Takotsubo Syndrome (TTS) is characterized by transient left ventricular dysfunction, often triggered by emotional or physical stress. While negative emotional events are common triggers, positive emotional events can also induce a rare variant known as Happy Heart Syndrome (HHS). This case report describes a 53-year-old male who presented with acute chest pain following a positive emotional stimulus: a birthday call offering him an opportunity to play with his favorite music group. Initial workup suggested an acute myocardial infarction, but coronary angiography revealed no obstruction. Left ventriculography showed the classic apical ballooning pattern of TTS. The patient was diagnosed with HHS. This case underscores the importance of considering positive emotional triggers in the diagnosis of TTS and highlights the need for further research into its diverse presentations and management ...

Lung ultrasound is a tool that is increasingly gaining strength in the initial evaluation of the patient in the emergency department and in critical care areas, making it particularly useful for cardiologists. In patients with ST elevation and acute myocardial infarction it has been observed that 25-45% of patients are wrongly classified as Class I in the Killip and Kimball classification after lung ultrasound (subclinical congestion). The clinical relevance of this finding lies in the fact that the greater the number of B lines, the greater short- and long-term the mortality is. An important advantage is that no prolonged time for learning the technique is required. More studies are needed to evaluate the role and importance of subclinical congestion in patients with acute myocardial infarction. Unfortunately, ultrasound is not widely available in developing countries, so the ph...

Systemic lupus erythematosus (SLE) is an inflammatory autoimmune disease with an important course due to systemic compromise. SLE is frequently associated with antiphospholipid syndrome, and pulmonary thromboembolism (PE) is particularly common. It is extremely rare for PE to be the initial clinical presentation and even more uncommon for it to coincide with cardiac tamponade, representing a challenge in diagnosis and management. We present a case of a 42-year-old woman with recurrent PE with severe pleural and pericardial effusion, hemodynamic instability, and cardiac tamponade. Laboratory workup revealed hypocomplementemia, leukopenia, negative SLE antibodies, and a positive lupus anticoagulant. This case emphasizes the importance of determining the etiology of PE, assessing risk classification, and implementing proper management, which are crucial for the patient's survival an...

Objective. The purpose of this study is to determine the prognostic value of the absolute decrease in the N-terminal portion of pro-B-type natriuretic peptide (NT-proBNP) to prevent fewer clinical events, in the population of CLUSTER-HF (efficacy of ultrasound lung to guide therapy and prevent readmissions in heart failure). Materials and methods. This study was conducted in a subgroup of ninety-four patients with available NT-proBNP information at hospital discharge and prior to randomization in the CLUSTER-HF study. The primary objective of the study was to determine the prognostic value of absolute NT-proBNP decline below which fewer events of all-cause death, emergency room visits, and rehospitalization for heart failure at 180 days. Results. The absolute decrease in NT-proBNP below 3,350 pg/mL has a moderate discriminative capacity with AUC= 0.602, with a prognostic value in the com...

Objetivo. Determinar el valor pronóstico del descenso absoluto de la porción N-terminal del propéptido natriurético tipo B (NT–proBNP) para prevenir menos eventos clínicos en la población del estudio CLUSTER-HF (eficacia del ultrasonido pulmonar para guiar la terapia y prevenir las rehospitalizaciones en insuficiencia cardiaca). Materiales y métodos. El presente estudio fue realizado en un subgrupo de 94 pacientes con información disponible de NT-proBNP al alta hospitalaria y previo a la aleatorización del estudio CLUSTER-HF. El objetivo primario del estudio fue determinar el valor pronóstico de descenso absoluto de NT - pro-BNP por debajo del cual se prediga menos eventos de muerte por todas las causas, visitas a urgencias y rehospitalización por insuficiencia cardiaca a 180 días. Resultados. El descenso absoluto de NT-proBNP por debajo de 3 350 pg/mL tiene una capacidad d...

Objective. The purpose of this study is to determine the prognostic value of the absolute decrease in the N-terminal portion of pro-B-type natriuretic peptide (NT-proBNP) to prevent fewer clinical events, in the population of CLUSTER-HF (efficacy of ultrasound lung to guide therapy and prevent readmissions in heart failure). Materials and methods. This study was conducted in a subgroup of ninety-four patients with available NT-proBNP information at hospital discharge and prior to randomization in the CLUSTER-HF study. The primary objective of the study was to determine the prognostic value of absolute NT-proBNP decline below which fewer events of all-cause death, emergency room visits, and rehospitalization for heart failure at 180 days. Results. The absolute decrease in NT-proBNP below 3,350 pg/mL has a moderate discriminative capacity with AUC= 0.602, with a prognostic value in the com...

Objective. Acute myocardial infarction-related cardiogenic shock (AMI-CS) is often accompanied by tachycardia, which, in turn, increases myocardial oxygen consumption and hinders the use of ventricular assist devices, such as intra-aortic balloon pump. Evidence suggests that ivabradine may reduce heart rate (HR) without affecting other hemodynamic parameters. The aim of the present study was to determine the effect of ivabradine on reducing HR and changes in other hemodynamic parameters such as cardiac index (CI), in patients with AMI-CS and tachycardia. Materials and methods. A single-center, open label, randomized clinical trial included patients diagnosed with AMI-CS and tachycardia with >100 beats per minute (BPM). Heart rate, cardiac index, and other hemodynamic parameters measured by pulmonary flotation catheter were compared at 0, 6, 12, 24, and 48 hours after randomization. Re...