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Cardiology in Review

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https://www.readbyqxmd.com/read/29300230/predictors-of-outcomes-in-myocardial-infarction-and-cardiogenic-shock
#1
Deepak Acharya
Myocardial infarction (MI) complicated by cardiogenic shock (CS) is a major cause of cardiovascular morbidity and mortality. Predictors of outcomes in AMI-CS include clinical, laboratory, radiologic variables, as well as management strategies. This article reviews the existing literature on short- and long-term predictors and risk stratification in MI complicated by CS.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited...
January 3, 2018: Cardiology in Review
https://www.readbyqxmd.com/read/29239886/acute-coronary-artery-dissection-a-review-of-the-literature-and-current-evidence
#2
Syed Raza Shah, Richard Alweis
Acute coronary artery dissection is a rare, complex disease occurring particularly in young women without traditional cardiovascular risk factors. The pathophysiology and treatment are different from acute coronary syndrome caused by plaque rupture or erosion. Its clinical presentation may vary from unstable angina to sudden cardiac death. Hence, early detection is crucial to manage the dissection and reduce the mortality and morbidity rates. Most coronary dissections will heal spontaneously, and conservative treatment is recommended for uncomplicated cases...
December 12, 2017: Cardiology in Review
https://www.readbyqxmd.com/read/29215418/switching-from-ticagrelor-or-prasugrel-to-clopidogrel
#3
James J Nawarskas, Tiffany N Montoya
Ticagrelor and prasugrel are newer antiplatelet drugs which, like clopidogrel, block the P2Y12 platelet receptor in order to inhibit platelet aggregation. Compared to clopidogrel, ticagrelor and prasugrel both have greater clinical efficacy but also have a higher risk of bleeding and are much more costly. Therefore, some institutions and providers switch patients from ticagrelor or prasugrel to clopidogrel in an effort to lower bleeding risk, stem costs, or otherwise ensure that patients can safely adhere to long-term P2Y12 inhibitor therapy...
December 5, 2017: Cardiology in Review
https://www.readbyqxmd.com/read/29077586/aorto-atrial-fistulas-a-contemporary-review
#4
Elizabeth Fierro, Rutuja R Sikachi, Abhinav Agrawal, Isha Verma, Marcin Ojrzanowski, Sonu Sahni
Aorto-atrial fistulas are a relatively rare, but potentially life-threatening condition, where an anomalous connection forms between the aortic structures and the cardiac atria. Aorto-atrial fistulas are most often the result of an underlying condition concerning the cardiac structures. It may be congenital, secondary to conditions such as aortic dissection, infective endocarditis, or valve replacement, or iatrogenic in nature. Secondary causes incite local deterioration of cardiac wall integrity leading to formation of fistulous connections, while iatrogenic causes are more traumatic in nature...
October 25, 2017: Cardiology in Review
https://www.readbyqxmd.com/read/29077585/cardiovascular-complications-of-proteasome-inhibitors-used-in-multiple-myeloma
#5
Daniel C Cole, William H Frishman
The use of proteasome inhibitors (PI) as targeted chemotherapeutics have significantly improved survival in patients with multiple myeloma (MM). However, rare and serious cardiovascular complications have occurred as a result of their use, most commonly congestive heart failure, hypertension, and arrhythmias. MM occurs in an aged population with many concurrent cardiovascular risk factors. The primary disease process also contributes to cardiovascular complications. Furthermore, many MM patients have prior exposure to cardiotoxic chemotherapy such as anthracyclines...
October 25, 2017: Cardiology in Review
https://www.readbyqxmd.com/read/29206746/mitral-valve-and-subvalvular-repair-for-secondary-mitral-regurgitation-rationale-and-clinical-outcomes-of-the-papillary-muscle-sling
#6
Christos G Mihos, Romain Capoulade, Evin Yucel, Steve Xydas, Francesco Nappi, Roy F Williams, Orlando Santana
Secondary mitral regurgitation (MR) is a common finding in patients with dilated cardiomyopathy, and it is associated with poor outcomes. It is the result of incomplete systolic closure of the mitral valve (MV) as a consequence of left ventricular dilatation, papillary muscle displacement with impaired systolic shortening, and mitral leaflet tethering. MV surgery may be performed in cases of significant secondary MR despite guideline-directed medical therapy. However, MV repair, which is most commonly performed with an undersized ring annuloplasty, is associated with a 30-60% recurrence of moderate or greater MR at mid-term follow-up...
January 2018: Cardiology in Review
https://www.readbyqxmd.com/read/29206745/cardiosphere-derived-cells-and-ischemic-heart-failure
#7
Carmel Ashur, William H Frishman
After a myocardial infarction, heart tissue becomes irreversibly damaged, leading to scar formation and inevitably ischemic heart failure. Of the many available interventions after a myocardial infarction, such as percutaneous intervention or pharmacological optimization, none can reverse the ischemic insult on the heart and restore cardiac function. Thus, the only available cure for patients with scarred myocardium is allogeneic heart transplantation, which comes with extensive costs, risks, and complications...
January 2018: Cardiology in Review
https://www.readbyqxmd.com/read/29053482/five-presidents-and-a-secretary
#8
William H Frishman
No abstract text is available yet for this article.
January 2018: Cardiology in Review
https://www.readbyqxmd.com/read/29045287/yosprala-a-fixed-dose-combination-of-aspirin-and-omeprazole
#9
Keith T Veltri
Cardiovascular disease is the leading cause of morbidity and mortality in the United States. Patients who survive a primary cerebrovascular or cardiovascular event are at increased risk of a subsequent occurrence. Antiplatelet therapy plays an essential role for secondary prevention in individuals with stroke, transient ischemic attack, acute or chronic artery disease, or peripheral arterial disease. Maintaining high-risk patients on low-dose aspirin therapy is a fundamental component of management. However, poor adherence, secondary to the drug's gastrointestinal side effects, has been associated with negative cardiovascular outcomes...
January 2018: Cardiology in Review
https://www.readbyqxmd.com/read/29045285/milrinone-dosing-and-a-culture-of-caution-in-clinical-practice
#10
Luke Yong Zheng Chong, Kumar Satya, Bernard Kim, Robert Berkowitz
Milrinone is an invaluable agent in the treatment of end-stage heart failure patients who are refractory to optimal medical therapy. In addition to its use in acute decompensated heart failure, milrinone can also be employed as a home infusion therapy or a bridge to cardiac transplant. Concerns about its adverse effects, such as an increased risk of arrhythmias and hypotension, often limit the doses of milrinone used in clinical practice. In addition, milrinone is infrequently used or avoided entirely in patients with acute renal failure or end-stage renal disease because the drug is primarily cleared by renal excretion...
January 2018: Cardiology in Review
https://www.readbyqxmd.com/read/28984671/early-coronary-angiography-for-survivors-of-out-of-hospital-cardiac-arrests-without-st-elevation
#11
Michael Goldfarb, Bojan Cercek
There are over 300,000 out-of-hospital cardiac arrests (OOHCA) in the United States each year, and the long-term survival rate is less than 10%. Despite improvements in postarrest management, the greatest drop-off in survival occurs during hospitalization, mostly due to myocardial dysfunction and neurological injury. Coronary artery disease is common in postcardiac arrest patients, with an incidence of approximately 60-80%. In patients with a chest pain syndrome and an ST-segment-elevation myocardial infarction pattern evident on the presenting electrocardiogram, immediate revascularization is recommended by cardiovascular societies due to established mortality benefits...
November 2017: Cardiology in Review
https://www.readbyqxmd.com/read/28984670/neprilysin-inhibition-and-the-treatment-of-heart-failure-recent-steps-in-the-right-direction
#12
Nicholas Bartell, William H Frishman
Numerous investigators have attempted to target the natriuretic peptide system in the treatment of heart failure since it was first described over 30 years ago. The history of neprilysin inhibition as a treatment for heart failure has been characterized by numerous setbacks. Recently, the PARADIGM-HF trial has shown favorable results, which may bring neprilysin inhibition into the mainstream of clinical practice. This article will review the history of the natriuretic peptide system and the investigations into it as a target for heart failure treatment, culminating in the positive results of the PARADIGM-HF trial, as well as planned and potential future directions for research...
November 2017: Cardiology in Review
https://www.readbyqxmd.com/read/28984669/vitamins-for-cardiovascular-diseases-is-the-expense-justified
#13
Sulaiman Sultan, Shishir Murarka, Ahad Jahangir, Farouk Mookadam, A Jamil Tajik, Arshad Jahangir
Despite the knowledge that a well-balanced diet provides most of the nutritional requirements, the use of supplemental vitamins is widespread among adults in the United States. Evidence from large randomized controlled trials over the last 2 decades does not support vitamin supplementation for the reduction of cardiovascular risk factors or clinical outcomes. Many of the vitamins used in common practice likely are safe when consumed in small doses, but long-term consumption of megadoses is not only expensive but has the potential to cause adverse effects...
November 2017: Cardiology in Review
https://www.readbyqxmd.com/read/28984668/brain-heart-interactions-in-traumatic-brain-injury
#14
Ayman El-Menyar, Abhishek Goyal, Rifat Latifi, Hassan Al-Thani, William Frishman
The cardiovascular manifestations associated with nontraumatic head disorders are commonly known. Similar manifestations have been reported in patients with traumatic brain injury (TBI); however, the underlying mechanisms and impact on the patient's clinical outcomes are not well explored. The neurocardiac axis theory and neurogenic stunned myocardium phenomenon could partly explain the brain-heart link and interactions and can thus pave the way to a better understanding and management of TBI. Several observational retrospective studies have shown a promising role for beta-adrenergic blockers in patients with TBI in reducing the overall TBI-related mortality...
November 2017: Cardiology in Review
https://www.readbyqxmd.com/read/28984667/ascending-aortic-aneurysm-is-an-inherited-disease-a-contemporary-literature-review-based-on-hill-s-criteria-of-specificity-strength-of-association-and-biological-coherence
#15
Mirza Mujadil Ahmad, Immad Arif Kiani, Khawaja Afzal Ammar, Mirza Nubair Ahmad, Bijoy K Khandheria, Timothy E Paterick, Renuka Jain, A Jamil Tajik
There is growing evidence of a differential etiological basis for thoracic aortic aneurysms (TAA), with ascending (As) TAAs being genetically mediated and descending (Des) TAAs more strongly related to acquired pathologies. A comprehensive literature review of this hypothesis has not been carried out. We carried out a systematic literature review based on the latest guidelines on TAA endorsed by the American Heart Association. The etiologies were classified as genetic and inherited, the studies were tabulated accordingly, and Hill's epidemiological criteria of causality were applied...
November 2017: Cardiology in Review
https://www.readbyqxmd.com/read/28984666/adrian-kantrowitz-md-1918-2008-and-his-contributions-to-cardiac-transplantation
#16
George L Hines
No abstract text is available yet for this article.
November 2017: Cardiology in Review
https://www.readbyqxmd.com/read/28984665/westchester-medical-center-and-its-health-care-system-one-hundred-years-1917-2017-of-dedicated-service-to-community-country-and-cardiology
#17
William H Frishman, John Savino
No abstract text is available yet for this article.
November 2017: Cardiology in Review
https://www.readbyqxmd.com/read/28832375/contemporary-diagnosis-and-management-of-atrial-flutter-a-continuum-of-atrial-fibrillation-and-vice-versa
#18
Antonis S Manolis
Atrial flutter (AFlu) is usually a fast (>240 bpm) and regular right atrial macroreentrant tachycardia, with a constrained critical region of the reentry circuit located at the cavotricuspid isthmus (CTI; typical CTI-dependent AFlu). However, a variety of right and left atrial tachycardias, resulting from different mechanisms, can also present as AFlu (atypical non-CTI-dependent AFlu). The electrocardiogram can provide clues to its origin and location; however, additional entrainment and more sophisticated electroanatomical mapping techniques may be required to identify its mechanism, location, and target area for a successful ablation...
November 2017: Cardiology in Review
https://www.readbyqxmd.com/read/28832373/pregnancy-in-patients-with-congenital-heart-disease-a-contemporary-challenge
#19
Despina Ntiloudi, Thomas Zegkos, Athanasios Koutsakis, George Giannakoulas, Haralambos Karvounis
The majority of female patients with congenital heart disease (CHD) survives into childbearing age and require evidence-based counseling regarding pregnancy options. Even though most of them will have an uneventful pregnancy, they may be at high risk of cardiac, obstetric, and fetal complications. Predictive factors for these complications have been previously identified in numerous studies and with the use of specific scores [CARdiac disease in PREGnancy, Zwangerschap bij Aangeboren HARtAfwijkingen, and World Health Organization (WHO) risk stratification...
November 2017: Cardiology in Review
https://www.readbyqxmd.com/read/28767504/echocardiography-in-the-evaluation-of-pulmonary-embolism
#20
Tanya Dutta, William H Frishman, Wilbert S Aronow
Pulmonary embolism is a major cause of mortality. Acute pulmonary embolism also encompasses a wide clinical spectrum of severity, ranging from asymptomatic silent disease to hemodynamic instability and shock. Echocardiography is a useful modality to improve treatment strategies for pulmonary embolus. Echocardiography plays a role in risk stratification at the time of diagnosis. The evaluation of the right ventricle (RV) has evolved over time. RV variables evaluated by echocardiography include RV size, RV/left ventricular ratio, RV fractional area of change, tricuspid annular plane systolic excursion, RV systolic pressure, and RV Tei index...
November 2017: Cardiology in Review
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