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https://www.readbyqxmd.com/read/28921886/clinical-practices-and-attitudes-regarding-the-diagnosis-and-management-of-heart-failure-findings-from-the-core-needs-assessment-survey
#1
Jonathan Howlett, Josep Comin-Colet, Kenneth Dickstein, Ahmet Fuat, Gerhard Pölzl, Sean Delaney
AIMS: CORE is a continuing medical education initiative designed to support the evidence-based management of heart failure (HF) in the primary and secondary care settings. The goal of the CORE Needs Assessment Survey is to describe current clinical practice patterns and attitudes among global stakeholders in HF care. METHODS AND RESULTS: The CORE Steering Committee guided the development of survey questions to assess clinical practice, confidence, and attitudes/perceptions among cardiologists, primary care physicians, and nurses involved in HF management...
September 18, 2017: ESC Heart Failure
https://www.readbyqxmd.com/read/28919290/utility-and-limitations-of-long-term-monitoring-of-atrial-fibrillation-using-an-implantable-loop-recorder
#2
Randall Lee, Suneet Mittal
Atrial fibrillation (AF) is the most common cardiac arrhythmia diagnosed and treated in the world. The treatment of patients' symptoms as well as the prevention of stroke and heart failure is dependent on accurate detection and characterization of AF. A variety of electrocardiographic (ECG) monitoring techniques are being used for these purposes. However, these intermittent ECG monitoring techniques have been shown to under diagnose AF events, while having limited ability to characterize AF burden and density...
September 12, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28918529/anatomic-repair-of-congenitally-corrected-transposition-of-the-great-arteries-single-center-intermediate-term-experience
#3
Shagun Sachdeva, Roni M Jacobsen, Ronald K Woods, Michael E Mitchell, Joseph R Cava, Nancy S Ghanayem, Peter C Frommelt, Peter J Bartz, James S Tweddell
We present our experience for patients who have undergone an anatomic repair (AR) for congenitally corrected transposition of the great arteries (CCTGA) at the Children's Hospital of Wisconsin. A retrospective chart review of patients who underwent AR for CCTGA from 2001 to 2015 was performed. The cohort consisted of 15 patients (74% male). Median age of anatomic repair was 15 months (range 4.5-45.6 months). Four patients had a bidirectional Glenn (BDG) prior to AR. At the time of AR,-9 (60%) underwent Senning/Rastelli procedure, 4 (26...
September 16, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28918428/modification-of-cardiovascular-pharmacotherapy-in-palliative-care-patients-with-cancer-narrative-review
#4
Tomasz Pasierski
Palliative care cancer patients are treated with many drugs especially at the end of life. Limiting of polypharmacy a decreases the risk of associated adverse effects, medical errors and harmful drug interactions The time lag to benefit of many medications used for cardiovascular diseases or risk factors like hypertension, hypercholesterolemia is frequently longer than palliative care cancer patient's life expectancy. It is ethically appropriate to modify, even to discontinue cardiovascular pharmacotherapy when there is no prospect of benefit...
September 13, 2017: Polish Archives of Internal Medicine
https://www.readbyqxmd.com/read/28917516/impact-of-frailty-on-outcomes-in-patients%C3%A2-undergoing-percutaneous-mitral%C3%A2-valve-repair
#5
Clemens Metze, Anna-Sophie Matzik, Maximilian Scherner, Maria Isabel Körber, Guido Michels, Stephan Baldus, Volker Rudolph, Roman Pfister
OBJECTIVES: The aim of this study was to describe the impact of frailty in patients undergoing percutaneous mitral valve repair (PMVR). BACKGROUND: Frailty is common in elderly patients and those with comorbidities and is associated with adverse prognosis. METHODS: Frailty according to the Fried criteria was assessed in consecutive patients admitted for PMVR. Associations of frailty with 6-week (device success, changes in 6-minute walking distance and Minnesota Living With Heart Failure Questionnaire and Short Form 36 physical and mental component scores, and improvement ≥1 New York Heart Association functional class) and long-term outcomes during a median follow-up period of 429 days were examined...
September 8, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28916640/clinical-profile-and-consequences-of-atrial-fibrillation-in-hypertrophic-cardiomyopathy
#6
Ethan J Rowin, Anais Hausvater, Mark S Link, Patrick Abt, William Gionfriddo, Wendy Wang, Hassan Rastegar, N A Mark Estes, Martin S Maron, Barry J Maron
Background -Atrial fibrillation (AF), the most common sustained arrhythmia in hypertrophic cardiomyopathy (HCM), is capable of producing symptoms that impact quality of life and is associated with risk for embolic stroke. However, the influence of AF on clinical course and outcome in HCM remains incompletely resolved. Methods -Records were accessed of 1558 consecutive patients followed at the Tufts Medical Center Hypertrophic Cardiomyopathy Institute for 4.8 ± 3.4 years, from 2004 to 2014. Results -Of the 1558 HCM patients, 304 (20%) had episodes of AF, of which 226 (74%) were confined to symptomatic paroxysmal AF (PAF; average 5 ± 5; range 1 to > 20), while 78 (26%) developed permanent AF, preceded by 7 ± 6 PAF episodes...
September 15, 2017: Circulation
https://www.readbyqxmd.com/read/28916516/an-uncommon-manifestation-of-shock-takotsubo-syndrome
#7
Ying X Gue, Sanjay S Bhandari, Mubarak Ahamed
76 year old female presented following an episode of collapse. She was hypotensive with the paramedics and remained refractory despite fluid resuscitation. Her initial baseline tests revealed an elevated troponin; she subsequently underwent a coronary angiogram which showed mild coronary artery disease. Left ventriculogram was performed which showed abnormal mid-wall ballooning and severely impaired systolic function, characteristic of takotsubo syndrome. Echocardiogram confirmed presence of diagnosis and presence of left ventricular outflow tract obstruction with high gradient...
September 15, 2017: Echo Research and Practice
https://www.readbyqxmd.com/read/28916422/watchful-waiting-in-aortic-stenosis-the-problem-of-acute-decompensation
#8
David S Wald, Sam Williams, Fatima Bangash, Jonathan P Bestwick
BACKGROUND: Acute decompensation with heart failure, angina or syncope may be the first indication of undiagnosed aortic stenosis, but should be uncommon when the disorder is known and managed by watchful waiting. There is a lack of information on the proportion of patients with acute decompensated aortic stenosis with and without a prior diagnosis and their outcomes. METHODS: We examined the records of patients with aortic stenosis (ICD code 135.0) admitted to three UK hospitals between January 2015 and January 2016...
September 12, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28914661/percutaneous-aortic-leak-closure-in-a-small-and-frail-annulus-after-double-heart-valve-replacement
#9
Guglielmo Saitto, Paolo Nardi, Gian P Ussia, Domenico Sergi, Paolo Prati, Marco Russo, Francesco Romeo, Giovanni Ruvolo
: Paravalvular leak (PVL) is an uncommon but serious complication associated with the implantation of prosthetic valves. Following aortic valve replacement, up to 5% of patients affected by PVL develop clinical symptoms of heart failure, hemolysis or both. Percutaneous treatment of PVL has emerged instead of conventional surgery, as a well tolerated and less invasive procedure but remains a challenge. We present the case of a young woman with mechanical aortic and mitral prostheses, who presented surgical aortic PVL caused by a serious frailty of native annulus, became symptomatic after 5 months and was successfully percutaneously treated with an Amplatzer Duct Occluder device...
September 12, 2017: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/28913397/cardiac-transplant-due-to-metal-toxicity-associated-with-hip-arthroplasty
#10
Sheldon Moniz, Sean Hodgkinson, Piers Yates
Concerns regarding metal-on-metal (MoM) bearing couples in total hip arthroplasty are well documented in the literature with cobalt (Co) and chromium (Cr) toxicity causing a range of both local and systemic adverse reactions. We describe the case of a patient undergoing cardiac transplantation as a direct result of Co and Cr toxicity following a MoM hip replacement. Poor implant positioning led to catastrophic wear generating abundant wear particles leading to Co and Cr toxicity, metallosis, bony destruction, elevated metal ion levels, and adverse biological responses...
September 2017: Arthroplasty Today
https://www.readbyqxmd.com/read/28910238/telemanagement-of-heart-failure-patients-across-the-post-acute-care-continuum
#11
Amy Dadosky, Heather Overbeck, Laura Barbetta, Ken Bertke, Maureen Corl, Kathleen Daly, Natasha Hiles, Nancy Rector, Eugene Chung, Santosh Menon
BACKGROUND: Heart failure (HF) is a chronic condition causing nearly 1 million hospital admissions annually in the United States with 25% of patients rehospitalized within 30 days. INTRODUCTION: The purpose of this study was to investigate whether telemanagement of HF patients throughout the post-acute continuum of care would reduce rehospitalization rates and improve patient self-care knowledge and satisfaction. MATERIALS AND METHODS: HF patients discharged to a skilled nursing facility (SNF) received telemanagement by HF clinicians with opportunity for continuation at home with assistance of home healthcare (HHC) nurses...
September 13, 2017: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/28906129/perceptions-of-u-s-veterans-affairs-and-community-healthcare-providers-regarding-cross-system-care-for-heart-failure
#12
Charlene A Pope, Boyd H Davis, Leticia Wine, Lynne S Nemeth, K Sue Haddock, Tom Hartney, R Neal Axon
Objectives This study explores perceptions of US Veterans Affairs (VA) and non-VA healthcare providers caring for Veterans with heart failure (HF) regarding Veteran knowledge and motivations for dual use, provider roles in recommending and coordinating dual use, systems barriers and facilitators, and suggestions for improving cross-system care. Methods Twenty VA and 11 non-VA providers participated in semi-structured interviews, which were analyzed using parallel qualitative content and discourse analysis. Results VA and non-VA providers described variable HF knowledge and self-management among Veterans, and both groups described the need for improved education addressing medication adherence, self-care, and management of acute symptoms...
January 1, 2017: Chronic Illness
https://www.readbyqxmd.com/read/28905701/outcomes-of-patients-with-severe-influenza-infection-admitted-to-intensive-care-units-a-retrospective-study-in-a-medical-centre
#13
Chien-Ming Chao, Chih-Cheng Lai, Khee-Siang Chan, Kuo-Chen Cheng, Willy Chou, Kuo-Shu Yuan, Chin-Ming Chen
PURPOSE: This study assessed clinical manifestations and prognostic factors of critically ill patients with severe influenza admitted to the intensive care unit (ICU) in Taiwan's recent outbreak. METHODOLOGY: Patients admitted to ICU for severe influenza between January 1, 2015, and March 31, 2016, were identified and their medical records were retrospectively reviewed. The primary endpoints were outcomes and predictors of in-hospital mortality. RESULTS: There were 125 patients with an average Acute Physiology and Chronic Health Evaluation II (APACHE II) score of 20...
September 14, 2017: Journal of Medical Microbiology
https://www.readbyqxmd.com/read/28904030/approach-to-advanced-heart-failure-at-the-end-of-life
#14
REVIEW
Leah Steinberg, Meghan White, Jennifer Arvanitis, Amna Husain, Susanna Mak
OBJECTIVE: To outline symptom management in, as well as offer a home-based protocol for, patients with advanced heart failure (HF). SOURCES OF INFORMATION: The terms palliative care and heart failure were searched in PubMed and relevant databases. All articles were reviewed. The specific medical management protocol was developed by the "HeartFull" collaborative team at the Temmy Latner Centre for Palliative Care in Toronto, Ont. MAIN MESSAGE: Educating patients about advanced HF and helping them understand their illness and illness trajectory can foster end-of-life discussions...
September 2017: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/28902648/-fabry-disease-an-overlooked-diagnosis-in-adult-cardiac-patients
#15
Meral Kayıkçıoğlu, Evrim Şimşek, Sema Kalkan Uçar, Selen Bayraktaroğlu, Hüseyin Onay, Eser Sözmen, Mahmut Çoker
Fabry disease is a rare, X-linked, lysosomal glycosphingolipid storage disorder. A deficiency of the enzyme alpha-galactosidase results in intracellular accumulation of globotriaosylceramide in multiple cell types, such as those of the nerves, kidneys, cardiac, and cutaneous tissues, leading to a multisystem disease. Male patients are more severely affected; however, heterozygous female patients may also be afflicted, though often the symptoms develop later. Cardiac involvement can include left ventricular hypertrophy, conduction abnormalities, arrhythmias, valvular abnormalities, and heart failure...
September 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/28901967/intervention-mapping-approach-in-the-design-of-an-interactive-mobile-health-application-to-improve-self-care-in-heart-failure
#16
Ponrathi Athilingam, John M Clochesy, Miguel A Labrador
Heart failure is a complex syndrome among older adults who may experience and interpret symptoms differently. These differences in symptom interpretation may influence decision-making in symptom management. A well-informed and motivated person may develop the knowledge and skills needed to successfully manage symptoms. Therefore, the patient-centered mobile health application HeartMapp was designed to engage patients with heart failure in self-care management by offering tailored alerts and feedback using mobile phones...
September 8, 2017: Computers, Informatics, Nursing: CIN
https://www.readbyqxmd.com/read/28900580/a-case-report-of-a-left-atrial-mass-the-importance-of-a-detailed-physical-exam
#17
Corey J Lum, Thuan V Nguyen, Zia Khan
Cardiac myxomas are rare clinical findings. They are frequently found in the left atrium and more commonly affect women. Clinical presentation can vary widely and symptoms can be vague and non-specific. We present a case of a 67-year-old woman presenting with 3 weeks of progressive heart failure symptoms that failed to respond to oral diuretic therapy. On physical exam, she was found to have a diastolic murmur, rumble and an early diastolic plop. Transthoracic echocardiogram revealed a 5.6 cm × 2.5 cm × 4...
September 2017: Hawai'i Journal of Medicine & Public Health: a Journal of Asia Pacific Medicine & Public Health
https://www.readbyqxmd.com/read/28899603/anaemia-but-not-iron-deficiency-is-associated-with-clinical-symptoms-and-quality-of-life-in-patients-with-severe-heart-failure-and-palliative-home-care-a-substudy-of-the-prefer-trial
#18
Kurt Boman, Mona Olofsson, Ann-Charlotte R Bergman, Margareta Brännström
BACKGROUND: To explore the relationships between anaemia or iron deficiency (ID) and symptoms, quality of life (QoL), morbidity, and mortality. METHODS: A post-hoc, non-prespecified, explorative substudy of the prospective randomized PREFER trial. One centre study of outpatients with severe HF and palliative need managed with advanced home care. Associations between anaemia, ID, and the Edmonton Symptom Assessment Scale (ESAS), Euro QoL (EQ-5D), Kansas City Cardiomyopathy Questions (KCCQ) were examined only at baseline but at 6months for morbidity and mortality...
September 9, 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/28895484/patterns-relevance-and-predictors-of-heart-failure-dyadic-symptom-appraisal
#19
Christopher S Lee, James O Mudd, Jonathan Auld, Jill M Gelow, Shirin O Hiatt, Christopher V Chien, Julie T Bidwell, Karen S Lyons
BACKGROUND: Caregivers are thought to play a major role in helping patients first appraise and then respond to heart failure (HF) symptoms. AIMS: The aims of this study were to: (a) characterise distinct patterns of HF patient-caregiver dyads with respect to symptom appraisal; and (b) link dyadic symptom appraisal to contributions to self-care and caregiver strain. METHODS AND RESULTS: A cross-sectional dyadic descriptive design was used to capture patient and caregiver appraisal of patient HF symptoms (i...
October 2017: European Journal of Cardiovascular Nursing
https://www.readbyqxmd.com/read/28895197/impact-of-cardiac-resynchronization-therapy-on-mitral-valve-apparatus-geometry-and-clinical-outcomes-in-patients-with-secondary-mitral-regurgitation
#20
Christos G Mihos, Evin Yucel, Romain Capoulade, Mary P Orencole, Gaurav A Upadhyay, Orlando Santana, Jagmeet P Singh, Michael H Picard
BACKGROUND: Cardiac resynchronization therapy (CRT) may improve secondary mitral regurgitation (MR) in patients with cardiomyopathy. The effects on mitral valve (MV) and left ventricular (LV) geometry, however, have not been clearly defined. METHODS: Between 2009 and 2012, 229 CRT implants were performed at a single academic center. Seventy-one had ≥mild MR at baseline and serial echocardiography, without subsequent MV intervention. The pre-CRT and follow-up echocardiograms were retrospectively reviewed for (1) MV and LV geometry measurements; (2) MR grade; and (3) LV remodeling indices...
September 12, 2017: Echocardiography
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