are inevitable during hands-off periods for shocks. Clinical exam gloves were found to facilitate safe contact with patients during shock delivery but the safety of this practice has been questioned. Polyethylene is of interest because of its safety record in the medical arena and its electrical insulation properties.

Breathing during cardiac arrest following exercise: a new function of the respiratory system?

We have found in four sheep that, following a muscular exercise, minute ventilation is maintained for 34-131 s during a cardiac arrest (CA), at a magnitude (from 28.2 and 54.7 l min(-1)) similar to the level of ventilation (and thus proportional to the metabolic rate) preceding the period of asystole.