Introduction Patients with end-stage chronic kidney disease without mature arteriovenous fistula frequently require central venous access for dialytic therapy. More than 15 percent of patients who receive these catheters have complications such as infection, arterial puncture, thrombosis and pneumothorax. Infective endocarditis (IE) is a rare and serious complication with high morbidity and mortality. Right-sided endocarditis is uncommon due to low hemodynamic pressure, but patients using central venous catheters have an increased risk. The correct therapeutic approach whenever there is no […]

Introduction Takotsubo’s syndrome is a cardiomyopathy characterized by transient left ventricular dysfunction. This condition is often described in postmenopausal women secondary to physical or emotional triggers. The clinical behavior mimics an acute coronary syndrome. However, angiography shows no obstructive epicardial coronary artery disease. This syndrome is considered a reversible cardiomyopathy. However, patients with Takotsubo cardiomyopathy have risk of serious complications, such as cardiogenic shock, ventricular tachycardia and ventricular thrombus. […]

Introduction Epipericardial fat necrosis (EPFN) is a rare, benign, and self-limiting condition, first described in 1957 by Jackson et al. Currently, there are only 33 cases described in the literature.– The pathophysiology of the disease remains uncertain. Likely predisposing factors include torsion of the vascular pedicle of adipose tissue, structural alterations that make the tissue more vulnerable and obesity, which, like the Valsalva maneuver, can lead to increased capillary pressure, causing hemorrhage into the adipose tissue. There are also reports […]

Introduction Hypertensive crisis (HC) is a clinical situation characterized by the quick, inappropriate, intense and symptomatic elevation of blood pressure, with or without risk of target-organ deterioration. HC has shown a decrease in incidence, most likely due to the advancement of outpatient antihypertensive therapy, but it still represents a challenge in emergency clinical practice. In over 80% of cases, patients already have a previous diagnosis of arterial hypertension (AH). However, undiagnosed AH or secondary causes may be the etiology of […]