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CT and MRI

Review: Acute and complicated inflammatory pericarditis – Mayo Clin Proc

6 May, 2024 | 18:03h | UTC

The article provides a comprehensive review of current approaches to the diagnosis and management of inflammatory pericardial disease, with a particular focus on acute and complicated cases of pericarditis. Here’s a summary tailored for a medical audience:

Key Points:

1 – Epidemiology and Presentation:

– Acute pericarditis is relatively common, particularly among younger populations.

– It can be effectively managed in most cases but poses a significant risk of recurrence and morbidity if not properly treated.

– Presentations can vary, with chest pain being a predominant symptom, which improves upon leaning forward and worsens in the supine position.

2 – Diagnostic Evaluation:

– Diagnosis hinges on a combination of clinical signs (e.g., chest pain, pericardial rub), ECG changes, imaging findings, and laboratory markers (elevated CRP and white blood cell count).

– Multimodality imaging plays a critical role in diagnosis and management, including echocardiography, CT, and MRI to evaluate pericardial effusion and inflammation.

3 – Management Strategies:

– The treatment landscape has evolved with the introduction of targeted anti-inflammatory therapies and a more systematic approach to care.

– Management includes NSAIDs as first-line therapy, colchicine to reduce recurrence rates, and corticosteroids for severe cases. Recent advancements include the use of interleukin-1 receptor blockers for complicated cases.

– Pericardiectomy may be considered in chronic or recurrent cases that are refractory to medical management.

4 – Future Directions:

– Ongoing research is directed at improving diagnostic accuracy through advanced imaging techniques and refining treatment protocols to minimize recurrence and manage complicated cases effectively.

– The integration of novel biological agents and personalized medicine approaches is anticipated to enhance outcomes for patients with pericardial disease.

This article emphasizes the importance of a protocol-driven approach to the initial care, the use of targeted therapeutics based on individual patient profiles, and the integration of care pathways to manage acute and complicated pericarditis effectively.

 

Reference (link to free full-text):
Malik, A. A., Lloyd, J. W., Anavekar, N. S., & Luis, S. A. (2024). Acute and Complicated Inflammatory Pericarditis: A Guide to Contemporary Practice. Mayo Clinic Proceedings, 99(5), 795-811. https://doi.org/10.1016/j.mayocp.2024.01.012

 

Consensus Statement | Clinical quantitative coronary artery stenosis and coronary atherosclerosis imaging

13 Jun, 2023 | 13:49h | UTC

Clinical quantitative coronary artery stenosis and coronary atherosclerosis imaging: a Consensus Statement from the Quantitative Cardiovascular Imaging Study Group – Nature Reviews Cardiology (if the link is paywalled, try this one)

 

Commentary on Twitter

 

Cohort Study | Coronary artery calcium score superior to polygenic score for CHD risk prediction

7 Jun, 2023 | 13:51h | UTC

Coronary Artery Calcium Score and Polygenic Risk Score for the Prediction of Coronary Heart Disease Events – JAMA (link to abstract – $ for full-text)

News Release: CT scan best at predicting heart disease risk in middle age: Scan beats genetics to gauge risk – Northwestern University

 

ACC/AHA Multimodality appropriate use criteria for the detection and risk assessment of chronic coronary disease

29 May, 2023 | 11:18h | UTC

ACC/AHA/ASE/ASNC/ASPC/HFSA/HRS/SCAI/SCCT/SCMR/STS 2023 Multimodality Appropriate Use Criteria for the Detection and Risk Assessment of Chronic Coronary Disease – Journal of the American College of Cardiology

Commentaries:

New Multimodality AUC Address Detection and Risk Assessment of Chronic Coronary Disease – American College of Cardiology

2023 Multimodality Appropriate Use Criteria for Chronic Coronary Disease: Key Points – American College of Cardiology

 

Commentary on Twitter

 

Consensus Statement | Multimodality imaging in thoracic aortic diseases

25 May, 2023 | 11:28h | UTC

Multimodality imaging in thoracic aortic diseases: a clinical consensus statement from the European Association of Cardiovascular Imaging and the European Society of Cardiology working group on aorta and peripheral vascular diseases – European Heart Journal – Cardiovascular Imaging

 

Review | Computed tomographic angiography in coronary artery disease

5 Apr, 2023 | 13:33h | UTC

Computed tomographic angiography in coronary artery disease – EuroIntervention

 

Cohort Study | Subclinical coronary atherosclerosis and risk for myocardial infarction

31 Mar, 2023 | 13:36h | UTC

Subclinical Coronary Atherosclerosis and Risk for Myocardial Infarction in a Danish Cohort: A Prospective Observational Cohort Study – Annals of Internal Medicine (link to abstract – $ for full-text)

Commentary: CTA-detected coronary artery disease associated with increased risk for myocardial infarction – ACP Internist

Related:

M-A: Evaluation of the incremental value of a coronary artery calcium score beyond traditional cardiovascular risk assessment.

New study challenges the idea that a coronary artery calcium score of 0 is enough for ruling out coronary stenosis in symptomatic patients, especially in young adults.

Cohort Study: Coronary Artery Calcium and Long-Term Risk of Death, Myocardial Infarction, and Stroke

USPSTF Statement: Risk Assessment for Cardiovascular Disease With Nontraditional Risk Factors

Research: Coronary Artery Calcium Score for Long-term Risk Classification in Individuals With Type 2 Diabetes and Metabolic Syndrome

The 10-Year Prognostic Value of Zero and Minimal CAC

 

Review | Multi-modality cardiac imaging evaluation of infective endocarditis

30 Mar, 2023 | 14:05h | UTC

Contemporary Review of Multi-Modality Cardiac Imaging Evaluation of Infective Endocarditis – Life

 

Review | Excessive trabeculation of the left ventricle

22 Feb, 2023 | 12:18h | UTC

Excessive Trabeculation of the Left Ventricle: JACC: Cardiovascular Imaging Expert Panel Paper – JACC: Cardiovascular Imaging

News Release: Review calls for a refreshed look at clinical approach to heart muscle disorder – Queen Mary, University of London

 

Retrospective Cohort | Incidental coronary artery calcification on non-gated CT thorax correlates with risk of CV events and death

31 Jan, 2023 | 13:51h | UTC

Incidental coronary artery calcification on non-gated CT thorax correlates with risk of cardiovascular events and death – European Radiology

 

The year in cardiovascular medicine 2022: the top 10 papers in cardiovascular imaging

9 Jan, 2023 | 14:21h | UTC

The year in cardiovascular medicine 2022: the top 10 papers in cardiovascular imaging – European Heart Journal

 

Commentary on Twitter

 

RCT | Utility of coronary CT angiography for patients with suspected acute coronary syndrome.

9 Dec, 2022 | 13:22h | UTC

Prospective RandOmised Trial of Emergency Cardiac Computerised Tomography (PROTECCT) – Heart

 

Commentary on Twitter

 

Under a http://creativecommons.org/licenses/by-nc/4.0/ License

 

Cohort Study | Distinguishing Type 1 from Type 2 myocardial infarction by using CT coronary angiography.

1 Nov, 2022 | 12:03h | UTC

Distinguishing Type 1 from Type 2 Myocardial Infarction by Using CT Coronary Angiography – Radiology: Cardiothoracic Imaging

 

Cohort Study | Diagnostic yield of ECG-gated cardiac CT in the acute phase of ischemic stroke vs. transthoracic echocardiography.

17 Oct, 2022 | 12:23h | UTC

Diagnostic Yield of ECG-Gated Cardiac CT in theAcute Phase of Ischemic Stroke vsTransthoracic Echocardiography – Neurology (link to abstract – $ for full-text)

Author Interview: ECG-Gated Cardiac CT in Acute Ischemic Stroke vs Transthoracic Echocardiography

Commentary: Add Cardiac CT to Acute Stroke Imaging to Detect Cardioembolism -Medscape (free registration required)

 

Expert Consensus | Cardiac computed tomographic imaging in cardio-oncology.

14 Oct, 2022 | 14:14h | UTC

Cardiac computed tomographic imaging in cardio-oncology: An expert consensus document of the Society of Cardiovascular Computed Tomography (SCCT). Endorsed by the International Cardio-Oncology Society (ICOS) – Journal of Cardiovascular Computed Tomography

 

Commentary on Twitter

 

M-A | The prognostic value of CAC zero among individuals presenting with chest pain.

14 Oct, 2022 | 14:10h | UTC

The Prognostic Value of CAC Zero Among Individuals Presenting With Chest Pain: A Meta-Analysis – JACC: Cardiovascular Imaging (link to abstract – $ for full-text)

 

Consensus Paper | Use of coronary CT angiography for patients with acute chest pain in the emergency department.

7 Oct, 2022 | 14:16h | UTC

2022 Use of Coronary Computed Tomographic Angiography for Patients Presenting with Acute Chest Pain to the Emergency Department: An Expert Consensus Document of the Society of Cardiovascular Computed Tomography (SCCT). Endorsed by the American College of Radiology (ACR) and North American Society for Cardiovascular Imaging (NASCI) – Journal of Cardiovascular Computed Tomography

Commentary: Acute Chest Pain in the ED? SCCT Offers Guidance for Using CCTA – TCTMD

 

Cohort Study | Cardiovascular MRI phenotypes and long-term outcomes in patients with suspected cardiac sarcoidosis.

30 Sep, 2022 | 12:39h | UTC

Cardiovascular Magnetic Resonance Imaging Phenotypes and Long-term Outcomes in Patients With Suspected Cardiac Sarcoidosis – JAMA Cardiology (link to abstract – $ for full-text)

Commentary: Cardiovascular magnetic resonance imaging phenotype with pathology-frequent late gadolinium enhancement associated with high-risk of ventricular arrhythmic and heart failure events – Physician’s Weekly

 

Commentary on Twitter

 

Consensus Statement | Cardiac computed tomographic imaging in cardio-oncology.

22 Sep, 2022 | 13:07h | UTC

Cardiac Computed Tomographic Imaging in Cardio-Oncology: An Expert Consensus Statement from the Society of Cardiovascular Computed Tomography, Endorsed by the International Cardio-Oncology Society (ICOS) – Journal of Cardiovascular Computed Tomography

 

Commentary on Twitter

 

Expert Analysis | Clinical applications of cardiac magnetic resonance imaging in pericardial diseases.

25 Aug, 2022 | 11:59h | UTC

Clinical Applications of Cardiac Magnetic Resonance Imaging in Pericardial Diseases – American College of Cardiology

Related: Case Series: Cardiac magnetic resonance in the assessment of pericardial abnormalities.

 

Review | Advances in imaging and targeted therapies for recurrent pericarditis.

22 Aug, 2022 | 12:06h | UTC

Advances in Imaging and Targeted Therapies for Recurrent Pericarditis: A Review – JAMA Cardiology (free for a limited period)

Videos:

Transthoracic Echocardiogram Showing Signs of Constrictive Physiology – JAMA

Cardiac Magnetic Resonance Showing Signs of Constrictive Physiology – JAMA

Cardiac Magnetic Resonance Finding in Constrictive Pericarditis – JAMA

 

Commentary on Twitter

 

Cohort Study | Markers of focal and diffuse nonischemic myocardial fibrosis are associated with adverse cardiac remodeling and prognosis in patients with hypertension.

26 Jul, 2022 | 11:46h | UTC

Markers of Focal and Diffuse Nonischemic Myocardial Fibrosis Are Associated With Adverse Cardiac Remodeling and Prognosis in Patients With Hypertension: The REMODEL Study – Hypertension

Commentary: Heart muscle scarring found in patients with hypertension are associated with worse outcomes – SingHealth

 

SCMR Consensus Statement | Cardiovascular magnetic resonance of acquired and non-structural pediatric heart disease.

22 Jul, 2022 | 11:43h | UTC

SCMR expert consensus statement for cardiovascular magnetic resonance of acquired and non-structural pediatric heart disease – Journal of Cardiovascular Magnetic Resonance

 

Coronary Artery Disease Reporting and Data System (CAD-RADS 2.0) reporting system for patients undergoing coronary CT angiography.

14 Jul, 2022 | 12:49h | UTC

CAD-RADSTM 2.0 2022 Coronary Artery Disease – Reporting and Data System An Expert Consensus Document of the Society of Cardiovascular Computed Tomography (SCCT), the American College of Cardiology (ACC), the American College of Radiology (ACR) and the North America Society of Cardiovascular Imaging (NASCI) – Journal of Cardiovascular Computed Tomography

Commentary: SCCT Releases New Expert Consensus Document on CAD Reporting – American College of Cardiology

 

Navigating a Complicated World | Commentary of the new AHA/ACC Chest Pain Guidelines.

12 Jul, 2022 | 12:40h | UTC

Navigating a Complicated World: The American Heart Association/American College of Cardiology/American College of Chest Physicians/Society of Academic Emergency Medicine/Society of Cardiovascular Computed Tomography/Society of Cardiovascular Magnetic Resonance Chest Pain Guidelines – CHEST

Original Guideline: 2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR Guideline for the Evaluation and Diagnosis of Chest Pain: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines – Journal of the American College of Cardiology

News Release: First-Ever Guideline Focused Solely on Chest Pain Evaluation, Diagnosis Released

Guideline Hub: Guideline for the Evaluation and Diagnosis of Chest Pain

Key Points: 2021 AHA/ACC Chest Pain Guideline – American College of Cardiology

Commentary: New Chest Pain Guidelines Out at Last: Most Tests Have a Role – TCTMD

 

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