scholarly journals Chagas Cardiomyopathy: From Romaña Sign to Heart Failure and Sudden Cardiac Death

Pathogens ◽  
2021 ◽  
Vol 10 (5) ◽  
pp. 505
Author(s):  
Antonia Pino-Marín ◽  
Germán José Medina-Rincón ◽  
Sebastian Gallo-Bernal ◽  
Alejandro Duran-Crane ◽  
Álvaro Ignacio Arango Duque ◽  
...  
Keyword(s):  
Sudden Cardiac Death ◽  
Cardiac Death ◽  
Molecular Mechanisms ◽  
Clinical Presentation ◽  
Clinical Manifestations ◽  
Treatment Strategies ◽  
Myocardial Damage ◽  
Western Hemisphere ◽  
Apparent Lack ◽  
Chagas Cardiomyopathy

Despite nearly a century of research and accounting for the highest disease burden of any parasitic disease in the Western Hemisphere, Chagas disease (CD) is still a challenging diagnosis, primarily due to its poor recognition outside of Latin America. Although initially considered endemic to Central and South America, globalization, urbanization, and increased migration have spread the disease worldwide in the last few years, making it a significant public health threat. The international medical community’s apparent lack of interest in this disease that was previously thought to be geographically restricted has delayed research on the complex host–parasite relationship that determines myocardial involvement and its differential behavior from other forms of cardiomyopathy, particularly regarding treatment strategies. Multiple cellular and molecular mechanisms that contribute to degenerative, inflammatory, and fibrotic myocardial responses have been identified and warrant further research to expand the therapeutic arsenal and impact the high burden attributed to CD. Altogether, cardiac dysautonomia, microvascular disturbances, parasite-mediated myocardial damage, and chronic immune-mediated injury are responsible for the disease’s clinical manifestations, ranging from asymptomatic disease to severe cardiac and gastrointestinal involvement. It is crucial for healthcare workers to better understand CD transmission and disease dynamics, including its behavior on both its acute and chronic phases, to make adequate and evidence-based decisions regarding the disease. This review aims to summarize the most recent information on the epidemiology, pathogenesis, clinical presentation, diagnosis, screening, and treatment of CD, emphasizing on Chagasic cardiomyopathy’s (Ch-CMP) clinical presentation and pathobiological mechanisms leading to sudden cardiac death.

scholarly journals Clinical Presentation, Diagnosis, and Management of Idiopathic Enlargement of the Right Atrium: An Analysis Based on Systematic Review of 153 Reported Cases

Cardiology ◽  
2020 ◽  
pp. 1-10
Author(s):  
Jing Zhang ◽  
Li Zhang ◽  
Lin He ◽  
He Li ◽  
Yuman Li ◽  
...  
Keyword(s):  
Sudden Cardiac Death ◽  
Surgical Resection ◽  
Right Atrium ◽  
Cardiac Death ◽  
Clinical Presentation ◽  
Clinical Manifestations ◽  
Diagnosis And Management ◽  
Presenting Symptoms ◽  
Life Threatening ◽  
The Right

Idiopathic enlargement of the right atrium (IERA) is a rare cardiac anomaly, and only sporadic cases have been reported. Little is known about its clinical relevance, and inconsistencies in medical and surgical management remain among different settings. In this paper, we systematically reviewed the published cases of the IERA in terms of clinical presentation, diagnosis, and management. A total of 153 cases of IERA were covered. Arrhythmia, dyspnea, and palpitation were found to be the most common clinical manifestations. It tends to be associated with life-threatening complications and sudden cardiac death. Diagnosis was mostly established by using echocardiography. Presenting symptoms, abnormal ECG findings, and therapeutic modalities were significantly related to the prognosis of IERA. Symptomatic patients were significantly more likely to have poor outcomes than asymptomatic patients (<i>p</i> = 0.044), and conservative treatment was more associated with adverse outcomes compared to surgical resection (<i>p</i> = 0.016). In conclusion, IERA, although rare, tends to be associated with potential life-threatening complications and sudden cardiac death. Echocardiography is the most common diagnostic modality. Surgical resection is indicated for symptomatic patients.

scholarly journals SUDDEN CARDIAC DEATH IN PATIENTS WITH DILATED CARDIOMYOPATHY

2014 ◽  
Vol 5 (4) ◽  
pp. 41-48
Author(s):  
D V Duplyakov ◽  
I V Kondratyeva ◽  
S V Garkina
Keyword(s):  
High Risk ◽  
Sudden Cardiac Death ◽  
Risk Stratification ◽  
Dilated Cardiomyopathy ◽  
Cardiac Death ◽  
Clinical Manifestations ◽  
Scientific Data ◽  
National Guidelines ◽  
Causative Factors ◽  
Definition Of

The review discusses accumulated to date scientific data on dilated cardiomyopathy: causative factors, clinical manifestations, sudden cardiac death in patients with the disease and its risk-stratification in the light of National guidelines on the definition of risk and prevention of sudden cardiac death (2012). A case of a patient with dilated cardiomyopathy and high-risk of sudden cardiac death is presented.

scholarly journals Hypertrophic cardiomyopathy: Translating cellular cross talk into therapeutics

2012 ◽  
Vol 199 (3) ◽  
pp. 417-421 ◽  
Author(s):  
Polakit Teekakirikul ◽  
Robert F. Padera ◽  
J.G. Seidman ◽  
Christine E. Seidman
Keyword(s):  
Heart Failure ◽  
Heart Disease ◽  
Hypertrophic Cardiomyopathy ◽  
Sudden Cardiac Death ◽  
Mouse Models ◽  
Clinical Diagnosis ◽  
Cardiac Death ◽  
Clinical Manifestations ◽  
Biochemical Properties ◽  
Adverse Outcomes

Hypertrophic cardiomyopathy (HCM) is a common inherited heart disease with serious adverse outcomes, including heart failure, arrhythmias, and sudden cardiac death. The discovery that mutations in sarcomere protein genes cause HCM has enabled the development of mouse models that recapitulate clinical manifestations of disease. Studies in these models have provided unexpected insights into the biophysical and biochemical properties of mutated contractile proteins and may help to improve clinical diagnosis and management of patients with HCM.

scholarly journals COVID-19: Characteristics and Therapeutics

Cells ◽  
2021 ◽  
Vol 10 (2) ◽  
pp. 206 ◽  
Author(s):  
Rameswari Chilamakuri ◽  
Saurabh Agarwal
Keyword(s):  
Molecular Mechanisms ◽  
Vaccine Development ◽  
Clinical Manifestations ◽  
Treatment Strategies ◽  
Drug Repurposing ◽  
World Health ◽  
Pharmacological Intervention ◽  
Multiple Treatment ◽  
The Usa ◽  
Novel Coronavirus

Novel coronavirus (COVID-19 or 2019-nCoV or SARS-CoV-2), which suddenly emerged in December 2019 is still haunting the entire human race and has affected not only the healthcare system but also the global socioeconomic balances. COVID-19 was quickly designated as a global pandemic by the World Health Organization as there have been about 98.0 million confirmed cases and about 2.0 million confirmed deaths, as of January 2021. Although, our understanding of COVID-19 has significantly increased since its outbreak, and multiple treatment approaches and pharmacological interventions have been tested or are currently under development to mitigate its risk-factors. Recently, some vaccine candidates showed around 95% clinical efficacy, and now receiving emergency use approvals in different countries. US FDA recently approved BNT162 and mRNA-1273 vaccines developed by Pfizer/BioNTech and Moderna Inc. for emergency use and vaccination in the USA. In this review, we present a succinct overview of the SARS-CoV-2 virus structure, molecular mechanisms of infection, COVID-19 epidemiology, diagnosis, and clinical manifestations. We also systematize different treatment strategies and clinical trials initiated after the pandemic outbreak, based on viral infection and replication mechanisms. Additionally, we reviewed the novel pharmacological intervention approaches and vaccine development strategies against COVID-19. We speculate that the current pandemic emergency will trigger detailed studies of coronaviruses, their mechanism of infection, development of systematic drug repurposing approaches, and novel drug discoveries for current and future pandemic outbreaks.

scholarly journals Sudden Cardiac Death due to Coronary Artery Vasculitis in a Patient with Relapsing Polychondritis

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Heather Bukiri ◽  
Steven M. Ruhoy ◽  
Jane H. Buckner
Keyword(s):  
Coronary Artery ◽  
Sudden Cardiac Death ◽  
Cardiac Disease ◽  
Cardiac Death ◽  
Plasma Cells ◽  
Clinical Manifestations ◽  
Relapsing Polychondritis ◽  
Tracheobronchial Tree ◽  
Systemic Autoimmune Disease ◽  
Igg4 Related Disease

Relapsing polychondritis (RP) is a systemic autoimmune disease characterized by relapsing and remitting inflammation of the cartilaginous structures of the ears, nose, tracheobronchial tree, and joints. Diagnosis is challenging due to the heterogeneity of clinical manifestations, the relapsing and remitting nature of the disease, the presence of coexistent diseases in at least one-third of patients, and the lack of a diagnostic blood test. Although RP-associated cardiac disease is the second most common cause of death behind tracheobronchial complications, coronary artery vasculitis is rare. This report describes a case of sudden cardiac death due to vasculitis affecting the coronary arteries in a patient with RP. The pathologic findings included obliterative coronary arteritis with plasma cells and storiform fibrosis, features suggesting that IgG4-related disease (IgG4-RD) may have contributed to the patient’s cardiac disease. The literature on vasculitis and cardiac disease in RP and the possible role of IgG4-RD in this setting is also reviewed. The primary take-home message from this case report is the importance of frequent screening for cardiac disease, regardless of symptoms, in patients with RP. In addition, considering the diagnosis of IgG4-RD in some cases thought to be RP may also be warranted.

scholarly journals Cardiomyopathy Associated With Tertiary Adrenal Insufficiency Manifesting as Refractory Heart Failure, Shock, and Sudden Cardiac Death: A Case Report

2021 ◽  
Vol 8 ◽  
Author(s):  
Xuefeng Wang ◽  
Yong Luo ◽  
Jian Feng
Keyword(s):  
Heart Failure ◽  
Sudden Cardiac Death ◽  
Dilated Cardiomyopathy ◽  
Adrenal Insufficiency ◽  
Cardiac Death ◽  
Clinical Manifestations ◽  
Underlying Disease ◽  
Pituitary Hormones ◽  
Idiopathic Dilated Cardiomyopathy ◽  
Cardiac Resynchronization

Dilated cardiomyopathy is an etiologically heterogeneous disorder. Early diagnosis and prompt treatment of the underlying disease are of great significance. Primary and secondary adrenal insufficiency are considered quite rare causes of dilated cardiomyopathy. However, to the best of our knowledge, no case of cardiomyopathy associated with tertiary adrenal insufficiency has been reported. Herein, we described a 68-year-old woman with a 15-year history of seasonal dermatitis presented with frequent heart failure and shock. At first, she was diagnosed with idiopathic dilated cardiomyopathy, but standard heart failure and antishock treatment failed. Given her long-term use of dexamethasone for treating seasonal dermatitis, and clinical manifestations consistent with adrenal insufficiency, we tested her basal plasma cortisol, simultaneous corticotropin, and other pituitary hormones, confirming that she had tertiary adrenal insufficiency. Additionally, abdominal enhanced computed tomography revealed atrophic bilateral adrenal glands, indicating long-standing and severe adrenal insufficiency. Then hydrocortisone replacement therapy was initiated, and she recovered rapidly. During the next 2 years of follow-up, she never experienced any episodes of heart failure and shock. Unfortunately, she refused the implantation of defibrillator with cardiac resynchronization therapy (CRT-D) and died of sudden cardiac death 2 years later. Although we could not exclude the coincidence of idiopathic dilated cardiomyopathy with tertiary adrenal insufficiency with 100% certainty, her unique clinical course strongly indicated that her cardiomyopathy resulted from tertiary adrenal insufficiency. This case demonstrates that patients on corticosteroids are at risk for tertiary adrenal insufficiency, which may result in refractory cardiomyopathy and even sudden cardiac death.

Hormone resistance syndromes

2018 ◽  
pp. 434-449
Author(s):  
Helen E. Turner ◽  
Richard Eastell ◽  
Ashley Grossman
Keyword(s):  
Thyroid Hormone ◽  
Molecular Mechanisms ◽  
Clinical Manifestations ◽  
Treatment Strategies ◽  
Glucocorticoid Resistance ◽  
Hormone Resistance ◽  
Androgen Insensitivity ◽  
Thyroid Receptor ◽  
Glucocorticoid Deficiency

This chapter discusses clinical features, epidemiology, and management/treatment strategies for resistance to hormones such as thyroid receptor alpha and beta resistance to thyroid hormone (TR-alpha RTH and TR-beta RTH, respectively). It also discusses androgen insensitivity, as in resistance to testosterone and dihydrotestosterone, which can result in complete, partial, and mild forms of androgen insensitivity. It describes Chrousos syndrome, which is a type of glucocorticoid resistance, and its clinical manifestations, molecular mechanisms, and clinical evaluation. The chapter also describes resistance to adrenocorticotrophin hormone, and the potentially resulting familial glucocorticoid deficiency (FGD) and triple A syndrome. It also discusses aldosterone resistance, describing potential manifestations such as generalized pseudohypoaldosteronism type 1 (PHA1) and renal PHA1.

Hypertrophic cardiomyopathy

2017 ◽  
Vol 27 (S1) ◽  
pp. S25-S30 ◽  
Author(s):  
Maully Shah
Keyword(s):  
Risk Factors ◽  
Heart Disease ◽  
Hypertrophic Cardiomyopathy ◽  
Sudden Cardiac Death ◽  
Cardiac Death ◽  
Clinical Presentation ◽  
Treatment Options ◽  
Athletic Participation ◽  
Complete Elimination ◽  
Clinical Events

AbstractHypertrophic cardiomyopathy is a common, inherited heart disease with a heterogeneous clinical presentation and natural history. Recently, advances in diagnosis and treatment options have been instrumental in decreasing the frequency of adverse clinical events; however, complete elimination of sudden cardiac death still remains an elusive gain. This article discusses several aspects of this condition in the young: epidemiology, clinical phenotypes, risk factors, prevention of sudden cardiac death, and risks of athletic participation.

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