Sepsis is a systemic inflammatory response syndrome of suspected or documented infectious origin, whose outcome is multiorgan failure. Sepsis-induced myocardial dysfunction (SIMD), present in more than 50% of septic patients, is characterized by (i) left ventricular (LV) dilatation with normal or low filling pressure, (ii) right and/or LV (systolic and/or diastolic) dysfunction and (iii) reversibility. Since the first definition proposed by Parker et al. in 1984, attempts have been made to define SIMD. Many parameters are used to assess cardiac function in septic patients, sometimes making it more difficult to measure due to the intrinsic hemodynamical changes in this condition. Nevertheless, with advanced echocardiographic techniques, such as speckle tracking analysis, it is possible to diagnose and assess systolic and diastolic dysfunction, even in the earliest stages of sepsis. Cardiac magnetic resonance imaging brings new insights into the reversibility of this condition. Many uncertainties still remain regarding the mechanisms, characteristics, treatment and even prognosis of this condition. There are also inconsistent conclusions from studies, therefore this review attempts to summarize our current knowledge of SIMD.

Vascular inflammation plays a crucial role in the pathogenesis of atherosclerosis and mediates various stages of atherosclerotic plaque development, from lipid streak formation to the plaque rupture and destabilization that precedes the clinical syndromes of cardiovascular disease. Inflammatory biomarkers constitute valuable tools to study this process, enabling the effects of different therapeutic interventions to be assessed. Currently, C-reactive protein (CRP) determined by high-sensitivity methods (hs-CRP) is the most extensively studied biomarker. Data regarding hs-CRP and cardiovascular risk, though largely consistent, are of unclear clinical relevance. This article provides a comprehensive review of current knowledge concerning cardiovascular risk and hs-CRP, and concludes with an evidence-based analysis of the current role of hs-CRP in cardiovascular risk assessment.

To determine the prevalence of pre-hypertension (pre-HTN) and hypertension (HTN) in Portuguese adolescents in Lisbon and to ascertain the relationship between blood pressure (BP) levels and the risk factors of gender, obesity, smoking, alcohol consumption, exercise and family history of HTN. This was a cross-sectional study in a non-randomized sample of 234 adolescents of both sexes, aged between 16 and 19 years. Information on habits and family history of HTN was obtained through a self-completed structured questionnaire. The study included 234 adolescents, mean age 16.4±0.9 years, 57% male. The prevalence of HTN was 34%, higher in males (44% vs. 21%, p=0.001) and 12% of pre-HTN, higher in females (13% vs. 10%, p=0.001). Higher body mass index was associated with significantly higher prevalence of pre-HTN (normal weight 9.40%, overweight 16.10%, and obesity 22.70%) and HTN (normal weight 30.4%, overweight 45.2%, and obesity 45.5%). With a family history of HTN, the prevalence of HTN and pre-HTN was approximately double (41% vs. 28% and 18% vs. 9%, respectively). Regular exercise, smoking and alcohol consumption were not significantly associated with BP values. The prevalence of pre-HTN and HTN in the sample studied was high. Of the risk factors evaluated, only gender, obesity and family history of HTN were significantly associated with BP values.

Constrictive pericarditis is a rare clinical entity that can pose diagnostic problems. The gold standard for diagnosis is cardiac catheterization with analysis of intracavitary pressure curves, which are high and, in end-diastole, equal in all chambers. The diastolic profile in both ventricles presents the classic dip-and-plateau pattern and the difference between the diastolic pressures of both ventricles should not exceed 3-5mmHg. Unfortunately, these traditional criteria are not always present and in fact the sensitivity and specificity of equalization of diastolic pressures are relatively low and of limited value in individual patients. This highlights the need to use new cardiac imaging techniques to resolve any doubts. The case described here is a good example.