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Résumé: Le coronavirus disease 2019 (Covid-19) est une maladie infectieuse secondaire au severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Le lien entre les maladies cardiovasculaires et l'infection par SARS-CoV2 entraînant le Covid semble double. Tout d'abord, les patients présentant des facteurs de risque cardiovasculaire ou des pathologies cardiovasculaires préexistantes seraient plus à risque de développer des formes graves de l'infection par Covid-19. De plus, l'infection par SARS-CoV2 peut se compliquer de lésions cardiovasculaires potentiellement mortelles, et dont les séquelles cardiorespiratoires à moyen terme demeurent inconnues. Malgré l'évolution rapide des données sur cette pandémie, cet article a pour objectif de résumer les liens entre Covid-19 et les pathologies cardiovasculaires que ce soit en tant que comorbidités incluant le questionnement de la place des bloqueurs du système rénine angiotensine ou que ce soit lié aux complications cardiovasculaires aiguës. The coronavirus disease-2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2. The link between cardiovascular disease and COVID-19 appears to be twofold. First, some reports of data indicate that certain groups of patients are more at risk of COVID-19. This includes patients with cardiovascular risk factors or pre-existing cardiovascular conditions and older patients. In addition, these patients incur disproportionately worse outcome. Second, SARS-CoV2 infection can be complicated by life-threatening cardiovascular acute diseases. Despite the rapid evolution of data on this pandemic, this review aims to highlight the cardiovascular considerations related to COVID-19 whether as comorbidities including concerns and uncertainty regarding the effect of renin–angiotensin-aldosterone system (RAAS) inhibitors on angiotensin conversion enzyme 2 or related to acute cardiovascular complications. [ABSTRACT FROM AUTHOR]

Type 2 MI is a category of myocardial infarction according to the UDMI, frequently encountered in routine practice but still poorly understood in terms of prevalence, diagnostic and therapeutic approach, it affects a heterogeneous population at high risk of major cardiovascular events and non-cardiac death. It is due to an inadequacy between oxygen supply and demand in the absence of a primary coronary event, e.g. coronary artery spasm, coronary embolism, anemia, arrhythmias, hypertension or hypotension. Diagnosis has traditionally required an integrated history assessment, with some combination of indirect evidence of myocardial necrosis based on biochemical, electrocardiographic, and imaging modalities. Differentiation between type 1 and type 2 MI is more complicated than it appears. Treatment of the underlying pathology is the primary goal of treatment., (Copyright © 2023 Elsevier Masson SAS. All rights reserved.)

Résumé: Introduction: L’hémorragie digestive constitue une urgence thérapeutique motivant le plus souvent une admission en réanimation. L’objectif de ce travail a été d’identifier les facteurs prédictifs de défaillance d’organes chez des patients admis en réanimation pour une hémorragie digestive. Type d’étude: Rétrospective et observationnelle Patients et méthodes: Entre janvier 2008 et décembre 2011, les patients admis dans notre unité de réanimation polyvalente pour hémorragie digestive ont été inclus. Le critère de jugement principal était la survenue d’au moins une défaillance d’organe. Une analyse univariée puis multivariée par régression logistique pas à pas descendante a été réalisée afin d’identifier les facteurs de risque indépendants associés à la survenue d’au moins une défaillance d’organe au cours de l’hospitalisation en réanimation. Résultats: Durant la période d’étude, 441 patients consécutifs d’un âge moyen de 67±15ans ont été inclus. Au cours du séjour en réanimation d’une durée médiane quatre (3–7) jours, 116 (26 % [IC95 % : 22–30]) patients ont présenté au moins une défaillance d’organe. L’analyse multivariée a identifié comme facteurs prédictifs indépendants de défaillance d’organe un antécédent de cirrhose (OR=3,5 [IC95 % : 1,9–6,7], p <0,001) et un taux de troponine supérieur à 99e percentile à l’arrivée (OR=3,1 [IC95 % : 1,8–5,5], p <0,001). Conclusion: Ces résultats confirment qu’un nombre non négligeable de patients hospitalisés en réanimation pour hémorragie digestive ne présente aucune défaillance viscérale. Le terrain cirrhotique et les conséquences systémiques du syndrome hémorragique comme la souffrance myocardique sont toutefois des facteurs de risque importants de morbi-mortalité à prendre en compte dans la prise en charge ultérieure du patient. [ABSTRACT FROM AUTHOR]

A 20-year-old patient is admitted to the emergency room for chest pain occurring in the context of recurrent left complete pneumothorax. Ultrasensitive troponinemia is elevated to 20 times normal. Myocardial distress is attributed to pneumothorax following the negativity of cardiological examinations (EKG, TTE, cardiac MRI). The pneumothorax is drained with a favorable evolution. This is the first reported case of pneumothorax associated with a significant elevation of troponin without ECG change, TakoTsubo syndrome, or myocardial inflammation. Several mechanisms are considered: rotation of the myocardium around its axis, increase in pulmonary vascular resistance with overload of right ventricular pressure, disturbance of coronary blood flow on significant mediastinal compression with decrease in systolo-diastolic myocardial perfusion., (Copyright © 2021 Elsevier Masson SAS. All rights reserved.)

Purpose. – Cardiac troponin I and troponin T have replaced creatine kinase MB (CK-MB) for the diagnosis of cardiomyocyte necrosis. Cardiac specificity of these new markers leads to a change in our practice.Current knowledge and key points. – Following necrosis, intracellular proteins are released into blood. This easy concept overlaps a biological complexity since troponins are released as complexes leading to various cut-off values depending on the assay used, as least for cardiac troponin I. The increase in both specificity and analytical sensitivity of these markers reached to propose a new definition of myocardial infarction. The diagnosis of acute coronary syndrome is a clinical based diagnosis, the use of troponin contributing to their classification. Finally, pathological processes leading to cardiac injury may induce an increase in the cardiac troponin level.Future prospects and projects. – Troponin standardization is a challenge for the near future leading to better follow-up of patients and comparison between cohorts. [Copyright &y& Elsevier]

The coronavirus disease-2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2. The link between cardiovascular disease and COVID-19 appears to be twofold. First, some reports of data indicate that certain groups of patients are more at risk of COVID-19. This includes patients with cardiovascular risk factors or pre-existing cardiovascular conditions and older patients. In addition, these patients incur disproportionately worse outcome. Second, SARS-CoV2 infection can be complicated by life-threatening cardiovascular acute diseases. Despite the rapid evolution of data on this pandemic, this review aims to highlight the cardiovascular considerations related to COVID-19 whether as comorbidities including concerns and uncertainty regarding the effect of renin-angiotensin-aldosterone system (RAAS) inhibitors on angiotensin conversion enzyme 2 or related to acute cardiovascular complications.

COVID-2019 disease mainly affects the respiratory tract and can progress in severe cases to pneumonia, acute respiratory distress syndrome and multi-organ failure. Patients with prior cardiovascular disease are at higher risk of developing an infection and progressing to a severe form of the disease. Also, due to the growing number of infected cases, it is clear that, in addition to the typical respiratory symptoms caused by the infection, some patients suffer from cardiovascular damage. This condition can, in fact, cause significant myocardial damage, which worsens the disease and affects the prognosis. Based on the results of currently published research, it seems important to discuss the manifestations and characteristics of myocardial damage induced by COVID-19 and its impact on patient prognosis.

Introduction: Gastrointestinal hemorrhage is an emergency requiring usually an admission in intensive care unit (ICU), which may prove abusive secondarily. The aim of this study was to identify predictive risk factors of organ failure in patients admitted for GH in our ICU., Design: Retrospective and observational, Methods and Measurements: Between January 2008 and December 2011, all patients admitted in our ICU for gastrointestinal hemorrhage were consecutively included. The primary endpoint was the occurrence of at least an organ failure. We realized an univariate analysis then a backward regression to identify independent risk factors associated with the occurrence of at least one organ failure during the ICU hospitalization., Results: During this period study, 441 consecutive patients with a mean age of 67±15years were included. The median ICU length of stay was of 4 (3-7) days and 116 (26% [IC95%: 22-30]) patients presented at least one organ failure. The multivariate analysis identified predictive risk factors of organ failure: history of cirrhosis (OR=3.5 [IC95%: 1.9-6.7], P<0.001) and an increase in troponin at the admission above the 99th percentile (OR=3.1 [IC95%: 1.8-5.5], P<0.001)., Conclusion: Our results confirmed that a large proportion of patients admitted in ICU for the primary diagnosis of gastrointestinal hemorrhage developed any organ failure. The history of cirrhosis and the systemic consequences of the hemorrhagic syndrome as myocardial damage represents important risk factors of morbidity and mortality and thus should be considered during the management., (Copyright © 2013 Société française d’anesthésie et de réanimation (Sfar). Published by Elsevier SAS. All rights reserved.)