RESUMO
We present the rare case of a patient with pulmonary hypertension in the context of the stiff left atrial syndrome after extensive catheter ablation, a unique constellation characterized by high pulmonary artery and pulmonary artery wedge pressures due to left atrial dysfunction but normal left ventricular end-diastolic pressure, normal mitral valve, and absence pulmonary vein stenosis. This patient was surprisingly oligosymptomatic, however, which may have been due to a persistent post-puncture atrial septal defect, which may have allowed for controlled left atrial decompression, which is in line with the novel concept of the catheter-based creation of an intracardiac shunt as a treatment for heart failure.
Assuntos
Antagonistas Adrenérgicos beta/uso terapêutico , Anticoagulantes/uso terapêutico , Fibrilação Atrial/complicações , Átrios do Coração/fisiopatologia , Hipertensão Pulmonar/etiologia , Pressão Propulsora Pulmonar/fisiologia , Idoso , Fibrilação Atrial/diagnóstico , Fibrilação Atrial/tratamento farmacológico , Quimioterapia Combinada , Ecocardiografia , Átrios do Coração/diagnóstico por imagem , Humanos , Hipertensão Pulmonar/diagnóstico , Hipertensão Pulmonar/tratamento farmacológico , Masculino , SíndromeAssuntos
Cardiopatias/diagnóstico , Insuficiência Cardíaca/complicações , Ventrículos do Coração/diagnóstico por imagem , Heparina/efeitos adversos , Trombocitopenia/induzido quimicamente , Trombose/diagnóstico , Ecocardiografia , Evolução Fatal , Fibrinolíticos/efeitos adversos , Cardiopatias/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Trombocitopenia/complicações , Trombose/etiologiaRESUMO
Patients with valvular heart disease or with a prosthetic heart valve replacement are seen with increasing frequency in clinical practice. The medical care and evaluation of patients with valvular heart disease before valve surgery, but also the post-operative treatment is complex and managed by general practitioners, cardiologists and cardiac surgeons. In this mini-review we will first discuss the preoperative assessment of the two most common valvulopathies, aortic stenosis and mitral regurgitation. Then we will discuss the post-operative care, which includes the management of anticoagulation, serial follow up and as well as the diagnostic assessment of complications such as thromboembolism, hemolysis, endocarditis and valve dysfunction.
Les patients présentant une valvulopathie cardiaque ou une prothèse valvulaire sont vus de plus en plus fréquemment en pratique courante. Le traitement médical et l'évaluation des patients avec valvulopathie avant l'intervention pour remplacement valvulaire, mais aussi le traitement post-opératoire son complexes et pris en charge par les généralistes, les cardiologues et les chirurgiens cardiaques. Dans cette mini-revue nous allons discuter en premier lieu l'évaluation pré-opératoire des deux valvulopathies les plus fréquentes, à savoir la sténose aortique et la régurgitation mitrale. Nous allons discuter ensuite la prise en charge post-opératoire, celle-ci incluant le traitement par anticoagulant, le suivi régulier et l'approche diagnostique des complications telles que la thromboembolie, l'hémolyse, l'endocardite et la dysfonction valvulaire.
