The incidence of premature ventricular contractions (PVCs) in a structurally normal heart can result in clinically significant consequences, including PVC-induced cardiomyopathy. It is essential to consider the electrophysiologic characteristics of the PVCs to determine the patient's susceptibility. In an asymptomatic patient with no other structural heart disease and with PVCs, it is crucial to understand both the prognostic significance of the PVCs and when to initiate treatment with the appropriate modality.
View Article and Find Full Text PDFCardiovascular disease (CVD) has remained the leading cause of death among adults for more than one hundred years. With persistently suboptimal outcomes and a profound economic burden on our healthcare system, there is growing interest in alternative treatment approaches for CVD. One such approach is Tongxinluo (TXL) capsules, a Traditional Chinese Medicine (TCM).
View Article and Find Full Text PDFRadiation therapy is a widely used treatment for cancer, but it can have detrimental effects on the heart, leading to radiotherapy-induced cardiotoxicity. This condition has become an area of increasing concern, especially as cancer treatments continue to evolve. This review aims to explore the recent literature on radiotherapy-induced cardiotoxicity, focusing on the latest research published.
View Article and Find Full Text PDFVasomotor symptoms (VMS), such as hot flashes and night sweats, are experienced by over 80% of women during menopause and can significantly impair quality of life. While hormone replacement therapy (HRT) is the gold standard for managing VMS, concerns over its association with breast cancer, cardiovascular disease (CVD), and thromboembolic events have led to increasing interest in nonhormonal alternatives. This review explores the efficacy and cardiovascular safety of nonhormonal treatments for VMS.
View Article and Find Full Text PDFDiabetic individuals of reproductive age face higher risks of poor pregnancy outcomes and abnormal fetal development. Approximately 4.5% of women of reproductive age have diabetes, with non-Hispanic Black women having the highest prevalence of 15%.
View Article and Find Full Text PDFTadalafil is a phosphodiesterase inhibitor currently approved for use in erectile dysfunction (ED), benign prostatic hyperplasia (BPH), and pulmonary arterial hypertension (PAH). While tadalafil's benefits in ED and BPH have been well-established for years, its benefits in PAH were identified only recently in major clinical trials, resulting in the recent approval of a single-tablet, combination therapy of tadalafil with an endothelin receptor antagonist for PAH. With Tadalafil's cardiovascular benefits in ED, BPH, and PAH, clinical researchers have begun investigating whether tadalafil's use extends to other cardiovascular diseases, especially heart failure (HF), an emerging epidemic in medicine.
View Article and Find Full Text PDFHypertensive disorders in pregnancy (HDPs) are a leading cause of maternal and fetal morbidity and mortality worldwide. The pathophysiology is complex and still poorly understood but thought to involve a combination of maternal modifiable and nonmodifiable risk factors and placental changes with resultant end-organ dysfunction. Treatment of HDP involves a combination of lifestyle modification and pharmacotherapy, with differing treatment thresholds across organizations.
View Article and Find Full Text PDFThe Food and Drug Administration (FDA) recently approved renal denervation to treat resistant hypertension. This procedure is a minimally invasive procedure that starts by placing a catheter in the renal artery. This catheter is used to send either radiofrequency heat or ultrasound waves to burn the superficial nerves surrounding the renal arteries while making certain no damage happens to the renal arteries themselves.
View Article and Find Full Text PDFMitral regurgitation (MR) is a prevalent valvular heart disease with significant morbidity, particularly in aging populations. Management strategies for MR have evolved from traditional open-heart surgery to innovative transcatheter approaches, addressing the limitations of surgical repair in high-risk patients. Transcatheter edge-to-edge repair, exemplified by devices such as MitraClip and PASCAL, has shown efficacy in reducing MR severity, improving functional capacity, and decreasing heart failure hospitalizations in selected patients.
View Article and Find Full Text PDFCongenital heart disease (CHD) affects approximately 0.5-1% of the population, with advancements in cardiovascular care enabling 97% of these individuals to survive to adulthood. Pregnancy in women with CHD presents with unique challenges due to increased hemodynamic demands and associated risks.
View Article and Find Full Text PDFOrthotopic liver transplant (OLT) medicine is a constantly evolving field, especially with the demographics of individuals with advanced liver disease drastically changing. OLT candidates are now older, and there is an increase of nonalcoholic steatohepatitis cirrhosis due to the epidemic of obesity, which has also resulted in an increase in cardiac comorbidities in this population. The pathophysiology of liver cirrhosis creates many complexities during the pre- and postoperative management of OLT.
View Article and Find Full Text PDFThe impact of excessive alcohol on human health is associated with a lifetime cumulative use of alcohol and is further affected by various factors such as age, gender, nutritional status, concurrent cigarette smoking or drug use, diabetes, obesity, other cardiovascular diseases, and socio-economic status. Alcohol cardiomyopathy (ACM) is a type of acquired dilated cardiomyopathy, which is associated with long-term heavy alcohol consumption with historical rates varying from 3.8% to 47 % among patients with heart failure.
View Article and Find Full Text PDFThe consumption of artificial sweeteners has significantly increased globally, particularly as a substitute for sugar for the management of conditions such as diabetes and obesity, which are significant risk factors for cardiovascular disease. Despite their widespread use, the health impacts of artificial sweeteners remain contentious. Research has suggested that certain sweeteners may contribute to systemic inflammation, endothelial dysfunction, and disruptions in gut microbiota, potentially altering glucose metabolism and exacerbating metabolic conditions such as diabetes and obesity.
View Article and Find Full Text PDFAging is a multifaceted biological process characterized by progressive physiological decline and increased susceptibility to diseases. Central to this process are molecular and cellular changes that contribute to hallmark features of aging, including mitochondrial dysfunction, genomic instability, telomere attrition, and cellular senescence. Emerging research highlights the role of nutrient deficiencies in accelerating aging, bringing dietary supplements such as taurine and berberine into focus.
View Article and Find Full Text PDFThe adverse effects of environmental noise on human health have been recognized for more than a century. In particular, during the last decades, the vast majority of studies have focused on the detrimental role of noise in the induction of cardiovascular diseases. In this study, we aim to conduct a literature review on chronic stress responses induced by environmental noise, the risk of cardiovascular disease, and the underlying pathophysiological mechanisms.
View Article and Find Full Text PDFAldosterone plays a critical role in maintaining volume and blood pressure control. It also plays a highly negative role in vascular diseases such as systemic hypertension, congestive heart failure, and cardiorenal syndrome due to the critical role that the renin-angiotensin-aldosterone system plays in these diseases from oxidative stress, vasoconstriction, and vascular remodeling caused by angiotensin II. Controlling aldosterone involves drugs such as angiotensin-converting enzyme inhibitor/angiotensin receptor blockers and mineralocorticoid receptor antagonists (MRAs).
View Article and Find Full Text PDFCoronary artery disease (CAD) is responsible for 690,000 deaths a year, a leading cause of mortality worldwide. CAD results from cholesterol plaque buildup in arteries. Chelation therapy, which uses ethylenediaminetetraacetic acid to remove toxic metals from the bloodstream, has been explored as an alternative treatment for atherosclerotic CAD.
View Article and Find Full Text PDFSickle cell trait was once considered to benign hereditary condition, besides the association of renal medullary carcinoma, affecting red blood cells. The inherited disorder creates several health issues under various conditions, such as dehydration, hypoxia, or extreme physical exertion. Healthcare professionals and patients with the disorder should understand the importance of vascular complications in sickle cell traits.
View Article and Find Full Text PDFCerebral venous sinus thrombosis (CVST) is a rare neurological emergency associated with significant morbidity and mortality. CVST has been found to account for up to 57% of pregnancy-related strokes. Pregnancy and the postpartum period are associated with physiological changes that lead to a hypercoagulable state, increasing the risk for CVST.
View Article and Find Full Text PDFTrimetazidine is an antianginal medication approved in numerous countries for use in the symptomatic treatment of stable coronary artery disease and angina pectoris. Its main mechanism of action revolves around the inhibition of β-oxidation of free fatty acids in the myocardium, in addition to its antioxidant properties and inhibition of cardiac fibrosis. Based on current evidence, trimetazidine is classified by European guidelines as a second-line antianginal agent and as an add-on for the symptomatic treatment of stable angina in patients not adequately controlled with first-line antianginal therapies such as beta-blockers.
View Article and Find Full Text PDFSyphilis is a disease caused by the spirochete bacterium Treponema pallidum, progressing in 4 stages: primary, secondary, latent, and tertiary syphilis. In the tertiary stage, patients may develop cardiovascular syphilis, which includes syphilitic aortitis, aortic aneurysm, aortic regurgitation, and coronary artery involvement. These cardiovascular manifestations increase morbidity and mortality during this late stage of syphilis.
View Article and Find Full Text PDFThere has been ongoing debate about whether to continue or withhold angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) in patients undergoing noncardiac surgery. With over 200 million surgeries performed annually worldwide and millions of patients on ACE inhibitors and ARBs, it is crucial to elucidate the best management strategy for patients undergoing noncardiac surgery while on these medications. Several large randomized controlled trials, the Stop-or-Not and the Perioperative Ischemic Evaluation-3 trials, were conducted to investigate this important issue.
View Article and Find Full Text PDFSodium-glucose cotransporter-2 (SGLT2) inhibitors were originally approved for use in type 2 diabetes, but in recent years, these medications were found to also have significant cardiovascular benefits in patients with heart failure with reduced and preserved ejection fraction and chronic kidney disease. Part of the cardiovascular benefits of SGLT2 inhibitors likely comes from their antihypertensive effect in addition to other unknown effects, but the mechanism by which these medications reduce blood pressure has not been identified yet. Multiple mechanisms have been proposed to describe SGLT2 inhibitors' antihypertensive effect, including their associated weight loss and diuretic effect.
View Article and Find Full Text PDFRight ventricular myocardial infarction (RVMI) is a significant and distinct form of acute myocardial infarction associated with considerable morbidity and mortality. It occurs most commonly due to proximal right coronary artery obstruction, often in conjunction with inferior myocardial infarction. RVMI poses unique diagnostic and therapeutic challenges due to the anatomical and functional differences between the right and left ventricles.
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