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3w
case study

Patient Background:

A 39-year-old male presented with exertional dyspnea, orthopnea, and shortness of breath. He was an active smoker with a history of pulmonary edema 10 months prior. On admission, his blood pressure was 120/70 mmHg, and he was receiving bisoprolol, ramipril, and furosemide. Though family history was unspecified, aortic dilation prompted consideration of first-degree relative screening, as recommended in bicuspid valve disease.

Assessment & Diagnosis:

Transthoracic echocardiography revealed severe aortic regurgitation (grade 4+), a left ventricular end-diastolic diameter of 65 mm, and preserved ejection fraction of 56%. The ascending aorta measured 54 mm. Preoperative imaging suggested a bicuspid aortic valve; however, intraoperative inspection revealed a rare pentacuspid aortic valve with five variably sized cusps, some exhibiting partial fusion. The final diagnosis was severe aortic regurgitation and ascending aortic aneurysm due to a pentacuspid valve anomaly.

  1. Why is pentacuspid aortic valve important in the workup of severe AR?
  2. How does early surgical intervention influence long-term outcomes in such patients?
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4w
Reconstruction of Traumatic External Iliac Artery Dissection Due to Vascular Clamping - PubMed

Reconstruction of Traumatic External Iliac Artery Dissection Due to Vascular Clamping - PubMed

Source : https://pubmed.ncbi.nlm.nih.gov/29108513/

Traumatic external iliac artery dissection after renal transplant is a rare complication, but it should be urgently managed due to its devastating effects on graft and lower limb circulation. External...

Two kidney transplant recipients developed traumatic external iliac artery dissection due to vascular clamping. After failed angioplasty, surgical reconstruction using polytetrafluoroethylene grafts restored graft function, emphasizing Doppler-based early detection and urgent vascular intervention.

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Attack Heart Disease

Sponsored
The Making of a Heart Attack

Barry Sanders learned about the link between high LDL-C and heart attacks firsthand. Now he’s sharing his story.

©2025 Amgen Inc. All rights reserved USA-CCF-83363 10/25

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1mo
Ambulatory Care Management in Low Blood Pressure Patient with HFrEF - PubMed

Ambulatory Care Management in Low Blood Pressure Patient with HFrEF - PubMed

Source : https://pubmed.ncbi.nlm.nih.gov/40771294/

Heart failure (HF) affects an estimated 38 million people globally, with most published research estimating a prevalence of 1 to 2% of the adult population. Low blood pressure (BP) is...

A 57-year-old man with HFrEF and hypotension was successfully managed with optimized guideline-directed therapy including sacubitril/valsartan, bisoprolol, and spironolactone, showing symptomatic and hemodynamic improvement under structured ambulatory follow-up.

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1mo
Bridging gaps in CHD care: pharmacologic advances and research needs in congenital heart disease

Congenital heart disease (CHD) remains the leading cause of death from birth defects worldwide. While survival exceeds 90% in high-income countries, many patients—particularly where surgery is limited—rely on pharmacologic management. Treatments often reflect adult heart failure regimens, targeting shared mechanisms like neurohormonal activation and cardiac remodeling.

Highlights:

  • ACE inhibitors, ARBs, beta-blockers, and diuretics to manage heart failure and ventricular dysfunction
  • Endothelin receptor antagonists, PDE-5 inhibitors, prostaglandins, and sGC stimulators for pulmonary arterial hypertension (PAH)
  • Digoxin, antiarrhythmics, and NSAIDs as adjunctive therapies for symptoms, arrhythmias, and ductal patency
  • Up to 85% of cardiovascular drugs in children are used off-label due to lack of pediatric-specific trials

What Sets This Study Apart:

This review consolidates pharmacologic strategies tailored to the complexity of CHD across age groups and comorbidities. It emphasizes treatment rationale, dosing nuances, and highlights critical evidence gaps that affect pediatric prescribing.

Limitations:

Current practice leans heavily on adult data. Clinical trials for pediatric CHD are scarce (<0.45% of NIH-funded CV trials), limiting evidence-based dosing, safety, and outcome data in children.

How do you balance limited pediatric trial data with the need for evidence-based care in CHD? What role could personalized, genomics-driven approaches play in shaping future outcomes?