scholarly journals Revisiting transthyretin related cardiac amyloidosis: Case report and review of literature

2018 ◽  
Author(s):  
Munish Sharma ◽  
Eduard Koman ◽  
Gary S. Ledley ◽  
Sung-Hae Cho
Keyword(s):  
Cardiac Amyloidosis ◽  
Cardiac Involvement ◽  
Treatment Strategies ◽  
Conduction System ◽  
Clinical Suspicion ◽  
Diagnostic Tools ◽  
Review Of Literature ◽  
Artery Disease ◽  
Worse Prognosis ◽  
Restrictive Pattern

Amyloidosis is a complex group of disorders that can involve many organs and cause their dysfunction. Cardiac involvement indicates worse prognosis and influences treatment strategies. Cardiac amyloidosis is an under-diagnosed entity and high index of clinical suspicion and careful interpretation of basic diagnostic tools such as electrocardiogram and echocardiography is needed for early detection. Congestive heart failure due to restrictive pattern and/or conduction system abnormality, in absence of coronary artery disease should raise suspicion. We present a case of transthyretin related cardiac amyloidosis and discuss the key clinical and diagnostic findings along with review of existing literature regarding its management and outcomes.

New Trends and Developments in Patients with Severe Aortic Stenosis – Towards Optimal Treatment?

2009 ◽  
Vol 5 (2) ◽  
pp. 81 ◽  
Author(s):  
Martijn WA van Geldorp ◽  
Johanna JM Takkenberg ◽  
Ad JJC Bogers ◽  
A Pieter Kappetein ◽  
◽  
...  
Keyword(s):  
Aortic Stenosis ◽  
Severe Aortic Stenosis ◽  
Surgical Techniques ◽  
Treatment Strategies ◽  
Tissue Doppler ◽  
Doppler Imaging ◽  
Treatment Modalities ◽  
Diagnostic Tools ◽  
Number Of Patients ◽  
Transcatheter Valve

Over the next few decades the number of patients diagnosed with aortic stenosis is expected to rise as the population ages and the use of several diagnostic tools expands. This will result in a growing need for both medical and surgical treatment and stimulate the development of new diagnostic and surgical techniques. This article briefly describes the prevalence, pathogenesis and clinical presentation of patients with aortic stenosis and focuses on developments in diagnostic tools, treatment strategies and treatment modalities: the use of echocardiography, tissue Doppler imaging, stress testing and biomarkers is discussed, as well as timing of surgery and the role microsimulation can play in prosthesis selection. Furthermore, newly developed transcatheter valve implantation techniques and their possible role in treating ‘inoperable’ or ‘elderly’ patients are discussed.

Microvascular (dys)Function in Stable Coronary Artery Disease: Cross Talk with Epicardial Segments

2018 ◽  
Vol 24 (25) ◽  
pp. 2900-2905
Author(s):  
Lucian Calmac ◽  
Vlad Bataila ◽  
Bogdan Dragoescu ◽  
Cosmin Mihai ◽  
Alexandru Scafa-Udriste ◽  
...  
Keyword(s):  
Coronary Flow ◽  
Stable Coronary Artery Disease ◽  
Microvascular Dysfunction ◽  
Complex Interaction ◽  
Diagnostic Tools ◽  
Pathological State ◽  
Hemodynamic Parameters ◽  
Artery Disease ◽  
Epicardial Stenosis ◽  
Current Guidelines

Myocardial ischemia is the consequence of an unbalance between coronary flow that can be achieved and myocardial metabolic needs. Pathological state of both epicardial and intramyocardial vessels may be responsible for inducing ischemia. However, revascularization decision should be based on the severity of each epicardial lesion that is evaluated. There are different diagnostic tools that may help for the evaluation of each compartment which is based on the measurement of coronary hemodynamics. Pressure-derived indices are recommended by current guidelines for evaluation of epicardial stenosis significance. We assess the complex interaction between hemodynamic parameters in order to understand how different parameters are influenced in the settings of microvascular dysfunction.

Combination of Hydroxychloroquine, Melatonin and Mercaptopurine as possible intervention for prophylaxis and treatment of Novel COVID-19 infection

Coronaviruses ◽  
2020 ◽  
Vol 01 ◽  
Author(s):  
Gyan Vardhan ◽  
Vikas Kumar ◽  
Megha Agrawal ◽  
Puneet Dhamija
Keyword(s):  
Mechanism Of Action ◽  
Drug Combination ◽  
Treatment Strategies ◽  
Effective Drug ◽  
Effective Alternative ◽  
Potential Candidate ◽  
Potential Drug ◽  
Review Of Literature ◽  
Scientific Review ◽  
Repurposed Drugs

Background: COVID-19 has been declared as a pandemic recently and has caused many deaths worldwide. Till date no effective drug or vaccine is available against SARS-CoV-2. There is an urgent need to find effective alternative preventive and treatment strategies to deal with SARS-CoV-2 outbreak. Objective: This communication proposes a new potential drug combination (repurposed) for prophylaxis and treatment of SARS-CoV-2. Methods and Materials: We performed a brief review of literature on combination of Hydroxychloroquine, Melatonin and Mercaptopurine for prophylaxis and treatment of Novel COVID-19 infection and also assessed their possible mechanism of action against SARS-CoV-2. Observation: Proposed combination seems to be safe and target is unlikely to develop resistance to this combination. Conclusion: This scientific review proposes potential repurposed drugs and their combination targeting SARS-CoV-2. Conclusion: This scientific review proposes potential candidate repurposed drugs and potential drug combinations targeting 2019-nCoV/SARS-CoV-2.

scholarly journals Cardiac Amyloidosis with Discordant QRS Voltage between Frontal and Precordial Leads

Medicina ◽  
2021 ◽  
Vol 57 (7) ◽  
pp. 660
Author(s):  
Csilla-Andrea Eötvös ◽  
Roxana-Daiana Lazar ◽  
Iulia-Georgiana Zehan ◽  
Erna-Brigitta Lévay-Hail ◽  
Giorgia Pastiu ◽  
...  
Keyword(s):  
Left Ventricular Hypertrophy ◽  
Cardiac Amyloidosis ◽  
Ventricular Hypertrophy ◽  
Low Voltage ◽  
Disease Process ◽  
Left Ventricular ◽  
Clinical Suspicion ◽  
Immunoglobulin Light Chain ◽  
Different Types

Among the different types, immunoglobulin light chain (AL) cardiac amyloidosis is associated with the highest morbidity and mortality. The outcome, however, is significantly better when an early diagnosis is made and treatment initiated promptly. We present a case of cardiac amyloidosis with left ventricular hypertrophy criteria on the electrocardiogram. After 9 months of follow-up, the patient developed low voltage in the limb leads, while still maintaining the Cornell criteria for left ventricular hypertrophy as well. The relative apical sparing by the disease process, as well as decreased cancellation of the opposing left ventricular walls could be responsible for this phenomenon. The discordance between the voltage in the frontal leads and precordial leads, when present in conjunction with other findings, may be helpful in raising the clinical suspicion of cardiac amyloidosis.

scholarly journals Diagnostic tools for neurosyphilis: a systematic review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Gustavo Henrique Pereira Boog ◽  
João Vitor Ziroldo Lopes ◽  
João Vitor Mahler ◽  
Marina Solti ◽  
Lucas Tokio Kawahara ◽  
...  
Keyword(s):  
New Technologies ◽  
Clinical Suspicion ◽  
Risk Of Bias ◽  
Diagnostic Methods ◽  
Diagnostic Tools ◽  
Test Accuracy ◽  
Cerebrospinal Fluid Analysis ◽  
Evaluation Methodologies ◽  
Fluid Analysis ◽  
Criteria For Diagnosis

Abstract Purpose Increasing incidences of syphilis highlight the preoccupation with the occurrence of neurosyphilis. This study aimed to understand the current diagnostic tools and their performance to detect neurosyphilis, including new technologies and the variety of existing methods. Methods We searched databases to select articles that reported neurosyphilis diagnostic methods and assessed their accuracy, presenting sensitivity and specificity values. Information was synthesized in tables. The risk of bias was examined using the Cochrane Handbook for Systematic Reviews of Diagnostic Test Accuracy recommendations. Results Fourteen studies were included. The main finding was a remarkable diversity of tests, which had varied purposes, techniques, and evaluation methodologies. There was no uniform criterion or gold standard to define neurosyphilis. The current basis for its diagnosis is clinical suspicion and cerebrospinal fluid analysis. There are new promising tests such as PCR tests and chemokine measurement assays. Conclusions The diagnosis of neurosyphilis is still a challenge, despite the variety of existing and developing tests. We believe that the multiplicity of reference standards adopted as criteria for diagnosis reveals the imprecision of the current definitions of neurosyphilis. An important next step for the scientific community is to create a universally accepted diagnostic definition for this disease.

Diagnostic Tools for Cardiac Amyloidosis: A Pragmatic Comparison of Pathology, Imaging and Laboratories.

2022 ◽  
pp. 101106
Author(s):  
Abdulaziz Joury ◽  
Christian Faaborg-Andersen ◽  
Raymundo A. Quintana ◽  
Adrian daSilva-deAbreu ◽  
Jose Nativi-Nicolau
Keyword(s):  
Cardiac Amyloidosis ◽  
Diagnostic Tools

Current state-of-the-art antiplatelet and anticoagulation therapy in diabetic patients with coronary artery disease

2021 ◽  
Author(s):  
Johny Nicolas ◽  
Victor Razuk ◽  
Gennaro Giustino ◽  
Roxana Mehran
Keyword(s):  
Diabetes Mellitus ◽  
Complex Disease ◽  
Anticoagulation Therapy ◽  
Treatment Strategies ◽  
Diabetic Patients ◽  
Current State ◽  
Organ Systems ◽  
Patients With Diabetes ◽  
The Status ◽  
Artery Disease

Diabetes mellitus is a complex disease that leads to long-term damage to various organ systems. Among the numerous cardiovascular disease-related complications, thrombotic events frequently occur in patients with diabetes. Although guidelines exist for treating and preventing most diabetes-related co-morbidities, the evidence on antithrombotic therapy in primary and secondary prevention is limited due to the scarcity of randomized trials dedicated to patients with diabetes mellitus. Most of the available data are derived from studies that only included a small proportion of patients with diabetes. The present review provides an overview of the status of knowledge on antiplatelet and anticoagulation therapy in patients with diabetes, focusing on the risk–benefit balance of these therapies and future treatment strategies.

CABG versus PCI in the Treatment of Unprotected Left Main Disease in Diabetics: A Literature Review

2021 ◽  
Vol 30 (03) ◽  
pp. 187-193
Author(s):  
Daniel Lambert ◽  
Allan Mattia ◽  
Angel Hsu ◽  
Frank Manetta
Keyword(s):  
Coronary Artery ◽  
Artery Bypass ◽  
Treatment Strategies ◽  
Coronary Intervention ◽  
Diabetic Patients ◽  
Left Main ◽  
Left Main Disease ◽  
Unprotected Left Main Disease ◽  
Long Term Follow Up ◽  
Artery Disease

AbstractThe approach to left main coronary artery disease (CAD) in diabetic patients has been extensively debated. Diabetic patients have an elevated risk of left main disease in addition to multivessel disease. Previous trials have shown increased revascularization rates in percutaneous coronary intervention compared with coronary artery bypass grafting (CABG) but overall comparable outcomes, although many of these studies were not using the latest stent technology or CABG with arterial revascularization. Our aim is to review the most recent trials that have recently published long-term follow-up, as well as other literature pertaining to left main disease in diabetic patients. Furthermore, we will be discussing some future treatment strategies that could likely create a paradigm shift in how left main CAD is managed.

The conduction system in cardiac amyloidosis

1977 ◽  
Vol 62 (5) ◽  
pp. 677-686 ◽  
Author(s):  
Ren L. Ridolfi ◽  
Bernadine H. Bulkley ◽  
Grover M. Hutchins
Keyword(s):  
Cardiac Amyloidosis ◽  
Conduction System

scholarly journals Diagnostic approach to light-chain cardiac amyloidosis and its differential diagnosis

2018 ◽  
Vol 49 (1) ◽  
pp. 9-14
Author(s):  
Monika Adamska ◽  
Anna Komosa ◽  
Tatiana Mularek ◽  
Joanna Rupa-Matysek ◽  
Lidia Gil
Keyword(s):  
Differential Diagnosis ◽  
Light Chain ◽  
Cardiac Amyloidosis ◽  
Cardiac Involvement ◽  
Diagnosis And Treatment ◽  
Diagnostic Approach ◽  
Al Amyloidosis ◽  
Delay In Diagnosis ◽  
Light Chain Amyloidosis ◽  
Novel Approaches

AbstractCardiac amyloidosis is a rare and often-misdiagnosed disorder. Among other forms of deposits affecting the heart, immunoglobulin-derived light-chain amyloidosis (AL amyloidosis) is the most serious form of the disease. Delay in diagnosis and treatment may have a major impact on the prognosis and outcomes of patients. This review focuses on the presentation of the disorder and current novel approaches to the diagnosis of cardiac involvement in AL amyloidosis.

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