Cátia Costa Oliveira

University of Minho · Life and Health Sciences Research Institute

The cardiovascular response to exercise has long been a focus of interest. Over a century ago, the first descriptions of electrocardiographic changes occurring during exercise highlighted the possible relevance of this dynamic assessment. In this background, the inception of the Bruce protocol circa 60 years ago allowed for a major leap in this fie...

Introduction: Breast cancer (BC) is the most frequently diagnosed cancer and the leading cause of cancer-related mortality in women. Advances in screening and treatment have improved survival but have also increased morbidity and mortality due to treatment side effects, particularly cardiotoxicity. Late cardiotoxicity generally develops several yea...

Sr. Editor: Presentamos el caso de un varón de 62 años que acude a urgencias con signos de síndrome neurológico agudo. Permanece bajo observación por la presencia de paraparesia espástica. Su historia clínica también incluye dislipemia, tabaquismo activo, abuso de alcohol en el pasado y psoriasis. Su medicación habitual es ácido acetilsalicílico 15...

To the Editor, This is the case of a 62-year-old man who presented to the emergency department with signs of an acute neurological syndrome. He remained under regular monitorization due to spastic paraparesis. The patient’s past medical history also included dyslipidemia, active smoking, former alcohol abuse, and psoriasis. His routine medication i...

Background: Although it is a poorly known disease, spontaneous coronary artery dissection is an important and frequently underdiagnosed cause of non-atherosclerotic acute coronary syndrome, particularly in women. The objective of this study was to characterize a consecutive sample of patients diagnosed with spontaneous coronary artery dissection wi...

Background: Although outcomes in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary interventions (PCI) have improved, women show higher mortality. Objectives: To assess gender differences in presentation, management and in-hospital mortality, at 30-days, 6-months and 1-year after STEMI. Me...

Resumo Reportamos o caso de um jovem desportista de 17 anos que recorreu ao serviço de urgência por palpitações e tonturas durante o exercício físico. Referia dois episódios de síncope com o exercício nos últimos seis meses. Na admissão apresentava-se taquicárdico e hipotenso. O eletrocardiograma mostrava taquicardia regular de complexos largos com...

Presentation A 59-year-old woman, with multiple cardiovascular risk factors, a history of CABG (left internal mammary artery—obtuse marginal artery; right internal mammary artery—left anterior descending artery) and PAD; presented to the emergency department with prolonged thoracic pain (3 hours) associated with dyspnea. She was hypertense at admis...

Introduction: Patients with ST-elevation myocardial infarction (STEMI) requiring inter-hospital transfer for primary percutaneous coronary intervention (PCI) often have delays in reperfusion. The door in-door out (DIDO) time is recommended to be less than 30 min. Objectives: To assess the DIDO time of hospitals that transfer patients with STEMI...

Background: Although coronary artery bypass grafting has been considered the gold-standard treatment for stable ischemic left main coronary artery disease, percutaneous coronary intervention has shown good results, and is an alternative to surgery. This study aimed to evaluate and compare a real-world population with stable left main coronary arter...

Funding Acknowledgements Type of funding sources: None. Introduction The most common clinical presentation of non-ST-segment elevation myocardial infarction (NSTEMI) is angina pectoris. However, some groups of patients such as elderly, women and patients with diabetes or chronic renal disease,may have atypical symptoms, like isolated dyspnea or sy...

Funding Acknowledgements Type of funding sources: None. Background In ST-segment elevation myocardial infarction (STEMI), emergency medical system delays importantly affect outcomes. The place of first medical contact may affect the time to reperfusion and consequently affect outcomes, as the most direct transfer to the catheterization laboratory...

Background Despite the widespread use of anthracyclines (ANT) and anti-HER2 antibodies as trastuzumab (TZB) in chemotherapy schemes, it is known the potential cardiotoxic effects that can limit its use. Aim To study the benefit of drugs commonly used to treat heart failure with reduced ejection fraction or drugs known for an antioxidative effect o...

Introduction Infective endocarditis (IE) is associated with high morbidity and mortality, despite advances in diagnosis and treatment. Objective To assess changes in the epidemiological profile of IE, to perform a time-trend analysis and to define short-term and long-term prognostic predictors of IE. Methods Retrospective analysis of 173 patients...

A 28-year-old male with a previous history of drug abuse was sent to an emergent coronary angiography, after a cardiac arrest, with a post-resuscitation eletrocardiogram showing ST-segment elevation from V1-V4. Angiography showed multivessel and multisegment spontaneous coronary artery dissection. Due to clinical instability, patient underwent left...

Introduction In ST-segment elevation myocardial infarction (STEMI) patients, emergency medical system delays importantly affect outcomes. The effect of admission time in STEMI patients is dubious when percutaneous coronary intervention (PCI) is the preferred reperfusion strategy. Aims The authors aimed to retrospectively describe the association b...

Background 2D left ventricular ejection fraction (LVEF) estimation through echocardiography has been the classic parameter for cancer therapy–related cardiac dysfunction (CTrCD) detection. However, it is hypothesized that other parameters can be used in order to detect early stages of subclinical cardiotoxicity when LVEF is still preserved. Therefo...

Background Cancer treatment–related cardiotoxicity (CTrCD) is commonly associated with anthracyclines and anti-HER2 agents which are widely used for the treatment of breast cancer. In order to mitgate CTrCD, exercise-based cardio-oncology rehabilitation (COR) involving a structured exercise program has been proposed. Objectives To evaluate the imp...

Introduction Bifurcation percutaneous coronary intervention (PCI) is associated with a higher degree of complexity when compared with non-bifurcation procedures. Although 1-stent PCI remains the standard approach for most bifurcation lesions, data is constantly being published on 2-stent PCI. Aim To evaluate and compare the characteristics and out...

Background Although outcomes in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary interventions (PCI) have improved, a gender disparity exists, with women showing higher mortality. Objectives To assess gender differences in presentation, management and in-hospital, at 30-days, 6-months and 1-...

Background Improvements in percutaneous coronary intervention have reduced complications in the treatment of left main coronary artery disease. The objective of this study was to characterize percutaneous coronary intervention procedures in left main coronary artery, and evaluate patients’ outcomes. Methods A retrospective study performed from Janu...

Funding Acknowledgements Type of funding sources: None. INTRODUCTION The time course of ventricular recovery in Takotsubo Syndrome (TS) patients(pts) is still not well characterized. Quantification of myocardial deformation using Cardiovascular Magnetic Resonance Feature-Tracking (CMR-FT) may be a useful method to better characterize ventricular r...

Funding Acknowledgements Type of funding sources: None. Background Syncope is a common reason for emergency department attendance. This entity may be associated with significant morbidity and mortality and its differential diagnosis is not straightforward. Arrhythmic causes include tachycardia and bradycardia; the later may require pacemaker impla...

Funding Acknowledgements Type of funding sources: None. INTRODUCTION Atrial fibrillation (AF) is an adverse prognostic factor during acute coronary syndrome (ACS). Current evidence recommends dual antithrombotic therapy (DAT), 1 antiplatelet drug and 1 anticoagulant drug, as the default strategy after nonST elevation ACS. AIM To identify the clin...

Funding Acknowledgements Type of funding sources: None. Introduction It is known that some subgroups (e.g. women or elderly) may experience a delay in diagnosis of acute myocardial infarction (AMI). This may be due to atypical symptoms that don’t trigger further evaluation as promptly as typical symptoms or due to underestimation of patient’s comp...

Funding Acknowledgements Type of funding sources: None. INTRODUCTION Symptoms like syncope and palpitations are frequent and represent a diagnostic challenge. The implantable loop recorder (LR) is an important diagnostic tool, in selected cases. AIM To describe the main implantation indications of LR and to evaluate the diagnostic findings and the...

Funding Acknowledgements Type of funding sources: None. INTRODUCTION Takotsubo syndrome (TS) is characterized by transient wall motion abnormality of the left ventricle, which may happen in response to different triggers. AIM To characterize the population with confirmed diagnosis of TS. METHODS We analysed retrospectively 129 patients (pts) adm...

Funding Acknowledgements Type of funding sources: None. INTRODUCTION Left atrial cardiopathy (LAC) is an independent predictor of atrial fibrillation (FA) and embolic stroke. It is more frequent in patients with embolic stroke of undetermined source (ESUS) than in non-embolic strokes. The current definition doesn’t include supraventricular ectopy....

Funding Acknowledgements Type of funding sources: None. Introduction Although coronary artery bypass grafting (CABG) has been considered the gold-standard method for the treatment for left main stable ischemic coronary disease (s-LMCAD), percutaneous coronary intervention (PCI) has shown good results. Objective To evaluate patients with s-LMCAD w...

Funding Acknowledgements Type of funding sources: None. INTRODUCTION According to 2017 ESC guidelines for STEMI, reperfusion time of patients not admitted in centers with primary PCImust be ≤120 minutes (min). OBJECTIVE: To analyze the proportion of patients with STEMI admitted in hospitals without primary PCI in which reperfusion time was ≤120 mi...

CASE PRESENTATION We present the case of a 36-year-old female (informed consent obtained) with a past medical history of childbirth 2 months before being admitted to the emergency room with signs of chest pain with irradiation to her left arm associated with diaphoresis and dyspnea with 1-hour evolution. The electrocardiogram (ECG) performed did no...

CASE RESOLUTION We decided to end the procedure because the patient became asymptomatic and the ST-segment elevation resolved. After the procedure, the blood test performed revealed a new increase of troponin I levels (4.4 ng/mL). The patient started therapy with dihydropyridine calcium channel blockers due to the observed vasospasm. While in obser...

RESOLUCIÓN DEL CASO Se optó por finalizar la intervención tras la desaparición de los síntomas de la paciente (se obtuvo el consentimiento pertinente) y resolución de la elevación del segmento ST. Tras la intervención, la analítica sanguínea que se realizó reveló nuevas subidas de los niveles de troponina I (4,4 ng/ml). La paciente inició un tratam...

PRESENTACIÓN DEL CASO Se presenta el caso de una mujer de 36 años con antecedentes de parto 2 meses antes de ser hospitalizada en urgencias con un cuadro de dolor torácico irradiado a brazo izquierdo asociado a diaforesis y disnea de 1 hora de evolución. Se obtuvo el consentimiento informado pertinente. El electrocardiograma (ECG) que se realizó no...

Funding Acknowledgements Type of funding sources: None. Introduction Aortic stenosis (AS) is prevalent in the elderly population. When severe and the patient is symptomatic or left ventricular dysfunction arises, the prognosis deteriorates and valve replacement (AVR) is recommended. During the asymptomatic phase regular clinical evaluation is advi...

Introduction: Although invasive strategies are the generalized approach in the management of ACS pts, their benefits in pts with significant anemia are unclear, as anemia is strongly associated with increased risk of morbidity and mortality. Aim: To determine the incidence and the impact of severe anemia (hemoglobin<10g/dL) on short- and long-term...

Introduction: An early invasive strategy has become the standard of care for pts at high-risk of NSTE-ACS in the latest guidelines, however the optimal timing of coronary intervention in this pts is still a matter of debate. Hypothesis: To compare the prognosis between pts at high-risk of NSTE-ACS submitted an early (<24h) versus a delayed invasive...

Introduction In recent years, the use of invasive strategies has become the generalized approach in the management of patients with acute coronary syndrome (ACS), justified by the associated prognostic benefit due to reduced mortality and the evolution of percutaneous coronary intervention (PCI). However, the benefits of an invasive approach in ACS...

Atrial fibrillation (AF) is a common complication in acute coronary syndrome (ACS). However, treating patients (pts) with new-onset AF (NOAF) after an ACS remains a challenge. Although it seems intuitive that pts who develop AF within the first 48h have increased morbidity and mortality, your prognosis is unclear because there are no robust studies...

INTRODUCTION Nonbacterial thrombotic endocarditis (NBTE) is a rare form ofnoninfectious endocarditis in which a small sterile vegetations deposited on the heart valves (mostly aortic and mitral).It has been reported in every age group, most commonly affecting patients between the fourth and eighth decades of life with no sex predilection. Patients...

A 67 years old woman with a previous history of hypertension, atrial fibrillation (AF) and known severe concentric hypertrophy (more pronounced at the interventricular septum) with moderate pulmonary hypertension and diastolic dysfunction of the left ventricle (LV) resorted to the urgency service for weight loss, asthenia and dyspnea for minor effo...

Introduction Complete vascular rings represent about 0.5-2% of all congenital cardiovascular malformations, with the double aortic arch (DAA) being the most common of the complete vascular rings, causing tracheoesophageal compression. The right (posterior) arch is usually dominant (70%), although the two arches can have the same size (5%). The left...

INTRODUCTION Although primary cardiac tumors are rare, papillary fibroelastoma (PFE) is the most common benign neoplasm of cardiac valvular structures. Because patients are often asymptomatic the true prevalence is unknown, being most commonly recognized given the evolution of higher-resolution imaging technology. The clinical presentation of PFEs...

INTRODUCTION Caseous calcification of the mitral annulus (CCMA) is a very rare variant of mitral annular calcification with a central liquefaction necrosis, being an uncommon echocardiographic finding (0.5 to 1%) which may be mistaken for an intracardiac tumor, thrombus or vegetation. This chronic degenerative process can occurs at advanced ages, p...

INTRODUCTION Cardiac tumors represent a challenging diagnosis, since the heart is an unusual site of metastasis from any malignancy.Metastatic tumors usually arise from lung, breast, renal cancer, melanomas, and lymphomas but cardiac metastization from bladder urothelial carcinoma is an extremely rare event. Here, we report the case of an 82-year-o...

A 61 years old female with history of rheumatic arthritis and Sjogren Syndrom resorted to the emergency room in December of 2017 for pleuritic chest pain and dyspnea. An angioCT showed a luminal filling defect at the left inferior pulmonary artery with extension to the segmentar vessels. A pulmonary embolism (PE) was diagnosed and the patient was a...

We report the case of a 17 years old athlete who resorted to the emergency service for palpitations and dizziness during exercising. He mentioned two episodes of syncope associated with exercise in the last 6 months. He was tachycardic (200 bpm) and hypotensive (85/56 mmHg). The electrocardiogram showed regular wide complex tachycardia with left bu...

Introduction Cardiogenic shock (CS) is an uncommon complex syndrome in patients (pts) with acute myocardial infarction (AMI). However, it remains the most serious complication and the most common cause of in-hospital mortality, with mortality rates ranging from 40% to 60%. The majority of pts are thought to develop CS after admission (late CS), but...

Background Transradial access is associated with fewer access-related complications, earlier discharge and lower mortality, being the preferred route to perform coronary angiogram and interventions due to its safety and cost effectiveness in STEMI patients. However, the radial artery is smaller, more superficial and thinner than the femoral artery...

Introduction STEMI time delays have been presented as an indicator of quality of care. Considering the system delay, the guidelines of European Society of Cardiology (ESC) and American Heart Association (AHA) for the management of STEMI patients (pts) diverge regarding the maximum time from STEMI diagnosis to wire crossing in pts presenting at prim...

Resumo Doente de 83 anos, sexo feminino, com antecedentes de artrite reumatoide há 10 anos, foi internada por infecção do trato urinário com lesão renal aguda em doença renal crónica e insuficiência cardíaca descompensada de etiologia não esclarecida. Ecocardiograma transesofágico (ETE) com vegetação apensa ao folheto posterior da válvula mitral, c...

An 83-year-old woman with a 10-year history of rheumatoid arthritis was admitted for urinary tract infection with exacerbation of chronic kidney disease and decompensated heart failure of unknown etiology. Transesophageal echocardiography (TEE) showed a vegetation involving the posterior mitral valve leaflet, and a hypothesis of infective endocardi...

The ability of peripheral nervous system (PNS) axons to regenerate and re-innervate their targets after an injury has been widely recognized. However, despite the considerable advances made in microsurgical techniques, complete functional recovery is rarely achieved, especially for severe peripheral nerve injuries (PNIs). Therefore, alternative the...