Left ventricular pseudoaneurysm in Lemierre's syndrome: a case report.

Background: Lemierre's syndrome is an infectious phenomenon characterized by oropharyngeal infection with bacteraemia, thrombophlebitis, and distant septic emboli. Septic emboli are a recognized cause of a Type 2 myocardial infarction, with a left ventricular pseudoaneurysm being a rare but important complication of this.

Case Summary: A 19-year-old male presented with acute confusion, fevers, and a cough.

Contouring techniques in cardiac magnetic resonance assessment of right ventricular volumes in repaired tetralogy of fallot.

Introduction: Right ventricular size and function on cardiac MRI provides thresholds for referral for pulmonary valve intervention in repaired Tetralogy of Fallot (RTOF). However, different contouring techniques are available to calculate right ventricular volumes and ejection fraction. It is not known whether these contouring techniques impact on threshold triggers for intervention.

Subtle aortic dissection in a patient with severe aortic regurgitation and undiagnosed bicuspid aortic valve: A case report with a literature review.

Background And Aim Of The Study: A subtle aortic dissection can be challenging to detect despite the availability of multiple diagnostic modalities. Whilst rare, the inability to detect this variant of aortic dissection can lead to a dismal prognosis. We present an extremely rare case of a subtle aortic dissection with supra-annular aortic root intimal tear and acute severe aortic regurgitation in a patient with a bicuspid aortic valve.

Prospective multicentre cohort study of transthoracic echocardiography provision in the South West of the UK during the first wave of SARS-CoV-2 pandemic.

Aims: It was predicted internationally that transthoracic echocardiography (TTE) would be vital during the SARS-CoV-2 outbreak. We therefore, designed a study to report the demand for TTE in two large District General Hospitals during the rise in the first wave of the SARS-CoV-2 pandemic in the UK. A primary clinical outcome of 30-day mortality was also assessed.

Body composition in heart failure and the impact of cardiac resynchronisation therapy: a proof-of-concept study.

Aims: Body composition (BC) is known to alter in heart failure. Cardiac resynchronisation therapy (CRT) improves left ventricular geometry but the impact on BC is unknown. Our aim was to evaluate BC in these patients before and after CRT implantation.

Characterisation of circulating biomarkers before and after cardiac resynchronisation therapy and their role in predicting CRT response: the COVERT-HF study.

Aims: Cardiac resynchronisation therapy (CRT) is effective treatment for selected patients with heart failure (HF) but has ~30% non-response rate. We evaluated whether specific biomarkers can predict outcome.

Methods: A prospective single-centre pilot study of consecutive unselected patients undergoing CRT for HF between November 2013 and December 2015 evaluating cardiac extracellular matrix biomarkers and micro-ribonucleic acid (miRNA) expression before and after CRT assessing ability to predict functional response and survival.

Journal clubs in the digital age: Twitter for continuing professional development.

The departmental journal club (JC) is a well-established form of continuing professional development (CPD). Social media offers a range of interactive online platforms, allowing the traditional JC to move from a formal educational meeting with local health professionals to a digital platform with users across the world. The authors created the General Internal Medicine JC (@GIMJClub) on Twitter and following a year of activity retrospectively analysed the participation and impact of this medium of JC delivery.

Extracellular cardiac matrix biomarkers in patients with reduced ejection fraction heart failure as predictors of response to cardiac resynchronisation therapy: a systematic review.

Objective: Cardiac resynchronisation therapy (CRT) is an effective therapy for selected patients with heart failure (HF); however, a significant non-response rate exists. We examined current evidence on extracellular cardiac matrix (ECM) biomarkers in predicting response following CRT.

Methods: Complete literature review of PubMed, Ovid SP MEDLINE, Cochrane Library and TRIP, reference lists, international cardiology conferences and ongoing studies between December 1999 and December 2015 conducted according to prospectively registered study selection and analysis criteria (PROSPERO:CRD42016025864) was performed.

Cardiac resynchronization therapy and its role in the management of heart failure.

The prevalence of heart failure is increasing and it is associated with significant mortality and morbidity. Optimal medical therapy improves outcome, but heart failure continues to have a substantial impact on both the individual patient and wider society. Over the last two decades, cardiac resynchronization therapy has revolutionized the treatment of selected patients who have heart failure.

The changing face of cardiovascular disease 2000-2012: An analysis of the world health organisation global health estimates data.

The pattern and global burden of disease has evolved considerably over the last two decades, from primarily communicable, maternal, and perinatal causes to non-communicable disease (NCD). Cardiovascular disease (CVD) has become the single most important and largest cause of NCD deaths worldwide at over 50%. The World Health Organisation (WHO) estimates that 17.

Long-Term Follow-Up of Isolated Epicardial Left Ventricular Lead Implant Using a Minithoracotomy Approach for Cardiac Resynchronization Therapy.

Background: Transvenous left ventricular (LV) lead placement for cardiac resynchronization therapy is unsuccessful in 5-10% of reported cases. These patients may benefit from isolated surgical placement of an epicardial LV lead via minithoracotomy approach.

Aim: To evaluate the success of this approach at long-term follow-up.

The interplay between heart failure, metabolism and body composition.

A complex interplay exists between heart failure, metabolic status and body composition. The idiosyncrasies of these relationships are poorly understood, but they offer prognostic value and potential clinical utility. Current understanding of this relationship and known clinical value are discussed in this article.

Safety and Cost-Effectiveness of Same-Day Cardiac Resynchronization Therapy and Implantable Cardioverter Defibrillator Implantation.

Cardiac resynchronization therapy (CRT) and implantable cardioverter defibrillator (ICD) implantation improve morbidity and mortality in selected patients. Many centers still admit patients overnight. We evaluated the safety, feasibility, and cost savings of same-day CRT/ICD device implantation by performing a retrospective study of all consecutive elective CRT/ICD implants at a tertiary center from January 2009 to April 2013.

Same-day cardiac catheter ablation is safe and cost-effective: Experience from a UK tertiary center.

Background: Catheter ablation is a curative intervention for common arrhythmias such as supraventricular tachycardia and atrial flutter. Many centers still admit patients overnight after this procedure.

Objective: This study was performed to evaluate the safety and cost-effectiveness of same-day standard catheter ablation.

Improving ECG Competence in Medical Trainees in a UK District General Hospital.

Background: Competency in electrocardiogram (ECG) interpretation is central to undergraduate and postgraduate clinical training. Studies have demonstrated ECGs are interpreted sub-optimally. Our study compares the effectiveness of two learning strategies to improve competence and confidence.

Cerebral venous sinus thrombosis associated with bulimia nervosa.

Central venous sinus thrombosis (CVST) is a rare cause of headache and stroke but has a wide clinical spectrum of presentations, including headache, seizures, focal neurological signs and alteration in consciousness, which can present in isolation or in various combinations. CVST is a difficult diagnosis to make in clinical practice but advances in neuroimaging allows for faster and more precise diagnosis, but it can still prove elusive. Non-infectious CVST are now more common that post-infectious, for which there are a variety of causes and risk factors in the clinical history that can suggest the diagnosis.

Matrix metalloprotease polymorphisms are associated with gas transfer in alpha 1 antitrypsin deficiency.

Unlabelled: Alpha-1-antitrypsin deficiency [AATD] is associated with variable development of emphysema and other features of chronic obstructive pulmonary disease [COPD]. Matrix metalloproteinases [MMPs] are believed to be important in the pathophysiology of COPD, and may therefore confer susceptibility to this phenotype in patients with AATD.

Objectives: to assess the role of polymorphism of MMP1, MMP3 and MMP12 in AATD phenotypes.

Secondary aorto-enteric fistula: a case report and review of literature.

Aorto-enteric fistula (AEF) is an uncommon but potentially fatal condition that is important to identify early because early diagnosis and aggressive management can reduce mortality. We report the case of a 73-year-old man with a history of aorto-bifemoral bypass grafting who was admitted for investigation of tiredness and lethargy. He passed melaena on the day of admission with an associated drop in haemoglobin.