Cardiotoxicity of Anticancer Therapies.

Cardiovascular diseases and cancer continue to remain major causes of mortality and morbidity. However, overall cancer death rates have declined 20% from their peak in 1991. These declines reflect changing patterns in smoking, prevention, earlier diagnosis, and better treatment options in chemotherapy.

Dabigatran: a new chapter in anticoagulation.

For the last 60 years warfarin has been the cornerstone for chronic anticoagulation in prevention of ischemic strokes and systemic embolization. Warfarin therapy has several limitations including frequent monitoring and various food and significant drug interactions, which make it a less than ideal chronic oral anticoagulant. The continued search for safe, effective, medications with predictable pharmacokinetic profiles has led to newer alternatives.

Total obstruction of the left main coronary artery.

A rare and often fatal condition, total obstruction of the left main coronary artery has been treated with increasing success in both acute and chronic clinical settings. Seventeen patients with acute occlusion have been reported in the literature. All were discovered at the time of acute periinfarction catheterization and were treated aggressively with intracoronary thrombolysis, percutaneous transluminal angioplasty, emergency bypass surgery, or a combination of techniques.

Ventricular arrhythmia: management strategy.

The management of ventricular arrhythmia continues to be one of the most difficult therapeutic problems in medicine today. Both invasive and noninvasive techniques have demonstrated success in management of patients at high risk for sudden cardiac death. High-risk subgroups include patients who have experienced sudden cardiac death and have been resuscitated successfully, patients with high-grade ventricular ectopy associated with left ventricular dysfunction, and patients who have had recent myocardial infarction.

Echocardiographic manifestations of tense pericardial effusion.

Echocardiography has emerged as a sensitive study in the evaluation of pericardial effusion. The specificity of echocardiographic signs in cardiac tamponade remains undefined, however. Two such signs, early diastolic collapse of the right ventricular free wall and late diastolic collapse of the right atrial wall, were observed in two patients without clinical evidence of cardiac tamponade.