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Copyright of Revista Española de Cardiología (18855857) is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Española de Cardiología (18855857) is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

BACKGROUND: Clinical manifestations in patients infected with coxsackievirus B are highly variable, with most cases being asymptomatic or mild, and fewer cases presenting with symptoms of severe disease. Multiorgan involvement associated with coxsackievirus B5 is very rare. CLINICAL CASE: A 20-year-old male patient admitted to the emergency department with jaundice, high fever, abdominal pain, and sepsis; initially treated as leptospirosis. His clinical status rapidly deteriorated to circulatory shock, pancreatitis, and acute renal failure with proteinuria. He subsequently developed acute respiratory failure, possibly due to cardiac failure secondary to viral myocarditis. He required vasoactive support, noninvasive mechanical ventilation, and admission to the intensive care unit. Coxsackie B5 virus was the most likely cause, diagnosed by IgM antibody titer nine days after admission. CONCLUSIONS: The reported case is rare because of multiorgan involvement by Coxsackie B5 virus, which is a common cause of myocarditis and pericarditis and other organ involvement. It is a multiorgan failure of unknown cause; viral infection should be suspected. Coxsackievirus has a wide clinical variability, ranging from asymptomatic infection to life-threatening disease requiring intensive supportive care to sustain life. [ABSTRACT FROM AUTHOR]

BACKGROUND: The appearance of the SARS-CoV-2 virus has generated a high rate of morbidity and mortality throughout the world, causing the COVID-19 pandemic. Since now it persists, the availability of vaccines has increased and there are few approved by the World Health Organization because of their quality, safety, and efficacy. These were created in order to prevent serious illness and hospitalization, essential to control the pandemic. Although erythema multiforme has been associated with different types of immunizations, there are very few reported cases as an adverse reaction to mRNA vaccines against COVID-19. CLINICAL CASE: A 31-year-old female patient with erythema multiforme and myocarditis secondary to the application of the second dose of the Pfizer vaccine against COVID-19, who presented a clinical picture of dyspnea, precordial pain and subsequent attack on general condition, unquantified fever, and rash. The diagnosis of these diseases was made with symptoms presented, as well as electrocardiogram and laboratory studies. The patient was treated with metoprolol and prednisone, achieving remission of the clinical picture. CONCLUSIONS: This is the first reported case of erythema multiforme and myocarditis as an adverse reaction to the vaccine, without history of these diseases. It is important to communicate the different adverse reactions to provide suitable information to patients and thus avoid rejection of vaccination. [ABSTRACT FROM AUTHOR]

Copyright of Medicina (Buenos Aires) is the property of Medicina (Buenos Aires) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

COVID-19 is an infectious disease caused by SARS-CoV-2 virus, which leads to a severe acute respiratory syndrome. SARS-CoV-2 infection has had a catastrophic impact globally, resulting in more than 6 million deaths worldwide. Viral myocarditis has proven to be a major complication of COVID-19, with distinct inflammatory characteristics, which makes it unique compared to other viral etiologies. Although the incidence of myocarditis caused by COVID-19 is not yet well understood, it has been demonstrated that the risk of viral myocarditis increases directly with the severity of the SARS-CoV-2 infection. We are presenting the case of a 33-year-old patient with no known personal medical history prior to the development of SARS-CoV-2 infection, who developed viral myocarditis. In context of myocarditis, severe aortic stenosis was detected, which had developed on a pre-existing bicuspid aortic valve. [ABSTRACT FROM AUTHOR]

BACKGRAUND: Enterovirus infections in neonates can present as very severe manifestations with high mortality, such as hepatitis with coagulopathy, meningoencephalitis, or myocarditis. CASE PRESENTATION: We present the case of a 4-day-old neonate who presented a severe enterovirus infection. The mother had presented peripartum fever. He initially developed hepatitis with coagulopathy and thrombocytopenia that required several transfusions of blood products. After resolution, myocarditis developed that required inotropic support. The evolution was favourable. CONCLUSION: This clinical case suggests that those neonates with severe early enterovirus infection may develop subsequent myocarditis and should therefore be monitored after resolution of the infection. [ABSTRACT FROM AUTHOR]

Copyright of Revista Española de Cardiología (18855857) is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Médica de Risaralda is the property of Universidad Tecnologica de Pereira and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Alerta (San Salvador) - Revista Cientifica del Instituto Nacional de Salud is the property of Instituto Nacional de Salud and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introducción: Las enfermedades cardiovasculares son la principal causa de muerte en el mundo, y las enfermedades oncológicas están aumentando en prevalencia. Los medicamentos oncológicos pueden tener efectos secundarios cardiovasculares, y la cardiooncología es una subespecialidad de la cardiología que se ocupa de la prevención y el tratamiento de las complicaciones cardiovasculares relacionadas con el cáncer. Puntos importantes del editorial: Las antraciclinas son un grupo de medicamentos oncológicos que pueden causar cardiotoxicidad, lo que puede causar una variedad de síntomas, incluyendo fatiga, disnea, edema y dolor en torácico. En casos graves, la cardiotoxicidad puede provocar insuficiencia cardíaca. Otros medicamentos oncológicos que pueden causar cardiotoxicidad incluyen los anticuerpos anti-HER2, el fluorouracilo y la gemcitabina. Los inhibidores de la tirosinkinasa y los inhibidores del factor de crecimiento derivado del endotelio también pueden causar problemas cardiovasculares, como hipertensión, formación de coágulos sanguíneos y arritmia. Los pacientes con cáncer también tienen un mayor riesgo de desarrollar complicaciones tromboembólicas venosas en miembros inferiores. Conclusión: El diagnóstico temprano y el tratamiento de las complicaciones cardiovasculares relacionadas con el cáncer son esenciales para mejorar la supervivencia de los pacientes con cáncer. La cardiooncología es una especialidad emergente y multidisciplinaria que requiere la participación de oncólogos, hematólogos, radiooncólogos y cardiólogos. El equipo de cardiooncología trabaja en conjunto para evaluar el riesgo cardiovascular de los pacientes con cáncer, prevenir las complicaciones cardiovasculares y tratar las complicaciones cardiovasculares que ocurren.

Recurrent myopericarditis is the acute inflammation of the pericardium and myocardium that relapses after a symptom-free interval of 4 to 6 weeks. A thorough differential diagnosis is necessary to identify uncommon causes that may have therapeutic and prognostic importance. These include autoinflammatory diseases, which can present as recurrent myopericarditis in genetically predisposed or impaired-immunity individuals. We present a 33-year-old male with polyclonal hypogammaglobulinemia and six episodes of myopericarditis, in which the diagnosis of a probable autoinflammatory syndrome was established. Targeted treatment based on the pathophysiological mechanismswas started with immunoglobulins and anakinra, with favourable clinical and serological outcome with no relapses. Organ-specific autoinflammatory diseases with myocardial involvement may be associated with life-threatening complications. The role of multidisciplinary care and a diagnostic approach focused on the pathophysiology of the disease could be the most important thing for early treatment to improve the prognosis and quality of life of our patients.

BACKGROUND: Eosinophilic myocarditis is a disease with multiple described causes, which shows infiltration of eosinophils in the myocardium, associated or not with hypereosinophilia in blood. CLINICAL CASE: An 85-year-old male patient, immunocompetent, with clinical and pathological findings of eosinophilic myocarditis due to strongyloidiasis, a currently uncommon cause. CONCLUSIONS: One of the causes of hypereosinophilia is strongyloidiasis that presents with myocarditis or de novo heart failure. Most fatal infections caused by Strongyloides stercoralis could be prevented with early detection and treatment of asymptomatic chronic infections. [ABSTRACT FROM AUTHOR]

La infección por SARS-CoV-2 tiene una relación muy importante con la patología cardiovascular. Desde el inicio de la pandemia se objetivó una relación estrecha entre la comorbilidad cardiovascular y un peor pronóstico de los pacientes COVID-19. El estudio de la fisiopatología de la infección por SARS-CoV-2 y la enfermedad cardiovascular sugieren varias hipótesis concomitantes: el daño miocárdico directo por el virus, la hipoxemia secundaria a la insuficiencia respiratoria, la respuesta inflamatoria a la infección y/o los fenómenos tromboembólicos. El daño cardiovascular se puede manifestar en la fase aguda de la infección con cuadros de infarto agudo de miocardio, miocarditis, arritmias..., durante esta fase los procedimientos de Cardiología Nuclear no han tenido un papel determinante en el diagnóstico y manejo de estos pacientes. En cambio, en la fase subaguda de la infección y en el síndrome del COVID post-agudo la Cardiología Nuclear parece ofrecer luz a lo que sucede en el sistema cardiovascular en esta fase de la enfermedad. La pandemia de la COVID-19 ha representado un gran reto para los sistemas de salud constatándose una reducción importante de pruebas diagnósticas no urgentes con el objetivo de disminuir el riesgo de transmisión a pacientes y personal sanitario. La Cardiología Nuclear no ha sido una excepción. Además de la priorización de pruebas urgentes/preferentes y las medidas generales de screening, higiene y distancia, los principales organismos y sociedades científicas de Medicina Nuclear y Cardiología Nuclear han elaborado recomendaciones y guías para su práctica segura introduciendo notables cambios en los protocolos SPECT de perfusión miocárdica. SARS-CoV-2 infection has a very important relationship with cardiovascular disease. Since the beginning of the pandemic, a close relationship has been observed between cardiovascular comorbidity and a worse prognosis in COVID-19 patients. The study of the pathophysiology of SARS-CoV-2 infection and cardiovascular disease suggests several concomitant hypotheses: direct myocardial damage by the virus, hypoxemia secondary to respiratory failure, inflammatory response to infection and/or thromboembolic phenomena. Cardiovascular damage can manifest in the acute phase of infection with acute myocardial infarction, myocarditis, arrhythmias..., during this phase Nuclear Cardiology procedures have not played a determining role in the diagnosis and management of these patients. On the other hand, in the subacute phase of the infection and in the post-acute COVID syndrome, Nuclear Cardiology seems to shed light on what happens in the cardiovascular system in this phase of the disease. The COVID-19 pandemic has represented a great challenge for health systems, with a significant reduction in non-urgent diagnostic procedures with the aim of reducing the risk of transmission to patients and health personnel. Nuclear Cardiology has not been an exception. In addition to the prioritization of urgent/non-deferrable procedures and general screening, hygiene and distance measures, the main organizations and scientific societies of Nuclear Medicine and Nuclear Cardiology released recommendations and guidelines for safe practice, introducing significant changes in myocardial perfusion SPECT protocols. [ABSTRACT FROM AUTHOR]

The COVID-19 disease has affected the entire world, becoming one of the worst pandemics of our generation, as well as being a great social and health challenge. This mainly affects the respiratory system, however, studies have shown that it compromises the cardiovascular system, which has generated a big concern, since this would imply greater vulnerability in patients with underlying cardiovascular pathologies, which represent a significant percentage of the population. Furthermore, the presence of comorbidities, such as hypertension, diabetes, and coronary artery disease, has been shown to be associated with higher mortality rates. This not only affects chronic cardiovascular patients, but it can also cause cardiovascular alterations in patients without a history of cardiovascular disease, so it is necessary to monitor cardiac biomarkers in these patients for a better approach in their development. Clinical studies have shown that the cardiovascular pathologies associated with COVID-19 are heart failure, myopericarditis, cardiogenic shock, acute cardiac injury, coagulation and thrombosis disorders, arrhythmias, acute coronary syndrome, and Kawasaki disease. This study is based on a comprehensive review of complications associated with COVID-19 and its possible mechanisms of action, for a better understanding of medical and health personnel (PROSPERO ID 316364). [ABSTRACT FROM AUTHOR]

Cardiac involvement in Takayasu arteritis (TA) is the major cause of morbidity and mortality. Cardiovascular magnetic resonance (CMR) is an excellent modality for the assessment of myocardial involvement. Studies have shown myocardial involvement in 25%–27% of patients. To evaluate the prevalence and pattern of myocardial involvement in TA on CMR. We also evaluated any correlation between CMR changes and disease activity score (ITAS 2010 and ITAS-A) assessed at the time of CMR. Patients classified as Takayasu arteritis according to Sharma et al. criteria were enrolled in the study. Demographic, clinical, and laboratory data were documented in the predesigned proforma. CMR was performed on a dedicated cardiac 3 Tesla MR machine. Disease activity was recorded by ITAS2010 and ITAS-A. A total of 37 TA patients were included. Mean (±SD) age was 29 ± 11 years. Female to male ratio was 3:1. Five patients (14%) had myocardial involvement on CMR. Two (2/5) had myocarditis and three (3/5) patients had features of ischaemic myocardial fibrosis. The myocardium is affected in TA, however the prevalence of subclinical myocardial involvement in our study was less (8% vs. 25%–27%) compared to the previous studies. Myocardial involvement trends towards early age of onset, less disease duration, lack of classical risk factors, and more with disease activity. [ABSTRACT FROM AUTHOR]

Copyright of Revista Argentina de Cardiología is the property of Sociedad Argentina de Cardiologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Argentina de Cardiología is the property of Sociedad Argentina de Cardiologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Española de Cardiología (18855857) is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Galicia Clínica is the property of Sociedad Gallega de Medicina Interna and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Española de Cardiología (18855857) is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Current knowledge about the COVID-19 pandemic is still limited, especially in the pediatric age group. So far, children are considered to be a minimally affected population; however, physicians from different parts of the world have recognized a new pediatric multi-systemic inflammatory syndrome, that provokes a multiple organ dysfunction, from which the heart is not exempted. The direct action of the virus on myocardial cells, as well as the cytokines storm -triggered by the infection-are responsible for the myocarditis developed in these patients. In this article a case with criteria of myocarditis associated with COVID-19 is described. Achieving an early diagnosis of myocarditis secondary to SARS-CoV-2 infection in the current epidemiological context allows a correct and timely therapeutic approach, avoiding the torpid evolution and fatal outcome of this disease, as well as other long-term complications. [ABSTRACT FROM AUTHOR]

Myocarditis is a multifactorial inflammatory condition of the myocardium. Recently myocarditis has been recognized as an adverse event in patients vaccinated against COVID-19 with Pfizer-BioNTech and Moderna (mRNA vaccines), mainly in adolescents and young adults. Cardiac magnetic resonance (CMR) allows the characterization of myocardial tissue and cardiac function and has become the non-invasive diagnostic gold standard in patients with suspected acute myocarditis. The authors present a 16-year-old male case with stabbing chest pain after the second dose of immunization against SARS-CoV-2 with the BNT162B2 (Pfizer-BioNTech) vaccine. The electrocardiogram (ECG) showed disclosed ST-segment elevation, and increased myocardial injury markers were also observed. Angio tomography (AngioCT) showed subtle signs of myocardial hypoperfusion and left ventricular dysfunction. Gadolinium CMR was performed, identifying global hypokinesis of the left ventricle (LV), myocardial edema hyperemia and late gadolinium enhancement (LGE) as evidence of myocardial injury, and markers of non-ischemic intramyocardial inflammatory lesion. Having excluded other etiologies, this presentation of acute myocarditis is proposed to be an adverse reaction associated with the BNT162b2 vaccine against COVID-19. The long-term risks of the COVID-19 vaccine in children, adolescents and young adults are still unknown, and further investigation will be needed. [ABSTRACT FROM AUTHOR]

Introducción: la miocarditis (MCT) se define como un infiltrado inflamatorio del miocardio con degeneración y/o necrosis asociada. Su etiología incluye múltiples gérmenes, tóxicos y enfermedades autoinmunes entre otros. La causa más común es la viral y el diagnóstico es un reto por la variabilidad de manifestaciones, imágenes y rendimiento del laboratorio. Objetivo: describir dos casos de miocarditis que debutaron con fibrilación auricular como manifestación poco usual. Metodología: se registraron dos casos en Cali, Colombia, con diagnóstico de miocarditis por resonancia magnética cardíaca (cRNM) contrastada. Presentación de los casos: el primero corresponde a una mujer de 66 años con antecedentes de diabetes e hipotiroidismo que ingresó por síncope y el segundo a un paciente joven con dolor torácico de 43 años sin antecedentes patológicos. Se documentó fibrilación auricular (FA) y MCT aguda por hallazgos en la cRNM. Se dió manejo médico y los pacientes evolucionaron en forma satisfactoria sin falla cardíaca en el seguimiento. Discusión y conclusiones: los casos ponen en evidencia la heterogeneidad de las manifestaciones clínicas de la MCT aguda y la importancia de sospecharla ante FA de novo. El diagnóstico puede retrasarse en nuestro medio por la falta de acceso a la cRNM, que se ha constituido como una herramienta fundamental para diferenciarla de otras etiologías que también elevan marcadores como la troponina ultrasensible y ponen en riesgo la vida del paciente como la isquemia miocárdica.

Cases of acute myocarditis have been after administration of the BNT162b2 and Ad26.COV2.S vaccine. Describe another possible mechanism of myocarditis after COVID-19 vaccination. We describe the clinical case of a 72-year-old female with pleuritic chest pain one week after the third of the BNT162b2 mRNA vaccine. Serological tests for cardiotropic pathogens were negative, and autoimmunity screening was positive with anti-nuclear antibody (ANA) in 1:160 dilution, Anti-double-stranded DNA (anti-dsDNA), and anti-histone antibodies. 18F-fluoro-deoxy-glucose (FDG) positron emission tomography/computed tomography (PET/CT) showed a focal myocardial and pericardial inflammatory process in the cardiac apex. Systemic lupus erythematosus (SLE) diagnosis was made with myocardial affection. As far as we know, this is the first report of a case of lupus myocarditis after the COVID-19 vaccine. Given the pathogenic rationales, the association between SLE and myocarditis should be considered. [ABSTRACT FROM AUTHOR]

Introducción: Las complicaciones cardiovasculares son actualmente una causa principal de morbilidad y mortalidad en la población infectada por el Virus de Inmunodeficiencia Humana (VIH), sobre todo en los países subdesarrollados. El paciente con infección por VIH no escapa de presentar complicaciones cardiovasculares, siendo estas últimas de las más catastróficas, ya que pueden tener un origen autoinmune o por efectos citopaticos directos del VIH. Enfermedad actual y antecedentes: Masculino de 28 años de edad, con antecedente de infección por VIH, hace 6 meses ingresa por presentar desde hacía 2 meses disnea de moderados a pequeños esfuerzos, así como edema en miembros inferiores ascendente y dolor precordial ocasional. Examen físico: A nivel cardiopulmonar alteraciones en la auscultación existiendo frote pericárdico con disminución de la intensidad de los ruidos, a nivel Abdominal sin alteración. Neurológico sin alteración. Se realiza ecocardiograma evidenciándose disminución de la FEVI ubicándose en un 25% con trastornos globales de la cinesia. Discusión y conclusiones del caso: La Terapia Anti Retroviral (TAR) es muy efectiva para controlar la infección por VIH y, por consiguiente, ha revolucionado el pronóstico y ha aumentado drásticamente la supervivencia de las personas que viven con el VIH. Sin embargo, dado que las poblaciones infectadas por el VIH que reciben TAR viven sustancialmente más tiempo, están cada vez más expuestas a nuevos problemas de salud emergentes, en especial enfermedades crónicas. El referido paciente a pesar de haber recibido manejo acorde fallece por las complicaciones previamente comentadas. Introduction: Cardiovascular complications are currently a leading cause of morbidity and mortality in the population infected by the Human Immunodeficiency Virus (HIV), especially in underdeveloped countries. The patient with HIV infection does not escape from presenting cardiovascular complications, the latter being the most catastrophic, because of they may have an autoimmune origin or direct cytopathic effects of HIV. Current disease and background: A 28-year-old male with a history of HIV infection 6 months ago is admitted for presenting moderate dyspnea for 2 months, as well as edema in the lower limbs and occasional chest pain. Physical examination: At the cardiopulmonary level alterations in auscultation, there being a pericardial rub with a decrease in the intensity of the noises, at the Abdominal level without alteration. Neurological without alteration. An echocardiogram was performed evidencing a decrease in LVEF, standing at 25% with global contractility disorders. Discussion and conclusions of the case: Anti Retroviral Therapy (ART) is very effective in controlling HIV infection and, therefore, has revolutionized the prognosis and dramatically increased the survival of people living with HIV. However, given that HIV-infected populations receiving ART live substantially longer, they are increasingly exposed to new emerging health problems, especially chronic diseases. The aforementioned patient, despite having received proper treatment, died from the complications previously mentioned.

The coronavirus disease 2019 (COVID-19) was declared a pandemic on March 11, 2020; one consequence has been the increase in sedentary lifestyle and reduction of sports activity. Exercise benefits the immune defense system especially in older adults; it is recommended to keep a distance of 1.5 meters between people, and if walking or jogging is carried out, the space must be up to 5 and 10 meters respectively. The reported cases are mostly mild up to 80% and can be critical in up to 4.7%; the risk factors are well known, hypertension, diabetes and previous heart disease. Severe or critical cases present as symptoms of acute respiratory distress syndrome, and in the case of cardiovascular disease, they mainly occur as myopericarditis, acute coronary syndromes, cardiogenic shock, thrombotic events, among others. Returning to exercise after recovery from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is always recommended, however it will depend on the clinical picture what measures should be taken prior to its onset, and it is in moderate cases and especially in the severe ones where the evaluation and prescription prior to returning to exercise or sport should be guided by medical personnel experts in cardiopulmonary rehabilitation, especially in athletes. [ABSTRACT FROM AUTHOR]

El compromiso cardíaco en la enfermedad de Still del adulto (ESA) usualmente se manifiesta como enfermedad pericárdica, la cual, generalmente, tiene un curso benigno. La miocarditis es una complicación infrecuente con una prevalencia del 7%. El diagnóstico de ESA se basa en los sets de criterios de Yamaguchi o Fautrel. El tratamiento con corticosteroides y metrotexato es la primera y segunda línea terapéutica, respectivamente, que combinados son efectivos en 70% de los casos. Reportamos un caso de ESA de presentación inusual por el compromiso tanto miocárdico como pericárdico.

Copyright of Revista Argentina de Cardiología is the property of Sociedad Argentina de Cardiologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

La cardiotoxicidad por citarabina es un efecto adverso poco conocido. Se presenta el caso de un paciente de 51 años con antecedentes de Leucemia Mieloide Aguda manejada con altas dosis de citarabina y que presentó como consecuencia miopericarditis aguda. Luego del manejo de soporte en cuidados intensivos, se inició tratamiento cardioprotector específico para falla cardiaca y, dada la alta posibilidad de requerir citarabina en el manejo oncológico ulterior, se inició tratamiento con antinflamatorios no esteroideos y colchicina con el fin de reducir el riesgo de recurrencia de la miopericarditis. Se presenta el caso clínico, y una estrategia diagnóstica para pacientes con altas dosis de citarabina y compromiso pericárdico y miocárdico.

La enfermedad de chagas (tripanosomiasis americana) es una zoonosis potencialmente mortal causada por el parásito Trypanosoma cruzi, transmitido por vectores encontrados principalmente en territorio latinoamericano, aunque tiene otras vías de transmisión menos comunes. La fase aguda puede ser asintomática, presentarse con síntomas generales inespecíficos o con complicaciones como miocarditis o meningoencefalitis; adicionalmente, se presentan formas crónicas que incluyen cardiomegalia y sus complicaciones, enfermedad gastrointestinal y neuropatía periférica. Los eventos tromboembólicos son frecuentes, siendo el infarto cerebral el más común. El tratamiento específico antitripanosómico tiene mayor impacto en las formas agudas; las formas crónicas deberán tratarse de acuerdo con sus complicaciones, excepto en casos seleccionados. A continuación se detalla la fisiopatología, las manifestaciones clínicas, así como el diagnóstico y el tratamiento de acuerdo con sus diferentes formas de presentación.

Copyright of Revista Española de Cardiología (18855857) is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

La miocarditis es una enfermedad inflamatoria del miocardio. Las infecciones virales son la causa más común, aunque también puede deberse a reacciones de hipersensibilidad y de etiología autoinmunitaria, entre otras. El espectro clínico de la enfermedad es variado y comprende desde un curso asintomático, seguido de dolor torácico, arritmias y falla cardiaca aguda, hasta un cuadro fulminante. El término ‘fulminante’ se refiere al desarrollo de un shock cardiogénico con necesidad de soporte vasopresor e inotrópico o dispositivos de asistencia circulatoria, ya sea oxigenación por membrana extracorpórea o balón de contrapulsación intraaórtico. Cerca del 10 % de los casos de falla cardiaca por miocarditis corresponde a miocarditis fulminante. La miocarditis por influenza se considera una condición infrecuente; no obstante, su incidencia ha aumentado desde el 2009 a raíz de la pandemia de influenza por el virus AH1N1. Por su parte, la miocarditis por influenza de tipo B sigue siendo una condición infrecuente. Se describen aquí dos casos confirmados de miocarditis fulminante por el virus de la influenza B atendidos en un centro cardiovascular, que requirieron dispositivos de asistencia circulatoria mecánica.

RESUMEN Introducción y objetivos: La biopsia endomiocárdica (BEM) es una técnica diagnóstica fundamental en el diagnóstico de distintas miocardiopatías, pero no está exenta de posibles complicaciones. Se presentan los resultados en términos de rentabilidad diagnóstica y seguridad de la serie de BEM realizadas en corazón no trasplantado en nuestro hospital, así como las consecuencias de la implementación de un protocolo de actuación y seguridad en BEM desarrollado en nuestro centro. Métodos: Se revisaron de forma retrospectiva todas las BEM en corazón no trasplantado realizadas desde septiembre de 2004 hasta julio de 2018. Se comparó la rentabilidad diagnóstica y seguridad en dos etapas: antes y después de la puesta en marcha del protocolo. Resultados: Se incluyeron 204 BEM realizadas en 190 pacientes. La indicación más frecuente fue el estudio de disfunción ventricular o sospecha de miocarditis (51,5%), seguida de estudio de miocardiopatía restrictiva o infiltrativa (44,6%). Se realizaron 172 BEM en cavidades derechas (84,3%) y 30 en cavidades izquierdas (14,7%); solo en 2 de los procedimientos se tomaron muestras de ambos ventrículos. La BEM permitió el diagnóstico definitivo en el 52% de los casos. Tras la implementación del protocolo se observó una mejoría en la rentabilidad diagnóstica (42,5 frente a 58,1%; p = 0,030) y una disminución en la tasa de complicaciones mayores (del 7,5% al 3,2%; p = 0,167), con una reducción estadísticamente significativa en la tasa de perforaciones cardiacas (6,3 frente a 0,8%; p = 0,025). Conclusiones: La BEM es una técnica con un gran potencial diagnóstico en pacientes con sospecha de miocardiopatía. Aunque puede presentar complicaciones potencialmente graves, la puesta en marcha de un protocolo de actuación y seguridad se asocia a una reducción en la tasa de complicaciones y a una mejoría en la rentabilidad diagnóstica.

La infección por enterovirus en los recién nacidos se puede desarrollar como una enfermedad multisistémica. Afecta principalmente el corazón, el hígado y los pulmones. Con una mortalidad importante que requiere un diagnóstico y tratamiento oportuno. Este es un reporte de caso de recién nacido a término de 24 días, procedente de un resguardo indígena, con cuadro clínico de 2 semanas de síntomas respiratorios con el antecedente del padre con episodio gripal, que presentó tirajes subcostales, desaturación de oxígeno, hepatomegalia y finalmente disociación toracoabdominal que requirió intubación orotraqueal. El panel viral para detección de antígeno viral por técnica de inmunofluorescencia en muestras respiratorias (IFI) fue positivo para enterovirus; radiografía de tórax con cardiomegalia; electrocardiograma con cambios en el segmento ST; ecocardiograma con hipertensión pulmonar severa y disfunción miocárdica; elevación de enzimas hepáticas y cardiacas. El recién nacido requirió soporte inotrópico y manejo con inmunoglobulina (1g/kg/día por 3 días); se realizaron paraclínicos de control luego de la última dosis de inmunoglobulina y se evidenció mejoría en los parámetros de laboratorio: enzimas hepáticas y cardiacas dentro de límites normales, ecocardiograma de control con adecuada función ventricular sin hipertensión pulmonar; se logró la extubación temprana y el egreso de la unidad sin comorbilidades.

Copyright of Enfermería en Cardiologia is the property of Asociacion Espanola de Enfermeria en Cardiologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Dengue's cardiological manifestations are diverse; the virus is able to enter the myocardium and cause acute myocarditis that sometimes may go unnoticed and be asymptomatic, with benign outcomes; while in others, it may produce electrocardiographic rhythm and conduction disturbances or signs of ventricular dysfunction that could lead to severe heart failure. We present the case of a 21-yearold man, a student, previously healthy, who was admitted to the Department of Cardiology with a diagnosis of dengue confirmed by serology and complicated with conduction disorders (2:1 advanced atrioventricular block) related to acute myocarditis due to dengue. This problem can be seen in areas where dengue is an emerging problem. Therefore it is critical to be aware of it in order to design strategies for prevention and treatment of complications. [ABSTRACT FROM AUTHOR]

Dengue is an acute febrile viral disease produced by the dengue virus, mainly transmitted by the bite of mosquitoes of the genus Aedes. It can take place with or without symptoms and it can cause serious clinical conditions. The case of a 47- year-old man is presented, who was admitted due to fever of three days of evolution, skin rash, nauseas, dry cough and lipothymias. Two days later, the rash worsened and extreme bradycardia appeared. The echocardiogram showed left ventricular dysfunction, with an ejection fraction of 38%. The patient was discharged after 14 days with the diagnosis of dengue complicated by myocarditis. It is evident that it was a viral myocarditis from the beginning of symptoms, which is described as unusual in the bibliography; cough and lipothymias were the expression of the low cardiac output, that together with the bradycardia, and the electroand echocardiographic alterations, helped to establish the diagnosis. [ABSTRACT FROM AUTHOR]

We present the case of a 72-year-old immunocompetent patient from Chocó, Colombia, with a 12-day course of fever, headache, progressive neurological deterioration, and rapid evolution to multiorgan failure and death. In the histopathological study of tissues obtained at necropsy, tissue cysts morphologically suggestive of being bradyzoites of Toxoplasma gondii were identified and confirmed by immunohistochemistry in heart, brain, and striated muscle.

Copyright of Medicina (Buenos Aires) is the property of Medicina (Buenos Aires) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Cirugía y Cirujanos is the property of Publicidad Permanyer SLU and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Dengue can compromise organs such as the myocardium and the liver. Clinical evolution may be aggravated by this fact, and for that reason, these organs have been considered in the revised classification of the World Health Organization (WHO) for this disease. Objective: To describe the affectation caused by dengue in organs such as the myocardium, the liver and the central nervous system (CNS) in children from Neiva, Colombia. Materials and methods: This study analyzed 930 children diagnosed with confirmed dengue and admitted to the Hernando Moncaleano Perdomo University Hospital of Neiva between January 2009 and December 2010. Diagnosis and clinical stratification were obtained based on the revised WHO classification. Dengue infection was confirmed by NS1 or specific IgM plasma detection. Daily clinical and paraclinical follow-up was performed during the full length of hospital stay. Results: Out of 930 children, 105 were classified as severe dengue (SD) and, of these, 19 had affected organs. The myocardium was the most compromised organ (14 cases), followed by the liver (4 cases) and the CNS (1 case). Conclusion: Clinical involvement of the myocardium, liver or CNS was observed in 18% of the cases of children with SD. A timely diagnosis and treatment of this pathology in children is necessary.

La miocarditis es una enfermedad inflamatoria del músculo cardiaco no asociada a anormalidades valvulares y en ausencia de enfermedad isquémica. Su prevalencia e incidencia se desconocen, ya que se presenta de manera subaguda o con síntomas iniciales inespecíficos. Su fisiopatología consta de tres fases: aguda (< 3 días–daño miocárdico mediado por acción directa del virus), subaguda (4-14 días–el daño miocárdico resulta de una disregulación de la respuesta autoinmune del huésped) y crónica (> 15 días–aclaramiento viral insuficiente y perpetuación del proceso inflamatorio, que conduce a remodelamiento cardiaco y falla cardiaca). Como agente etiológico más frecuente se describe el Parvovirus B19 y el herpes virus humano 6. Entre las manifestaciones clínicas: dolor torácico, arritmias, en lactantes (letargo, taquipnea, dificultad respiratoria leve, etc.), puede iniciar con pródromo viral, disfunción ventricular o muerte súbita. Tiene cuatro posibles presentaciones clínicas: asintomático, miocarditis aguda, fulminante o miocardiopatía crónica dilatada. El electrocardiograma detecta anormalidades entre el 93 al 100%; la resonancia magnética nuclear cardiovascular con gadolinio es de mayor uso, principalmente en la biopsia endomiocárdica. El tratamiento se basa en la monitorización hemodinámica del paciente, la evaluación de la necesidad de diuréticos, inhibidores de la enzima convertidora de angiotensina, betabloqueadores no selectivos, soporte inotrópico, antiarrítmicos o, en casos severos, el requerimiento de soporte mecánico cardiovascular. Se evalúa el uso de inmunoglobulina y, de manera controversial, el de inmunosupresor y antiviral. El pronóstico es variable y depende de factores inherentes al ambiente y al huésped. Se realizó una revisión actualizada de la literatura.

El lupus eritematoso sistémico es una enfermedad autoinmune de etiología desconocida, cuyo cuadro clínico incluye diversas manifestaciones cardiovasculares, que se pueden presentar entre el 50 y 60 % de los pacientes. La miocarditis es infrecuente (10 %) y puede evolucionar tanto a miocardiopatía dilatada como a la mejoría. Por tales razones se presenta el caso de una paciente femenina de 24 años, de color de piel negra, ingresada en el Hospital José Ramón Martínez del municipio de Guanajay, Artemisa, por disnea y palpitaciones ante moderados esfuerzos. Tenía historia previa de infección respiratoria durante el periodo epidémico de la influenza H1N1, diagnosticada por neumonía con derrame cuya evolución fue tórpida. Los elementos clínicos claves en la sospecha y diagnóstico de lupus eritematoso sistémico fueron la presencia de úlceras en el paladar blando y signos de artritis de las articulaciones interfalángicas de ambos pies, así como la historia previa de derrame pleural y manifestaciones de insuficiencia cardíaca, es decir participación multisistémica. Los exámenes de laboratorio mostraron el cribado de anticuerpos antinucleares positivo, disminución de los niveles de complemento CH50 y C3. Actualmente está controlada con esteroides e inmunosupresores.

Myocarditis is an inflammatory disease of the myocardium. Viral infections are the most common cause, although it can also be due to hypersensitivity reactions and autoimmune etiology, among other causes. The clinical spectrum of the disease is varied, from an asymptomatic course, followed by chest pain, arrhythmias and acute heart failure, to fulminant picture. The term fulminant refers to the development of cardiogenic shock with the need for vasopressor support, inotropic or assisted circulation devices either extracorporeal membrane oxygenation (ECMO) or intra-aortic counterpulsation balloon. About 10% of cases of heart failure due to myocarditis correspond to fulminant myocarditis. Influenza myocarditis has been considered an infrequent condition, however, its incidence has increased since 2009 as a result of the AH1N1 pandemic; otherwise, myocarditis due to Influenza type B remains an infrequent entity. We describe the experience in a cardiovascular center of 2 confirmed cases of fulminant myocarditis due to Influenza B that required circulatory assistance devices. [ABSTRACT FROM AUTHOR]

Copyright of Gaceta Médica de Caracas is the property of Academia Nacional de Medicina and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)