Percutaneous drainage of a localized biatrial haematoma causing regional tamponade in a patient with prior coronary artery bypass graft surgery: a case report.

Background: Regional cardiac tamponade presented as posterior extrapericardial haematomas compressing both atria, with cardiogenic obstructive shock due to inflow abolition is a rare cause of post-percutaneous coronary intervention vascular collapse.

Case Summary: We present such a case where computed tomography-guided anterior pericardiocentesis decompressed the atria and restored cardiac output.

Discussion: Prior coronary artery bypass grafting should not be considered protective from cardiac tamponade in patients in whom perforation occurs, because loculated effusions can develop beneath adhesions of the pericardium and compress various cardiac structures (such as the left atrium or the right ventricle); they appear several hours after the intervention and cause atypical haemodynamic manifestations.

Hopelessness and cognitive impairment are risk markers for mortality in systolic heart failure patients.

Objective: Depression exacerbates the burden of heart failure and independently predicts mortality. The aim of this study was to investigate which specific symptoms of depression predict all-cause mortality in systolic heart failure patients.

Methods: Consecutive outpatients with heart failure and impaired left ventricular ejection fraction (LVEF), attending an Australian metropolitan heart function clinic between 2001 and 2011, were enrolled.

A nurse-led up-titration clinic improves chronic heart failure optimization of beta-adrenergic receptor blocking therapy--a randomized controlled trial.

Background: Beta-adrenergic blockade has been shown to improve left ventricular function, reduce hospital admissions and improve survival in chronic heart failure with reduced ejection fraction (HFrEF), with mortality reduction starting early after beta-adrenergic receptor blocker initiation and being dose-related. The aim of this pilot study was to determine the effectiveness of a nurse-led titration clinic in improving the time required for patients to reach optimal doses of the beta-adrenergic receptor blocking agents.

Method: We conducted a prospective pilot randomized controlled trial.

Effect of exercise training on left ventricular remodeling in diabetic patients with diastolic dysfunction: rationale and design.

Introduction: This study will examine the effects of combined aerobic and resistance training on left ventricular remodeling in diabetic patients with diastolic dysfunction. This is the first randomized controlled trial to look for effects of combined strength training and aerobic exercise on myocardial function as well as other clinical, functional, or psychological parameters in diabetic patients with isolated diastolic dysfunction, and will provide important insights into the potential management strategies for heart failure with preserved ejection fraction.

Methods And Analysis: This is a prospective, randomized controlled investigator initiated single center trial.

Implantation of a stent graft in the right pulmonary artery enables radical resection of a central endothelial sarcoma of the left pulmonary artery.

In a patient with a huge endothelial sarcoma of the left pulmonary artery, we report successful implantation of a stent graft in the right pulmonary artery, including the pulmonary arterial trunk. This preoperative measure enabled a safe and radical left-sided pneumonectomy, including the tumor and the central parts of the left pulmonary artery. No major blood loss occurred, and neither use of a heart-lung machine nor cardiopulmonary bypass was necessary.