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Emergency Echocardiography

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https://www.readbyqxmd.com/read/28345156/evolving-new-concepts-in-the-assessment-of-aortic-stenosis
#1
REVIEW
Peerawut Deeprasertkul, Masood Ahmad
Echocardiography has been pivotal in evaluating aortic stenosis (AS) over the past several decades. Recent experience has shown a wide spectrum in the clinical presentation of AS. A better understanding of the underlying hemodynamic principles has resulted in emergence of new subtypes of AS. New treatment modalities have also been introduced, requiring precise evaluation of aortic valve (AV) pathology for implementation of these therapies. This review will discuss new concepts and indices in the use of echocardiography in patients with AS...
March 27, 2017: Echocardiography
https://www.readbyqxmd.com/read/28341982/pocket-sized-point-of-care-cardiac-ultrasound-devices-role-in-the-emergency-department
#2
A Colclough, P Nihoyannopoulos
BACKGROUND: Acute breathlessness accounts for 8% of accident and emergency attendances. Point-of-care cardiac ultrasound (US) effectively reduces time to diagnosis. Fast and practical information via pocket-sized cardiac US devices may better the diagnosis in this complex patient group. METHODS: We prospectively enrolled 40 consecutive patients presenting with shortness of breath at the emergency department (ED). Divided into two groups were all adult patients over 18 with acute breathing difficulties (triage category 1-3): 21 patients received a short focused cardiac US scan using a pocket-sized Vscan and 19 patients received no scan...
March 24, 2017: Herz
https://www.readbyqxmd.com/read/28336204/n-terminal-pro-brain-natriuretic-peptide-is-related-with-coronary-flow-velocity-reserve-and-diastolic-dysfunction-in-patients-with-asymmetric-hypertrophic-cardiomyopathy
#3
Milorad Tesic, Jelena Seferovic, Danijela Trifunovic, Ana Djordjevic-Dikic, Vojislav Giga, Ivana Jovanovic, Olga Petrovic, Jelena Marinkovic, Sanja Stankovic, Jelena Stepanovic, Arsen Ristic, Milan Petrovic, Nebojsa Mujovic, Bosiljka Vujisic-Tesic, Branko Beleslin, Vladan Vukcevic, Goran Stankovic, Petar Seferovic
BACKGROUND: The relations of elevated N-terminal pro-brain natriuretic peptide (NT-pro-BNP) and cardiac ischemia in hypertrophic cardiomyopathy (HCM) patients is uncertain. Therefore we designed the study with the following aims: (1) to analyze plasma concentrations of NT-pro-BNP in various subsets of HCM patients; (2) to reveal the correlations of NT-pro-BNP, myocardial ischemia, and diastolic dysfunction; (3) to assess predictors of the elevated plasma levels of NT-pro-BNP. METHODS AND RESULTS: In 61 patients (mean age 48...
March 20, 2017: Journal of Cardiology
https://www.readbyqxmd.com/read/28332218/changes-in-myocardial-deformation-after-transcatheter-and-surgical-aortic-valve-replacement
#4
REVIEW
Vinisha Garg, Jonathan K Ho, Gabriel Vorobiof
Speckle tracking echocardiography (STE) has emerged as a novel angle-independent modality in assessing myocardial velocity, deformation, and strain. Its role in assessing change before and after aortic valve replacement in patients with aortic stenosis (AS) has recently generated interest. This review summarizes the practical utility and clinical implications of myocardial deformation by STE after surgical or transcatheter aortic valve replacement (TAVR). Overall, atrial strain and ventricular strain as measured by STE improve after surgical and transcatheter aortic intervention in short- and long-term follow-up with evidence of a more pronounced acute improvement in patients who undergo TAVR...
March 23, 2017: Echocardiography
https://www.readbyqxmd.com/read/28328838/development-and-validation-of-a-risk-prediction-nomogram-for-in-hospital-mortality-in-adults-poisoned-with-drugs-and-nonpharmaceutical-agents-an-observational-study
#5
Catalina Lionte, Victorita Sorodoc, Elisabeta Jaba, Alina Botezat
Acute poisoning with drugs and nonpharmaceutical agents represents an important challenge in the emergency department (ED).The objective is to create and validate a risk-prediction nomogram for use in the ED to predict the risk of in-hospital mortality in adults from acute poisoning with drugs and nonpharmaceutical agents.This was a prospective cohort study involving adults with acute poisoning from drugs and nonpharmaceutical agents admitted to a tertiary referral center for toxicology between January and December 2015 (derivation cohort) and between January and June 2016 (validation cohort)...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28323905/elevated-plasma-levels-of-cardiac-troponin-i-predict-left-ventricular-systolic-dysfunction-in-patients-with-myotonic-dystrophy-type-1-a-multicentre-cohort-follow-up-study
#6
Mark J Hamilton, Yvonne Robb, Sarah Cumming, Helen Gregory, Alexis Duncan, Monika Rahman, Anne McKeown, Catherine McWilliam, John Dean, Alison Wilcox, Maria E Farrugia, Anneli Cooper, Josephine McGhie, Berit Adam, Richard Petty, Cheryl Longman, Iain Findlay, Alan Japp, Darren G Monckton, Martin A Denvir
OBJECTIVE: High sensitivity plasma cardiac troponin-I (cTnI) is emerging as a strong predictor of cardiac events in a variety of settings. We have explored its utility in patients with myotonic dystrophy type 1 (DM1). METHODS: 117 patients with DM1 were recruited from routine outpatient clinics across three health boards. A single measurement of cTnI was made using the ARCHITECT STAT Troponin I assay. Demographic, ECG, echocardiographic and other clinical data were obtained from electronic medical records...
2017: PloS One
https://www.readbyqxmd.com/read/28321497/intra-procedural-determination-of-viability-by-myocardial-deformation-imaging-a-randomized-prospective-study-in-the-cardiac-catheter-laboratory
#7
Alexander Schuh, Vadim Karayusuf, Ertunc Altiok, Sandra Hamada, Jörg Schröder, Andras Keszei, Malte Kelm, Matias de la Fuente, Michael Frick, Klaus Radermacher, Nikolaus Marx, Michael Becker
BACKGROUND: The benefit of revascularization for functional recovery depends on the presence of viable myocardial tissue. OBJECTIVE: Myocardial deformation imaging allows determination of myocardial viability. METHODS: In a first approach, we assessed the optimal cutoff value to determine preserved viability by layer-specific echocardiographic myocardial deformation imaging at rest and low-dose dobutamine (DSE) echocardiography: regional endocardial circumferential strain (eCS) <-19% at rest was as accurate as eCS at DSE...
March 20, 2017: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/28320222/demographic-and-perinatal-outcome-data-of-fetuses-with-sua-pruv
#8
Lulu Sun, Yanlin Wang
AIM: Identify structural anomalies and adverse pregnancy outcomes accompanying single umbilical artery (SUA) and persistent right umbilical vein (PRUV) and to investigate whether SUA and PRUV are associated with chromosomal abnormalities and if these defects warrant invasive antenatal diagnosis. METHODS: We retrospectively analyzed pregnancies with an antenatal diagnosis of SUA/PRUV from the International Peace Maternity and Child Health Hospital (IPMCHH) database...
March 20, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28317170/added-clinical-value-of-applying-myocardial-deformation-imaging-to-assess-right-ventricular-function
#9
REVIEW
Vladislavs Sokalskis, Diletta Peluso, Annika Jagodzinski, Christoph Sinning
Right heart dysfunction has been found to be a strong prognostic factor predicting adverse outcome in various cardiopulmonary diseases. Conventional echocardiographic measurements can be limited by geometrical assumptions and impaired reproducibility. Speckle tracking-derived strain provides a robust quantification of right ventricular function. It explicitly evaluates myocardial deformation, as opposed to tissue Doppler-derived strain, which is computed from tissue velocity gradients. Right ventricular longitudinal strain provides a sensitive tool for detecting right ventricular dysfunction, even at subclinical levels...
March 19, 2017: Echocardiography
https://www.readbyqxmd.com/read/28301889/geburtshilfe-an%C3%A3-sthesie-bei-exit-prozedur
#10
Alexander Torossian
The ex utero intrapartum treatment (EXIT) procedure is performed as a part of an extended caesarean section for example to treat fetal airway disorders. For treatment, optimal uterine relaxation is necessary, however utero-placental supply of the fetus has to be guaranteed as well. "Balanced" anesthesia, tocolysis and tight maternal arterial blood pressure control are recommended. Standard fetal monitoring comprises pulse oxymetry and echocardiography. The article describes the physiology and anesthestic goals of the EXIT procedure, discusses alternative anesthesia techniques and gives an outlook on emerging progress...
March 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/28301416/speckle-tracking-strain-of-the-right-ventricle-an-emerging-tool-for-intraoperative-echocardiography
#11
Natalie Silverton, Massimiliano Meineri
No abstract text is available yet for this article.
March 15, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28293009/-ruptured-left-ventricular-pseudoaneurysm-representing-cardiac-tamponade-report-of-a-case
#12
Masatoshi Komooka, Shinichi Higashiue, Satoshi Kuroyanagi, Onichi Furuya, Masahide Enomoto, Saburo Kojima, Naohiro Wakabayashi
A 64-year-old woman was followed by the other hospital because of left ventricular false aneurysm after percutaneous coronary intervention for acute myocardial infarction of which culprit lesion was left circumflex artery. She admitted to the hospital suffering from nausea and dyspnea. Echocardiography showed huge pericardial effusion and cardiac tamponade due to ruptured left ventricular false aneurysm and transferred to our hospital under pericardial drainage. She presented with symptoms such as shock, so we performed emergent left ventricular reconstruction...
March 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28292545/adding-fuel-to-the-fire-coronary-artery-dissection-complicating-blunt-chest-trauma
#13
Ankit Maheshwari, Thenappan Thenappan, Gladwin Das
A 21year-old male presented to the emergency department with 6 h of atypical chest pain after suffering blunt chest trauma. His electrocardiogram revealed 1-1.5mm ST segment elevation in leads V1-V3 with reciprocal depressions in II, III, and aVF. Mid-anterior wall akinesis was observed on echocardiography associated with an estimated left ventricular ejection fraction of 40%. A left main coronary artery dissection was diagnosed and treated surgically with a bypass graft. Although rare, coronary dissections can be a catastrophic complication of chest trauma...
March 7, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28291128/the-use-of-ultrasound-in-obstetric-anesthesia
#14
Carolyn F Weiniger, Limor Sharoni
PURPOSE OF REVIEW: The current review considers an array of recent applications for point-of-care ultrasound in clinical practice including diagnostic and therapeutic procedures that may be relevant for the obstetric anesthesiologist. The rapid advancement of technology and clinical applications for bedside ultrasound in obstetric anesthesiology requires an appraisal of the limitations and uses. RECENT FINDINGS: The review presents the most recent literature describing ultrasound-guided airway assessments, airway management, cricothyroidotomy, transthoracic echocardiography, gastric volume assessments, point-of-care lung ultrasound diagnoses, intracranial pressure assessments, vascular access, neuraxial blocks, and transversus abdominis plane blocks...
March 11, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28279544/inferior-vena-cava-filter-limb-fracture-with-embolization-to-the-right-ventricle
#15
Bradley S Jackson, Mykel Sepula, Jared T Marx, Chad M Cannon
BACKGROUND: Inferior vena cava (IVC) filter and filter limb embolization is a known phenomenon, with a prevalence of up to 25% for certain filter types. Most commonly, the site of embolization is to the heart. Point-of-care ultrasound is an easily accessible imaging modality that should be utilized when considering IVC filter complications. CASE REPORT: A 28-year-old woman with a history of metastatic sarcoma and IVC filter placement for deep venous thrombosis presented to the Emergency Department (ED) for chest pain...
March 6, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28279382/trials-of-imaging-use-in-the-emergency-department-for-acute-chest-pain
#16
REVIEW
Gilbert L Raff, Udo Hoffmann, James E Udelson
Over 8 million patients seek emergency department care for acute chest pain annually in the United States alone, and <5% have an acute coronary syndrome. In the absence of overt electrocardiographic or biomarker evidence, expensive and time-consuming diagnostic strategies are frequently required. Beginning in 2000, radionuclide myocardial perfusion, stress echocardiography, cardiac magnetic resonance imaging, and coronary computed tomographic angiography have become increasingly common in evaluating these patients...
March 2017: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28275939/current-management-of-patients-with-severe-aortic-regurgitation
#17
REVIEW
Charles Nadeau-Routhier, Ons Marsit, Jonathan Beaudoin
Chronic aortic regurgitation can result from various congenital and acquired anomalies and can be associated with proximal aortic disease. As the number of aortic valve procedures is growing, the incidence of post-procedural regurgitation also increases with associated morbidity. Typical evolution is characterized by a clinically silent phase of variable duration followed by a rather rapid decline with high incidence of adverse events. A challenge remains to find the optimal timing for an intervention: Patients are exposed to unnecessary surgical risks if treated prematurely, but peri- and post-operative prognosis is worse when the intervention is performed too late...
February 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28268512/multiview-echocardiography-fusion-using-an-electromagnetic-tracking-system
#18
Kumaradevan Punithakumar, Abhilash R Hareendranathan, Riitta Paakkanen, Nehan Khan, Michelle Noga, Pierre Boulanger, Harald Becher
Three-dimensional ultrasound is an emerging modality for the assessment of complex cardiac anatomy and function. The advantages of this modality include lack of ionizing radiation, portability, low cost, and high temporal resolution. Major limitations include limited field-of-view, reliance on frequently limited acoustic windows, and poor signal to noise ratio. This study proposes a novel approach to combine multiple views into a single image using an electromagnetic tracking system in order to improve the field-of-view...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28267111/blind-sided-by-cosmetic-vein-sclerotherapy-a-case-of-ophthalmic-arterial-occlusion
#19
Meena Arunakirinathan, Robbie J E Walker, Noor Hassan, Sally Ameen, Saad Younis
PURPOSE: Cosmetic vein sclerotherapy is increasingly used to treat varicose veins because of its effectiveness and adherence with British Pharmacopoeia specifications. We present the first documented case of ophthalmic artery occlusion resulting in panocular ischemia secondary to intravascular injection of sodium tetradecyl sulfate sclerosant in a young healthy women seeking treatment for prominent facial veins in her forehead. METHODS: The patient presented with unilateral sudden loss of vision...
March 6, 2017: Retinal Cases & Brief Reports
https://www.readbyqxmd.com/read/28266730/echocardiographic-assessment-in-patients-with-chronic-kidney-disease-current-update
#20
REVIEW
Samir Sulemane, Vasileios F Panoulas, Petros Nihoyannopoulos
Patients with chronic kidney disease (CKD) carry a high cardiovascular risk. An abundance of evidence has emerged in recent years establishing minor reductions in estimated glomerular filtration rate as an independent risk factor for cardiovascular mortality. Additionally, cardiac changes, such as left ventricular hypertrophy and impaired left ventricular systolic function, have been associated with an unfavorable prognosis. Despite the significant prevalence of underlying cardiac abnormalities, symptoms may not manifest in many patients with CKD...
March 7, 2017: Echocardiography
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