SC - Artigos publicados em revistas indexadas na Medline
Permanent URI for this collection
Browse
Browsing SC - Artigos publicados em revistas indexadas na Medline by Issue Date
Now showing 1 - 10 of 18
Results Per Page
Sort Options
- Associação de Arco Aórtico Cervical a Delecção 22q11 – Papel da RMN no DiagnósticoPublication . Almeida, R.; Álvares, S.; Fortuma, A.; Moreira, J.; Vieira, A.As anomalias do arco aórtico são relativamente comuns, ocorrendo em 0,5-3% da população, tendo recentemente sido reconhecidas como fazendo parte do espectro de anomalias cardiovasculares associadas à delecção do cromossoma 22q11. Actualmente a RMN surge como mais um método disponível para o seu diagnóstico, pois permite definir com precisão a anatomia vascular (nomeadamente da aorta) e as suas relações com a traqueia e esófago, obviando as limitações da ecocardiografia convencional de superfície e evitando algumas das desvantagens da angiografia convencional, nomeadamente o uso de radiação ionizante e de contraste iodado. Apresentam-se dois casos de arco aórtico cervical e CIV associados ao síndrome de DiGeorge (CATCH22 +), em cujos diagnósticos foram utilizadas a angiografia convencional e a angioressonância, respectivamente.Aortic arch anomalies are relatively common, occurring in 0.5-3% of the population. In recent years, they have been recognized as being among the cardiovascular malformations found in chromosome 22q11 deletion. MRI is now an alternative method of diagnosing aortic arch anomalies since it accurately defines aortic anatomy and its relation with the trachea and esophagus, with some advantages in comparison with echocardiography and conventional angiography. The authors present two cases of cervical aortic arch and VSD associated with DiGeorge syndrome (CATCH22 +), diagnosed by conventional angiography and magnetic resonance imaging, respectively.
- Successful management of Listeria monocytogenes pericarditis: case report and review of the literature.Publication . Dias, V.; Cabral, S.; Anjo, D.; Vieira, M.; Antunes, N.; Carvalheiras, G.; Gomes, C.; Meireles, A.; Mendonça, T.; Torres, S.Listeria monocytogenes, although an uncommon cause of illness in the general population, is feared principally because of the morbidity and mortality associated with CNS infections. Cardiovascular involvement with L. monocytogenes is very rare, and has been limited to endocarditis. We describe a case of Listeria pericarditis, which occurred in a 60-year-old man with Child-Pugh B cirrhosis who presented to the emergency department with asthenia, anorexia, and respiratory distress. The echocardiogram showed severe pericardial effusion and after pericardiocentesis, L. monocytogenes was isolated in the culture of pericardial fluid. After surgical pericardiectomy with draining of the pericardial effusion and antibiotic treatment with ampicillin, the patient experienced a slow, but full recovery. Documentation of L. monocytogenes pericarditis is an extremely rare entity with very scarce reports in medical literature, and is usually associated with a very poor prognosis. A case report is presented together with a review of the literature.
- Recurrent orthodeoxia and patent foramen ovale.Publication . Magalhães, L.; Pinto, R.; Oliveira, J.; Oliveira, F.; Reis, E.Introdução: Foramen ovale patente (FOP) ocorre em até 25% dos adultos saudáveis. Pode favorecer embolização paradoxal, enxaqueca e insuficiência respiratória (IR). Apresenta-se caso de IR e ortodeoxia por shunt direito-esquerdo via FOP sem evidência prévia de aumento da pressão intra-auricular direita. Encerramento do FOP resolveu eficazmente IR. Caso clínico: Homem, 52 anos. Mieloma múltiplo IgA/k diagnosticado um ano antes. Internado por IR hipoxémica grave com ortodeoxia e má resposta à oxigenoterapia, após colocação de cateter venoso central (CVC) na subclávia direita. Referia parestesias e alterações visuais inespecíficas, após manipulações do CVC. Características da IR sugeriam shunt entre circulação pulmonar e sistémica. Sem evidência clínica ou imagiológica de shunt intra-pulmonar. Ecocardiograma transtorácico com contraste: shunt direito- -esquerdo. Ecocardiograma transesofágico: FOP. Cateterismo cardíaco (após resolução espontânea da IR): sem shunt. Uma semana depois recorreu IR grave, que resolveu (bem como queixas neurológicas) com encerramento do FOP. Discussão: IR por shunt intra-cardíaco sem aumento da pressão nas cavidades direitas é de difícil interpretação hemodinâmica. Raros relatos (em adultos) associam esta entidade a anomalias anatómicas, que favorecerão shunt por orientação preferencial do fluxo sanguíneo para o FOP. São exemplos parésia diafragmática direita e ectasia da aorta ascendente, identificadas no doente apresentado. O papel do CVC, colocado imediatamente antes da IR, é especulativo. O completo sucesso terapêutico após encerramento do FOP apoia o diagnóstico. Conclusão: Avaliar correctamente IR (pesquisar ortodeoxia e resposta à oxigenoterapia) permite suspeitar de shunt, que se diagnostica utilizando meios acessíveis, seguros e rentáveis. Shunt intra-cardíaco sem aumento da pressão à direita deve ser considerado porque tem tratamento eficaz. Background: Patent foramen ovale (PFO) occurs in 25% of healthy adults. It can lead to paradoxical embolization, migraine and respiratory failure (RF). The authors present a case of RF and orthodeoxia due to a rightto- left shunt via a PFO without previous elevation of right atrial pressure. Closure of the PFO effectively resolved the RF. Case report: A 52-year-old man, with IgA-k multiple myeloma diagnosed one year before, was admitted for severe hypoxemic RF, with orthodeoxia and poor response to oxygen supplementation, after placement of a central venous catheter (CVC) in the right subclavian vein. The patient reported paresthesia and nonspecific visual changes after manipulation of the CVC. The RF suggested a shunt between the pulmonary and systemic circulations. There was no clinical or radiological evidence of an intrapulmonary shunt. Contrast echocardiography showed a right-to-left shunt and transesophageal echocardiography revealed a PFO. Cardiac catheterization, after spontaneous resolution of the RF, showed no shunt. A week later, severe RF recurred. Complete resolution of respiratory dysfunction and neurological symptoms was seen after PFO closure. Discussion: RF due to an intracardiac shunt without increased right-sided pressure is hemodynamically difficult to interpret. A few reports (in adults) relate this entity to anatomical anomalies, which can lead to a shunt by directing blood flow preferentially to the PFO. Examples include right diaphragmatic paresis and ectasia of the ascending aorta, which were observed in this patient. The role of the CVC, which was placed immediately before the RF, is uncertain. Complete therapeutic success after closure of the PFO supports the diagnosis. Conclusion: Correct evaluation of RF (by investigating orthodeoxia and response to oxygen therapy) enables the suspicion of a shunt, which can be confirmed through simple, safe and cost-effective exams. Intracardiac shunt without increased rightsided pressure should be considered because it can be successfully treatment.
- Assessment of left ventricular diastolic function with cardiovascular MRI: what radiologists should knowPublication . Duarte, R.; Fernadez-Perez, G.; Bettencourt, N.; Sampaio, F.; Miranda, D.; França, M.; Portugal, P.Abstract Diastolic dysfunction is a common entity and the predominant cause of heart failure in 40%-50% of patients. Diagnosis of diastolic dysfunction is clinically relevant and is associated with a poor prognosis. The aim of this essay was to review the pathophysiology and different grades of diastolic dysfunction and to provide an overview on the role of cardiovascular magnetic resonance imaging in the assessment of diastolic function.
- Pulmonary embolism with thromboembolus in transitPublication . Silva-Vieira, M.; Anjo, D.; Antunes, N.; Cyrne-Carvalho, H.; Torres, S.
- Stent Thrombosis Eight Years Past Drug-Eluting Stent Placement – A Case ReportPublication . Baptista, A.; Ferreira, C.; Mateus, P.; Cyrne-Carvalho, H.; Moreira, I.
- Triple, simultaneous, very late coronary stent thrombosisPublication . Silva-Vieira, M.; Luz, A.; Anjo, D.; Antunes, N.; Santos, M.; Cyrne-Carvalho, H.; Torres, S.Abstract Coronary artery stent thrombosis is an uncommon but potentially catastrophic complication. The risk of very late stent thrombosis (VLST) raises important safety issues regarding the first generation of drug-eluting stents (DES). Although several complex mechanisms for VLST have been suggested and various predictors have been described, its pathophysiology is not completely understood and it is not known whether longer-term dual antiplatelet therapy reduces the risk. We present a rare case of simultaneous very late DES thrombosis in the three vascular territories, following discontinuation of antiplatelet therapy seven years after stent placement, presenting as cardiogenic shock.
- Coronary artery fistula presenting as unstable anginaPublication . Silva-Vieira, M.; Antunes, M.; Anjo, D.; Palma, P.; Cyrne-Carvalho, H.; Torres, S.
- Psoríase e Doença CardiovascularPublication . Torres, T.; Sales, R.; Vasconcelos, C.; Selores, M.A psoríase é uma doença inflamatória sistémica crónica, frequente, associada a várias comorbilidades, destacando-se a obesidade, a hipertensão arterial, a diabetes, a dislipidemia e síndrome metabólico. Adicionalmente associa-se também a aumento do risco de doença cardiovascular – enfarte agudo do miocárdio e acidente vascular cerebral. A inflamação sistémica crónica presente na psoríase tem sido sugerida como um factor de risco independente para estas comorbilidades e para o aparecimento de aterosclerose precoce. Esta revisão das várias comorbilidades cardio-metabólicas e do risco de doença cardiovascular associado à psoríase tem como objectivopromover o conhecimento e alertar os clínicos para a necessidade de rastreio, monitorização e tratamento dos factores de risco de doença cardiovascular nestes doentes.
- Position statement on bioresorbable vascular scaffolds in PortugalPublication . Teles, R.; Pereira, H.; Cyrne-Carvalho, H.; Patrício, L.; Santos, R.; Baptista, J.; Pipa, J.; Farto-Abreu, P.; Faria, H.; Ramos, S.; Gama-Ribeiro, V.; Martins, D.; Almeida, M.BACKGROUND: Bioresorbable vascular scaffolds (BVS) were recently approved for percutaneous coronary intervention in Europe. The aim of this position statement is to review the information and studies on available BVS, to stimulate discussion on their use and to propose guidelines for this treatment option in Portugal. METHODS AND RESULTS: A working group was set up to reach a consensus based on current evidence, discussion of clinical case models and individual experience. The evidence suggests that currently available BVS can produce physiological and clinical improvements in selected patients. There are encouraging data on their durability and long-term safety. Initial indications were grouped into three categories: (a) consensual and appropriate - young patients, diabetic patients, left anterior descending artery, long lesions, diffuse disease, and hybrid strategy; (b) less consensual but possible - small collateral branches, stabilized acute coronary syndromes; and (c) inappropriate - left main disease, tortuosity, severe calcification. CONCLUSION: BVS are a viable treatment option based on the encouraging evidence of their applicability and physiological and clinical results. They should be used in appropriate indications and will require technical adaptations. Outcome monitoring and evaluation is essential to avoid inappropriate use. It is recommended that medical societies produce clinical guidelines based on high-quality registries as soon as possible.