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Background Following infection with severe acute respiratory syndrome coronavirus, a post-infectious multisystem inflammatory syndrome in adults (MIS-A) has been identified. It affects multiple organ systems and can lead to multi-organic failure. Case summary This case report describes a patient with MIS-A with significant cardiac involvement including peri-myocarditis, pulmonary hypertension, right-sided heart failure, tricuspid regurgitation, and cardiogenic shock. After being diagnosed and treated correctly for MIS-A, the patient recovered completely, without any cardiac sequelae. Discussion The hyperinflammation in MIS-A can have cardiac engagement. Although more research is required to further clarify the underlying mechanisms, prompt diagnosis and anti-inflammatory treatment are crucial for better outcomes and cardiac recovery. [ABSTRACT FROM AUTHOR]

Right ventricular heart failure (RVHF) mostly occurs due to the failure of the left-side of the heart. RVHF is a serious disease that leads to swelling of the abdomen, ankles, liver, kidneys, and gastrointestinal (GI) tract. A total of 506 heart-failure subjects from the Faculty of Medicine, Cardiovascular Surgery Department, Ege University, Turkey, who suffered from a severe heart failure and are currently receiving support from a ventricular assistance device, were involved in the current study. Therefore, the current study explored the application of both the direct and inverse modelling approaches, based on the correlation analysis feature extraction performance of various pre-operative variables of the subjects, for the prediction of RVHF. The study equally employs both single and hybrid paradigms for the prediction of RVHF using different pre-operative variables. The visualized and quantitative performance of the direct and inverse modelling approach indicates the robust prediction performance of the hybrid paradigms over the single techniques in both the calibration and validation steps. Whereby, the quantitative performance of the hybrid techniques, based on the Nash–Sutcliffe coefficient (NC) metric, depicts its superiority over the single paradigms by up to 58.7%/75.5% and 80.3%/51% for the calibration/validation phases in the direct and inverse modelling approaches, respectively. Moreover, to the best knowledge of the authors, this is the first study to report the implementation of direct and inverse modelling on clinical data. The findings of the current study indicates the possibility of applying these novel hybridised paradigms for the prediction of RVHF using pre-operative variables. [ABSTRACT FROM AUTHOR]

Right ventricular heart failure (RVHF) is a critical complication in patients with respiratory failure, particularly among those who transitioned to lung transplantation using venovenous (VV) extracorporeal membrane oxygenation (ECMO). In these patients, both cardiac and respiratory functions are supported using venoarterial or venoarterial-venous ECMO. However, these modalities increase the risk of device-related complications, such as thromboembolism, bleeding, and limb ischemia, and they may disturb early rehabilitation. Due to these limitations, a right ventricular assist device with an oxygenator (Oxy-RVAD) using ECMO may be considered for patients with RVHF with VV ECMO. A retrospective case series and literature review. A single tertiary care university hospital. The study comprised lung transplantation candidates on ECMO bridging who developed right-sided heart failure. An RVAD with ECMO. Of eight patients who underwent the study protocol, seven were bridged successfully to lung transplantation (BTT), and all patients with BTT were discharged, with a 30-day survival rate of 100% (7/7 patients). The 180-day survival rate was 85% (6/7 patients). The study suggested that Oxy-RVAD using ECMO may be a viable option for bridging patients with RVHF to lung transplantation. Retrospectively registered. [ABSTRACT FROM AUTHOR]

Chronic heart failure is one of the most dreadful complications in the early postoperative period following lung transplantation. At the same time, the effect of using levosimendan in the early post-lung transplant period is currently insignificant and remains debatable. This paper presents a clinical case where levosimendan was successfully used in a patient with right ventricular heart failure during lung transplantation undergoing central venoarterial extracorporeal membrane oxygenation (VA-ECMO).

The article presents the discussion on conducting a correlation analysis of the use of nitroglycerin by medical rescue teams (MRT) in patients with ACS STEMI and the impact on selected biochemical parameters. Topics include cardiological societies and associations not recommending the use of nitroglycerin in patients with acute coronary syndrome ST-elevation myocardial infarction (ACS STEMI); and providing emergency medical units with the appropriate equipment and using electrocardiogram (ECG).

Objective: the aim of the study was to characterize the mechanical properties of the pulmonary arterial wall (PA) in patients with pulmonary arterial hypertension (PAH) using magnetic resonance imaging (MRI) of the heart, and to determine their diagnostic and prognostic value. Materials and methods: 57 patients with PAH were examined. The diagnosis of PAH was verified according to the recommendations of the ERS/ESC from 2015. All patients underwent a detailed echocardiographic (ECHO) study, MRI of the heart and right heart catheterization (RHC). To calculate the stiffness of the pulmonary artery wall, the MRI and RHC data were used. Results: We identified a correlation between the functional class of PAH and the parameters of hemodynamic, physical performance, ECHO parameters of the right chambers. There were no differences in the stiffness of the pulmonary artery wall, depending on the functional class of PAH. Among the six stiffness indicators, only pulsation index was associated with the structural and functional parameters of the right ventricle and pulmonary vascular resistance. Conclusion: The MRI pulsation index is the simpleststiffness index of the pulmonary artery wall and the most promising one for evaluating the prognosis of patients with PAH.

Summary: Background: Right ventricular (RV) dysfunction may be caused by either pressure or volume overload. RV function is conventionally assessed with echocardiography using tricuspid annular plane systolic excursion (TAPSE), RV fractional area change (RVFAC), tricuspid lateral annular systolic velocity (S′) and RV index of myocardial performance (RIMP). The purpose of this study was to evaluate whether RV global longitudinal strain (RVGLS) and RV‐free wall strain (RV‐free) could add additional information to differentiate these two causes of RV overload. Methods and results: The study enrolled 89 patients with an echocardiographic trans‐tricuspid gradient >30 mmHg. Forty‐five patients with pulmonary arterial hypertension or chronic thromboembolic pulmonary hypertension (pressure overload) were compared with 44 patients with an atrial septum defect (volume overload). RV size was larger in the volume group (P<0·05). TAPSE and S′ were lower in the pressure group (P<0·05, P<0·01). RVFAC was lower in the pressure group (P<0·001) as well as RVGLS (−12·1 ± 3·3% versus −20·2 ± 3·4%, P<0·001) and RV‐free (−12·9 ± 3·3% versus −19·4 ± 3·4%, P<0·001). Conclusion: In this study, RVGLS and RV‐free could more accurately discriminate RV pressure from volume overload than conventional measures. The reason could be that TAPSE and S′ are unable to differentiate active deformation from passive entrainment caused by the left ventricle. The pressure group had evidence of marked RV hypertrophy despite standard functional parameters (TAPSE and S) within normal range. This would enhance the value of strain to more sensitively detect abnormal function. A cut‐off value of below −16% for RVGLS and RV‐free predicts RV pressure overload with high accuracy. [ABSTRACT FROM AUTHOR]

Case report: 56-year-old male patient was admitted due to fever of unknown origin. Upon admission, the patient was in bad general condition with high values of inflammatory markers in laboratory results and signs of right side heart failure. 12-lead ECG showed nonspecific conduction disorders. No signs of systemic disease have been found with extensive internal and diagnostic treatment. Scintigraphy with labeled leukocytes, as attempt to find origin of infection did not show any pathological accumulation. Coronarography excludes atherosclerotic changes in epicardial vessels. Transthoracic (TTE) and transesophageal (TEE) echocardiography described a visible hyperechogenic formation in a right ventricular outflow tract (RVOT), oriented towards pulmonic valve, 1.6 cm long and 0.3 cm wide (Figure 1). Right ventricle (RV) showed milder reduced systolic function, with signs of right-side congestion. There was moderate pulmonary valve regurgitation (PR 2+), and mild tricuspid regurgitation with estimation of right ventricular systolic pressure of 27 mmHg. Preserved left ventricular fraction of 58% was observed. MSCT of thorax identified a strange metal body, resembling to sewing needle in the RV area. The patient initially refused the surgical procedure of foreign body extraction, until the clinical condition deteriorated. He was hospitalized again with fever, hem culture positive on Escherichia coli. Transthoracic echocardiography now showed a formation of 8 mm, possibly vegetation, on the ventricular surface of the pulmonary valve with severe pulmonary insufficiency, severe tricuspid regurgitation and moderate right-side heart failure. Diagnosis of pulmonary valve endocarditis has been established. The patient was successfully operated, the bioprosthetic pulmonary valve was implanted combined with tricuspid valve repair and the foreign body was removed from the right ventricle. Postoperative recovery went well, and control echocardiography showed a good function of the bioprosthetic pulmonary valve and tricuspid valve repair. Foreign body was a sewing needle, but the patient could not remember how did it get there. Conclusion: Isolated right ventricular heart failure can be caused by pulmonary valve insufficiency, as in our case by foreign body in RVOT finally complicated by endocarditis of pulmonary valve. [ABSTRACT FROM AUTHOR]