Endocarditis in Adult Congenital Heart Disease Patients: Prevention, Recognition, and Management.

Purpose Of Review: Present an updated overview of the prevention, diagnosis, and management of infective endocarditis in adult patients with congenital heart disease.

Recent Findings: Care for patients with infective endocarditis is changing in the areas of specialized teams, diagnostics, and prevention. Endocarditis teams should be involved in the care of ACHD patients.

Thoracic Stent Grafts Induce Persistent Aortic Remodeling in Aortic Coarctation.

Background: This study's objective is to describe outcomes of adult patients who underwent thoracic stent graft placement treatment for primary or recurrent aortic coarctation.

Methods: This is a retrospective study of 30 adult patients who underwent thoracic stent graft placement for aortic coarctation at our institution. Average age was 46.

Percutaneous Balloon Dilation of the Pulmonary Valve in a 79-Year-Old With Congenital Pulmonary Valve Stenosis.

• Congenital valvar PS is a rare cause of heart failure in the geriatric population. • Transcatheter PV dilation is an effective treatment of congenital PS in older adults. • Cardiac CT can be very useful in the evaluation of suspected valvar PS in adults.

Left Ventricular Pseudoaneurysm in an Adult With a Repaired Partial Atrioventricular Canal Defect.

• LV pseudoaneurysm formation is rare after congenital heart disease repair. • Conservative management of LV pseudoaneurysm was successful in this unique case. • CCT and 3D printing are valuable in the characterization of LV pseudoaneurysm.

Body mass index and age are associated with ventricular end-diastolic pressure in adults with a Fontan circulation.

Introduction: Systemic ventricular end-diastolic pressure is an important haemodynamic variable in adult patients with Fontan circulation. Risk factors associated with elevated end-diastolic pressure have not been clearly identified in this population.

Methods: All patients > 18 years with Fontan circulation who underwent cardiac catheterisation at our centre between 1/08 and 3/19 were included.

Nonexercise activity thermogenesis in obesity management.

Obesity is linked to cardiovascular disease. The global increase in sedentary lifestyle is an important factor contributing to the rising prevalence of the obesity epidemic. Traditionally, counseling has focused on moderate- to vigorous-intensity exercise, with disappointing results.

Hypoplasia, pseudocoarctation and coarctation of the aorta - a systematic review.

Aortic arch abnormalities are uncommon and may be seen in association with other congenital cardiac anomalies. Coarctation, pseudocoarctation and hypoplastic aortic arch are known aortic arch abnormalities, with the former being well studied, whilst for the latter two, much less is known. There are similarities and differences that are important to distinguish among these three conditions in order to avoid errors in diagnosis that may result in unnecessary investigations, which may in turn result in physical or emotional harm to the patient.

Interferon-α and pericardial injury: a case report and literature review.

Interferon- α (IFN-α) alone or in combination with other chemotherapeutic agents has been used in the management of many malignant and non-malignant conditions. Pericarditis with or without pericardial effusion has been reported with IFN-α therapy, and available literature is limited to case reports. Pericardial constriction after interferon use has not been described in the published literature to date.

Papillary fibroelastoma of the pulmonary valve--a systematic review.

The pulmonary valve is the least affected site for valvular papillary fibroelastoma. With increasing use of routine echocardiography and other modalities of imaging, pulmonary valve papillary fibroelastomas (PVPFE) are being recognized more frequently. PVPFE is more often an incidental diagnosis and symptomatic patients usually present with shortness of breath.

Coronary artery ectasia in an adult Noonan syndrome detected on coronary CT angiography.

Coronary ectasia is rare in patients with Noonan syndrome. When suspected during echocardiography more common causes including Kawasaki disease in children and atherosclerosis coronary artery disease in adults should be ruled out. Coronary CT angiogram, a non-invasive imaging tool may be preferred over conventional coronary angiogram in the initial diagnosis and monitoring the progression of coronary ectasia in such patients.

Aborted myocardial infarction: is it real in the troponin era?

Background: Cardiac troponins are the markers of choice for the diagnosis of acute myocardial infarction. The objective of this study was to compare the frequency of "aborted myocardial infarction" (no detectable myocardial injury) determined by measurement of troponin versus that determined by creatine kinase (CK) and creatine kinase-muscle brain (CK-MB) measurement criteria among patients with ST-elevation myocardial infarction (STEMI) who received reperfusion therapy.

Methods: Since 2004, the Mayo Clinic (Rochester, MN) has had a standard reperfusion protocol for the treatment of patients with STEMI.

Long-term prognostic significance of elevated cardiac troponin levels in critically ill patients with acute gastrointestinal bleeding.

Background: Elevations in troponin level have prognostic importance in critically ill patients, including those with gastrointestinal (GI) bleeding. However, there are no data addressing the independent association of troponin levels and mortality, adjusted for the severity of the underlying disease, in patients with GI bleeding.

Objective: This study was designed to determine whether troponin T elevations are independently associated with in-hospital, short-term (30 days), and long-term mortality in medical intensive care unit patients with GI bleeding after adjusting for the severity of disease measured by the Acute Physiology, Age, and Chronic Health Evaluation score prognostic system.

Coarctation of the aorta presenting as systemic hypertension in a young adult.

Background: A 20-year-old male presented with a history of systemic hypertension. Examination revealed a systolic murmur with an early ejection click, and femoral pulses were markedly reduced.

Investigations: Physical examination, laboratory testing, electrocardiography, chest radiography, comprehensive echocardiography including pulsed-wave Doppler examination, and CT of the chest.

Elevated cardiac troponin is an independent risk factor for short- and long-term mortality in medical intensive care unit patients.

Background: Troponin elevations are common in critically ill patients. Whether they are predictors of mortality independent of the severity of the underlying disease is unclear.

Objective: To determine whether troponin elevations predict in-hospital, short-term, and long-term mortality in medical intensive care unit patients independent of the severity of the underlying disease as measured by Acute Physiology and Chronic Health Evaluation III prognostic system.

Infarct size, ejection fraction, and mortality in diabetic patients with acute myocardial infarction treated with thrombolytic therapy.

Background: Diabetic patients with acute myocardial infarction (MI) have higher mortality than nondiabetic patients. The purpose of this study was to examine if larger infarct size explains the higher mortality in diabetic patients with acute ST-segment-elevation MI.

Methods: In the CORE trial (n = 2948), subsets of patients underwent quantitative radionuclide measurement of technetium Tc 99m sestamibi infarct size (n = 1164) or gated equilibrium left ventricular ejection fraction (LVEF) (n = 1137) at days 6 to 16 after thrombolytic therapy.

Cell therapy for cardiovascular disease: what cells, what diseases and for whom?

Experimental and human data suggesting progenitor cells possess the capacity to regenerate tissue and augment repair in injured organs has generated widespread interest in the basic research and clinical communities. Nowhere have these findings been more tantalizing than in human cardiovascular disease, in which vasculogenesis and myocardial regeneration logically and understandably remain as attractive therapeutic targets. Burgeoning experimental evidence attests to the proangiogenic, vasculogenic and tissue reparative capabilities of a broad range of progenitor cells derived from the bone marrow, circulation and a number of other tissues in vivo.

Myocardial bridging.

Myocardial bridging, a congenital coronary anomaly, is a clinical condition with several possible manifestations, and its clinical relevance is debated. This article reviews current knowledge about the anatomy, pathophysiology, clinical relevance, and treatment of myocardial bridging. Myocardial bridging is present when a segment of a major epicardial coronary artery, the 'tunnelled artery', runs intramurally through the myocardium.

[Cushing's disease treatment with transsphenoidal surgery during pregnancy].

We report a 26 year old female with Cushing's disease who became pregnant during the course of her disease. She was treated by transsphenoidal surgery during the second trimester of pregnancy, achieving resolution of hypercortisolism. She had a normal delivery at term, her offspring was healthy, and she had a normal lactation.