Prophylaxis – ABC CARDIOL

ABC

Letter to the Editor

The Challenge of Effective Secondary Stroke Prophylaxis in Chagas Patients

The recent update on the guideline for the management of cardiomyopathy in Chagas disease brings several significant improvements. The evidence on etiological stroke investigation, management of secondary prophylaxis, and overall epidemiology are all of vital importance for clinicians to improve treatment for these patients.

One concern that arises from the guideline pertains to the indication of oral anticoagulation, particularly the suggestion that any previous ischemic stroke would warrant such intervention.

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ABC

Review Article

Infective Endocarditis: Still More Challenges Than Convictions

Catarina Sousa et al. Fausto J. Pinto

Abstract

After fourteen decades of medical and technological evolution, infective endocarditis continues to challenge physicians in its daily diagnosis and management. Its increasing incidence, demographic shifts (affecting older patients), microbiology with higher rates of Staphylococcus infection, still frequent serious complications and substantial mortality make endocarditis a very complex disease. Despite this, innovations in the diagnosis, involving microbiology and imaging, and improvements in intensive care and cardiac surgical techniques, materials and timing can impact the prognosis of this disease. Ongoing challenges persist, including rethinking prophylaxis, improving the diagnosis criteria comprising blood culture-negative endocarditis and prosthetic valve endocarditis, timing of surgical intervention, and whether to perform surgery in the presence of ischemic stroke or in intravenous drug users. A combined strategy on infective endocarditis is crucial, involving advanced clinical decisions and protocols, a multidisciplinary approach, national healthcare organization and health policies to achieve better results for our patients.

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The Challenge of Effective Secondary Stroke Prophylaxis in Chagas Patients

Infective Endocarditis: Still More Challenges Than Convictions

Abstract

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