RESUMO
[This corrects the article DOI: 10.3389/fcvm.2024.1323023.].
RESUMO
Aesop's fable of the wolf in sheep's clothing encourages us to look beneath the exterior appearance of a situation and evaluate the truth that lies beneath. This concept should be applied when managing older patients with severe aortic stenosis. This population of patients is increasingly being identified as having concomitant cardiac amyloidosis, which is an underrecognized cause of common cardiac conditions. The presence of cardiac amyloidosis negatively affects the outcome of patients with aortic stenosis, these patients undergo transcatheter aortic valve replacement (TAVR) with increasing frequency and have a significantly higher overall mortality rate than patients with aortic stenosis alone. Although left ventricular wall hypertrophy is expected in patients with aortic stenosis, it should not be assumed that this is caused only by aortic stenosis. A suspicion of cardiac amyloidosis should be raised in patients in whom the degree of hypertrophy is disproportionate to the degree of aortic stenosis severity. The remodeling, age, injury, systemic, and electrical (RAISE) score was developed to predict the presence of cardiac amyloidosis in patients with severe aortic stenosis. This article highlights the value of increased clinical suspicion, demonstrates the use of the multiparameter RAISE score in daily clinical practice, and illustrates the scoring system with case studies. In elderly patients being considered for TAVR, systematic testing for cardiac amyloidosis should be considered as part of the preoperative workup.
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Causes of bilateral low vision (BLLV) and bilateral blindness (BLB) were investigated among 720 outpatients aged > 45 years in Irbid, Jordan, between July 1999 and October 2000. All received full ophthalmic examinations. BLLV was defined as visual acuity < 6/18 but > 3/60 in the better eye; BLB as acuity < 3/60 in the better eye. The leading cause of BLB and BLLV was cataract. Refractive error was the second major cause of BLLV. Other common causes were diabetic retinopathy and glaucoma. Age-related macular degeneration was the single cause of BLB and BLLV for only 1.6% and 2.8% respectively. A population-based survey of BLB and BLLV in the elderly, yearly vision examinations and an ophthalmic education programme are recommended.
Assuntos
Cegueira/epidemiologia , Cegueira/etiologia , Transtornos da Visão/epidemiologia , Transtornos da Visão/etiologia , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Cegueira/diagnóstico , Cegueira/prevenção & controle , Catarata/complicações , Causalidade , Retinopatia Diabética/complicações , Feminino , Glaucoma/complicações , Hospitais Militares , Humanos , Jordânia/epidemiologia , Degeneração Macular/complicações , Masculino , Pessoa de Meia-Idade , Avaliação das Necessidades , Oftalmoscopia , Vigilância da População , Prevalência , Encaminhamento e Consulta , Erros de Refração/complicações , Transtornos da Visão/diagnóstico , Transtornos da Visão/prevenção & controle , Seleção Visual , Acuidade VisualRESUMO
Causes of bilateral low vision [BLLV] and bilateral blindness [BLB] were investigated among 720 outpatients aged > 45 years in Irbid, Jordan, between July 1999 and October 2000. All received full ophthalmic examinations. BLLV was defined as visual acuity < 6/18 but > 3/60 in the better eye; BLB as acuity < 3/60 in the better eye. The leading cause of BLB and BLLV was cataract. Refractive error was the second major cause of BLLV. Other common causes were diabetic retinopathy and glaucoma. Age-related macular degeneration was the single cause of BLB and BLLV for only 1.6% and 2.8% respectively. A population-based survey of BLB and BLLV in the elderly, yearly vision examinations and an ophthalmic education programme are recommended
