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[crimsonpublisherscardiology]

The Rare Case of Family Hereditary Disease Recurrent Myxoma of the Heart by Abdumadzhidov Kh A* in Open Journal of Cardiology & Heart Diseases_ Heart Disease Research Articles

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[sureshbhagia]

 Cardiac Arrest in Young Age - What Causes It, and How to Avoid Sudden Cardiac Death

Christian Eriksen's abrupt fall on the field during the opening half of Denmark's match versus Finland at the Euro 2020 soccer tournament on June 12, 2021, shocked millions worldwide. The Danish midfielder appeared strong, fit, and in excellent spirits; he was probably the last person you would anticipate suffering a heart arrest. He, fortunately, obtained cardiopulmonary resuscitation (CPR) promptly, saving his life.

abrupt cardiac arrest in a child

Although uncommon, a sudden cardiac arrest does occasionally occur in young persons. According to the Centers for Disease Control and Prevention (CDC), sudden cardiac arrest claims the lives of roughly 2,000 young, otherwise healthy people under 25 every year in the US. Younger folks are experiencing an alarming increase in heart attacks and cardiac arrests. Medical professionals at Fortis Hospital, Mulund, discuss what can cause cardiac arrest in young people and what can be done to prevent sudden cardiac death.

A cardiac arrest is what?

Cardiac arrest is the sudden cessation of a heartbeat or the heart's ability to pump blood throughout the body. Typically, there is no advance notice. A person who experiences a cardiac arrest will suddenly pass out, lose consciousness, and not be breathing at all. Some warning signs to look out for include unexplained fainting, chest pain or shortness of breath, and a family history of cardiac arrest. If a cardiac arrest is not treated quickly, it might result in death.

cardiac arrest caused in young adults

The reasons for cardiac arrest typically change with age. Most cardiac arrests in adults over 35 are brought on by coronary artery disease. The causes of cardiac arrest in young persons can vary. Young adults may experience cardiac arrest due to a variety of conditions, such as:

Hypertrophic cardiomyopathy 

A complex form of cardiac disease in which the heart muscle thickens excessively.

2. Disturbed coronary arteries

Some people have improperly linked coronary arteries from birth, which can reduce blood flow to the heart muscle during activity and lead to cardiac arrest.

3. Long QT syndrome 

Fast and erratic heartbeats can result from this inherited heart rhythm problem.

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[lifewithhealth]

Cardilogy health - heart care - Konic Healthcare

Are suffering from Heart or Cardio problems and searching for Cardiologist, Heart specialist doctors? Visit Konic HealthCare - A Digital Platform - Website : https://www.konichealthcare.com  - Phone +91 7696 416 416

Cardiology, the branch of medicine dedicated to the study and treatment of the heart and circulatory system, is a critical field that addresses a wide spectrum of cardiovascular conditions. From innovative diagnostic tools to advanced treatment modalities, cardiologists play a vital role in preserving and improving the heart health of individuals.

Understanding the Cardiovascular System:

The cardiovascular system comprises the heart, blood vessels, and blood. The heart, a muscular organ, functions as a pump to circulate blood throughout the body, delivering oxygen and nutrients while removing waste products. Understanding the intricate workings of this system is fundamental to appreciating the complexities that cardiologists navigate in their daily practice.

Common Cardiovascular Conditions:

Coronary Artery Disease (CAD):

A condition characterized by the narrowing or blockage of coronary arteries, reducing blood flow to the heart muscle.

Symptoms may include chest pain (angina), shortness of breath, and fatigue.

Heart Failure:

Occurs when the heart is unable to pump blood effectively, leading to insufficient oxygen delivery to the body's tissues.

Symptoms include fatigue, swelling (edema), and difficulty breathing.

Arrhythmias:

Irregular heart rhythms that may manifest as palpitations, dizziness, or fainting.

Types range from atrial fibrillation to bradycardia (slow heart rate).

Vascular Heart Disease:

Involves abnormalities in the heart valves, affecting blood flow within the heart.

Conditions such as aortic stenosis or mitral regurgitation fall under this category.

Diagnostic Tools in Cardiology:

Electrocardiogram (ECG or EKG):

Records the electrical activity of the heart, aiding in the detection of rhythm abnormalities.

Echocardiography:

Uses sound waves to create images of the heart's structure and function, helping diagnose structural issues and heart failure.

Cardiac Catheterization:

Involves threading a catheter through blood vessels to the heart, often used for diagnosing and treating coronary artery disease.

Stress Testing:

Measures the heart's response to increased workload, assessing its performance under stress.

Interventional Procedures:

Angioplasty and stent placement address blockages in coronary arteries, restoring blood flow.

Surgical Interventions:

Coronary artery bypass grafting (CABG) involves rerouting blood around blocked arteries.

Implantable Devices:

Pacemakers and defibrillators help regulate heart rhythm and prevent sudden cardiac death.

Preventive Measures:

Cardiologists emphasize the importance of preventive measures to maintain heart health. This includes adopting a heart-healthy diet, engaging in regular physical activity, managing stress, avoiding tobacco, and controlling conditions like hypertension and diabetes.

FAQs

1. What are heart problems?

Heart problems, or cardiovascular disorders, refer to a range of conditions that affect the heart and blood vessels. These may include coronary artery disease, heart failure, arrhythmias, valvular diseases, and more.

2. What are the common symptoms of a heart problem?

Symptoms vary based on the specific condition but may include chest pain or discomfort, shortness of breath, fatigue, palpitations, dizziness, and swelling in the legs or abdomen.

3. What is the leading cause of heart problems?

The primary cause is often the buildup of plaque in the arteries, leading to atherosclerosis. This condition can result from factors like high blood pressure, high cholesterol, smoking, diabetes, and a sedentary lifestyle.

4. How is heart disease diagnosed?

Diagnosis involves a combination of medical history review, physical examination, and various diagnostic tests such as electrocardiogram (ECG or EKG), echocardiography, stress testing, and cardiac catheterization.

5. Can heart problems be prevented?

Yes, adopting a heart-healthy lifestyle can significantly reduce the risk of heart problems. This includes maintaining a balanced diet, regular exercise, avoiding tobacco, managing stress, and controlling conditions like hypertension and diabetes.

6. What is angina, and how is it related to heart problems?

Angina is chest pain or discomfort that occurs when the heart muscle doesn't receive enough oxygen-rich blood. It is often a symptom of coronary artery disease and can be a warning sign of potential heart problems.

7. How is high blood pressure linked to heart problems?

High blood pressure, or hypertension, puts extra strain on the heart and blood vessels, increasing the risk of conditions like coronary artery disease, heart failure, and stroke. Controlling blood pressure is crucial in preventing heart problems.

8. What is the role of cholesterol in heart health?

Cholesterol is a fatty substance that can accumulate in the arteries, leading to atherosclerosis. High levels of "bad" LDL cholesterol are a risk factor for heart problems. Managing cholesterol through diet, exercise, and medication can mitigate this risk.

9. Can heart problems be hereditary?

Yes, a family history of heart disease can increase the risk. Genetic factors may contribute to conditions like high blood pressure, coronary artery disease, and certain cardiac arrhythmias.

10. What lifestyle changes can improve heart health?

Adopting a heart-healthy lifestyle involves maintaining a balanced diet rich in fruits, vegetables, and whole grains, engaging in regular physical activity, avoiding tobacco and excessive alcohol consumption, managing stress, and monitoring and controlling conditions like diabetes and hypertension.

11. How is heart failure different from a heart attack?

A heart attack occurs when blood flow to part of the heart muscle is blocked, leading to damage. Heart failure is a chronic condition where the heart is unable to pump blood effectively. While a heart attack can contribute to heart failure, they are distinct conditions.

12. What role does exercise play in heart health?

Regular exercise is crucial for maintaining heart health. It helps control weight, lowers blood pressure and cholesterol levels, improves circulation, and enhances overall cardiovascular fitness.

Always consult with a healthcare professional for personalized advice and treatment options tailored to your heart conditions. Visit Konic Healthcare

Website : https://www.konichealthcare.com

Phone  :  +91 7696 416 416

[healthinnovations]

Blocking brain signals detected in the kidney could help unlock treatments for kidney failure.

Blocking brain signals detected in the kidney could help unlock treatments for kidney failure. Thoughts health innovators?

Chronic kidney disease (CKD) is a major public health issue, affecting over 10 percent of the global population, frequently occurring as a result of other disorders such as hypertension, diabetes, obesity, or metabolic syndrome. An early sign of CKD is the increased level of liver protein albumin in the urine, also known as albuminuria. Shown to damage the glomerulus, the kidney’s filtering…

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https://www.linkedin.com/in/arun-sharan-b185b238

[hospitto-blog]

Heart failure, sometimes known as congestive heart failure, occurs when your heart muscle doesn't pump blood as well as it should. Certain conditions, such as narrowed arteries in your heart or high blood pressure,

To know more about Heart Failure visit :-https://www.hospitto.com/doctor/Jaipur/dr-anshul-patodia

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Maxremind Specialties in Cardiology

[crimsonpublisherscardiology]

Patient Blood Management Strategies During Coronavirus Disease 2019 Pandemic by Mathur G* in Open Journal of Cardiology & Heart Diseases_ Heart Disease Research Articles

https://crimsonpublishers.com/ojchd/fulltext/OJCHD.000576.php

[sureshbhagia]

A short, flexible tube known as a catheter is used in the non-surgical discipline of interventional cardiology to treat restricted arteries, weak or damaged blood vessels, and other heart structural issues. An interventional cardiologist is a cardiologist who has completed an additional one to two years of education and training in the diagnosis and treatment of congenital (present at birth) and structural heart conditions as well as cardiovascular disease using catheter-based techniques like angioplasty and stinting.

[lupine-publishers-acr]

Lupine Publishers | The Current Status of Continuous Flow Left Ventricular Assist Devices

Abstract

In this review, we hope to give a perspective of the new realities of cardiac mechanical circulatory assist devices. New iterations of devices are providing greater durability and freedom of complications. Work is near to provide internal batteries and transcutaneous energy transfer systems for completely implantable systems, avoiding the need for an externalized drive line.

Keywords: Heart Failure; Transplantation; Mechanical Circulatory Support

Twine and Twine or Lose the Plug- Dislodged Left Atrial Appendage Closure Device

In patients with severe heart failure, cardiac transplantation has been shown to provide considerable benefit. Since 1967, in excess of 88,000 total heart transplants have been performed and 1-year survival is 81%, the annual mortality is 4% per year thereafter. The supply of donor hearts is incredibly limited and much research has focused on mechanical means of improving myocardial function, and several such left ventricular assist devices (LVADs) have been developed through the National Institutes of Health artificialheart program. Several devices have been previously approved by the Food and Drug Administration as bridging therapy to transplantation, though none have been studied as long-term alternatives to transplantation. The Randomized Evaluation of Mechanical Assistance for the Treatment of Congestive Heart Failure (REMATCH) [1] trial explored whether a specific type of LVAD (a previous generation pulsatile device), when used in the long-term, would reduce mortality (Figure 1). The survival following severe heart failure was extremely poor in the optimally medically treated group in this trial (defined as End-stage heart failure was defined as New York Heart Association (NYHA) class IV symptoms for at least 90 days, left ventricular ejection fraction (LVEF) <25%, peak oxygen consumption <12 mL/kg/min or continued need for intravenous inotropes for symptomatic hypotension).

In the optimally medically treated control arm of the Randomized Evaluation of Mechanical Assistance for the Treatment of Congestive Heart Failure (REMATCH) trial [1] which evaluated an externalized pulsation ventricular assist device, survival at one year was 28% and 6% at two years, underlying the poor prognosis of this clinical entity (Figure 1). Driving the need for mechanical circulatory support (MCS) is the relative paucity of donors and the unmet need for orthotopic heart transplantation in the general population. There has also been an increase in the number of patients who require mechanical circulatory support (MCS) as a bridge to transplantation [2]. This has been driven, particularly in the UK by limitation of the number of hearts for donation, and also to buy time on the transplant waiting list. This is due to an increase in the numbers of non-heart beating donors (DCDs), whereby retrieval takes place in a circulation arrested donor, and the increased survival of head injury patients and those with intracranial bleeds who are treated by a decompressive craniotomy, reducing the pool of donors who have raised intracranial pressure and who have coned, resulting in brain stem death. The net result is a retrieval rate for heart transplantation of around 19%. The risk of having preformed antibodies directed against the donor heart (sensitised patients) is increasingly likely and is particularly challenging as it may increase the risk of rejection and allograft vasculopathy. There has also been an increase in the number of patients requiring MCS as a bridge to transplantation [3]. This allows many severely ill adults and paediatric patients to survive until a suitable donor heart is available. Patients with MCS are at increased risk for rejection, infection, stroke, and bleeding. The need for transfusions also increases the risk of pre-sensitization [3-5]. Survival at 1 and 5 years is decreased in patients requiring MCS prior to transplantation, but still higher than 80% and 70%, respectively (ISHLT database) [2].

Figure 1:  Randomized Evaluation of Mechanical Assistance for the Treatment of Congestive Heart Failure (REMATCH) trial (Rose et al N Engl J Med 2001; 345:1435-1443).

Advances in Donor Allocation and Selection

Recipient criteria for heart transplantation include, severe symptoms despite maximal medical management, the absence of reversible or surgically amenable heart disease, and where estimated 1-year survival is less than 50% [6]. An estimate of functional capacity in ambulatory patients can be best quantified by measurement of peak O2 consumption (VO2max). Patients with low VO2max (<12 ml/min/kg) have high mortality even if treated with beta blockers and transplantation should be considered for these patients. In addition, heart failure prognosis scores to estimate survival, such as the Heart Failure Severity Score may be used. This calculates a survival probability on the basis of the presence of ischaemic cardiomyopathy, resting heart rate, left ventricular ejection fraction, mean blood pressure, interventricular conduction delay, VO2max and serum sodium concentration [7].

Figure 2:  Competing outcomes for continuous flow LVADS (82% survival at 1 year, intention to treat).

Transplantation eligibility is always considered with regard to risk factors, especially, pulmonary hypertension (Figure 2). Right heart catheterization must be performed in all potential candidates for heart transplantation in order to quantify pulmonary vascular resistance [7]. Right heart failure is a substantial cause of mortality. Right ventricular failure is likely when post implant pulmonary artery pressures exceed 50 mmHg. Patients with chronic heart failure may develop pulmonary hypertension due to elevated left ventricular end diastolic pressure with elevated left atrial and pulmonary venous pressures. This is a reactive form of pulmonary hypertension and may fall when the cardiac output is increased with inotropes or unloaded with nitrate infusions [7]. The transpulmonary gradient is calculated by subtracting the left atrial filling pressure from the mean pulmonary artery pressure. A fixed transpulmonary gradient in excess of 14 mmHg is associated with greatly elevated risk, and thus this cut off is used in the UK [8]. In such patients a destination therapy strategy may be used with continuous flow LVADS.

Mechanical Circulatory Assist Devices

In recent years, the use of MCS device in treating patients with end-stage heart disease has increased significantly, as bridge to transplantation and as destination therapy for transplant ineligible candidates. This increase is based on the accumulated experience with new second-generation continuous-flow devices which show significant improvements in survival, functional capacity and quality of life [9,10]. On the basis of the Heart Mate II Registry experience (1300 patients), guidelines for the clinical management of patients treated with continuous-flow devices have been published [11]. Risk scoring systems, such as the Seattle Heart Failure Model [12] and the Cumulative Risk Score for 90-Day in-Hospital Mortality [13] and the Destination Therapy Risk Score have been investigated to stratify patients who might benefit from LVAD support [14].

Right ventricle failure is a leading cause of morbidity and death after LVAD implant (incidence of about 35%), and can be very difficult to predict [15,16]. Various means to assess right ventricle function both pre- and postoperatively have been assessed (10). Right ventricular failure risk scores have been created that stratify the risk of right ventricular failure (RVFRS) and death after LVAD implantation (Figure 3). One such RVFRS found independent predictors of right ventricular failure to include vasopressor requirement, aspartate aminotransferase >80 IU/L, bilirubin >2.0mg/dL and creatinine >2.3mg/dL [15]. Another study developed a score to predict RVAD need after LVAD placement, which included factors of cardiac index, right ventricular stroke work index, severe preoperative right ventricular dysfunction, creatinine, previous cardiac surgery and systolic blood pressure [16]. More recently the presence of severe TR and a tricuspid annulus of >43mm and right ventricular sphericity have been proposed as predictive of occult RV failure and need for biventricular support. The Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) registry, which follows all long-term MCS systems in the United States, has defined patient profiles that can help identify risks associated with the timing of implant [17]. In the future, the INTERMACS patient profile would be a useful tool to improve management and outcomes of patients who need VAD implant and unify criteria for future clinical trials and devices (Figure 4). As more LVAD patients are listed for heart transplant, a competition has occurred for organs between stable LVAD supported registrants and less stable registrants listed UNOS status 1A or 1B (the highest categories and most at risk if not urgently transplanted). A recent study found that stable LVAD patients had significantly less 30-day risk of events compared to other status 1A patients concluding that allowance of 30 days of elective status 1A time should not be allocated to stable registrants with implanted LVADs [18]. As VAD technology improves, further revisions to the allocation system will need to be recommended.

Figure 3:  Heartmate 3, the latest centrifugal blood pump in comparison to Heartmate II an axial flow pump. Superior event free survival is seen with HM 3.

Figure 4:  Heart-mate 3 vs Heartmate II comparison of event free survival.

INTERMACS Profile and Description and Timescale to MCS

a) “Crashing and burning”—critical cardiogenic shock. Within hours b) “Progressive decline”—inotrope dependence with continuing deterioration. Within a few days c) “Stable but inotrope dependent”—describes clinical stability on mild-to-moderate doses of intravenous inotropes (patients stable on temporary circulatory support without inotropes are within this profile). Within a few weeks d) “Recurrent advanced heart failure”—“recurrent” rather than “refractory” decompensation. Within weeks to months e) “Exertion intolerant”—describes patients who are comfortable at rest but are exercise intolerant. Variable f) “Exertion limited”—describes a patient who is able to do some mild activity but fatigue results within a few minutes of any meaningful physical exertion. Variable g) “Advanced NYHA III”—describes patients who are clinically stable with a reasonable level of comfortable activity, despite history of previous decompensation that is not recent. Not a candidate for MCS

INTERMACS = Interagency Registry for Mechanically Assisted

Circulatory Support; MCS = mechanical circulatory support;

NYHA = New York Heart Association.

Figure 5:  Durability of HM 3 vs HM II, freedom from pump replacement due to pump thrombosis or haemolysis.

Temporary MCS are available that can be implanted quickly and simply to normalise cardiac output in patients with severe acutely decompensated heart failure. The CentriMag [19], Tandem Heart [20], Impella [21] and Circulite [22]. Clinical trials suggest that treatment of temporary VADs does not necessarily correlate with better survival, but merely comprise a component of treatment leading to recovery, upgrade to fully implantable systems as a bridge to transplant or destination therapy, or transplantation [23,24]. Device miniaturisation, without externalized drive-lines connecting the device to a console and longer endurance will be the future trend of mechanical design for long term support. Blood pumps with magnetically levitated rotors has shown satisfactory 1-year survival [25]. The smaller size and weight of the continuousflow devices has allowed an extension of the new VADs into smaller patients. Fully wireless resonant coupling power sources are currently undergoing evaluation, which if successful will greatly reduce the incidence of drive line infections (Figure 5), which is the weakest point of the technology of current fully implantable systems. There is some evidence that fully implantable systems will be available in the near future to greatly improve the quality of life and to reduce the frequency of severe infections with continuous flow LVADS.

Many recent studies have focused on the reversed molecular and cellular alterations, such as improved β-adrenergic responses and decreased calcium-regulating gene expression (Figure 6), in patients using LVAD as a bridge to recovery therapy [26]. Functional recovery has been observed in a subset of heart failure patients [26,27]. Recently, a clinical trial using clenbuterol (β-2 agonist and anabolic agent) and LVAD in refractory non-ischemic heart failure patients, reported recovery of heart function in 60% of patients (n=20) with non-ischemic cardiomyopathy that allows the pump to be explanted (Harefield Recovery Protocol Study for Patients with Refractory Chronic Heart Failure, HARPS) [28]. LVAD therapy is associated with decreased collagen turnover and crosslinking and increased tissue angiotensin II. LVAD combined with angiotensinconverting enzyme inhibition results in decreased tissue angiotensin II and collagen cross-linking, normalizes left ventricular end-diastolic pressure volume relationships and is associated with modestly higher rates of bridge to recovery [29]. Other adjunctive treatments including other medications, cell or gene therapy with over expression of SERCA2a might in conjunction with VAD support provide a meaningful alternative therapy in patients with severe heart disease [30].

Figure 6.  

Conclusion

Heart transplantation is associated with excellent long-term outcomes and is the gold standard solution for intractable end stage heart failure in eligible patients. What limits its impact, overall, is the limited availability of donor organs. The development of ventricular assist devices has mitigated against this, to some extent. Subsequent device iterations with further miniaturisation and continuous flow have resulted in effective bridge to transplant solutions. The presence of an externalized drive line exposes the VAD recipient to infections, however, which may precipitate urgent listing for heart transplant in the bridge to transplant candidate and may limit the life span of the destination therapy candidate. Fully implantable driveline free systems will definitely enhance the utility of these systems in these settings. As our knowledge of molecular medicine increases, manipulation of key proteins implicated in the pathophysiology of heart failure such as SERCA2a may allow some recovery of the myocardium in patients with heart failure to the extent that transplantation may be deferred or the LVAD explanted [31-35].

https://lupinepublishers.com/cardiology-journal/pdf/ACR.MS.ID.000125.pdf

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6th International Conference on Cardiology and Vascular Biology is taking place in London, UK during  11-12 November 2019. Get world conference alerts london 2019.

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