Lockdown cardiomyopathy: from a COVID-19 pandemic to a loneliness pandemic.

Social distancing/isolation is vital for infection control but can adversely impact on mental health. As the spread of COVID-19 is contained, mental health issues will surface with particular concerns for elderly, isolated populations. We present a case of Takotsubo cardiomyopathy related to lockdown anxiety.

Aortic regurgitation management: a systematic review of clinical practice guidelines and recommendations.

Guidelines for the diagnosis and management of aortic regurgitation (AR) contain recommendations that do not always match. We systematically reviewed clinical practice guidelines and summarized similarities and differences in the recommendations as well as gaps in evidence on the management of AR. We searched MEDLINE and Embase (1 January 2011 to 1 September 2021), Google Scholar, and websites of relevant organizations for contemporary guidelines that were rigorously developed as assessed by the Appraisal of Guidelines for Research and Evaluation II tool.

Management of mitral stenosis: a systematic review of clinical practice guidelines and recommendations.

A number of guidelines exist with recommendations for diagnosis and management of mitral stenosis (MS). We systematically reviewed existing guidelines for diagnosis and management of MS, highlighting their similarities and differences, in order to guide clinical decision-making. We searched national and international guidelines in MEDLINE and EMBASE (5/4/2011-5/9/2021), the Guidelines International Network, Guideline Library, National Guideline Clearinghouse, National Library for Health Guidelines Finder, Canadian Medical Association Clinical Practice Guidelines Infobase, and websites of relevant organizations.

Mitral regurgitation management: a systematic review of clinical practice guidelines and recommendations.

Multiple guidelines exist for the diagnosis and management of mitral regurgitation (MR), the second most common valvular heart disease in high-income countries, with recommendations that do not always match. We systematically reviewed guidelines on diagnosis and management of MR, highlighting similarities and differences to guide clinical decision-making. We searched national and international guidelines in MEDLINE and EMBASE (1 June 2010 to 1 September 2021), the Guidelines International Network, National Guideline Clearinghouse, National Library for Health Guidelines Finder, Canadian Medical Association Clinical Practice Guidelines Infobase, and websites of relevant organizations.

Tricuspid regurgitation management: a systematic review of clinical practice guidelines and recommendations.

Tricuspid regurgitation (TR) is a highly prevalent condition and an independent risk factor for adverse outcomes. Multiple clinical guidelines exist for the diagnosis and management of TR, but the recommendations may sometimes vary. We systematically reviewed high-quality guidelines with a specific focus on areas of agreement, disagreement, and gaps in evidence.

Management of aortic stenosis: a systematic review of clinical practice guidelines and recommendations.

Multiple guidelines exist for the management of aortic stenosis (AS). We systematically reviewed current guidelines and recommendations, developed by national or international medical organizations, on management of AS to aid clinical decision-making. Publications in MEDLINE and EMBASE between 1 June 2010 and 15 January 2021 were identified.

Routine iso-osmolar contrast media use and acute kidney injury following percutaneous coronary intervention for ST elevation myocardial infarction.

Background: Temporal changes in contrast-induced acute kidney injury (CI-AKI) incidence following primary percutaneous coronary intervention (PPCI) are poorly defined. Additionally, the benefits of iso-osmolar contrast media (IOCM) compared to low osmolar CM (LOCM) are uncertain.

Methods: Using data from a regional PPCI service, temporal changes in baseline risk and annual incidence of CI-AKI were studied.

Association of comorbid burden with clinical outcomes after transcatheter aortic valve implantation.

Objectives: To investigate the association of the CharlsonComorbidity Index (CCI) with clinical outcomes after transcatheter aortic valve implantation (TAVI).

Background: Patients undergoing TAVI have high comorbid burden; however, there is limited evidence of its impact on clinical outcomes.

Methods: Data from 1887 patients from the UK, Canada, Spain, Switzerland and Italy were collected between 2007 and 2016.

Myocardial ischaemia as a result of external coronary compression from infective aortic root aneurysm: atypical presentation of prosthetic valve endocarditis.

Unlabelled: SummaryThis case describes an unusual presentation of prosthetic valve endocarditis (PVE): an acute coronary syndrome. A 67-year-old male presented with cardiac sounding chest pain on a background of a short history of night sweats, weight loss and general malaise. Four months previously, he had undergone bio-prosthetic aortic valve replacement for severe aortic stenosis and single vessel bypass grafting of the obtuse marginal.

76-year-old gentlemen with primary cardiac lymphoma presenting as acute coronary syndrome and atrioventricular block.

We report the case of an immunocompetent patient who presented with symptoms suggestive of acute coronary syndrome and was found to be in complete heart block. He re-presented within 2 months with worsening breathlessness and investigations confirmed infiltrative cardiac disease. We describe here an uncommon presentation of primary cardiac lymphoma as acute coronary syndrome and atrioventricular block.

Proteus endocarditis in an intravenous drug user.

Infective endocarditis (IE) is a life-threatening condition with adverse consequences and increased mortality, despite improvements in treatment options. Diagnosed patients usually require a prolonged course of antibiotics, with up to 40-50% requiring surgery during initial hospital admission. We report a case of a 42-year-old intravenous drug user who presented feeling generally unwell, with lethargy, rigours, confusion and a painful swollen right leg.

Using coronary artery calcification combined with pretest clinical risk assessment as a means of determining investigation and treatment in patients presenting with chest pain in a rural setting.

462 patients presenting with chest pain to a rural district general hospital underwent calcium scoring and pretest clinical risk assessment in order to stratify subsequent investigations and treatment was retrospectively reviewed. The patients were followed up for two years and further investigations and outcomes recorded. Of the 206 patients with zero calcium score, 132 patients were immediately discharged from cardiac follow-up with no further investigation on the basis of their calcium score, low pretest risk of coronary artery disease, and no significant incidental findings.

Should we consider patients with coexistent hepatitis B or C infection for orthotopic heart transplantation?

Heart transplantation (HTX) is the gold standard surgical treatment for patients with advanced heart failure. The prevalence of hepatitis B and hepatitis C infection in HTX recipients is over 10%. Despite its increased prevalence, the long-term outcome in this cohort is still not clear.

Should we consider heart rate reduction in cardiac transplant recipients?

Increased resting heart rate is an independent modifiable risk factor for the development of cardiovascular disease. Numerous studies have demonstrated improved clinical outcomes with heart rate reduction in patients with coronary artery disease and heart failure, but its role in transplanted hearts is not yet established. Sinus tachycardia is more common in heart transplant recipients due to graft denervation.

Late perforation of a defibrillator lead managed by percutaneous, intravenous extraction.

We report the case of a patient with ischaemic cardiomyopathy who underwent cardiac resynchronization therapy with defibrillator back-up. He re-presented 3 weeks later with chest pain, having received two shocks. We describe a case of late perforation with the Riata lead causing inappropriate shocks.