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Cardiology Clinics

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https://www.readbyqxmd.com/read/29173685/emergency-cardiac-care-rowing-together
#1
EDITORIAL
Amal Mattu, John Field
No abstract text is available yet for this article.
February 2018: Cardiology Clinics
https://www.readbyqxmd.com/read/29173684/multidisciplinary-management-of-the-post-cardiac-arrest-patient
#2
REVIEW
Ryan D Madder, Joshua C Reynolds
Cardiac arrest afflicts more than 300,000 persons annually in North America alone. Improving outcomes after cardiac arrest requires an integrated and multidisciplinary approach to postresuscitation intensive care and subsequent recovery. This article reviews components of injury within the post-cardiac arrest syndrome, the salient features of brain-oriented intensive care, best practices in neurologic prognostication, and a rational approach to emergency revascularization and hemodynamic support.
February 2018: Cardiology Clinics
https://www.readbyqxmd.com/read/29173683/evolving-strategies-in-cardiac-arrest-management
#3
REVIEW
Bram J Geller, Benjamin S Abella
Cardiac arrest is a leading cause of death in the United States, with a hospital discharge rate of approximately 10%. International resuscitation guidelines offer standardized cardiac arrest management approaches, but beyond the guidelines, are promising innovations to improve resuscitative care. Although clinical data do not yet support the routine use of mechanical chest compressions, corticosteroids, thrombolytics, and adjunctive ventilation devices during arrest, these therapies may have an important role in select patients...
February 2018: Cardiology Clinics
https://www.readbyqxmd.com/read/29173682/acute-dyspnea-and-decompensated-heart-failure
#4
REVIEW
Peter S Pang, Sean P Collins, Mihai Gheorghiade, Javed Butler
The majority of patients hospitalized with acute heart failure (AHF) initially present to the emergency department (ED). Correct diagnosis followed by prompt treatment ensures optimal outcomes. Paradoxically, identification of high risk is not the unmet need, given nearly all ED AHF patients are hospitalized; rather, it is identification of low-risk. Currently, no risk-stratification instrument can be universally recommended to safely discharge ED patients. With the exception of diagnosis, management recommendations are largely expert opinion, informed by existing evidence and tradition...
February 2018: Cardiology Clinics
https://www.readbyqxmd.com/read/29173681/cardiogenic-shock
#5
REVIEW
Semhar Z Tewelde, Stanley S Liu, Michael E Winters
Cardiogenic shock (CS) is a physiologic state in which cardiac pump function is inadequate to perfuse the tissues. If CS is not rapidly recognized and treated, tissue hypoperfusion can quickly lead to organ dysfunction and patient death. Evaluation of patients with suspected CS should include an electrocardiogram, chest radiograph, laboratory studies, and bedside echocardiogram. Initial resuscitation is directed toward restoring cardiac output and tissue perfusion. Mechanical circulatory support is indicated for patients with CS who do not respond to pharmacologic therapy...
February 2018: Cardiology Clinics
https://www.readbyqxmd.com/read/29173680/non-st-segment-acute-coronary-syndromes
#6
REVIEW
Tarlan Hedayati, Neha Yadav, Jagadish Khanagavi
Acute coronary syndrome (ACS) represents an umbrella of ischemic myocardial disease and diagnoses encompassing unstable angina (UA), non-ST-elevation myocardial infarction (NSTEMI), and ST-elevation myocardial infarction (STEMI). UA and NSTEMI for all intents and purposes, share similar pathophysiology, but at increasing severity. This article focuses on the diagnosis, risk stratification, management, and strategies that impact outcomes in NSTEMI.
February 2018: Cardiology Clinics
https://www.readbyqxmd.com/read/29173679/cardiac-biomarkers-in-emergency-care
#7
REVIEW
Richard Body, Cara Hendry
This article critically reviews the latest evidence to guide the use of biomarkers for the diagnosis of acute coronary syndromes in practice. It shows how modern cardiac troponin assays can enable diagnoses to be ruled in or ruled out with a single blood test, with many more diagnoses confirmed or refuted in as little as 1 hour later. Finally, this article appraises the latest evidence for other cardiac biomarkers, such as heart-type fatty acid-binding protein and copeptin.
February 2018: Cardiology Clinics
https://www.readbyqxmd.com/read/29173678/blunt-cardiac-trauma-review
#8
REVIEW
Maite A Huis In 't Veld, Colin A Craft, Robert E Hood
Patients suffering blunt cardiac trauma vary widely in the severity of their condition on presentation. Although some may present with mild sternal bruising, others may present with acute valvular rupture or malignant arrhythmia. Disposition for these patients ranges from discharge home to admission for urgent cardiac surgery. This article discusses some of the common types of blunt cardiac trauma and reviews the current literature and guidelines for their triage and initial management.
February 2018: Cardiology Clinics
https://www.readbyqxmd.com/read/29173677/cardiovascular-emergencies-in-pregnancy
#9
REVIEW
Tala K Al-Talib, Stanley S Liu, Mukta Srivastava
Heart disease in pregnancy may manifest as acute coronary syndromes, decompensated valvular disease, and acute heart failure. These disease processes may represent progression of preexisting disease versus newly developed disease resulting from the physiologic changes of pregnancy. Early recognition of clinical presentations, judicious use of diagnostic studies, and multidisciplinary management of patient and fetal considerations can lead to optimal outcomes in this unique patient subset.
February 2018: Cardiology Clinics
https://www.readbyqxmd.com/read/29173676/a-new-face-of-cardiac-emergencies-human-immunodeficiency-virus-related-cardiac-disease
#10
REVIEW
Nqoba Tsabedze, Ahmed Vachiat, Don Zachariah, Pravin Manga
The human immunodeficiency virus epidemic is a major health challenge of the twenty-first century as the transition from infectious complications to noncommunicable disease becomes more evident. These patients may present to the emergency department with a variety of cardiovascular diseases, such as acute coronary syndromes, heart failure, pericardial disease, infective endocarditis, venothromboembolism, and other conditions. Increased awareness is needed among health care professionals to enhance adequate identification and promote prompt management of these patients...
February 2018: Cardiology Clinics
https://www.readbyqxmd.com/read/29173675/acute-management-of-atrial-fibrillation-from-emergency-department-to-cardiac-care-unit
#11
REVIEW
Clare L Atzema, Sheldon M Singh
The prevalence of atrial fibrillation is increasing rapidly, resulting in more patients presenting for care in the emergency department and in-hospital settings. To reduce morbidity and mortality, and improve patient quality of life, clinicians working in these settings need to be both current and facile in their approach to management of these patients. Frequent updates to guideline recommendations (based on emerging research) make this challenging for practicing physicians. This article reviews the acute management of atrial fibrillation in the emergency and in-hospital settings, including practical approaches to rhythm and rate control, anticoagulation, and special situations, incorporating the most up-to-date guidelines...
February 2018: Cardiology Clinics
https://www.readbyqxmd.com/read/29173674/evolving-electrocardiographic-indications-for-emergent-reperfusion
#12
REVIEW
Michael J Lipinski, Amal Mattu, William J Brady
Chest pain or other symptoms concerning for acute coronary syndrome continues to remain a major reason for presentation to the emergency department. However, there is significant heterogeneity in the spectrum of risk severity of these patients. The electrocardiogram (ECG) remains a critically valuable tool in the physician's arsenal to diagnose patients and help with risk stratification. There are multiple high-risk ECG findings that are suggestive of adverse outcome and may benefit from rapid transfer for coronary angiography...
February 2018: Cardiology Clinics
https://www.readbyqxmd.com/read/29173673/ventricular-arrhythmias
#13
REVIEW
William F Dresen, John D Ferguson
Ventricular tachycardia (VT) is the most common form of wide complex tachycardia and is associated with a high mortality rate. Electrocardiographic analysis remains paramount in diagnosis and helps to direct therapy. Antiarrhythmic agents, although effective in reducing arrhythmia burden, have never demonstrated a mortality benefit. The implantable cardioverter-defibrillator aids not only in the acute termination of ventricular arrhythmia, but provides a wealth of information for the long-term management of patients with VT...
February 2018: Cardiology Clinics
https://www.readbyqxmd.com/read/29173672/acute-valvular-heart-disease
#14
REVIEW
Varun Maheshwari, Brian Barr, Mukta Srivastava
Valvular heart disease (VHD) is a common clinical entity. Recognition of decompensated VHD is crucial to instituting appropriate workup and management. Initial evaluation focuses on hemodynamics, peripheral perfusion, volume overload, and active myocardial ischemia. Initial therapy is targeted at improving hemodynamics, fluid status, and decreasing myocardial ischemia before intervention. Echocardiography can rapidly identify VHD etiology and severity along with physical examination findings. Owing to improved survival with cardiac surgery over the past several decades, prosthetic valve dysfunction should be recognized and initial treatment understood...
February 2018: Cardiology Clinics
https://www.readbyqxmd.com/read/29173671/acute-myopericardial-syndromes
#15
REVIEW
Ali Farzad, Jeffrey M Schussler
Acute myopericardial syndromes are common but can be challenging to manage and potentially have life-threatening complications. Careful clinical history, physical examination, electrocardiogram interpretation, and application of diagnostic criteria are needed to make an accurate diagnosis, exclude concomitant disease, and properly treat patients. Therapy for acute pericarditis should be guided per the underlying cause. For the most common causes, nonsteroidal antiinflammatory drugs or aspirin with the addition of colchicine remains the mainstay of therapy...
February 2018: Cardiology Clinics
https://www.readbyqxmd.com/read/29173670/evaluation-of-chest-pain-and-acute-coronary-syndromes
#16
REVIEW
Anna Marie Chang, David L Fischman, Judd E Hollander
Chest pain is a common complaint in the emergency department, and it is the job of clinicians to rule out life-threatening diagnoses such as acute coronary syndrome. The history, physical examination, cardiac risk factors, electrocardiogram findings, and clinician judgment are often not enough to distinguish between causes of chest pain syndromes and to reliably rule out acute myocardial ischemia. New cardiac troponin assays, especially in conjunction with clinical decision algorithms, help clinicians rapidly exclude acute myocardial infarction...
February 2018: Cardiology Clinics
https://www.readbyqxmd.com/read/29025552/the-pericardium-simple-and-innocent-but-complex-and-fascinating
#17
EDITORIAL
Jae K Oh, William R Miranda, Terrence D Welch
No abstract text is available yet for this article.
November 2017: Cardiology Clinics
https://www.readbyqxmd.com/read/29025551/tuberculous-and-infectious-pericarditis
#18
REVIEW
Sung-A Chang
Viral pericarditis is the most common cause of acute pericarditis and it is typically responsive to aspirin or nonsteroidal anti-inflammatory drugs. Tuberculous pericarditis is common in immunocompromised patients or in immunocompetent patients in endemic areas. The diagnosis of tuberculous pericarditis usually requires a multidisciplinary approach, and presumptive treatment should be started for people with suspected infections living in endemic areas. Antituberculous treatment along with corticosteroid therapy can reduce complications from constrictive pericarditis...
November 2017: Cardiology Clinics
https://www.readbyqxmd.com/read/29025550/congenital-abnormalities-of-the-pericardium
#19
REVIEW
Yuvrajsinh J Parmar, Ankit B Shah, Michael Poon, Itzhak Kronzon
Congenital abnormalities of the pericardium are a rare group of disorders that include congenital absence of the pericardium, pericardial cysts, and diverticula. These congenital defects result from alterations in the embryologic formation and structure of the pericardium. Although many cases are incidentally found, they can present as symptomatic, life-threatening disease. Owing to their rarity, many cases are inappropriately diagnosed. Alterations in the embryologic formation and structure may result in the formation of these congenital abnormalities...
November 2017: Cardiology Clinics
https://www.readbyqxmd.com/read/29025549/neoplastic-pericardial-disease
#20
REVIEW
Joseph J Maleszewski, Nandan S Anavekar
Pericardial tumors are rare lesions that include a range of neoplastic conditions that may arise within the pericardium or metastasize to involve it secondarily. Understanding the spectrum of lesions that are included in the differential diagnosis of a pericardial mass-lesion is critical to making timely, accurate diagnoses and getting the appropriate therapy should one be necessary. This review summarizes the radiologic and pathologic findings of the most commonly encountered of these entities.
November 2017: Cardiology Clinics
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