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Emergency Echocardiography

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https://www.readbyqxmd.com/read/29469616/prehospital-echocardiography-during-resuscitation-impacts-treatment-in-a-physician-staffed-helicopter-emergency-medical-service-an-observational-study
#1
Rein Ketelaars, Christian Beekers, Geert-Jan Van Geffen, Gert Jan Scheffer, Nico Hoogerwerf
BACKGROUND: Patients in cardiac arrest must receive algorithm-based management such as basic life support and advanced (cardiac) life support. International guidelines dictate diagnosing and treating any factor that may have caused the arrest or may be complicating the resuscitation. Ultrasound may be of potential value in this process and can be used in a prehospital setting. The objective is to evaluate the use of prehospital ultrasound during traumatic and non-traumatic CPR and determine its impact on prehospital treatment decisions in a Dutch helicopter emergency medical service (HEMS)...
February 22, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29468335/use-of-speckle-tracking-strain-in-preload-dependent-patients-need-for-cautious-interpretation
#2
C Nafati, M Gardette, M Leone, L Reydellet, V Blasco, A Lannelongue, F Sayagh, S Wiramus, F Antonini, J Albanèse, L Zieleskiewicz
BACKGROUND: In critical patients, left ventricular ejection fraction and fractional shortening are used to reflect left ventricular systolic function. An emerging technique, two-dimensional-strain echocardiography, allows assessment of the left ventricle systolic longitudinal deformation (global longitudinal strain) and the speed at which this deformation occurs (systolic strain rate). This technique is of increasing use in critical patients in intensive care units and in the peri-operative period where preload constantly varies...
February 21, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29468314/recent-advances-and-trends-in-pediatric-cardiac-imaging
#3
REVIEW
Wadi Mawad, Luc L Mertens
Cardiac imaging is central to today's pediatric cardiology practice not only to diagnose structural congenital defects and delineate cardiac and extracardiac anatomy but also for determining the hemodynamic impact of the structural defects and acquired pediatric diseases. Not so long ago, clinicians had to heavily rely on angiography as the main cardiac imaging modality to visualize the heart. Particularly, the development of echocardiography in the 1970s and 1980s together with the development of magnetic resonance imaging (MRI) and computed tomography (CT) resulted in a non-invasive diagnostic revolution with diagnostic catheterization becoming obsolete apart for very specific indications...
February 21, 2018: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/29467048/pregnancy-associated-spontaneous-coronary-artery-dissection-pascad-an-etiology-for-chest-pain-in-the-young-peripartum-patient
#4
Richard Lee, David Carr
Cardiac emergencies in pregnancy and the postpartum period are rare but often life-threatening. An emergency physician's differential diagnosis for chest pain in the peripartum patient often includes serious etiologies such as pulmonary embolism or myocardial infarction (MI). A lesser-known but important consideration on the differential for MI is that of a spontaneous coronary artery dissection (SCAD). SCAD is defined as an intramural hematoma within the coronary artery that compresses the true lumen. Expansion by increased pressures may lead to subsequent myocardial ischemia and infarction...
February 22, 2018: CJEM
https://www.readbyqxmd.com/read/29463343/characteristics-associated-with-mortality-in-patients-with-chronic-obstructive-pulmonary-disease-copd-heart-failure-coexistence
#5
Franciele Plachi, Fernanda M Balzan, Renata A Sanseverino, Dora V Palombini, Renata D Marques, Nadine O Clausell, Marli M Knorst, J Alberto Neder, Danilo C Berton
Aim To investigate if cardiac/pulmonary functional tests and variables obtained from clinical practice (body mass index, dyspnea, functional class, clinical judgment of disability to perform an exercise test and previous hospitalization rate) are related to mortality in patients with overlap chronic obstructive pulmonary disease (COPD) and chronic heart failure (CHF). BACKGROUND: Although the coexistence of COPD and CHF has been growingly reported, description of survival predictors considering the presence of both conditions is still scarce...
February 21, 2018: Primary Health Care Research & Development
https://www.readbyqxmd.com/read/29457261/angiography-vs-transesophageal-echocardiography-guided-patent-foramen-ovale-closure-a-propensity-score-matched-analysis-of-a-two-center-registry
#6
Paolo Scacciatella, Ilaria Meynet, Mauro Giorgi, Lorenza M Biava, Ivana Matranga, Luigi Biasco, Pierluigi Omedè, Fulvio Orzan, Fiorenzo Gaita
OBJECTIVES: The purpose of this study is to compare the long-term outcomes of patent foramen ovale (PFO) closure using angiography or transesophageal echocardiography as procedural guidance. BACKGROUND: The interventional treatment is emerging as a safe and efficient option for patients with high likelihood of PFO-related cryptogenic stroke and high risk of recurrence. The "gold-standard" guidance technique remains an issue. METHODS: Two cohorts of patients undergoing PFO closure for cryptogenic stroke in two catheterization laboratories of the same institution, using similar inclusion criteria but different guidance, were compared with propensity score matching...
February 19, 2018: Echocardiography
https://www.readbyqxmd.com/read/29456641/multiple-site-bleeding-at-pleural-adhesions-and-massive-hemothorax-following-percutaneous-coronary-intervention-with-stent-implantation-a-case-report
#7
Xiaoli Luo, Weibin Shi, Xiaoqun Zhang, Xiaoli Yang, Wei Wang, Chunyu Zeng, Hongyong Wang
An elderly male patient with coronary heart disease underwent coronary angiography, which revealed bilateral severe coronary artery stenosis. Four stents were implanted, and at 5 h post-surgery, typical hemorrhagic shock appeared. Echocardiography verified heavy bleeding in the right thoracic cavity. Emergency angiography excluded injury or perforation of the coronary artery, aorta, right subclavian artery and brachiocephalic artery. Considering the patient's history of chronic obstructive pulmonary disease and severe cough during the operation, it was suspected that hemothorax was induced by a blood vessel rupture in the pleura...
March 2018: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29455309/right-heart-failure-caused-by-direct-pressure-of-distal-arch-aneurysm
#8
Hironobu Sugiyama, Ryo Tohma, Takuya Misato, Kazuma Okamoto, Taro Hayashi, Satoshi Tobe, Tatsuro Matsuo, Kotaro Tsunemi, Takanori Oka, Nobuhiro Tanimura
We report a rare case of right heart failure caused by distal aortic aneurysm. Although aortopulmonary fistula is a common complication of giant aortic arch aneurysm, right heart failure caused by mechanical pressure by aneurysm is very rare. A 79-year-old female patient presented dyspnea. Contrast computed tomography (CT) of the thorax delineated a 78 mm aortic arch aneurysm pressing the main to left pulmonary artery and a 40 mm pericardial effusion at maximum depth at posterior side. Echocardiography showed the acceleration flow from main to left pulmonary artery and moderate pulmonary hypertension...
February 17, 2018: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29452989/prognostic-role-of-cardiac-calcifications-in-primary-prevention-a-powerful-marker-of-adverse-outcome-highly-dependent-on-underlying-cardiac-rhythm
#9
Carmine Mazzone, Gianni Cioffi, Concetta Di Nora, Giulia Barbati, Federica Guidetti, Pompilio Faggiano, Nicola Gaibazzi, Giorgio Faganello, Endria Casanova Borca, Andrea Di Lenarda
BACKGROUND: Increasing evidence exists regarding calcium detected in aortic cusps and/or mitral annulus (AOC_MAC) at transthoracic echocardiogram as a predictor of cardiovascular (CV) events and mortality. PURPOSE: To verify whether AOC_MAC has a prognostic role in the setting of primary prevention independently of the presence of atrial fibrillation (AF). METHODS: All subjects consecutively referred from January 2011 to October 2014 to the Cardiovascular Centre for CV risk assessment in primary prevention were selected...
January 31, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29446681/coronary-ct-angiography-use-in-patients-with-chest-pain-presenting-to-emergency-departments
#10
David C Levin, Laurence Parker, Ethan J Halpern, Vijay M Rao
OBJECTIVE: Previously published reports have shown that coronary CT angiography (CCTA) is a more efficient method of diagnosis than myocardial perfusion imaging (MPI) and stress echocardiography for patients presenting to emergency departments (EDs) with acute chest pain. In light of this evidence, the objective of this study was to examine recent trends in the use of these techniques in EDs. MATERIALS AND METHODS: The nationwide Medicare Part B databases for 2006-2015 were the data source...
February 15, 2018: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/29444774/comparison-between-different-strategies-of-rheumatic-heart-disease-echocardiographic-screening-in-brazil-data-from-the-provar-rheumatic-valve-disease-screening-program-study
#11
Bruno R Nascimento, Craig Sable, Maria Carmo P Nunes, Adriana C Diamantino, Kaciane K B Oliveira, Cassio M Oliveira, Zilda Maria A Meira, Sandra Regina T Castilho, Júlia P A Santos, Letícia Maria M Rabelo, Karlla C A Lauriano, Gabriel A L Carmo, Allison Tompsett, Antonio Luiz P Ribeiro, Andrea Z Beaton
BACKGROUND: Considering the limited accuracy of clinical examination for early diagnosis of rheumatic heart disease (RHD), echocardiography has emerged as an important epidemiological tool. The ideal setting for screening is yet to be defined. We aimed to evaluate the prevalence and pattern of latent RHD in schoolchildren (aged 5-18 years) and to compare effectiveness of screening between public schools, private schools, and primary care centers in Minas Gerais, Brazil. METHODS AND RESULTS: The PROVAR (Rheumatic Valve Disease Screening Program) study uses nonexperts and portable and handheld devices for RHD echocardiographic screening, with remote interpretation by telemedicine, according to the 2012 World Heart Federation criteria...
February 14, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29431384/cardiomyopathy-an-overview
#12
Jay Brieler, Matthew A Breeden, Jane Tucker
The definition and classification of cardiomyopathy have evolved considerably in recent years. Cardiomyopathy can be separated into primary (genetic, mixed, or acquired) and secondary categories, which result in varied phenotypes including dilated, hypertrophic, and restrictive patterns. Hypertrophic cardiomyopathy is the most common primary cardiomyopathy and can cause exertional dyspnea, presyncope, atypical chest pain, heart failure, and sudden cardiac death. Dilated cardiomyopathy can be genetic or acquired and typically presents with classic symptoms of heart failure with reduced ejection fraction...
November 15, 2017: American Family Physician
https://www.readbyqxmd.com/read/29430433/a-life-threatening-bronchogenic-cyst
#13
Sung Joon Han, Hyun Jin Cho, Min-Woong Kang, Jae Hyeon Yu, Myung Hoon Na, Shin Kwang Kang
A bronchogenic cyst causing cardiac tamponade is a rare condition. We report an unusual case of a bronchogenic cyst that caused cardiac tamponade. A 49-year-old female patient presented at our emergency room with complaints of palpitations and shortness of breath that had lasted for 5 days preceding the visit. Echocardiography revealed a very large cystic mass compressing the left a trium posteriorly, and a large amount of pericardial effusion caused the diastolic collapse of the ventricles. Atrial fibrillation and aggravated dyspnea were observed, and the patient's vital signs were unstable after admission...
February 2018: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29423213/cardiovascular-effects-of-metabolic-syndrome-after-transplantation-convergence-of-obesity-and-transplant-related-factors
#14
Kristen Sgambat, Sarah Clauss, Asha Moudgil
Children are at increased risk of developing metabolic syndrome (MS) after kidney transplantation, which contributes to long-term cardiovascular (CV) morbidities and decline in allograft function. While MS in the general population occurs due to excess caloric intake and physical inactivity, additional chronic kidney disease and transplant-related factors contribute to the development of MS in transplant recipients. Despite its significant health consequences, the interplay of the individual components in CV morbidity in pediatric transplant recipients is not well understood...
February 2018: Clinical Kidney Journal
https://www.readbyqxmd.com/read/29416251/aortic-dissection-masquerading-as-a-bicuspid-aortic-valve
#15
Harendra Arora, Priya Ajit Kumar
A 37-year-old male presented to the Emergency Department with acute worsening of back pain and new onset dyspnea. Transthoracic echocardiography revealed moderate left ventricular dysfunction and a bicuspid aortic valve (BAV). In addition, he was noted to have a dilated thoracic aorta concerning for a dissection, severe aortic insufficiency (AI), and both a pericardial and pleural effusion. Magnetic resonance imaging revealed a Type A ascending aortic dissection. He was taken emergently to the operating room for repair...
October 2017: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/29410163/management-of-low-risk-pulmonary-embolism-lope-patients-without-hospitalization-the-lope-prospective-management-study
#16
Joseph Bledsoe, Scott Woller, Scott Stevens, Valerie Aston, Rich Patten, Todd Allen, Benjamin Horne, Lydia Dong, James Lloyd, Greg Snow, Troy Madsen, Gregory Elliott
BACKGROUND: The efficacy and safety of managing patients with low-risk pulmonary embolism (PE) without hospitalization requires objective data from US medical centers. We sought to determine the 90-day composite rate of recurrent symptomatic venous thromboembolism (VTE), major bleeding events, and all-cause mortality among consecutive patients diagnosed with acute low-risk PE managed without inpatient hospitalization; and to measure patient satisfaction. METHODS: We performed a prospective cohort single-arm management study conducted from January 2013 to October 2016 in five emergency departments...
February 1, 2018: Chest
https://www.readbyqxmd.com/read/29409525/pre-hospital-transthoracic-echocardiography-for-early-identification-of-non-st-elevation-myocardial-infarction-in-patients-with-acute-coronary-syndrome
#17
Ingo Bergmann, Benedikt Büttner, Elena Teut, Claudius Jacobshagen, José Hinz, Michael Quintel, Ashham Mansur, Markus Roessler
BACKGROUND: Non-ST elevation myocardial infarction (NSTEMI) is a common manifestation of acute coronary syndrome (ACS), but delayed diagnosis can increase mortality. In this proof of principle study, the emergency physician performed transthoracic echocardiography (TTE) on scene to determine whether NSTEMI could be correctly diagnosed pre-hospitalization. This could expedite admission to the appropriate facility and reduce the delay until initiation of correct therapy. METHODS: Pre-hospital TTE was performed on scene by the emergency physician in patients presenting with ACS but without ST-elevation in the initial 12-lead electrocardiography (ECG) (NSTE-ACS)...
February 7, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29404975/the-emerging-role-of-cardiac-magnetic-resonance-imaging-in-the-evaluation-of-patients-with-hfpef
#18
REVIEW
Jessica Webb, Lauren Fovargue, Kristin Tøndel, Bradley Porter, Benjamin Sieniewicz, Justin Gould, Christopher Aldo Rinaldi, Tevfik Ismail, Amedeo Chiribiri, Gerald Carr-White
PURPOSE OF REVIEW: To give an update on the emerging role of cardiac magnetic resonance imaging in the evaluation of patients with heart failure with preserved ejection fraction (HFpEF). This is important as the diagnosis of HFpEF remains challenging and cardiac imaging is pivotal in establishing the function of the heart and whether there is evidence of structural heart disease or diastolic dysfunction. Echocardiography is widely available, although the gold standard in quantifying heart function is cardiac magnetic resonance (CMR) imaging...
February 5, 2018: Current Heart Failure Reports
https://www.readbyqxmd.com/read/29402990/diastolic-dysfunction-is-more-apparent-in-stz-induced-diabetic-female-mice-despite-less-pronounced-hyperglycemia
#19
Chanchal Chandramouli, Melissa E Reichelt, Claire L Curl, Upasna Varma, Laura A Bienvenu, Parisa Koutsifeli, Antonia J A Raaijmakers, Miles J De Blasio, Cheng Xue Qin, Alicia J Jenkins, Rebecca H Ritchie, Kimberley M Mellor, Lea M D Delbridge
Diabetic cardiomyopathy is a distinct pathology characterized by early emergence of diastolic dysfunction. Increased cardiovascular risk associated with diabetes is more marked for women, but an understanding of the role of diastolic dysfunction in female susceptibility to diabetic cardiomyopathy is lacking. To investigate the sex-specific relationship between systemic diabetic status and in vivo occurrence of diastolic dysfunction, diabetes was induced in male and female mice by streptozotocin (5x daily i...
February 5, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29395765/emergency-medicine-considerations-in-atrial-fibrillation
#20
REVIEW
Brit Long, Jennifer Robertson, Alex Koyfman, Kurian Maliel, Justin R Warix
BACKGROUND: Atrial fibrillation (AF) is an abnormal heart rhythm which may lead to stroke, heart failure, and death. Emergency physicians play a role in diagnosing AF, managing symptoms, and lessening complications from this dysrhythmia. OBJECTIVE: This review evaluates recent literature and addresses ED considerations in the management of AF. DISCUSSION: Emergency physicians should first assess patient clinical stability and evaluate and treat reversible causes...
January 30, 2018: American Journal of Emergency Medicine
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