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Extracorporeal cardiopulmonary resuscitation for refractory cardiac arrest - PubMed

Extracorporeal cardiopulmonary resuscitation for refractory cardiac arrest - PubMed

Source : https://pubmed.ncbi.nlm.nih.gov/40456239/

When conventional cardiopulmonary resuscitation (CCPR) cannot restore spontaneous circulation, the initiation of venoarterial extracorporeal membrane oxygenation during refractory cardiac arrest-known as extracorporeal CPR (ECPR)-might restore circulation and adequate tissue oxygenation....

ECPR, used when CCPR fails, can restore circulation and improve survival but faces limitations due to complexity, cost, and risks. Outcomes depend on patient factors, timing, and procedural effectiveness.

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Maternal Serum Folate During Pregnancy and Congenital Heart Disease in Offspring - PubMed

Maternal Serum Folate During Pregnancy and Congenital Heart Disease in Offspring - PubMed

Source : https://pubmed.ncbi.nlm.nih.gov/39388179/

In this case-control study of CHD, low maternal serum folate levels in early to midpregnancy were associated with an increased CHD risk in offspring, and excessively high folate levels were...

Maternal folate levels showed a U-shaped association with CHD risk in offspring; both low and high levels increased risk, especially with concurrent vitamin B12 deficiency or elevated homocysteine.

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Advancing Alzheimer's Research: Gender Differences, Cardiometabolic Risk, and Lifestyle Interventions.

At AAIC 2025, Dr. Heather Snyder, Senior Vice President of Medical and Scientific Relations at the Alzheimer's Association, highlights key findings on gender differences in Alzheimer’s disease, including women’s increased susceptibility following traumatic brain injury and the potential cognitive protection offered by managing cardiometabolic risk factors such as hypertension and diabetes.

Dr. Rachel Whitmer, Professor of Public Health Sciences and Neurology at UC Davis, presents results from the US POINTER study. This large-scale lifestyle intervention suggests that a structured program of diet, exercise, and cognitive engagement may delay cognitive aging over two years.

These insights underscore the importance of early, personalized, and holistic brain health strategies that span the entire adult lifespan.

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How to handle polypharmacy in heart failure. A clinical consensus statement of the Heart Failure Association of the ESC - PubMed

How to handle polypharmacy in heart failure. A clinical consensus statement of the Heart Failure Association of the ESC - PubMed

Source : https://pubmed.ncbi.nlm.nih.gov/40091554/

The multiplicity of coexisting comorbidities affecting patients with heart failure (HF), together with the availability of multiple treatments improving prognosis in HF with reduced ejection fraction, has led to an...

Polypharmacy in heart failure patients increases risks of poor adherence, adverse reactions, and hospitalizations. This consensus advocates multidisciplinary strategies to optimize treatment, reduce redundancy, and enhance outcomes.

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case study

Patient Background: A 36-year-old man with well-controlled first-grade essential hypertension presented for a routine cardiovascular evaluation. He had a known heart murmur since childhood and had previously been told he might have a ventricular septal defect. Physical examination was unremarkable.

Assessment and Diagnosis: Initial ECG showed sinus rhythm (62 bpm), poor R-wave progression in leads V1–V4, and T wave inversions. Transthoracic echocardiography (TTE) revealed atypical cardiac positioning with suboptimal image acquisition. Atrial septal defect was suspected. Cardiac magnetic resonance (CMR) imaging delineated complete left-sided pericardial agenesis—demonstrating the heart displaced laterally and posteriorly into the left hemithorax, lung interposition between the great vessels, and absence of the left-sided pericardium. A patent foramen ovale (PFO) without significant right-to-left shunting was also identified.

Suggested Treatment Plan and Patient Education: No treatment was advised for the pericardial defect given the patient’s asymptomatic status. However, the potential risk of paradoxical embolism through the PFO was discussed, and closure of the defect was considered. Patient education focused on recognizing signs of cryptogenic stroke and understanding the clinical implications of the PFO.

Follow-up: Annual echocardiographic follow-up was recommended. At 6 months, the patient remained asymptomatic.

  1. Why was CMR essential in diagnosing pericardial agenesis in this asymptomatic patient? Answer CMR delineated heart displacement, lung interposition, and absence of pericardium—details not discernible on suboptimal TTE—making it essential for confirming the diagnosis.
  2. What is the management for asymptomatic pericardial agenesis with a PFO? Answer Asymptomatic pericardial agenesis requires no treatment. However, the PFO may increase stroke risk, and closure may be considered to prevent paradoxical embolism.