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Pericardial effusion secondary to epicardial undifferentiated pleomorphic sarcoma in a young cat.

CASE SUMMARY: A 6.4 kg 3-year-old male neutered indoor-outdoor domestic shorthair cat was referred for further evaluation of non-resolving lethargy and hyporexia of 4 days' duration. Physical examination identified tachypnea with mild respiratory effort and muffled lung sounds bilaterally. Point-of-care ultrasound revealed a large volume of pleural and pericardial effusion (PCE), which was confirmed by thoracic radiography. Echocardiogram indicated normal cardiac function but revealed a mass-like structure along the left epicardium within the pericardial space. After 72 hours in hospital, re-e

Unveiling the unseen: navigating heart involvement in amyloidosis with biomarkers beyond the horizons of imaging.

Amyloidosis refers to a heterogenous group of systemic diseases characterized by the presence of a misfolded protein that deposits as amyloid fibrils in the interstitium of organs and tissues. The vast majority of cases of cardiac involvement (cardiac amyloidosis-CA) are due to immunoglobulin light chain (AL) amyloidosis, or transthyretin (ATTR) amyloidosis (either in its wild-type form-ATTRwt, or variant-ATTRv). The diagnostic workup of these diseases reflects the differences in terms of aetiology. Although imaging techniques represent fundamental tools in the diagnosis and follow-up of patie

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… Therefore, in AL-CA both the cardiologist and the haematologist must be aware of both the respective response criteria, in order to properly tailor and taper their therapies in the single patient. … Different backgrounds and expertise (cardiologists more confident with ATTR amyloidosis, haematologists with AL amyloidosis) may in part justify this. …

Prognosis After Withdrawal of Cardioprotective Therapy in Patients With Improved Cancer Therapeutics-Related Cardiac Dysfunction.

BackgroundThe long-term prognosis after the discontinuation of cardioprotective therapy (CPT) in patients with cancer therapeutics-related cardiac dysfunction (CTRCD) that has shown improvement remains unclear.ObjectivesThis study aims to assess the prognosis after CPT withdrawal in patients exhibiting improved CTRCD.MethodsIn this retrospective analysis of a single-center prospective cohort study, patients with improved CTRCD, defined as an increase in left ventricular ejection fraction (LVEF) ≥10 percentage points from the time of CTRCD diagnosis, were included. We analyzed their clinical ou

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… These examinations were performed by 3 experienced sonographers and 2 cardiologists. … Two cardiologists, completely independent from the conception, design, patient enrollment, and data handling of this study, reviewed hospitalization records for each patient. …

Cardiac Amyloid for the Internist.

Cardiac amyloid is an uncommon cause of diastolic dysfunction the recognition of which requires the internist to have clinical suspicion to guide diagnosis and treatment. Cardiac amyloid is an infiltrative cardiomyopathy with significant morbidity and mortality. Appropriate diagnosis is important because management of cardiac amyloid differs from typical heart failure with preserved ejection fraction. An astute internist must be able to recognize common findings of cardiac amyloidosis. Here we present a case of a patient presenting with diastolic heart failure and the steps leading towards dia

Multidisciplinary collaborative guidance on the assessment and treatment of patients with Long COVID: A compendium statement.

BACKGROUND: In 2021, the American Academy of Physical Medicine and Rehabilitation established the Multi-Disciplinary Post-Acute Sequelae of … ultidisciplinary group whose members include physiatrists, primary care physicians, pulmonologists, cardiologists, psychiatrists, neuropsychologists, neurologists, occupational therapists, physical therapists, speech and language pathologists, patients, and government representatives. Over 40 Long COVID centers are represented in the collaborative. RESULTS: Lo …

3rd-Degree Atrioventricular Block.

AUDIENCE: This oral boards case is appropriate for emergency medicine residents and medical students on emergency medicine rotations. INTRODUCTION/BACKGROUND: Third-degree heart block (also known as complete heart block) is a cardiovascular emergency that requires prompt recognition. Complete heart block is a type of atrioventricular (AV) block whereby no atrial impulses reach the ventricular conduction system. The most common etiology of AV block is ischemic heart disease, with up to 1 in 5 patients developing some type of conduction disturbance after an MI.1 Complete heart block is seen in

Cardiopulmonary Exercise Testing in Aortic Stenosis.

UNLABELLED: Patients with moderate to severe aortic stenosis (AVA <1.3 cm2) who were judged, by a referring cardiologist, as asymptomatic or equivocal symptomatic from the aortic stenosis were included in the study. Patients with left ventricular ejection fraction <50% were not included. Twenty-nine percent of the referred patients were judged asymptomatic and 71% equivocal symptomatic from their valve disease. The mean age was 72 years and 90% of the patients had an AVA-index <0.6 cm2/m2. By clinical evaluation in the outpatient clinic, 48% were judged as having functional limitation correspo

[Cardiovascular risk stratification. Systolic, diastolic or pulse pressure?].

It is well known that hypertension is a highly prevalent condition in the population, carries a significant risk of adverse cardiovascular e … ich in the spirit of "operativeness" of the Area Prevenzione of the Italian Association of Hospital Cardiologists, follow the objective of bringing together scientific and managerial needs.

Multidisciplinary Approach to Older Adults with Hematologic Malignancies-a Paradigm Shift.

Hematologic malignancies are most likely to present in the seventh and eighth decades of life. Continued population growth will lead to increasing numbers of older adults with hematologic malignancies. Oncology care for older adults is complex and must account for the effect of aging on disease biology and treatment tolerance. Multidisciplinary oncology care has been utilized in solid tumor oncology for decades, initially driven by the need for multi-modality treatment. In this review, we make the case for multidisciplinary oncogeriatric care for older adults with hematologic malignancies in o

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… Our CAC team is comprised of nephrologists, neurologists, cardiologists, hematologists, and physical therapists. The CAC runs biweekly with up to six patients scheduled on a half-day clinic. … The importance of early recognition and management of these patients in a multidisciplinary setting including an experienced hematologist, a cardiologist, and a genetic counselor that can identify patients with co-occurring germline mutations and counsel family members appropriately has led to investment …

Intraoperative transit time flow measurements during off-pump coronary artery bypass surgery: The impact of coronary stenosis on competitive flow.

BackgroundCombining preoperative angiography findings with intraoperative transit time flow measurements (TTFM) may improve patency of coronary artery bypass grafts. Nevertheless, graft flow might be impaired by native coronary flow based on the severity of stenoses, with inferior long-term outcomes. This study investigates the impact of left anterior descending artery (LAD) stenosis on competitive flow measured in left internal mammary artery (LIMA) grafts during off-pump coronary artery bypass grafting.MethodsFifty patients were included in this prospective single-center cohort study. LAD st

Сфингосин-1-Фосфатные модуляторы для лечения ультразвукового колита: обзор наррации, сосредоточенный на безопасности.

Ульцеративный колит представляет собой хроническое иммуносодержащее воспалительное заболевание толстой кишки, которое вызывает значительную заболеваемость и повышает риск рака цвета. Был разработан ряд целевых методов лечения умеренно-сильного язвительного колита, что значительно улучшило его лечение. Озанимод и этирасимод, пероральные небольшие молекулярные препараты, являются последним дополнением. Они относятся к классу модуляторов сфингосин-1-фосфатного рецептора (S1PR) и являются первыми членами этого класса, получившими официальное утверждение на наличие язвительного колита. Они действую

Characteristics of patients with newly diagnosed hematological malignancies referred for echocardiography.

ObjectiveThe importance of cardio-hemato-oncology programs is increasing. The main aim of the study was to identify all coexisting cardiovascular disorders in patients with new hematological malignancies referred for echocardiography during baseline evaluation before anticancer therapy.Material and methodsThe study was based on 900 echocardiographic examinations performed within 12 months at the Institute of Hematology and Transfusion Medicine in Poland: 669 tests (74.3%) were dedicated to hemato-oncology patients at the different stages of cancer therapy, however almost a third of the tests (

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… The authors tried to prove that the permanent employment of cardiologists in a leading hematology center in the country has a deep justification. … The study analyses the experience of cardiologists gained by them in the period of 12 months before the publication of the first European guidelines on cardio-oncology. …

Current Therapies and Future Horizons in Cardiac Amyloidosis Treatment.

Purpose of reviewCardiac amyloidosis (CA) is a condition characterized by misfolding and extracellular deposition of proteins, leading to organ dysfunction. While numerous forms of CA exist, two subtypes dominate clinical prevalence: Transthyretin amyloid (ATTR) and immunoglobulin light chain amyloid.Recent findingsThe current scientific landscape reflects the urgency to advance therapeutic interventions with over 100 ongoing clinical trials. Heart failure treatment is affected by CA phenotype with poor tolerance of otherwise frequently used medications. Treating comorbidities including atrial

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… The increasing recognition of the disease by cardiologists and scientific progress has led to a great dynamic in the development of innovative therapeutic approaches. This article summarizes the current state of science and the outlook for therapies for CA. … Best Practices in Specialized Amyloidosis Centers in the United States: A Survey of Cardiologists, Nurses, Patients, and Patient Advocates. Clinical Medicine Insights. …

Ventricular Arrhythmia in Cancer Patients: Mechanisms, Treatment Strategies and Future Avenues.

Cardiovascular disease and cancer are the leading causes of morbidity and mortality in the US. Despite the significant progress made in cancer treatment leading to improved prognosis and survival, ventricular arrhythmias (VA) remain a known cardiovascular complication either exacerbated or induced by the direct and indirect effects of both traditional and novel cancer treatments. Although interruption of cancer treatment because of VA is rarely required, knowledge surrounding this issue is essential for optimising the overall care of patients with cancer. The mechanisms of cancer-therapeutic-i

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… A universal consensus nomenclature, definitions and protocols agreed upon by both oncologists and cardiologists are urgently needed. This framework will help to establish and thereafter uniformly analyse real-world dynamic arrhythmia registries. … It is important for cardiologists to be aware of the association of individual chemotherapeutic agents with ventricular conduction/repolarisation abnormalities and arrhythmias to identify drug-mediated arrhythmias early and treat them effectively. References 1. …

Temporal trends in disease-specific causes of cardiovascular mortality amongst patients with cancer in the USA between 1999 and 2019.

AimsWe report disease-specific cardiovascular causes of mortality among cancer patients in the USA between 1999 and 2019, considering temporal trends by age, sex, and cancer site.Methods and resultsWe used the Multiple Cause of Death database, accessed through the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research resource. We included 629 308 decedents with cardiovascular disease (CVD) recorded as the primary cause of death and active malignancy listed as a contributing cause of death. We created disease-specific CVD categories and grouped cancers b

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… Given the rising number of cancer survivors and the huge prognostic implications of cardiovascular disease in this cohort, the cardiovascular care of cancer patients is transitioning from an area with a dedicated specialist focus to having growing relevance to the general cardiologist. … Indeed, cardiologists across all subspecialties will increasingly encounter cancer survivors with cardiovascular disease and understanding the patterns and risk profiles of such patients is highly important for appropriate treatment decisions. …

Carfilzomib in multiple myeloma: unraveling cardiac toxicities - from mechanisms to diagnosis and management.

The survival rates of patients with hematological malignancies such as multiple myeloma have improved with advances in cancer treatment. However, the risk of cardiovascular disease associated with novel therapeutic agents, including proteasome inhibitors (PIs), is becoming increasingly evident. PIs act on proteasome peptidases, leading to cell cycle arrest or apoptosis. Carfilzomib (CFZ), an intravenously administered irreversible PI, exhibits pronounced cardiovascular toxicity that is characterized by heart failure, hypertension, arrhythmia, and ischemic heart disease (IHD). This review focus

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… CFZ should be initiated carefully in patients with established heart failure and administered in conjunction with Guideline-Directed Medical Therapy as recommended by their cardiologists. … The decision to continue or restart CFZ therapy should be made collaboratively by the hematologist and cardiologist by factoring in the patient’s clinical status and carefully weighing the risks and benefits of continuing treatment to minimize cardiac dysfunction ( Bringhen et al., 2019 ; Lyon et al. …

Inequity in Cardio-Oncology: Identifying Disparities in Cardiotoxicity and Links to Cardiac and Cancer Outcomes.

Minority and underresourced communities experience disproportionately high rates of fatal cancer and cardiovascular disease. The intersection of these disparities within the multidisciplinary field of cardio-oncology is in critical need of examination, given the risk of perpetuating health inequities in the growing vulnerable population of patients with cancer and cardiovascular disease. This review identifies 13 cohort studies and 2 meta-analyses investigating disparate outcomes in treatment-associated cardiotoxicity and situates these data within the context of oncologic disparities, preexis

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… Overview of Cancer Disparities It is important for even the general cardiologist to understand basic cancer disparities together with cardiovascular ones given that most patients with cancer are more likely to have access to a general cardiologist than a cardio‐oncology specialist. … In areas where cardio‐oncology providers are not available, general cardiologists should assume the collaborative role with a patient’s oncology team. …

Guía de práctica clínica mexicana para el diagnóstico y tratamiento de las dislipidemias y enfermedad cardiovascular aterosclerótica.

ANTECEDENTES: Las enfermedades cardiovasculares son la principal causa mundial de mortalidad y México no es la excepción. Los datos epidemio … collaboration with the Mexican Society of Nutrition and Endocrinology, AC, National Association of Cardiologists of Mexico, AC, Mexican Association for the Prevention of Atherosclerosis and its Complications, AC, National Normative Committee of General Medicine, AC, National College of Geriatric Medicine, AC, College of Internal Medicine of Mexico, AC, Mexican …

The Amyloidosis Forum: a public private partnership to advance drug development in AL amyloidosis.

BACKGROUND: Immunoglobulin light chain (AL) amyloidosis is a rare, multi-systemic disorder characterized by two disease processes: an underlying plasma cell dyscrasia that provides the source of pathologic light chains, and the resulting organ dysfunction caused by deposition of amyloid light chain fibrils. There are no FDA approved treatments for AL amyloidosis; regimens developed for multiple myeloma are used off-label to treat the plasma cell disorder and no therapies are directed at organ deposition. Thus, an unmet medical need persists despite advances in disease management. A public-priv

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… The most common early symptoms are non-specific and include dyspnea, fatigue/weakness, palpitations, numbness, pain, altered bowl habits, and edema (Fig. 2 a) leading most patients to be initially referred to cardiologists [ 4 ]. … The diagnosis of AL amyloidosis was most commonly obtained from hematologist/oncologists (34.1%), followed by nephrologists (22.6%) and cardiologists (18.7%) [ 4 ]. New approaches are needed to identify AL patients earlier. …

Incidence and survival of transthyretin amyloid cardiomyopathy from a French nationwide study of in- and out-patient databases.

BACKGROUND: Precise data about ATTR-CM incidence rates at national level are scarce. Consequently, this study aimed to estimate the annual incidence and survival of transthyretin amyloid cardiomyopathy (ATTR-CM) in France between 2011 and 2019 using real world data. We used the French nationwide exhaustive data (SNDS database) gathering in- and out-patient claims. As there is no specific ICD-10 marker code for ATTR-CM, diagnosis required both amyloidosis (identified by E85. ICD-10 code or a tafamidis meglumine delivery) and a cardiovascular condition (identified by ICD-10 or medical procedure