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The reduction in patients presenting with ST-elevation myocardial infarction (STEMI) during the COVID19 crisis could have resulted from fears about developing COVID-19 infection in hospital. Patients who delay presenting with STEMI are more likely to develop mechanical complications, including acute ischemic mitral regurgitation (MR). We present a 69-year-old women with an inferior STEMI and cardiogenic shock due to acute ischemic MR who delayed presenting to hospital due to the fear of COVID-19. Early identification of this mechanical complication using transthoracic echocardiography in the Emergency Department enabled the team to target her optimisation. Ultimately these patients require urgent surgery to repair the mitral valve and revascularize the myocardium but they are often too unwell to undergo surgery and even when it is feasible the outcomes are poor.
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http://dx.doi.org/10.1016/j.ajem.2020.10.028 | DOI Listing |
Cardiovasc Revasc Med
August 2025
Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, USA. Electronic address:
Secondary mitral regurgitation (SMR) remains a prevalent and challenging complication in patients with heart failure (HF), associated with poor prognosis despite optimal guideline-directed medical therapy (GDMT) and cardiac resynchronization therapy. Current American and European guidelines recommend GDMT as first-line therapy, with transcatheter edge-to-edge repair (TEER) reserved for severe symptomatic SMR patients who remain refractory. However, both guidelines preceded the reporting of pivotal randomized controlled trials (RESHAPE-HF2, MATTERHORN, and EFFORT) and emerging evidence in new clinical scenarios.
View Article and Find Full Text PDFJACC Case Rep
September 2025
Department of Radiology, Gaziantep City Hospital, Gaziantep, Turkey.
Background: Coronary artery pseudoaneurysms (CAP) are rare, especially without any history of coronary angioplasty and coronary bypass graft. The symptoms range from asymptomatic to cardiogenic shock. Because of its rarity and variable symptoms, patients with CAP should be treated with an individualized approach.
View Article and Find Full Text PDFJACC Case Rep
September 2025
Department of Cardiac Surgery, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China. Electronic address:
Background: Infective endocarditis (IE) with irreversible structural damage has high mortality despite conventional surgery. Heart transplantation (HTx) remains underused in active IE owing to guideline limitations and historical contraindications.
Case Summary: A 61-year-old man with recurrent prosthetic valve IE (aortic/tricuspid vegetations, perivalvular abscesses, and coronary embolism) developed cardiogenic shock.
Cureus
August 2025
Internal Medicine, Baptist Memorial Hospital-North Mississippi, Oxford, USA.
Fulminant myocarditis is a rare but life-threatening complication of influenza A infection that can result in acute biventricular failure leading to cardiogenic shock. Here, we present the case of a young patient who developed acute bilateral heart failure secondary to influenza A and was successfully stabilized using both right and left-sided Impella devices. This case highlights the critical role of early and aggressive mechanical circulatory support (MCS) in managing fulminant myocarditis and emphasizes the utility of Impella in cases of severe cardiac dysfunction.
View Article and Find Full Text PDFEur J Clin Invest
September 2025
Department of Medicine, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain.
Background: Age-related differences in Takotsubo Syndrome (TTS) have been described, but there is limited information regarding TTS patients who develop cardiogenic shock (CS).
Methods And Results: We analysed data from 408 CS-TTS patients in the RETAKO registry. Patients were stratified into three age groups: ≤50 years (9%), 51-74 years (48%), and ≥75 years (43%).