Common Cardiovascular Diseases in Women.

Cardiovascular disease is a leading cause of death for women in the United States. This article encompasses the epidemiology/etiology, clinical presentation, diagnostic assessment, management, and prognosis of some common cardiovascular disorders seen in women with a special focus on pregnancy.

Hypertension in Women and Pregnancy.

Hypertension has been shown to have long-term cardiovascular effects if left untreated. Hypertension also has been shown to affect women during pregnancy, which can be detrimental not only to the patient but also to the fetus. Early identification and treatment are paramount to prevent adverse outcomes. This article details the epidemiology, clinical presentation, diagnosis, and treatment of essential hypertension in women, gestational hypertension, preeclampsia, and eclampsia.

Hematologic and Oncologic Emergencies.

This article reviews both hematologic and oncologic emergencies that may be seen in the intensive care setting. Hematologic emergencies, including autoimmune hemolytic anemia, thrombotic thrombocytopenic purpura, hemolytic uremic syndrome, and disseminated intravascular coagulation, as well as oncologic emergencies including tumor lysis syndrome, superior vena cava syndrome, and cardiac tamponade secondary to metastatic disease, are discussed in detail. This review focuses on the pathophysiology, clinical features, diagnosis, and treatment of each entity.

Acute Cardiac Emergencies.

Acute cardiac emergencies are life threatening. The initial responses to acute cardiac emergencies must be rapid, efficient, skillful, and well-planned. The goal of this article is to provide information that can be used to facilitate the prompt recognition and treatment of the most common acute cardiac emergencies.

COPD and Cardiovascular Disease: A Review of Association, Interrelationship, and Basic Principles for Integrated Management.

The presence of comorbid cardiovascular disease (CVD) in patients with chronic obstructive pulmonary disease (COPD) can result in unfavorable outcomes, ranging from deterioration in quality of life to increases in all-cause and cardiovascular mortality. Moreover, cardiovascular events are major cause of hospitalization in patients with COPD and contributing significantly to the economic burden of the disease. Despite the acknowledgment of the prognostic significance of CVD comorbidity in COPD patients, CVD remains underrecognized and undertreated in this patient population. In this article, we address the current knowledge about the estimated prevalence, pathophysiologic association, as well as important considerations in the diagnosis and management of CVD in COPD patients.

COVID-19 and the Cardiovascular System.

COVID-19, a symptom complex of respiratory failure induced by a highly infectious pathogen, severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), has been classified as a pandemic. As of April 15, 2020, there have been 2 million people diagnosed with the viral infection and 130 000 deaths globally. It is highly likely that the number of infections is underrepresented secondary to variations in testing and reporting strategies globally. In this short review, we aim to summarize the current understanding of SARS-CoV-2 as it pertains to cardiovascular disease. We discuss the basis of cardiac pathophysiology and address some of the clinical scenarios that cardiovascular physicians may face. We introduce the concept of conservative management of acute coronary syndromes and address some complications such as myocarditis, heart failure, and cardiac arrhythmias that may be relevant for the management of patients presenting with COVID-19.

Cardiac Dysfunction in Acute Respiratory Distress Syndrome.

Acute respiratory distress syndrome is a heterogenous condition with significant mortality and limited therapeutic options. Although hypoxic respiratory failure tends to be the hallmark of the disease, there can be significant cardiac compromise, particularly in the right ventricle. Echocardiography plays an important role in the early diagnosis and recognition of right ventricular dysfunction. Treatment of said dysfunction with mechanical ventilation strategies and therapies such as inhaled nitric oxide or extracorporeal membrane oxygenation remain poorly studied but offer potential salvage strategies.

A case of severe mitral regurgitation due to an unusually long aberrant chorda tendinea straddling the anterior mitral leaflet.

We present a case of a 27-year-old female with severe mitral regurgitation caused by a single long aberrant chorda tendinea. This chorda extended from the base of the right coronary cusp of the aortic valve, through the A2 scallop of the mitral valve, and attached to the dome of the left atrium. Initial transthoracic echocardiogram (TTE) demonstrated a mildly redundant anterior mitral leaflet with thickened leaflet tip and moderate eccentric, posteriorly directed mitral regurgitation. Repeat TTE revealed a chord-like structure attached to the midportion of the anterior mitral leaflet and extending to the left ventricular outflow tract. Transesophageal echocardiography (TEE) suggested two aberrant chordae tendineae tethering the A2 scallop on both the left atrial and left ventricular side. Patient underwent surgical resection of the aberrant chorda. During the excision of the chorda the structural integrity of the A2 scallop was compromised, necessitating mitral valve repair with excellent results.