(COVID-19) I Have a Heart Condition. Am I at More Risk of Getti
Total Page:16
File Type:pdf, Size:1020Kb
Load more
Recommended publications
-
Cardiac Involvement in COVID-19 Patients: a Contemporary Review
Review Cardiac Involvement in COVID-19 Patients: A Contemporary Review Domenico Maria Carretta 1, Aline Maria Silva 2, Donato D’Agostino 2, Skender Topi 3, Roberto Lovero 4, Ioannis Alexandros Charitos 5,*, Angelika Elzbieta Wegierska 6, Monica Montagnani 7,† and Luigi Santacroce 6,*,† 1 AOU Policlinico Consorziale di Bari-Ospedale Giovanni XXIII, Coronary Unit and Electrophysiology/Pacing Unit, Cardio-Thoracic Department, Policlinico University Hospital of Bari, 70124 Bari, Italy; [email protected] 2 AOU Policlinico Consorziale di Bari-Ospedale Giovanni XXIII, Cardiac Surgery, Policlinico University Hospital of Bari, 70124 Bari, Italy; [email protected] (A.M.S.); [email protected] (D.D.) 3 Department of Clinical Disciplines, School of Technical Medical Sciences, University of Elbasan “A. Xhuvani”, 3001 Elbasan, Albania; [email protected] 4 AOU Policlinico Consorziale di Bari-Ospedale Giovanni XXIII, Clinical Pathology Unit, Policlinico University Hospital of Bari, 70124 Bari, Italy; [email protected] 5 Emergency/Urgent Department, National Poisoning Center, Riuniti University Hospital of Foggia, 71122 Foggia, Italy 6 Department of Interdisciplinary Medicine, Microbiology and Virology Unit, University of Bari “Aldo Moro”, Piazza G. Cesare, 11, 70124 Bari, Italy; [email protected] 7 Department of Biomedical Sciences and Human Oncology—Section of Pharmacology, School of Medicine, University of Bari “Aldo Moro”, Policlinico University Hospital of Bari, p.zza G. Cesare 11, 70124 Bari, Italy; [email protected] * Correspondence: [email protected] (I.A.C.); [email protected] (L.S.) † These authors equally contributed as co-last authors. Citation: Carretta, D.M.; Silva, A.M.; D’Agostino, D.; Topi, S.; Lovero, R.; Charitos, I.A.; Wegierska, A.E.; Abstract: Background: The widely variable clinical manifestations of SARS-CoV2 disease (COVID-19) Montagnani, M.; Santacroce, L. -
Non Commercial Use Only
Cardiogenetics 2017; volume 7:6304 Sudden death in a young patient with atrial fibrillation Case Report Correspondence: María Angeles Espinosa Castro, Inherited Cardiovascular Disease A 22-year-old man suffered a sudden Program, Cardiology Department, Gregorio María Tamargo, cardiac arrest without previous symptoms Marañón Hospital, Dr. Esquerdo, 46, 28007, María Ángeles Espinosa, while he was at rest, waiting for a subway Madrid, Spain. Víctor Gómez-Carrillo, Miriam Juárez, train. Cardiopulmonary resuscitation was Tel.: +34.91.586.82.90. immediately started using an Automated E-mail: [email protected] Francisco Fernández-Avilés, External Defibrillation that identified the Raquel Yotti Key words: KCNQ1; mutation; channelopa- presence of ventricular fibrillation and thy; sudden cardiac death; atrial fibrillation. Inherited Cardiovascular Disease delivered a shock. Return of spontaneous Program, Cardiology Department, circulation was achieved after three Contributions: MT, acquisition and interpreta- Gregorio Marañón Hospital, Madrid, attempts, being atrial fibrillation (AF) the tion of data for the work, ensuring that ques- Spain patient’s rhythm at this point (Figure 1). tions related to the accuracy or integrity of any He was admitted to our Cardiovascular part of the work is appropriately investigated Intensive Care Unit and therapeutic and resolved; MAE, conception of the work, hypothermia was performed over a period critical revision of the intellectual content, final approval of the version to be published, Abstract of 24 h. After completing hypothermia, ensuring that questions related to the accuracy rewarming, and another 24 h of controlled of any part of the work is appropriately inves- Sudden cardiac death (SCD) in young normothermia the patient awakened with no tigated and resolved; VG-C, acquisition and patients without structural heart disease is residual neurologic damage. -
Myocarditis and Cardiomyopathy
CE: Tripti; HCO/330310; Total nos of Pages: 6; HCO 330310 REVIEW CURRENT OPINION Myocarditis and cardiomyopathy Jonathan Buggey and Chantal A. ElAmm Purpose of review The aim of this study is to summarize the literature describing the pathogenesis, diagnosis and management of cardiomyopathy related to myocarditis. Recent findings Myocarditis has a variety of causes and a heterogeneous clinical presentation with potentially life- threatening complications. About one-third of patients will develop a dilated cardiomyopathy and the pathogenesis is a multiphase, mutlicompartment process that involves immune activation, including innate immune system triggered proinflammatory cytokines and autoantibodies. In recent years, diagnosis has been aided by advancements in cardiac MRI, and in particular T1 and T2 mapping sequences. In certain clinical situations, endomyocardial biopsy (EMB) should be performed, with consideration of left ventricular sampling, for an accurate diagnosis that may aid treatment and prognostication. Summary Although overall myocarditis accounts for a minority of cardiomyopathy and heart failure presentations, the clinical presentation is variable and the pathophysiology of myocardial damage is unique. Cardiac MRI has significantly improved diagnostic abilities, but endomyocardial biopsy remains the gold standard. However, current treatment strategies are still focused on routine heart failure pharmacotherapies and supportive care or cardiac transplantation/mechanical support for those with end-stage heart failure. Keywords cardiac MRI, cardiomyopathy, endomyocardial biopsy, myocarditis INTRODUCTION prevalence seen in children and young adults aged Myocarditis refers to inflammation of the myocar- 20–30 years [1]. dium and may be caused by infectious agents, systemic diseases, drugs and toxins, with viral infec- CAUSE tions remaining the most common cause in the developed countries [1]. -
Myocarditis, Pericarditis and Other Pericardial Diseases
Heart 2000;84:449–454 Diagnosis is easiest during epidemics of cox- GENERAL CARDIOLOGY sackie infections but diYcult in isolated cases. Heart: first published as 10.1136/heart.84.4.449 on 1 October 2000. Downloaded from These are not seen by cardiologists unless they develop arrhythmia, collapse or suVer chest Myocarditis, pericarditis and other pain, the majority being dealt with in the primary care system. pericardial diseases Acute onset of chest pain is usual and may mimic myocardial infarction or be associated 449 Celia M Oakley with pericarditis. Arrhythmias or conduction Imperial College School of Medicine, Hammersmith Hospital, disturbances may be life threatening despite London, UK only mild focal injury, whereas more wide- spread inflammation is necessary before car- diac dysfunction is suYcient to cause symp- his article discusses the diagnosis and toms. management of myocarditis and peri- Tcarditis (both acute and recurrent), as Investigations well as other pericardial diseases. The ECG may show sinus tachycardia, focal or generalised abnormality, ST segment eleva- tion, fascicular blocks or atrioventricular con- Myocarditis duction disturbances. Although the ECG abnormalities are non-specific, the ECG has Myocarditis is the term used to indicate acute the virtue of drawing attention to the heart and infective, toxic or autoimmune inflammation of leading to echocardiographic and other investi- the heart. Reversible toxic myocarditis occurs gations. Echocardiography may reveal segmen- in diphtheria and sometimes in infective endo- -
Myocarditis and Mrna Vaccines
Updated June 28, 2021 DOH 348-828 Information for Clinical Staff: Myocarditis and mRNA Vaccines This document helps clinicians understand myocarditis and its probable link to some COVID-19 vaccines. It provides talking points clinicians can use when discussing the benefits and risks of these vaccines with their patients and offers guidance on what to do if they have a patient who presents with myocarditis following vaccination. Myocarditis information What are myocarditis and pericarditis? • Myocarditis is an inflammation of the heart muscle. • Pericarditis is an inflammation of the heart muscle covering. • The body’s immune system can cause inflammation often in response to an infection. The body’s immune system can cause inflammation after other things as well. What is the connection to COVID-19 vaccination? • A CDC safety panel has determined there is a “probable association” between myocarditis and pericarditis and the mRNA COVID-19 vaccines, made by Moderna and Pfizer-BioNTech, in some vaccine recipients. • Reports of myocarditis and pericarditis after vaccination are rare. • Cases have mostly occurred in adolescents and young adults under the age of 30 years and mostly in males. • Most patients who developed myocarditis after vaccination responded well to rest and minimal treatment. Talking Points for Clinicians The risk of myocarditis is low, especially compared to the strong benefits of vaccination. • Hundreds of millions of vaccine doses have safely been given to people in the U.S. To request this document in another format, call 1-800-525-0127. Deaf or hard of hearing customers, please call 711 (Washington Relay) or email [email protected]. -
Antithrombotic Therapy in Atrial Fibrillation Associated with Valvular Heart Disease
Europace (2017) 0, 1–21 EHRA CONSENSUS DOCUMENT doi:10.1093/europace/eux240 Antithrombotic therapy in atrial fibrillation associated with valvular heart disease: a joint consensus document from the European Heart Rhythm Association (EHRA) and European Society of Cardiology Working Group on Thrombosis, endorsed by the ESC Working Group on Valvular Heart Disease, Cardiac Arrhythmia Society of Southern Africa (CASSA), Heart Rhythm Society (HRS), Asia Pacific Heart Rhythm Society (APHRS), South African Heart (SA Heart) Association and Sociedad Latinoamericana de Estimulacion Cardıaca y Electrofisiologıa (SOLEACE) Gregory Y. H. Lip1*, Jean Philippe Collet2, Raffaele de Caterina3, Laurent Fauchier4, Deirdre A. Lane5, Torben B. Larsen6, Francisco Marin7, Joao Morais8, Calambur Narasimhan9, Brian Olshansky10, Luc Pierard11, Tatjana Potpara12, Nizal Sarrafzadegan13, Karen Sliwa14, Gonzalo Varela15, Gemma Vilahur16, Thomas Weiss17, Giuseppe Boriani18 and Bianca Rocca19 Document Reviewers: Bulent Gorenek20 (Reviewer Coordinator), Irina Savelieva21, Christian Sticherling22, Gulmira Kudaiberdieva23, Tze-Fan Chao24, Francesco Violi25, Mohan Nair26, Leandro Zimerman27, Jonathan Piccini28, Robert Storey29, Sigrun Halvorsen30, Diana Gorog31, Andrea Rubboli32, Ashley Chin33 and Robert Scott-Millar34 * Corresponding author. Tel/fax: þ44 121 5075503. E-mail address: [email protected] Published on behalf of the European Society of Cardiology. All rights reserved. VC The Author 2017. For permissions, please email: [email protected]. 2 G.Y.H. Lip 1Institute of Cardiovascular Sciences, University of Birmingham and Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Aalborg University, Denmark (Chair, representing EHRA); 2Sorbonne Universite´ Paris 6, ACTION Study Group, Institut De Cardiologie, Groupe Hoˆpital Pitie´-Salpetrie`re (APHP), INSERM UMRS 1166, Paris, France; 3Institute of Cardiology, ‘G. -
Currentstateofknowledgeonaetiol
European Heart Journal (2013) 34, 2636–2648 ESC REPORT doi:10.1093/eurheartj/eht210 Current state of knowledge on aetiology, diagnosis, management, and therapy of myocarditis: a position statement of the European Society of Cardiology Working Group on Myocardial and Pericardial Diseases Downloaded from Alida L. P. Caforio1†*, Sabine Pankuweit2†, Eloisa Arbustini3, Cristina Basso4, Juan Gimeno-Blanes5,StephanB.Felix6,MichaelFu7,TiinaHelio¨ 8, Stephane Heymans9, http://eurheartj.oxfordjournals.org/ Roland Jahns10,KarinKlingel11, Ales Linhart12, Bernhard Maisch2, William McKenna13, Jens Mogensen14, Yigal M. Pinto15,ArsenRistic16, Heinz-Peter Schultheiss17, Hubert Seggewiss18, Luigi Tavazzi19,GaetanoThiene4,AliYilmaz20, Philippe Charron21,andPerryM.Elliott13 1Division of Cardiology, Department of Cardiological Thoracic and Vascular Sciences, University of Padua, Padova, Italy; 2Universita¨tsklinikum Gießen und Marburg GmbH, Standort Marburg, Klinik fu¨r Kardiologie, Marburg, Germany; 3Academic Hospital IRCCS Foundation Policlinico, San Matteo, Pavia, Italy; 4Cardiovascular Pathology, Department of Cardiological Thoracic and Vascular Sciences, University of Padua, Padova, Italy; 5Servicio de Cardiologia, Hospital U. Virgen de Arrixaca Ctra. Murcia-Cartagena s/n, El Palmar, Spain; 6Medizinische Klinik B, University of Greifswald, Greifswald, Germany; 7Department of Medicine, Heart Failure Unit, Sahlgrenska Hospital, University of Go¨teborg, Go¨teborg, Sweden; 8Division of Cardiology, Helsinki University Central Hospital, Heart & Lung Centre, -
Common Types of Supraventricular Tachycardia: Diagnosis and Management RANDALL A
Common Types of Supraventricular Tachycardia: Diagnosis and Management RANDALL A. COLUCCI, DO, MPH, Ohio University College of Osteopathic Medicine, Athens, Ohio MITCHELL J. SILVER, DO, McConnell Heart Hospital, Columbus, Ohio JAY SHUBROOK, DO, Ohio University College of Osteopathic Medicine, Athens, Ohio The most common types of supraventricular tachycardia are caused by a reentry phenomenon producing acceler- ated heart rates. Symptoms may include palpitations (including possible pulsations in the neck), chest pain, fatigue, lightheadedness or dizziness, and dyspnea. It is unusual for supraventricular tachycardia to be caused by structurally abnormal hearts. Diagnosis is often delayed because of the misdiagnosis of anxiety or panic disorder. Patient history is important in uncovering the diagnosis, whereas the physical examination may or may not be helpful. A Holter moni- tor or an event recorder is usually needed to capture the arrhythmia and confirm a diagnosis. Treatment consists of short-term or as-needed pharmacotherapy using calcium channel or beta blockers when vagal maneuvers fail to halt or slow the rhythm. In those who require long-term pharmacotherapy, atrioventricular nodal blocking agents or class Ic or III antiarrhythmics can be used; however, these agents should generally be managed by a cardiologist. Catheter ablation is an option in patients with persistent or recurrent supraventricular tachycardia who are unable to tolerate long-term pharmacologic treatment. If Wolff-Parkinson-White syndrome is present, expedient referral -
Severe Acute Mitral Valve Regurgitation in a COVID-19-Infected Patient
Case report BMJ Case Rep: first published as 10.1136/bcr-2020-239782 on 18 January 2021. Downloaded from Severe acute mitral valve regurgitation in a COVID- 19- infected patient Ayesha Khanduri, Usha Anand, Maged Doss, Louis Lovett Graduate Medical Education, SUMMARY damage leading to pulmonary oedema and respira- WellStar Health System, The ongoing SARS- CoV-2 (COVID-19) pandemic has tory failure secondary to congestive heart failure. In Marietta, Georgia, USA presented many difficult and unique challenges to the these patients, a broader differential for pulmonary medical community. We describe a case of a middle- aged oedema and respiratory failure must be considered Correspondence to to ensure timely and appropriate treatment. Dr Ayesha Khanduri; COVID-19- positive man who presented with pulmonary ayesha. khanduri@ wellstar. org oedema and acute respiratory failure. He was initially diagnosed with acute respiratory distress syndrome. CASE PRESENTATION Accepted 3 December 2020 Later in the hospital course, his pulmonary oedema and A middle-aged man presented to the emergency respiratory failure worsened as result of severe acute department with progressively worsening short- mitral valve regurgitation secondary to direct valvular ness of breath, a non-productive cough and hypox- damage from COVID-19 infection. The patient underwent emia. His medical history was significant for atrial emergent surgical mitral valve replacement. Pathological flutter status post ablation in 2017. The patient evaluation of the damaged valve was confirmed to be is a lifelong non- smoker who bikes 2 miles daily. secondary to COVID-19 infection. The histopathological At that time in 2017, an echocardiogram revealed findings were consistent with prior cardiopulmonary mild mitral valve regurgitation with a normal left autopsy sections of patients with COVID-19 described ventricular ejection fraction (LVEF >55%). -
COVID 19 Vaccine for Adolescents. Concern About Myocarditis and Pericarditis
Opinion COVID 19 Vaccine for Adolescents. Concern about Myocarditis and Pericarditis Giuseppe Calcaterra 1, Jawahar Lal Mehta 2 , Cesare de Gregorio 3 , Gianfranco Butera 4, Paola Neroni 5, Vassilios Fanos 5 and Pier Paolo Bassareo 6,* 1 Department of Cardiology, Postgraduate Medical School of Cardiology, University of Palermo, 90127 Palermo, Italy; [email protected] 2 Department of Medicine, University of Arkansas for Medical Sciences and the Veterans Affairs Medical Center, Little Rock, AR 72205, USA; [email protected] 3 Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy; [email protected] 4 Cardiology, Cardiac Surgery, and Heart Lung Transplantation Department, ERN, GUAR HEART, Bambino Gesu’ Hospital and Research Institute, IRCCS Rome, 00165 Rome, Italy; [email protected] 5 Neonatal Intensive Care Unit, Department of Surgical Sciences, Policlinico Universitario di Monserrato, University of Cagliari, 09042 Monserrato, Italy; [email protected] (P.N.); [email protected] (V.F.) 6 Department of Cardiology, Mater Misericordiae University Hospital and Our Lady’s Children’s Hospital Crumlin, University College of Dublin, School of Medicine, D07R2WY Dublin, Ireland * Correspondence: [email protected]; Tel.: +353-1409-6083 Abstract: The alarming onset of some cases of myocarditis and pericarditis following the adminis- tration of Pfizer–BioNTech and Moderna COVID-19 mRNA-based vaccines in adolescent males has recently been highlighted. All occurred after the second dose of the vaccine. Fortunately, none of Citation: Calcaterra, G.; Mehta, J.L.; patients were critically ill and each was discharged home. Owing to the possible link between these de Gregorio, C.; Butera, G.; Neroni, P.; cases and vaccine administration, the US and European health regulators decided to continue to Fanos, V.; Bassareo, P.P. -
Basic Mechanisms of Myocarditis KIRK U
Basic Mechanisms of Myocarditis KIRK U. KNOWLTON, M.D. INTERMOUNTAIN MEDICAL CENTER, SALT LAKE CITY, UTAH UNIVERSITY OF CALIFORNIA, SAN DIEGO Major mechanisms that contribute to myocarditis Infection Virus Bacteria Parasites Immune activation against infectious pathogens Innate immunity Adaptive immunity Primary immune mechanisms Myocyte injury Antigen mimicry Hypersensitivity reactions Causes of Myocarditis Checkpoint inhibitors Are there common questions between viral myocarditis and checkpoint-inhibitor mediated myocarditis? Low incidence of myocarditis in patients treated with checkpoint inhibitors A very small percentage of patients that receive checkpoint inhibitors develop myocarditis- 0.09% or 0.27% of patients treated single checkpoint inhibitors or combination checkpoint inhibitors, respectively. Low incidence of myocarditis in patients infected with viruses that are known to cause myocarditis While many patients are infected with common viruses such as Coxsackievirus, adenovirus, parvovirus, herpes virus, Epstein-Barr virus, only a very small percentage actually develop myocarditis Why? Potential genetic variants/ mutations Innate immunity Adaptive immunity Sarcolemmal membrane integrity Other factors Underlying infection Nutrition Age Pregnancy Hormones The incidence of disease is likely affected by a combination of multiple influences Therefore, Review mechanisms that have been shown to cause myocarditis And, those that increase susceptibility to myocarditis SCIENCE VOL 291 12 JANUARY 2001 Nature -
Histopathological Characterization of Mitral Valvular Lesions from Patients with Rheumatic Heart Disease
Artigo Original Caracterização Histológica das Lesões da Valva Mitral de Pacientes com Cardiopatia Reumática Histopathological Characterization of Mitral Valvular Lesions from Patients with Rheumatic Heart Disease Nayana F. A. Gomes,1 Marcelo A. Pascoal-Xavier,1 Livia S. A. Passos,1 Thiago Mendonça Nunes Paula,1 João Marcelo de Souza Aguiar,1 Felipe Vieira Guarçoni,1 Maria Cecília Landim Nassif,1 Claudio Leo Gelape,1 Renato Braulio,1 Paulo Henrique N. Costa,1 Luiz Guilherme Passaglia,1 Raquel Braga Martins,1 Walderez O. Dutra,1 Maria Carmo P. Nunes1 Universidade Federal de Minas Gerais,1 Belo Horizonte, MG - Brasil Resumo Fundamentos: Os mecanismos subjacentes pelos quais a doença cardíaca reumática (DCR) levam à disfunção valvar grave não são totalmente compreendidos. Objetivo: O presente estudo avaliou as alterações histopatológicas nas valvas mitrais (VM) buscando uma associação entre o padrão de disfunção valvar predominante e os achados histopatológicos. Métodos: Em 40 pacientes submetidos à troca da VM devido a DCR e em 20 controles submetidos a transplante cardíaco, foram analisados os aspectos histológicos da VM excisada. Dados clínicos e ecocardiográficos também foram coletados. As análises histológicas foram realizadas usando coloração com hematoxilina-eosina. Determinou-se inflamação, fibrose, neoangiogênese, calcificação e metaplasia adiposa. Valores de p<0,05 foram considerados estatisticamente significativos. Resultados: A idade média dos pacientes com DCR foi de 53±13 anos, sendo 36 (90%) do sexo feminino, enquanto a idade média dos controles foi de 50±12 anos, semelhante aos casos, sendo a maioria do sexo masculino (70%). O endocárdio valvar reumático apresentou espessura maior que os controles (1,3±0,5 mm versus 0,90±0,4 mm, p=0,003, respectivamente), e infiltrado inflamatório mais intenso no endocárdio (78% versus 36%; p=0,004), com predominância de células mononucleares.