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European Heart Journal - Acute Cardiovascular Care - Vol. 2 No. 2

Outstanding articles from the EHJ-ACVC journal, recommended by Prof. C. Vrints, Editor-in-Chief.

Acute Coronary Syndromes (ACS)

The June issue of EHJ-ACVC is focusing on acute cardiorespiratory failure and acute coronary syndromes.

C Lazzeri et al. from Ospedaliero-Universitaria Careggi, Italy made an extensive literature review on the use of extracorporeal membrane oxygenation (ECMO) in patients with refractory cardiac arrest and acute heart failure and its impact on clinical outcome. Optimal utilization of ECMO requires a careful selection of patients and the presence of a high level intensive acute cardiac care expertise.

TakoTsubo cardiomyopathy has a similar pattern of clinical presentation as acute myocardial infarction and is often misdiagnosed as acute coronary syndrome. V. Weihs et al. report the largest published series of patients with TakoTsubo cardiomyopathy included in a large multicenter registry in Austria. Four different types of TakoTsubo cardiomyopathy based on regional wall motion abnormalities are described.

The triage and diagnosis of acute myocardial infarction in patients with presenting with chest pain and with a bundle branch block on the ECG is a major challenge. JT Sørensen et al. from the Aarhus University Hospital, Denmark examined the prevalence and long term outcome of myocardial infarction with and without bundle branch block were studied in a large prehospital cohort of patients.
In spite of a well organized prehospital care system less than 25% of the patients with an acute myocardial infarction and bundle branch block underwent revascularization and only very few patients with new-onset bundle branch block were transferred for urgent revascularization.  One year mortality of acute myocardial infarction patients was more than two times higher in the patients with any (left or right) bundle branch block than in patients without. Improved triage by prehospital implementation of cardiac biomarker assays could possibly lead to a better outcome of patients with acute myocardial infarction and bundle branch block.


Chiara Lazzeri, Pasquale Bernardo, Andrea Sori, Lisa Innocenti, Pierluigi Stefano, Adriano Peris, Gian F Gensini and Serafina Valente
Venous-arterial extracorporeal membrane oxygenation for refractory cardiac arrest: a clinical challenge.
EHJACC DOI: 10.1177/2048872613484687

Valerie Weihs, Daniela Szücs, Barbara Fellner, Bernd Eber, Wolfgang Weihs, Thomas Lambert, Bernhard Metzler, Georg Titscher, Beate Hochmayer, Cornelia Dechant, Veronika Eder, Peter Siostrzonek, Franz Leisch, Max Pichler, Otmar Pachinger, Georg Gaul, Heinz Weber, Andrea Podczeck-Schweighofer, Hans-Joachim Nesser and Kurt Huber
Stress-induced cardiomyopathy (Tako-Tsubo syndrome) in Austria.
EHJACC doi: 10.1177/2048872613483592

Jacob Thorsted Sørensen, Carsten Stengaard, Christina Ankjær Sørensen, Kristian Thygesen, Hans Erik Bøtker, Leif Thuesen and Christian Juhl Terkelsen.
Diagnosis and outcome in a prehospital cohort of patients with bundle branch block and suspected acute myocardial infarction.
EHJACC DOI: 10.1177/2048872613483591