Browsing by Author "Torres, S."
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- Cardiac Mass: Left Atrial MyxomaPublication . Fontes-Oliveira, Marta; Rodrigues, Patrícia; Silveira, Inês; Cabral, S.; Torres, S.
- Coronary artery fistula presenting as unstable anginaPublication . Silva-Vieira, M.; Antunes, M.; Anjo, D.; Palma, P.; Cyrne-Carvalho, H.; Torres, S.
- 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.
- ENCERRAMENTO PERCUTÂNEO DE COMUNICAÇÃO INTERAURICULAR E FORAMEN OVALE PATENTE EM ADULTOS – A EXPERIÊNCIA DE UM CENTROPublication . Vieira, M.; Dias, V.; Meireles, A.; Gomes, C.; Antunes, N.; Anjo, D.; Guedes, R.; Oliveira, F.; Cabral, S.; Pereira, L.; Braga, P.; Cyrne-Carvalho, H.; Torres, S.
- A good excuse for skipping the test: electrical storm in a teenagerPublication . Rodrigues, P.; Pinheiro-Vieira, A.; Loureiro, M.; Álvares, S.; Anjo, D.; Roque, C.; Sousa, M.; Torres, S.We describe the case of a teenager with a structurally normal heart that presented with torsades de pointes and cardiac arrest. He had a history of epilepsy in childhood, mild cognitive impairment and cognitive visual dysfunction. The baseline electrocardiogram had prominent J waves and a marked early repolarization pattern in all the leads, with normal QT interval. We discuss the differential diagnosis for this interesting case, as well as the patient's management.
- HOME MONITORING SYSTEM EM DOENTES COM POLINEUROPATIA AMILOIDÓTICA FAMILIARPublication . Vieira, M.; Dias, V.; Meireles, A.; Gomes, C.; Antunes, N.; Anjo, D.; Roque, C.; Reis, H.; Lagarto, V.; Cyrne-Carvalho, H.; Torres, S.
- 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.
- Long-term effects of a cardiac rehabilitation program in the control of cardiovascular risk factorsPublication . Magalhães, S.; Ribeiro, M.; Barreira, A.; Fernandes, P.; Torres, S.; Lopes-Gomes, J; Viamonte, S.Os programas de reabilitação cardíaca visam melhorar a capacidade funcional do doente com patologia cardíaca, assim como educar e acompanhar no controlo dos seus fatores de risco cardiovasculares. Objetivo Avaliar os efeitos de um programa de reabilitação cardíaca em doentes com doença cardíaca isquémica ao longo de 12 meses de follow-up no que se refere ao controlo dos fatores de risco cardiovascular. Métodos Estudo prospetivo que inclui doentes com diagnóstico de doença cardíaca isquémica que completaram programa de reabilitação cardíaca baseado no exercício entre janeiro de 2008 a dezembro de 2009, sem perda de dados no follow-up. Foram avaliados num momento inicial (primeira consulta da fase ii) aos 3, 6 e 12 meses depois, com registo dos seguintes parâmetros: índice de massa corporal, circometria abdominal, perfil lipídico, HbA1c nos doentes diabéticos, tensão arterial, tabagismo e nível de atividade física (através do International Physical Activity Questionnaire). Resultados Amostra de 256 doentes (76,2%; idade média: 67 anos); a dislipidemia revelou-se o fator de risco mais prevalente (74,2%) seguido de excesso ponderal (71,5%). No final da fase ii ocorreu uma melhoria estatisticamente significativa (p < 0,05) em todos os fatores de risco estudados, que se manteve aos 6 e 12 meses de follow-up, com a exceção do IMC (perda do significado estatístico na avaliação dos 6 meses; p=0,92). Conclusão Este estudo salienta a necessidade de programas de reabilitação cardíaca no contexto da prevenção secundária da doença cardiovascular e a importância de implementar estratégias que potenciem a manutenção dos benefícios a longo prazo.
- 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.