In the cardiovascular intensive care unit (CVICU), hemodynamic monitoring provides the foundation for evaluating tissue perfusion, guiding fluid resuscitation, titrating vasoactive medications, and assessing response to therapy. However, the optimal approach to hemodynamic monitoring remains a subject of ongoing debate. This article highlights the nuances of hemodynamic monitoring in the CVICU and reviews both established and emerging technologies and how they may be combined with clinical judgement to optimize patient outcomes for the critically ill patients.

This article provides an overview of vascular and hematologic disorders affecting the central nervous system, highlighting their clinical manifestations, imaging characteristics, differential diagnoses, and management considerations. It covers inflammatory vasculitis as well as noninflammatory entities including reversible cerebral vasoconstriction syndrome and moyamoya disease. Hematologic and thrombotic conditions are discussed along with treatment-related complications seen in extracorporeal membrane oxygenation patients. Across entities, MR imaging and angiographic techniques such as MR angiography and MR vessel wall imaging and digital subtraction angiography play a central role in diagnosis, while understanding characteristic patterns helps distinguish inflammatory, infectious, thrombotic, and treatment-related causes of neurologic injury.

Stroke mimics are conditions that resemble acute ischemic stroke, posing a major diagnostic challenge in time-sensitive care. Accurate differentiation is essential to prevent unnecessary thrombolysis, reduce costs, and avoid complications. Clinical assessment, scoring systems, and neuroimaging-particularly MRI-are key to improving diagnostic accuracy. This article reviews common stroke mimics such as seizures, migraine, metabolic disorders, demyelinating diseases, and tumors, emphasizing their clinical and imaging features. Practical imaging strategies are also provided to enhance diagnostic accuracy.

Hypothyroidism is a common endocrine disorder with potential multi-system involvement. While pericardial effusion may occur in up to 30% of patients with hypothyroidism, cardiac tamponade is rare.We present a case of a woman in her mid 60s who came with complaints of progressive dyspnoea on exertion, apathy, cold intolerance and weight gain. Clinically, she was hypotensive, tachypnoeic and hypoxic but had a normal pulse rate. Echocardiography revealed massive pericardial effusion with cardiac tamponade. She was managed with urgent pericardiocentesis and oral thyroxine replacement.Cardiac tamponade is a medical emergency that necessitates immediate intervention. Our case underscores the need to suspect hypothyroidism as the underlying cause in a patient presenting with cardiac tamponade with a normal heart rate or bradycardia.

Prolonged intensive care unit (ICU) stay after heart valve surgery may delay recovery and increase complications; however, the risk factors remain underexplored.

In this study, we aimed to identify pre-, intra-, and postoperative clinical factors associated with prolonged ICU stay after heart valve surgery.

A retrospective case-control analysis was conducted on 498 patients admitted to the cardiovascular surgical ICU of a tertiary hospital in Seoul from January 1, 2021, to December 31, 2022. Patients were grouped based on ICU length of stay: ≤72 hours (nonprolonged, n = 332) and >72 hours (prolonged, n = 166), matched by age, sex, and surgery date. Data were obtained from the electronic medical records. Statistical analyses included t tests, Mann-Whitney U test, chi-square test, Fisher's exact test, and logistic regression.

Significant predictors of prolonged ICU stay included New York Heart Association class (NYHA) II (odds ratio [OR] = 3.33, 95% confidence interval [CI] = 1.79-6.18), higher EuroSCORE II (OR = 1.29, 95% CI = 1.10-1.53), fluid imbalance (OR = 1.27, 95% CI = 1.01-1.59), and longer intubation duration (OR = 1.01, 95% CI = 1.01-1.02). Additional factors included postoperative arrhythmia, red blood cell transfusion, neurological complications, hemodialysis, and fever.

Multiple clinical and postoperative factors were associated with a prolonged ICU stay after valve surgery. These findings can inform nursing protocols and targeted interventions to enhance recovery and reduce ICU burden.

Severe cardiomyopathies in children may often demand a treatment with inclusion of mechanical circulatory support (MCS) or heart transplantation (HTx). Although these cardiomyopathies are not always hereditary, myocarditis may be regarded as a likely cause, if clinical course is not chronic. The aims of the study were to determine the genetic profile and prevalence of myocarditis in a pediatric population with clinical signs of severe cardiomyopathy.

We retrospectively included 106 pediatric and adolescent cardiomyopathy (CMPY) patients requiring HTx, MCS, or any in-hospital treatment. DNA-sequencing was done and sequence variants were classified based on ACMG guidelines. Myocarditis was diagnosed according to the clinical protocol.We overall genotyped 106 index patients; 92 (87%) patients receiving HTx or MCS, 14 (13%) received in hospital treatment. 87 patients (82%) had dilated cardiomyopathy and 54 (51%) carried a (likely) pathogenic (P/LP) variant with TNNI3 as one of the leading affected genes. In 84 genotyped patients (80%) myocarditis was examined. 57 (68%) of the 84 had myocarditis, with chronic lymphocytic myocarditis in 34 (40%) cases. In 28 (49%) of 57 patients with and 14 (52%) of 27 patients without myocarditis P/LP-variants were found. In 41 cases (39%) genotyping of the parents suggests de novo P/LP-variants (34%).

In severe CMPY, genetic causes and myocarditis because of infection are common. About 50% of childhood cardiomyopathies are linked to pathogenic genetic variants. Myocarditis signatures commonly observed in severe pediatric cardiomyopathies, are not necessarily specific and the only reason for early presentation of heart failure. Genotyping in severe CMPY is essential to identify the causes of myocarditis. Providing genetic counseling may support families facing challenging psychosocial situations.

The platelet-surface Ero1α-protein disulfide isomerase (PDI) system is essential for integrin αIIbβ3 activation and platelet aggregation. Targeting the functional interplay between Ero1α and PDI emerges as a promising antithrombotic strategy. Using a tiered high-throughput screen, we identified two clinical-stage compounds, Luminespib and AZ5104, as selective inhibitors of the Ero1α-PDI interaction. They bind a hydrophobic pocket in the PDI b' domain, inhibiting the pathway in biochemical and cellular assays without affecting other PDI family members. The antiplatelet effects of Luminespib and AZ5104 were abolished in megakaryocyte-specific Pdi or Ero1a knockout mice, confirming on-target specificity. Mechanistically, they concurrently inhibit Ero1α-PDI-driven extracellular integrin activation and intracellular Ca²⁺ signaling. Both compounds potently reduced arterial thrombosis in mice without prolonging bleeding time. Our work establishes Luminespib and AZ5104 as clinical-stage antithrombotic agents that target the platelet Ero1α-PDI system, offering an effective strategy to achieve potent antithrombosis without compromising hemostasis.

Heart failure (HF) represents the terminal clinical stage of a broad spectrum of cardiac disorders, distinguished by notably high rates of incidence and mortality. Extensive clinical investigations have proved that monitoring of N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels can reliably forecast HF and inform targeted clinical decision-making. Current detections for NT-proBNP depend on centralized laboratory instrumentation, which frequently creates delays that hinder the delivery of timely clinical care and decision-making. Here, we present a wearable microneedle-based electrochemical aptamer sensor (MEAS) for real-time, dynamic monitoring detection of NT-proBNP. Furthermore, this MEAS integrates real-time signal processing with wireless communication capabilities (e.g., Bluetooth to smartphones), enabling dynamic data analysis and visual reading out of the NT-proBNP level. In vitro characterization demonstrated high analytical performance, including a wide linear range (10-2000 pg/mL), a low detection limit (8.61 pg/mL), excellent selectivity against common interferents, and stable responses over repeated measurements. The microneedle biosensor exhibited favorable biosafety and enabled reliable in vivo NT-proBNP monitoring, with good agreement between sensor readouts and ELISA measurements. Together, these results position the proposed microneedle aptasensor as a promising alternative to conventional blood-based testing, with the potential to support real-time, patient-centered monitoring and advance next-generation HF management strategies.

The impact of long-COVID can be substantial for individuals, health systems and the economy, nevertheless, treatment and support options are limited. Yoga offers a potential solution to reduce the burden of long-COVID, demonstrating positive impacts on the biological mechanisms implicated in long-COVID, key long-COVID symptoms and associated mental health challenges. Yoga interventions can also be designed for people with limited physical ability, and online delivery can increase accessibility.

To understand the perceptions and experiences of yoga among people with long-COVID (PWLC), and assess its potential benefits.

An online survey of PWLC, comprised closed and open response questions on: long-COVID symptoms, support needs, perceptions of a yoga intervention and its components and yoga use. Participants (n = 171) were recruited via Prolific. Inclusion criteria were long-COVID (formal diagnosis or self-reported) and living in the UK. Inductive thematic analysis was used for open ended responses.

Analysis identified unmet needs among PWLC that align with the potential benefits of a yoga intervention, particularly in supporting symptom management, self-management and associated psychological symptoms. Additionally, a yoga intervention could provide acknowledgment and support to PWLC who feel despondent about their condition and abandoned by health professionals. Participants reported a high level of interest in a yoga intervention, perceiving it could be of benefit. Barriers to yoga practise included anxiety regarding the group setting, fitting sessions into schedules, lack of energy and concerns about suitability for long-COVID. Those already practising yoga with long-COVID reported that yoga helped to manage symptoms and associated psychological challenges, as well as increasing flexibility and providing a safer alternative to exercise.

Many PWLC have positive perceptions of yoga and there is a good level of interest in a yoga intervention among this population. These findings suggest that yoga is a suitable intervention for study in future research as well as delivery in the community by qualified yoga instructors with a knowledge of long-COVID - provided that any intervention is appropriately tailored to fit the ability and address the concerns of PWLC. It should be offered in the context of health professional validation of symptoms.

The current study sought to identify the barriers to and facilitators of connecting older adult cancer survivors (OACS) to mental health treatment in cancer survivorship and to better understand the opportunities to improve the likelihood that OACS receive appropriate services in survivorship.

Four virtual focus groups with 22 stakeholders (i.e., OACS, social workers, and APPs) were conducted. A semi-structured focus group guide queried participants about their experiences of referring and connecting to mental health services during cancer survivorship with a focus on barriers and facilitators. Thematic content analysis guided the generation and interpretation of major and minor study themes from the focus groups.

OACS were 56% female [n = 5; mean age = 74 (range: 66-85)]. Providers were 92% female (n = 12) and 69% (n = 9) had been working in oncology for over ten years. Three major conceptual themes were identified: (1) Care pathway characteristics (i.e., limited referral resources and knowledge); (2) Patient-level characteristics (i.e., motivation, stigma); (3) Perspectives on telehealth (i.e., overall increased access to care but may present challenges for some OACS). These overarching themes included sub-themes of barriers and facilitators to connecting OACS to mental health services.

OACS remain disconnected from mental health services and providers struggle to overcome systemic barriers to getting survivors the care they need. Given the standard of care to screen for depression in cancer survivorship, OACS will continue to be identified as depressed with no clear recourse for intervention. Therefore, future research on how to mitigate barriers and improve existing care pathways to connect OACS to mental health treatment is warranted.