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GUEST EDITORIAL
Year : 2022  |  Volume : 19  |  Issue : 3  |  Page : 133-134

Hemming heart with newer needles: I hope the thread last forever


Department of Cardiology, Apollo Hospital, Indore, Madhya Pradesh, India

Date of Submission13-Jun-2022
Date of Decision29-Jun-2022
Date of Acceptance30-Jun-2022
Date of Web Publication05-Aug-2022

Correspondence Address:
Sarita Rao
Department of Cardiology, Apollo Hospital, Indore, Madhya Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/am.am_91_22

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How to cite this article:
Rao S. Hemming heart with newer needles: I hope the thread last forever. Apollo Med 2022;19:133-4

How to cite this URL:
Rao S. Hemming heart with newer needles: I hope the thread last forever. Apollo Med [serial online] 2022 [cited 2022 Nov 30];19:133-4. Available from: https://apollomedicine.org/text.asp?2022/19/3/133/353352



The world as we know it today has changed in various ways. The COVID pandemic has ravaged families, organizations, and businesses alike. Last year, when March almost collided with April and the lockdown stopped the wheels of world prosperity into a screeching halt, it seemed like the drought may have pierced into a usually rainy June. Life was as uncertain as never before. Still, our skilled doctors were at work in these testing times and, through the trials and tribulations, went from triumph to triumph amid every holt and heath in stitching our strength and skills together, to make realize the already tormented and defeated world that how hard, honest work, and sharp clinical acumen can bring changes in the lives of their loved ones. Last year, the one thing that has brought to our notice was the selfless devotion, care, sacrifice, and dedication of our frontline warriors, the Doctors. Medicine has always been a noble branch, but its importance has now been brought to the forefront.

Numerous advances are now being made in the field of Cardiology. Pinhole procedures are doing valve replacements today; Transcatheter Aortic Valve Implantation (TAVI) and Mitraclip have opened up new opportunities and brought relief for many patients who were earlier inoperable with multiple comorbidities. Patients go home much earlier, with no requirement for blood transfusion, no incision on the body, and no need for healing of the scar, and they have a very rapid recovery.

In Patients with multiple calcified lesions earlier the only option was a Bypass surgery. However now with the latest advancements in technology and the availability of Rotaablation, intravascular lithotrypsy, cutting balloon and excimer laser such calcified lesions can now be dealt with percutaneous coronary intervention and bypass surgery can be avoided. Coronary calcification is commonly associated with a more considerable plaque burden and a greater degree of lesion complexity, including involvement of coronary bifurcation or chronic total occlusion. Moreover, specific patterns of coronary calcifications, such as calcified nodules and coronary microcalcifications, are associated with plaque instability and vulnerability, with data suggesting higher platelet reactivity and blood thrombogenicity in patients with lesions with high calcium content. We now have newer modalities such as shockwave lithotripsy and rotablation, which have made angioplasty possible in such patients with complex coronary artery disease. As discussed finely and in an elaborate manner, clearing the dust for the time being until newer modalities appear on the podium as imaging has become the tool to go to for understanding pathophysiology and every day uncovering the tombstones to find appropriate ways to stay away from the grave.

The technological advancements in cardiology have progressed toward less invasive procedures and provided relief to many critically ill patients. Even pacemaker implantations are now being done via pinhole using the leadless pacemakers.

Patients with severe left ventricular (LV) dysfunction now have an option beyond medical therapy in the form of cardiac resynchronization therapy. In addition, a host of support devices are now available for patients when they require procedures, such as LV assist devices, intra-aortic balloon pumps, and the IMPELLA system. The advances in cardiology have been numerous and varied, opening up new vistas of patient care.

The COVID pandemic has been fraught with various cardiac complications and manifestations during the illness and recovery phase. In this issue, we also look at all the cardiac manifestations of COVID and how to deal with them. The importance of early treatment and initiation of anticoagulant therapy is highlighted, especially in sicker patients. Going through the article makes us wiser and we will be more vigilant in the future. The post-COVID squeals are as pertinent and essential as the disease, and their management has been challenging. It is the same for the persistent LV dysfunction following COVID myocarditis so much so that the World Health Organization has developed coding guidance for healthcare encounters related to post-COVID conditions: as U09.9 Post-COVID Unspecified.

A fascinating case report has been highlighted in this about HOCM and sepsis, which gives us insights into the usage of different vasopressors in sepsis and HOCM with heart failure emphasizing the inverted hemodynamics of HOCM meaning that the more ionotropes we use as in usual hypotension the shock worsens so it has an inverted relationship in this regards and also a very justified use of timely intervention with age-old alcohol septal ablation, as a bailout of persistent shock is highlighted.

Sepsis hemodynamics is marked by vasodilation which worsens HOCM gradient and leads to spiraling into what's aptly labeled as SUICIDAL LV, in the article on HOCM. The future of medicine is bright with various innovations, research, and developments. This issue focuses on various cardiac ailments and the innovations in their treatments.






 

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