No abstract

Background: Erectile Dysfunction (ED) is associated with increased risk of coronary artery disease (CAD).

Circulatory shock is characterized by a state of inefficient tissue oxygen supply and multiple organ dysfunction. Patients with circulatory shock require fast and assertive diagnosis and therapies to reduce its high lethality. Echocardiography has already been established as a fundamental method in managing patients with circulatory shock. It provides crucial assistance in etiological diagnosis, prognosis, hemodynamic monitoring, and volume estimation in these patients; its potential advantages include portability, absence of contrast or radiation, low cost, and real-time serial assessment. In the intensive care unit setting, it demonstrates a high correlation with invasive (pulmonary artery catheter) and minimally invasive (transpulmonary thermodilution) forms of hemodynamic monitoring. Currently, other techniques, such as pulmonary ultrasound and VExUS score, have been added to echocardiographic assessment, making the method more comprehensive and accurate. These techniques add relevant data to blood volume estimation in critical patients, influencing the probabilistic decision of fluid responsiveness and providing additional information in the diagnostic reasoning of the causes of shock, thus optimizing these patients' prognosis. Point of care ultrasound (POCUS) aims to make abilities to obtain information at the bedside more accessible to physicians who are not specialists in radiology, by means of ultrasound, which assists them in decision-making. This article addresses the diverse applications of echocardiography in patients with circulatory shock, including prognostic evaluation and etiological diagnosis by means of the parameters found in the main causes of shock, in addition to hemodynamic monitoring, evaluation of fluid responsiveness, and practical use of pulmonary ultrasound.

VAE-Volume do átrio esquerdo VAEmáx-Volume do átrio esquerdo máximo VAEmín-Volume do átrio esquerdo mínimo VAEpre-Volume do átrio esquerdo pré-onda p VE-Ventrículo esquerdo VTI-Integral velocidade tempo LISTA DE GRÁFICOS Gráfico-Risco de desfecho em 14 dias de acordo com a pontuação obtida no escore

Takotsubo syndrome (TTS) is characterized by acute and reversible cardiac dysfunction. Because of clinical similarities between TTS and acute coronary syndrome, their differential diagnosis is a challenge.To describe the prevalence of TTS among patients suspected of ST-elevation myocardial infarction (STEMI) and compare the clinical profile of TTS with that of STEMI.A retrospective analysis of medical records was performed on patients diagnosed with TTS with ST elevation (cases) and patients diagnosed with STEMI (controls) at Cárdio Pulmonar Hospital, Bahia, Brazil, between 2011 and 2017. For each case, four controls were randomly selected. Categorical data were compared using Pearson's chi-square and Mann-Whitney tests.Six patients had a confirmed diagnosis of TTS, corresponding to 3.2% of the patients suspected of STEMI. All TTS cases were female; ejection fraction was lower in TTS than in STEMI (35.5 vs. 56.0%; p = 0.018); patients with STEMI had higher peak troponin levels (9.4 vs. 2.2 ng/mL; p = 0.033), and neuropsychiatric disorders were more common in the TTS group (50.0 vs. 12.5%; p = 0.04). The median InterTAK diagnostic score was 60.5 (interquartile range 43.0 67.0) in cases and 24 (interquartile range 18.0-39.5) in controls (p < 0.001).TTS differed from STEMI in that it was more prevalent in females and was associated with emotional or physical stress, neuropsychiatric disorders, lower ejection fraction, and lower peak troponin levels.