Levosimendan: a new approach for the treatment of patients with severe heart failure. A brief summary based on a clinical case

Looking at the clinical report of a single patients admitted with severely decompensated heart failure and successfully managed with levosimendan, the authors review the current knowledge about this new drug. The treatment of severely decompensated heart failure is currently based on classical catecholamines (dopamine and dobutamine). The various new positive inotropics investigated in the past have failed to improve survival. In spite of some symptomatic improvement an increase in long-term mortality was noticed in different trials testing different drugs. More recently a new concept has been introduced regarding a new way to improve myocardial contractility and vasodilation based on calcium-sensitizing properties with additional action on adenosine triphosphate-sensitive potassium channels. Levosimendan is a representative of this new class recently launched in the Portuguese market.

[Classical pacemaker syndrome. Report of 2 cases with severe clinical manifestations]

We report two cases of classic pacemaker syndrome. Both patients developed severe clinical manifestations after implantation of a VVI pacemaker. One patient presented syncopal episodes and the other one manifest cardiac heart failure. Additionally, we review the mechanisms responsible for this clinical entity.