Heart Failure in a Child: Multimodality Approach Leading to an Unusual Cause.
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ABSTRACT:
SUBMITTER: Karuru UD
PROVIDER: S-EPMC8642737 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Peripartum cardiomyopathy is a weakness of the heart muscle. It is an idiopathic cardiomyopathy that presents with heart failure secondary to left ventricular systolic dysfunction toward the end of pregnancy or in the months after delivery, in the absence of any other cause of heart failure. It is a rare condition that can carry mild or severe symptoms.
| S-EPMC5290678 | biostudies-literature
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| S-EPMC8551396 | biostudies-literature
Project description:Aims:So far, a total of five patients with eclipsed mitral regurgitation (MR) have been reported in the literature by three different teams. The aim of this article was to detail clinical and echocardiographic characteristics, and outcome of patients presenting eclipsed MR. Methods and results:We defined eclipsed MR as spontaneous appearance, at rest, from 1 min to the next of an acute restriction in the motion of mitral leaflets preventing coaptation and leading to massive MR in patients with normal left ventricular end-diastolic diameter, left ventricular ejection fraction >45%, and baseline MR ?2. Spontaneous regression occurred within 30 min, and no obvious trigger such as acute hypertension, new-onset arrhythmia, or myocardial ischaemia is present. Clinical data, ECG, echocardiographic data, surgery report, and follow-up status of six patients with eclipsed MR are reported: all were post-menopausal women with median age of 74 [57-80] years presenting hypertension (4/6), chronic kidney disease (5/6), or chronic anaemia (4/6). Five out of six patients experienced acute pulmonary oedema requiring hospitalization and underwent mitral valve replacement because of heart failure recurrence. Two patients died in the first days after surgery while the three others are free of symptoms at, respectively, 56, 18, and 10 months follow-up. Conclusion:Eclipsed MR is a clinical and echocardiographic syndrome responsible for heart failure with preserved EF. It is presently underdiagnosed and should be evoked in cases of recurrent acute pulmonary oedema without obvious trigger, in particular in patients presenting discordant evaluation of MR severity over time.
| S-EPMC5837450 | biostudies-other
Project description:The long-term results of transatrial transpulmonary tetralogy of Fallot (TOF) repair have been excellent. Progressive pulmonary regurgitation and consequent right ventricular (RV) dilatation are the most common long-term sequel of definitive repair in childhood. Overt systemic venous congestion after TOF repair is limited to the rare setting where RV dysfunction sets in due to deferred surgery or progressive arrhythmia. Here, we report a unique case of right heart failure from an unexpected etiology, 28 years after TOF repair. Cardiac catheterization confirmed findings of elevated right heart pressures. Magnetic resonance imaging showed obliteration of the RV apex with late gadolinium enhancement of the right ventricular apical endomyocardium.
| S-EPMC9802613 | biostudies-literature
Project description:BackgroundConstrictive Pericarditis(CP) can be viewed as a constellation of syndromes resulting from compression of the heart, etiologies, course and types are well discussed in other reports. However, localized CP as a cause of right heart failure is rare, and presentation with interposed fluid under-pressure is extremely odd.Case reportA case of C.X. Z, male aged 39 years old, who presented to our department with sudden onset of symptoms of subacute right heart failure due localized CP. In January, 2018 C.X.Z presented to the county hospital with complaints of 10-day history of transient mild bilateral pedal edema. He was managed on diuretic therapy and symptoms resolved completely. 10 months later, he suddenly presented to the local facility with symptoms of subacute right heart failure. 7 days after on-set of symptoms, his condition shifted from NYHA I to III-IV. Although wake-up chest radiography appeared normal, standard medical therapy yielded no positives results. He was referred to our hospital, upon which after echocardiography and computed tomography investigations, aforementioned diagnosis was made. We performed off-pump partial pericardiectomy with no complications. After operation, he received analgesics and diuretics for pain and edema(ascites) respectively. He was discharged 7-days after operation on analgesics only, with no symptoms of right heart failure.ConclusionLocalized constrictive pericarditis as a cause of subacute right heart failure (RHF) has never been reported elsewhere, and presentation with interposed fluid is extremely odd. Progressive symptoms of Acute RHF in the absence of typical radiologic clue 'egg-shell' should heighten suspicion index of CP.
| S-EPMC6570946 | biostudies-literature
Project description:BackgroundReduction of 30-day all-cause readmissions for heart failure (HF) has become an important quality-of-care metric for health care systems. Many hospitals have implemented quality improvement programs designed to reduce 30-day all-cause readmissions for HF. Electronic medical record (EMR)-based measures have been employed to aid in these efforts, but their use has been largely adjunctive to, rather than integrated with, the overall effort.ObjectivesWe hypothesized that a comprehensive EMR-based approach utilizing an HF dashboard in addition to an established HF readmission reduction program would further reduce 30-day all-cause index hospital readmission rates for HF.MethodsAfter establishing a quality improvement program to reduce 30-day HF readmission rates, we instituted EMR-based measures designed to improve cohort identification, intervention tracking, and readmission analysis, the latter 2 supported by an electronic HF dashboard. Our primary outcome measure was the 30-day index hospital readmission rate for HF, with secondary measures including the accuracy of identification of patients with HF and the percentage of patients receiving interventions designed to reduce all-cause readmissions for HF.ResultsThe HF dashboard facilitated improved penetration of our interventions and reduced readmission rates by allowing the clinical team to easily identify cohorts with high readmission rates and/or low intervention rates. We significantly reduced 30-day index hospital all-cause HF readmission rates from 18.2% at baseline to 14% after implementation of our quality improvement program ( P = .045). Implementation of our EMR-based approach further significantly reduced 30-day index hospital readmission rates for HF to 10.1% ( P for trend = .0001). Daily time to screen patients decreased from 1 hour to 15 minutes, accuracy of cohort identification improved from 83% to 94.6% ( P = .0001), and the percentage of patients receiving our interventions, such as patient education, also improved significantly from 22% to 100% over time ( P < .0001).ConclusionsIn an institution with a quality improvement program already in place to reduce 30-day readmission rates for HF, an EMR-based approach further significantly reduced 30-day index hospital readmission rates.
| S-EPMC7651943 | biostudies-literature
Project description:BackgroundIntracardiac thrombosis is a relatively common pathological condition. Often, it is diagnosed at echocardiography during the subacute or chronic phase. In the very acute phase, tissue composition can make thrombus appearance very different from that usually seen. Fresh thrombosis has been previously found also in peripartum cardiomyopathy (PPC), but with imaging features different from our case.Case summaryA 27-year-old woman was referred to our hospital for PPC, with echocardiographic finding of intraventricular masses, resembling big bubbles. Cardiac magnetic resonance (CMR) allowed definitively diagnosing intracardiac 'very acute' thrombosis, which is rarely detected.DiscussionOur case provides a practical lesson about management of an unusual presentation of a common problem. When early echocardiography does not allow making a certain diagnosis, CMR can be helpful and decisive, due to its unique ability to provide characterization of intracardiac masses.
| S-EPMC7873811 | biostudies-literature
Project description:Congential aorta-right atrial tunnel (ARAT) is a rare anomaly. Many patients are asymptomatic and diagnosis can be made during investigation of systolic and diastolic continuous murmur heard on cardiac oscultation. In some patients, symptoms such as palpitation, dyspnea, and fatigue on exertion can be seen. With transthoracic and transesophageal echocardiography diagnosis can usually be made, but more definite diagnosis is possible with coronary angiography, aortography, and computerized tomography. Herein with the data from current literature we will discuss a case who was admitted to our clinic with symptoms of heart failure and diagnosed with ARAT.
| S-EPMC6265038 | biostudies-literature
Project description:IntroductionThe detection of acquired arteriovenous fistulas (AVFs) is mostly incidental. However, the modification of haemodynamic conditions secondary to AVFs can lead to dramatic systemic complications, including cardiac complications. In this report, two unusual cases of congestive heart failure secondary to acquired AVF are presented.ReportA 40 year old man with past history of gunshot wound of the right flank complained of severe right limb swelling and shortness of breath. An AVF between the right external iliac artery and external iliac vein responsible for the cardiac failure was diagnosed. A 40 year old woman with past history of spinal surgery complained of breathlessness and lower limb oedema. She presented with recurrent episodes of ascites and dyspnoea. An AVF between the right common iliac artery and the common iliac vein responsible for high output cardiac failure was diagnosed. Open surgery was performed in both patients and treatment of the AVFs led to the resolution of all symptoms. Follow up at four and three years, respectively, was uneventful in both cases.DiscussionAlthough rare, heart failure secondary to an AVF can be encountered. These rare cases highlight the significance of careful inquiry into the patient's medical history and meticulous follow up physical examinations for patients with injuries in close proximity to vessels.
| S-EPMC8501500 | biostudies-literature
Project description:Noncompaction cardiomyopathy (NCCM) is a rare but important cause of heart failure. The reported prevalence of left ventricle NCCM based on echocardiographic criteria varies between 0.014% and 1.3%, while the biventricular involvement is extremely rare with only few cases reported.
| S-EPMC5986029 | biostudies-literature