Browsing by Author "Luz, A."
Now showing 1 - 8 of 8
Results Per Page
Sort Options
- Efficacy And Safety Of Implantable Loop Recorder: Experience Of A CenterPublication . Silveira, I.; Sousa, M.; Antunes, N.; Silva, V.; Roque, C.; Pinheiro-Vieira, A.; Lagarto, V.; Hipólito-Reis, A.; Luz, A.; Torres, S.Introduction: Symptoms like syncope or palpitations frequently present a diagnostic challenge. An implantable loop recorder (ILR) is an important aid in the management of these patients. Methods: A retrospective study of patients that underwent ILR implantation from November 2007 to 2014. For each patient the indication for implantation, baseline characteristics, previous study, complications, recorded tracing and interventions were evaluated. Results: A total of 62 patients were included, 50% men, with a mean age of 62.5±18.8 years old. Previously to ILR implantation 88.7% of patients had performed Holter, 17.7% external events recorder, 33.9% Tilt test and 29% an electrophysiological study. The implantation indications were recurrent syncope in 90.3%, palpitations 8.1% and ischemic stroke in one patient. Mean follow-up time was 17.1±16.3 months. Symptoms were reported in 66.1% of the patients, 46.8% of those yielding a diagnostic finding. In all cases of palpitation complaints with diagnosis we found atrial fibrillation (AF). In patients with syncope atrioventricular conduction disturbance was demonstrated in 19.6%, sinus node dysfunction in 16.1%, paroxysmal supra-ventricular tachycardia 7.1% and AF in 1.8%. These finding resulted in 19 pacemaker and one CRT-D implantation, introduction of anticoagulation in five patients and one ablation of accessory pathway. There were no major complications. Conclusion: ILR proved to be safe and efficient. It has enabled the identification or exclusion of serious rhythm disturbances in more than half of patients and provided a targeted therapeutic intervention.
- Left-sided infective endocarditis: analysis of in-hospital and medium-term outcome and predictors of mortalityPublication . Ferreira, J.; Gomes, F.; Rodrigues, P.; Araújo Abreu, M.; Maia, J.; Bettencourt, P.; Luz, A.; Torres, S.; Araújo Correia, J.Abstract Introduction: Despite diagnostic and therapeutic advances, infective endocarditis (IE) remains a challenging and potentially lethal disease. The prognosis of IE remains poor; in the last 30 years, its incidence and mortality have only been marginally reduced. Early identification of high-risk patients can change the course of the disease and improve outcomes. Objectives and methods: To describe and investigate predictors of mortality during hospital stay and in the six months after discharge in a cohort of left-sided IE patients in two tertiary centers. All patients diagnosed with IE (ICD9 code 133) were registered in a uniform database. Results: One hundred and forty-seven consecutive case patients with left-sided IE were included in this study. Thirty-five patients (23.8%) died during hospital stay. The variables significantly associated with increased mortality in univariate analysis were Charlson index ≥5, use of immunosuppressants, sepsis (severe sepsis and/or septic shock), cardiogenic shock and inappropriate use of antibiotic therapy. Conversely, surgical therapy and hospital length of stay ≥30 days were significantly associated with lower mortality. In multivariate analysis the most important predictors of in-hospital mortality were sepsis (severe and/or shock), use of immunosuppressants and inappropriate use of antibiotic therapy. There was a significant relation between the use of immunosuppressants and the occurrence of sepsis. The presence of significant valve disease after IE significantly increased the risk of heart failure. Conclusions: Our results may help to identify IE patients at increased risk for in-hospital mortality and medium-term disability. These findings can help to identify candidates for earlier and more aggressive management.
- Partial Papillary Muscle Rupture after Myocardial Infarction and Early Severe Obstructive Bioprosthetic Valve Thrombosis: an Unusual CombinationPublication . Silveira, I.; Oliveira, M.; Gomes, C.; Cabral, S.; Luz, A.; Torres, S.Mechanical complications after myocardial infarction (MI) have become uncommon since the introduction of primary angioplasty. They can lead to a rapid clinical deterioration and a fatal outcome, with patient’s survival being dependent on their prompt recognition and intervention. We describe a case of two rare mechanical complications: a partial papillary muscle rupture after MI, followed by an early severe obstructive thrombosis of the implanted bioprosthetic valve.
- PROGNÓSTICO A CURTO E LONGO PRAZO E FOLLOW-UP ANGIOGRÁFICO APÓS INTERVENÇÃO CORONÁRIA PERCUTÂNEA COM STENTS REVESTIDOS COM RAPAMICINA EM OCLUSÕES CORONÁRIAS CRÓNICAS: ESTUDO PROSPECTIVO DE UM CENTROPublication . Vieira, M.; Dias, V.; Meireles, A.; Gomes, C.; Antunes, N.; Anjo, D.; Luz, A.; Dias, H.; Correia, A.; Pinto, R.; Silveira, J.; Sousa, P.; Cyrne-Carvalho, H.; Torres, S.
- Right coronary artery aneurysmPublication . Luz, A.; Silveira, J.; Cyrne-Carvalho, H.; Gomes, L.Int J Cardiol. 2007 Jan 18;114(3):e122-3. Epub 2006 Oct 16. Right coronary artery aneurysm. Luz A, Silveira J, Carvalho H, Gomes L. Abstract Coronary artery aneurysms, characterized by abnormal dilatations of a localized portion of the coronary artery, are an uncommon finding during angiography. We present a case where a giant right coronary aneurysm was detected during angiography, in a patient admitted with a inferior wall myocardial infarction. PMID: 17049395 [PubMed - indexed for MEDLINE]
- Transferências Inter-Hospitalares de Adolescentes a partir de uma Urgência PediátricaPublication . Arriaga, C.; Jerónimo, M.; Luz, A.; Moleiro, P.Introdução: A Rede de Referenciação Materno-Infantil, estabelecida em Portugal desde 2001, permite uma complementaridade no atendimento e apoio entre unidades prestadoras de cuidados, garantindo o acesso universal aos cuidados de saúde. Objetivo: Caraterização das transferências inter-hospitalares de adolescentes a partir da Urgência Pediátrica (UP) de um hospital de tipologia B1. Material e Métodos: Estudo retrospetivo analítico. Consultaram-se os registos dos episódios de urgência dos adolescentes transferidos da UP, em 2011. Definiram-se e compararam-se dois grupos etários: dos 10 aos 14 anos (G1) e dos 15 aos 18 anos (G2), caraterizando as transferências quanto à demografia, diagnóstico, exames complementares e motivo de transferência. A análise estatística foi efetuada com recurso ao programa PASW 18.0® (p<0,05). Resultados: Registaram-se 43.409 admissões na UP, sendo que 24,2% (n=10.498) eram adolescentes, com idade média de 14,5 (±2,1) anos, sendo 67% do sexo masculino. Foram transferidos 1,2% (n=131) dos adolescentes, correspondendo a 46% do total de transferências. Dos adolescentes admitidos, 65,8% pertenciam ao G1 e dos transferidos 57,3 % pertenciam ao G2 (p< 0,001). Nos transferidos, registou-se patologia traumática em 45%, médica em 37,4% e cirúrgica em 17,6%. Os principais diagnósticos de saída pertenciam a patologia otorrinolaringológica (ORL), urológica e psiquiátrica. Realizaram-se exames complementares de diagnóstico em 42,7%, 82,1% dos quais imagiológicos. A falta de especialidades, em regime de urgência, no hospital de origem foi o motivo de transferência em 90,8%, e a especialidade em falta foi cirúrgica em 72,2%. A patologia psiquiátrica foi mais frequentemente diagnóstico de saída no G2 (22,7% versus 9,1%, p=0,037). Dos adolescentes transferidos para o hospital de nível A1 ficaram Internados 28,2%. Conclusões: Embora totalizando um quarto do movimento da UP, os adolescentes representaram uma importante percentagem de transferências, predominantemente os mais velhos. Transferiram-se maioritariamente por falta de especialidades na UP, nomeadamente ORL e Pedopsiquiatria.
- Triple, simultaneous, very late coronary stent thrombosisPublication . Silva-Vieira, M.; Luz, A.; Anjo, D.; Antunes, N.; Santos, M.; Cyrne-Carvalho, H.; Torres, S.Abstract Coronary artery stent thrombosis is an uncommon but potentially catastrophic complication. The risk of very late stent thrombosis (VLST) raises important safety issues regarding the first generation of drug-eluting stents (DES). Although several complex mechanisms for VLST have been suggested and various predictors have been described, its pathophysiology is not completely understood and it is not known whether longer-term dual antiplatelet therapy reduces the risk. We present a rare case of simultaneous very late DES thrombosis in the three vascular territories, following discontinuation of antiplatelet therapy seven years after stent placement, presenting as cardiogenic shock.
- Viridans streptococcus endocarditis associated with spondylodiscitis.Publication . Luz, A.; Castro, A.; Ribeiro, R.; Bernardo, L.; Cyrne-Carvalho, H.; Bernardo, A.; Gomes, L.Rev Port Cardiol. 2004 May;23(5):723-8. Viridans streptococcus endocarditis associated with spondylodiscitis. [Article in English, Portuguese] Luz A, Castro A, Ribeiro R, Bernardo L, Carvalho H, Bernardo A, Gomes L. SourceServiço de Cardiologia e Medicina 2 do Hospital Geral de Santo António, Porto, Portugal. andrecoimbraluz@hotmail.com Abstract The authors report a case of a 78-year-old male, admitted to the Hospital with fever, lumbar pain and a systolic murmur. Viridans streptococcus endocarditis associated with spondylodiscitis was diagnosed. Images and results of the exams are presented. This case is compared with similar studies in the literature. PMID: 15279456 [PubMed - indexed for MEDLINE]