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Emergency Echocardiography

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https://www.readbyqxmd.com/read/27907878/ultrasound-in-cardiac-trauma
#1
Theodosios Saranteas, Andreas F Mavrogenis, Christina Mandila, John Poularas, Fotios Panou
In the perioperative period, the emergency department or the intensive care unit accurate assessment of variable chest pain requires meticulous knowledge, diagnostic skills, and suitable usage of various diagnostic modalities. In addition, in polytrauma patients, cardiac injury including aortic dissection, pulmonary embolism, acute myocardial infarction, and pericardial effusion should be immediately revealed and treated. In these patients, arrhythmias, mainly tachycardia, cardiac murmurs, or hypotension must alert physicians to suspect cardiovascular trauma, which would potentially be life threatening...
November 5, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27899066/predictive-factors-for-unfavorable-outcomes-of-tuberculous-pericarditis-in-human-immunodeficiency-virus-uninfected-patients-in-an-intermediate-tuberculosis-burden-country
#2
In Young Jung, Young Goo Song, Jun Yong Choi, Moo Hyun Kim, Woo Yong Jeong, Dong Hyun Oh, Yong Chan Kim, Je Eun Song, Eun Jin Kim, Ji Un Lee, Su Jin Jeong, Nam Su Ku, June Myung Kim
BACKGROUND: In areas where Mycobacterium tuberculosis is endemic, tuberculosis is known to be the most common cause of pericarditis. However, the difficulty in diagnosis may lead to late complications such as constrictive pericarditis and increased mortality. Therefore, identification of patients at a high risk for poor prognosis, and prompt initiation of treatment are important in the outcome of TB pericarditis. The aim of this study is to identify the predictive factors for unfavorable outcomes of TB pericarditis in HIV-uninfected persons in an intermediate tuberculosis burden country...
November 29, 2016: BMC Infectious Diseases
https://www.readbyqxmd.com/read/27891405/complete-heart-block-in-pregnancy-a-report-of-emergency-caesarean-section-in-a-parturient-without-pacemaker
#3
Vandana Mohapatra, Aparajita Panda, Satyanarayan Behera, Jagadish Chandra Behera
Management of women with Complete Heart Block (CHB) presenting without pacing, during pregnancy and labour is debatable. Temporary pacemakers have been routinely inserted for labour and birth probably to withstand any haemodynamic variations. However, due to lack of large scale prospective studies, the necessity of this procedure has not been objectively assessed. Also, the most appropriate anaesthetic technique for caesarean section in women with CHB is yet to be clarified. We report herein the case of a pregnant woman with CHB who had uneventful emergency caesarean delivery under spinal anaesthesia without temporary pacing...
October 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27884633/recent-trends-in-imaging-use-in-hospital-settings-implications-for-future-planning
#4
David C Levin, Laurence Parker, Vijay M Rao
PURPOSE: To compare trends in utilization rates of imaging in the three hospital-based settings where imaging is conducted. METHODS: The nationwide Medicare Part B databases for 2004-2014 were used. All discretionary noninvasive diagnostic imaging (NDI) CPT codes were selected and grouped by modality. Procedure volumes of each code were available from the databases and converted to utilization rates per 1,000 Medicare enrollees. Medicare's place-of-service codes were used to identify imaging examinations done in hospital inpatients, hospital outpatient departments (HOPDs), and emergency departments (EDs)...
November 21, 2016: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/27884577/low-pressure-pericardial-tamponade-case-report-and-review-of-the-literature
#5
Brooks M Walsh, Lauren A Tobias
BACKGROUND: Focused cardiac ultrasound (FoCUS) is accurate for determining the presence of a pericardial effusion. Using FoCUS to evaluate for pericardial tamponade, however, is more involved. Many experts teach that tamponade is unlikely if the inferior vena cava (IVC) shows respiratory variation and is not distended. CASE REPORT: A 53-year-old woman presented to the emergency department (ED) with severe orthostatic hypotension, exertional dyspnea, and hypoxia...
November 21, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27873284/a-case-of-acute-myocardial-infarction-due-to-cardiovascular-syphilis-with-aortic-regurgitation-and-bilateral-coronary-ostial-stenosis
#6
Mutsuo Tanaka, Minoru Okamoto, Toshihiko Murayama
We report an interesting case of a 66-year-old man with acute myocardial infarction (AMI) with bilateral coronary ostial stenosis cardiovascular syphilis complicated by aortic regurgitation (AR). A 12-lead electrocardiogram and blood tests on arrival suggested AMI, and echocardiography showed moderate AR. Emergency coronary angiography showed bilateral coronary ostial stenosis. The patient underwent emergency surgical treatment, coronary artery bypass grafting, and aortic valve replacement with a bioprosthetic valve...
December 2016: Surgical Case Reports
https://www.readbyqxmd.com/read/27873135/left-atrium-the-last-bulwark-before-overt-heart-failure
#7
Matteo Cameli, Giulia Elena Mandoli, Sergio Mondillo
Heart failure (HF) with preserved ejection fraction (HFpEF) has emerged as an important public health issue in recent years. It represents the most common type of HF in ambulatory setting, and it has been recognized as a different entity from the reduced ejection fraction (EF) form. In HFpEF, continuous growing attention has been focused on the role of the left atrium (LA) in preserving good ventricular function and asymptomatic condition of the patient since the very first stages of diastolic dysfunction (DD)...
November 22, 2016: Heart Failure Reviews
https://www.readbyqxmd.com/read/27867587/acute-chest-pain-in-a-triathlete-rupture-of-the-noncoronary-sinus-of-valsalva-into-the-right-ventricle
#8
Ernan Zhu, Ralf Westenfeld, Mareike Gastl, Florian Bönner, Alexander Assmann, Amir M Nia, Malte Kelm, Christian Jung
Sinus of Valsalva (SoV) aneurysm is a rare cardiac disease which can be congenital or acquired. A ruptured SoV aneurysm presents a clinical emergency and can lead to progressively deteriorating heart failure. Therefore, appropriate treatment requires prompt and accurate diagnosis. Most ruptured or nonruptured SoV aneurysms are diagnosed by the means of echocardiography. However, cardiovascular magnetic resonance (CMR) can provide information on precise anatomy and mechanisms due to its excellent soft tissue contrast and high resolution, and thereby allows for optimized preoperative planning of the repair strategy...
October 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/27865485/comparison-of-the-effectiveness-of-stress-echocardiography-versus-myocardial-perfusion-imaging-in-patients-presenting-to-the-emergency-department-with-low-risk-chest-pain
#9
Rhian Davies, Guodong Liu, Christopher Sciamanna, William R Davidson, Douglas L Leslie, Andrew J Foy
The aim of this study was to compare clinically relevant cardiovascular outcomes and downstream resource utilization associated with stress echocardiography (SE) and myocardial perfusion imaging (MPI) in emergency department patients with low-risk chest pain. This was a retrospective analysis of health insurance claims data for a national sample of privately insured patients over the period January 1 to December 31, 2011. Subjects were selected who presented to the emergency department with a primary or secondary diagnosis of chest pain and underwent either SE or MPI...
December 15, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/27863908/role-of-echocardiography-for-catheter-based-management-of-valvular-heart-disease
#10
REVIEW
Takahiro Shiota
Catheter-based treatment of valvular heart disease, such as transvalvular aortic valve replacement (TAVR) or mitral clip procedure, has been increasingly accepted as a treatment choice for the past several years. Such new treatment options have been changing the management of patients with valvular heart disease drastically while socio-economic factors regarding their application need to be taken into consideration. The use of echocardiography, including transesophageal echocardiography (TEE), for such catheter-based treatments is essential for the success of the procedures...
November 15, 2016: Journal of Cardiology
https://www.readbyqxmd.com/read/27858229/usefulness-of-three-dimensional-transesophageal-echocardiography-for-diagnosis-of-hemolytic-anemia-due-to-inverted-internal-felt-strip-after-surgery-for-aortic-dissection
#11
Takeshi Oda, Hiroshi Yasunaga, Yasuyuki Zaima, Akiko Arimura, Shinichi Imai, Ryo Kanamoto, Hayato Fukuda, Eiji Nakamura, Hideki Tashiro, Shigeaki Aoyagi
Felt strips are widely used for reinforcement of the aortic stump in surgery for aortic dissection (AD). Postoperative hemolytic anemia (HA) due to an inverted internal felt strip at the aortic stump fixation for AD is extremely rare. A 70-year-old woman underwent ascending aorta replacement for acute type A AD, where both proximal and distal anastomotic sites were reinforced with Teflon felt strips. A week later, macroscopic hematuria and HA emerged. Three-dimensional transesophageal echocardiography (3D-TEE) demonstrated that the proximal inner felt strip turned up and protruded into the aortic inner lumen...
November 17, 2016: Journal of Medical Ultrasonics
https://www.readbyqxmd.com/read/27821651/can-the-myocardial-performance-index-be-used-as-a-new-predictive-factor-for-a-poor-prognosis-in-fetuses-with-idiopathic-polyhydramnios
#12
Cenk Gezer, Atalay Ekin, Mehmet Ozeren, Cuneyt Eftal Taner, Emre Mat, Ulas Solmaz
OBJECTIVES: The purpose of this study was to determine whether there are any changes in cardiac function in fetuses with idiopathic polyhydramnios and also to evaluate the value of the myocardial performance index for prediction of adverse perinatal outcomes. METHODS: A prospective case-control study was conducted with a total of 134 fetuses between 24 and 40 weeks' gestation. Polyhydramnios was defined as an amniotic fluid index of greater than 24 cm. Seventy-three fetuses of healthy mothers were assigned as the control group whereas 36 fetuses with an amniotic fluid index of 24 to 34 cm constituted the nonsevere polyhydramnios group, and 31 fetuses with an amniotic fluid index of 35 cm or greater constituted the severe polyhydramnios group...
November 7, 2016: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/27816333/ischemic-stroke-due-to-hypoperfusion-in-a-patient-with-a-previously-unrecognized-danon-disease
#13
Marco Marino, Olimpia Musumeci, Giuseppe Paleologo, Maria Cucinotta, Alba Migliorato, Carmelo Rodolico, Antonio Toscano
Danon disease, an X-linked multisystemic disorder, is due to deficiency of Lysosome-Associated Membrane Protein 2 (LAMP2). It is usually characterized by hypertrophic cardiomyopathy, mental retardation and skeletal myopathy, sometimes also with atypical features. A 20-year-old man with cognitive impairment was admitted to the Emergency Room because of a sudden chest pain. ECG showed Wolff-Parkinson-White syndrome; echocardiography revealed hypertrophic cardiomyopathy, and, shortly after, he experienced a cardiac arrest followed by an occipital ischemic stroke...
October 5, 2016: Neuromuscular Disorders: NMD
https://www.readbyqxmd.com/read/27816114/integrated-imaging-in-hypertrophic-cardiomyopathy
#14
REVIEW
Lubna Choudhury, Vera H Rigolin, Robert O Bonow
Hypertrophic cardiomyopathy (HC) has a very heterogeneous clinical spectrum and lends itself to multimodality imaging for evaluation and management. This review addresses clinical applications of cardiac imaging in patients with HC. Integrating various techniques of echocardiography and cardiac magnetic resonance (CMR) is discussed in the clinical context such as diagnosis, evaluation, management, risk stratification, and family screening of patients with HC. The utility of periprocedural imaging techniques is highlighted for guiding surgical and transcatheter septal reduction procedures...
October 11, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/27814268/mean-transaortic-gradient-is-an-emerging-predictor-of-chronic-kidney-disease-in-elderly-patients
#15
Ingrid Platania, Valentina Terranova, Salvatore Davide Tomasello, Marouane Boukhris, Chiara Cilia, Salvatore Di Marca, Marcella Pisano, Gianluca Mastrosimone, Emanuela Cataudella, Benedetta Stancanelli, Lorenzo Malatino
Arterial hypertension (AH) is a major risk factor for chronic kidney disease (CKD). However, whether AH maintains this role in the development of CKD in elderly patients with aortic stenosis (AS) or whether transaortic gradient influences CKD remains unclear. Consecutive hospitalized patients were prospectively recruited to evaluate the relationship between AS and CKD. In all patients, transthoracic 2-dimensional echocardiography was performed to evaluate AS; renal function was evaluated using the Chronic Kidney Disease Epidemiology Collaboration formula...
October 7, 2016: Angiology
https://www.readbyqxmd.com/read/27802866/point-of-care-ultrasonography-as-a-training-milestone-for-internal-medicine-residents-the-time-is-now
#16
Bruce F Sabath, Gurkeerat Singh
Point-of-care (POC) ultrasonography is considered fundamental in emergency medicine training and recently has become a milestone in critical care fellowship programs as well. Currently, there is no such standard requirement for internal medicine residency programs in the United States. We present a new case and briefly review another case at our institution - a community hospital - in which internal medicine house staff trained in ultrasonography were able to uncover unexpected and critical diagnoses that significantly changed patient care and outcomes...
2016: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/27800569/classification-of-high-risk-with-cardiac-troponin-and-shock-index-in-normotensive-patients-with-pulmonary-embolism
#17
Savas Ozsu, Muge Erbay, Zerrin Gürel Durmuş, Tevfik Ozlu
Accurate risk stratification of normotensive patients with acute pulmonary embolism (PE) require further investigation. We aimed to develop a simple model using clinical (shock index) and laboratory findings (cardiac Troponin, echocardiography) to assess the risk of 30-day mortality in normotensive patients with acute PE. In this retrospective study, 489 normotensive patients with acute PE diagnosed objectively. The primary end-point was defined as a all cause 30-day mortality. Shock index was calculated on admission...
October 31, 2016: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/27797880/ventricular-fibrillation-via-torsade-des-pointes-of-cardiac-sarcoidosis-with-preserved-left-ventricular-ejection-fraction
#18
Takayuki Sekihara, Eisaku Nakane, Kazutaka Nakasone, Moriaki Inoko
Generally, low left ventricular ejection fraction (LVEF) is a risk for ventricular arrhythmia in patients with cardiac sarcoidosis. We present a case of cardiac sarcoidosis with preserved LVEF that evoked ventricular fibrillation (VF). A 73-year-old woman with VF presented to our emergency department. She had a history of ocular sarcoidosis, with gradual thinning of the basal intraventricular septum. LVEF was 62% on the most recent echocardiography. The electrocardiogram after defibrillation showed complete atrioventricular block (CAVB) with QT segment prolongation and frequent ventricular premature beats...
October 25, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27793505/emergency-physician-performed-tricuspid-annular-plane-systolic-excursion-in-the-evaluation-of-suspected-pulmonary-embolism
#19
James Daley, John Grotberg, Joseph Pare, Amanda Medoro, Rachel Liu, Michael Kennedy Hall, Andrew Taylor, Christopher L Moore
OBJECTIVES: The primary objectives were to describe the diagnostic characteristics tricuspid annular plane systolic excursion (TAPSE) for pulmonary embolism (PE) and to optimize the measurement cutoff of TAPSE for the diagnosis of PE. Secondary objectives included assessment of interrater reliability and the quantitative visual estimation of TAPSE. METHODS: This is a prospective observational cohort study involving a convenience sample of patients at an urban academic emergency department...
October 11, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27793101/pulmonary-artery-compression-by-a-localized-epicardial-hematoma-in-a-patient-with-idiopathic-thrombocytopenic-purpura-after-percutaneous-coronary-intervention-a-case-report
#20
Satoshi Kawaguchi, Toshiharu Takeuchi, Naoyuki Hasebe
BACKGROUND: The most common complication of coronary artery perforation, a rare complication of percutaneous coronary intervention (PCI), is hemopericardium with cardiac tamponade. However, localized extra-coronary bleeding can lead to epicardial hematoma, which is a rare phenomenon. We report the case of an unusual delayed presentation of post-PCI hematoma with unrecognized guidewire perforation. CASE PRESENTATION: A 70-year-old man with idiopathic thrombocytopenic purpura (ITP) and a history of coronary artery bypass grafting (CABG) underwent PCI...
October 28, 2016: BMC Cardiovascular Disorders
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