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Congestive Heart Failure
Published in Jahangir Moini, Matthew Adams, Anthony LoGalbo, Complications of Diabetes Mellitus, 2022
Jahangir Moini, Matthew Adams, Anthony LoGalbo
Dilated cardiomyopathy occurs without other disorders that are able to cause the myocardium to be dilated. These include severe occlusive CAD, hypertension, and valvular heart disease. Sometimes, dilated cardiomyopathy starts with acute myocarditis (usually of viral origin). There is a latent phase of various lengths, then diffuse necrosis of the myocardial myocytes because of an autoimmune reaction to myocytes altered by the virus, and then, chronic fibrosis. The myocardium is dilated, thinner, and hypertrophied as a compensatory mechanism. This often results in functional tricuspid or mitral regurgitation as well as atrial dilation. Dilated cardiomyopathy affects both ventricles in most cases, less often affecting just the LV, and only rarely affecting just the RV. When chamber dilation and dysfunction progress, mural thrombi can form because of stasis of blood. The acute myocarditis and late chronic dilated phases are often complicated by cardiac tachyarrhythmias. Atrioventricular block may also develop. As the left atrium becomes dilated, atrial fibrillation often occurs.
Fetal echocardiography
Published in Hung N. Winn, Frank A. Chervenak, Roberto Romero, Clinical Maternal-Fetal Medicine Online, 2021
Caroline K. Lee, Erik C. Michelfelder, Gautam K. Singh
Atrioventricular block due to AV node or ventricular conducting pathway abnormalities are the most common cause of persistent fetal bradycardia. The atrioventricular block can be of first degree, which demonstrates prolonged AV interval >150 msec (75); second degree, which has a fixed atrioventricular conduction block (2:1 or 3:1 block) or progressive prolongation of the AV interval until an atrial beat is nonconducted (Wenckebach); or third degree, which has permanent atrioventricular block (complete heart block) with complete dissociation between atrial and ventricular contractions.
Hunter disease/mucopolysaccharidosis type II/iduronate sulfatase deficiency
Published in William L. Nyhan, Georg F. Hoffmann, Aida I. Al-Aqeel, Bruce A. Barshop, Atlas of Inherited Metabolic Diseases, 2020
Survival for as long as 87 years has been observed [32], but death may occur in the second decade, even in the mild phenotypes. The cause may be cardiac disease, pulmonary infection, or airway obstruction. Sudden death after complete atrioventricular block has been reported [40].
The challenging management of cardiac involvement in systemic sarcoidosis
Published in Acta Cardiologica, 2022
Chiara Andreoli, Emilia Biscottini, Gianluca Savarese, Federico Fortuni, Johny Helou, Cristina Tutarini, Elisa Quintavalle, Federico Crusco, Francesco Marchetti, Maurizio Scarpignato
An asymptomatic healthy 34 year-old man was occasionally diagnosed with a complete atrioventricular block, no complex ventricular arrhythmias were found on 24-hour Holter ECG recording. Echocardiography as well as cardiac magnetic resonance (CMR) were normal. A chest X-ray showed bilateral pulmonary consolidations and interstitial thickening. A chest computed tomography (CT) showed typical finding of sarcoidosis: multiple subpleuric micronodules, ground-glass opacities and perilymphatic irregular nodular thickening. Excisional supraclavicular lymph node biopsy found noncaseating granulomas confirming the suspected diagnosis. A fluorodeoxyglucose (FDG) positron emission tomography (PET) detected systemic localization of granulomas (Figure 1(A)) and particularly FDG cardiac uptake within the heart (Figure 1(B)). After few weeks of corticosteroid therapy, the AV conduction normalized and a new FDG-PET showed only few lung uptake persistence (Figure 1(C)) without cardiac uptake (Figure 1(D)). To monitor cardiac rhythm, an implantable loop recorder (ILR) was implanted.
Left ventricular long-axis ultrasound strain (GLS) is an ideal indicator for patients with anti-hypertension treatment
Published in Clinical and Experimental Hypertension, 2022
Tingting Wu, Lulu Zheng, Saidan Zhang, Lan Duan, Jing Ma, Lihuang Zha, Lingfang Li
The Research Ethics Committee of the Xiangya Hospital of Central South University had approved this study. All participating members had carefully read and signed informed consent. All enrolled members were divided into three groups, including 1) hypertensive treatment experimental group: 56 patients with newly diagnosed essential hypertension were followed up. 3) Healthy control group: 37 normal volunteers from the physical examination center were collected. The inclusion criteria are as follows: 1) Newly diagnosed essential hypertension. The diagnostic criteria included not taking antihypertensive drugs, measuring blood pressure three times on a different day, systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg (14); 2) 2) Patients with the previous diagnosis of hypertension and poor blood pressure control. After taking antihypertensive drugs, blood pressure was measured three times on a different day. The systolic blood pressure ≥140 mmHg and/or diastolic blood pressure≥90 mmHg. Moreover, exclusion criteria were as follows: 1) Patients have diagnosed as coronary heart disease; 2) Patients with various types of valvular heart disease; 3) Patients with various types of cardiomyopathy; 4) Patients with atrial fibrillation and atrial flutter; 5) Patients were previously diagnosed with primary and secondary pulmonary hypertension; 6) Patients with secondary hypertension; 7) LVEF <50% of patients with hypertension; 8) Patients with diabetes; 9) Patients with atrioventricular block of
Cardiac arrhythmias associated with COVID-19 infection: state of the art review
Published in Expert Review of Cardiovascular Therapy, 2021
Marwan Mohammad, Mustafa Emin, Ayat Bhutta, Essa H. Gul, Elijah Voorhees, Muhammad R. Afzal
A retrospective observational cohort study of 756 patients in New York found increased mortality with a right bundle branch block or wave inversion (OR 3.49, 95% CI 1.56–7.80, P = 0.002), also with an intraventricular conduction block (OR 2.61, 95% CI 1.32–5.18, P = 0.002). Atrioventricular block was prevalent in 2.6% of patients, 2.5% of them had a first-degree block, and 0.1% of them had sinus rhythm with complete heart block and a junctional escape rhythm. Aberrant intraventricular conduction was found in 11.8% of patients, with the right bundle branch block being in 7.8% of them, the left bundle branch block in 1.5% of them, and the nonspecific intraventricular conduction block in 2.5%[29]. A retrospective cross-sectional multicentric study with 431 patients found that 9% had incomplete RBBB and 11% had complete RBBB. Complete RBBB was more common with patients older than 74 years (16% vs. 8%, P = 0.007). Also, left anterior hemiblock was more common with patients older than 74 years (11% vs. 4%, P = 0.01)[33]. A cohort study performed with 3011 patients found that arrhythmia and conduction disorders occurred in 8.6% of patients[35]. A retrospective observational cohort study of 1053 patients found that atrioventricular block was in 0.4% of the patients[24].