Early surgical repair has some advantages such as; prevention of cardiac decompensation, decrease of the risk for endocarditis, prevention of excessive adhesions which makes it difficult for reoperations, correction of a simple laceration easily beside repairing a long fistula tract, prevention of outpatient follow-up loss, and prevention of frequent patient follow up for determining the next operation's timing (3, 8).
Nevertheless, once an intracardiac fistula is detected after an emergent surgery, early surgical repair is recommended to prevent cardiac decompensation and endocarditis.
A 76-year-old woman was admitted for cardiac decompensation
, hypertension, and renal failure.
At index time, all participants were hospitalized for an episode of cardiac decompensation.
We suggest that after an episode of acute cardiac decompensation successful therapeutic intervention rapidly resets neurohormonal values to their steady state.
SOB/WK may be attributable to various underlying conditions, including cardiac decompensation
with or without ACS.
Plasma BNP and N-BNP in particular have shown a close relationship with the degree of cardiac decompensation
, hemodynamic and imaging indicators of left ventricular dysfunction, and prognosis in acute coronary syndromes and in heart failure (1-3).
To date, only symptomatic patients with MCD deficiency have been detected, and many of them were already severely handicapped at the time of diagnosis because of residues of acute metabolic crises or from episodes of cardiac decompensation
, which may develop as a consequence of secondary carnitine deficiency.
Whereas systemic arterial hypertension is associated with atherosclerosis and mortality in most other diseases, in this group of patients, where hypertension occurs frequently either as the cause or the effect, the fall in blood pressure often denotes cardiac decompensation