Publications by authors named "Hugo Corte-Real"

Cardiac myxoma is the most common primary heart tumor in adults. Although biologically benign, they can be life-threatening by obstructing heart function. They typically develop in the left atrium and can be polypoid (causing more obstruction) or papillary (more likely to cause embolizations).

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Coronary vasospasm is a well-recognized cause of angina (also known as Prinzmetal angina) and a common cause of admissions to the emergency department and coronary intensive care units. It is however an uncommon cause of cardiac arrest. We describe a patient with multiple episodes of chest pain followed by cardiac arrest in pulseless electrical activity (PEA) due to coronary vasospasm.

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Objectives: The Sequential Organ Failure Assessment (SOFA) score is a predictor of mortality in ICU patients. Although it is widely used and has been validated as a reliable and independent predictor of mortality and morbidity in cardiac ICU, few studies correlate early postoperative SOFA with long-term survival.

Design: Retrospective observational cohort study.

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62 year-old man admitted in ICU post myocardial infarction with ventricular septal defect (VSD) and cardiogenic shock due to anterior descending artery stenosis. VSD corrected percutaneously after intra-aortic Figure 1 Transthoracic echocardiography with Doppler showing VSD after myocardial infarction due to anterior descendent stenosis. balloon pump insertion, resulting in iatrogenic tricuspid regurgitation.

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Infective endocarditis is a multisystem and potentially fatal disease. Systemic embolization is a relatively common complication, the spleen and central nervous system being the most frequent sites for septic emboli formation. Coronary artery septic embolization is extremely uncommon and its management remains controversial.

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Acute aortic dissection and acute pulmonary embolism are two life-threatening emergencies. The presented case is of an 81-year-old man who has been diagnosed with an acute Stanford type A aortic dissection and referred to a tertiary hospital for surgical treatment. After a successful aortic repair and an overall favourable postoperative recovery, he was diagnosed with cervical and upper extremity deep vein thrombosis and was anticoagulated accordingly.

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Background: Cardiogenic shock is the main cause of death in hospitalized patients with acute coronary syndromes, with a high mortality rate. The management of graft thrombosis after coronary artery bypass graft (CABG) surgery is challenging and the best revascularization strategy is not well defined. In patients who develop cardiac arrest due to graft thrombosis, the benefits of mechanical support during advanced cardiac life support are uncertain.

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Objectives: Extracorporeal membrane oxygenation through a veno-arterial circuit (ECMO-VA) is an organ support option in refractory cardiogenic shock, when the primary cause of decompensation is thought to be reversible. We report the clinical results of this technique in patients submitted to cardiac surgery at our center.

Methods: We present a retrospective study of patients that underwent ECMO-VA after cardiac surgery and subsequent admission at the intensive care unit (ICU), in our center.

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A formal echocardiographic approach in a general intensive care unit requires a 24 hour availability of an expert in echocardiography, who could not be easily found. Therefore, a goal-directed echocardiogram strategy specifically tailored to the intensivist should be created. The concept of goal-directed echocardiography (GDE) has been incompletely evaluated and it is necessary to find a curriculum program to grant proficiency.

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The use of the transoesophageal echocardiography (TEE) in the critically ill patient admitted to the general intensive care unit begins to turn out to be very important but it is still little spread. The full implementation of the echocardiography in the general intensive cares is compromised by the acoustic window. However, TEE can flyover this difficulty adding to the advantages widely described of the transthoracic echocardiography (TTE) other high values 1.

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