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Cardiac emergencies

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https://www.readbyqxmd.com/read/28222456/nausea-vomiting-%C3%A2-tachycardia-%C3%A2-unintentional-weight-loss-%C3%A2-dx
#1
Daryl J Selen, Matthew P Gilbert
A 22-year-old woman presented to the emergency department (ED) with a 24-hour history of nausea, vomiting, diarrhea, generalized abdominal pain, and mild headache. She denied shortness of breath, chest pain, or anxiety, and didn't have a history of cardiac problems. The physical examination revealed tachycardia (heart rate, 135 beats/min) and a respiratory rate of 24 breaths per minute.
February 2017: Journal of Family Practice
https://www.readbyqxmd.com/read/28221262/recent-advances-in-computed-tomographic-technology-cardiopulmonary-imaging-applications
#2
Azadeh Tabari, Roberto Lo Gullo, Venkatesh Murugan, Alexi Otrakji, Subba Digumarthy, Mannudeep Kalra
Cardiothoracic diseases result in substantial morbidity and mortality. Chest computed tomography (CT) has been an imaging modality of choice for assessing a host of chest diseases, and technologic advances have enabled the emergence of coronary CT angiography as a robust noninvasive test for cardiac imaging. Technologic developments in CT have also enabled the application of dual-energy CT scanning for assessing pulmonary vascular and neoplastic processes. Concerns over increasing radiation dose from CT scanning are being addressed with introduction of more dose-efficient wide-area detector arrays and iterative reconstruction techniques...
March 2017: Journal of Thoracic Imaging
https://www.readbyqxmd.com/read/28220713/the-influence-of-targeted-temperature-management-on-the-pharmacokinetics-of-drugs-administered-during-and-after-cardiac-arrest-a-systematic-review
#3
Tessa Crombez, Said Hachimi-Idrissi
OBJECTIVE: Pharmacokinetic parameters of drugs are widely investigated under normothermic conditions and normal hemodynamic parameters. The European Resuscitation Council recommends the use of targeted temperature management (TTM) with a target temperature of 34 °C in cardiac arrest (CA) patients. The aim of this literature review is to investigate the influence of CA combined with TTM on the pharmacokinetics of drugs. Results of preclinical and clinical studies are compared with each other...
February 21, 2017: Acta Clinica Belgica
https://www.readbyqxmd.com/read/28220232/targeted-temperature-management-after-intraoperative-cardiac-arrest-a-multicenter-retrospective-study
#4
Anne-Laure Constant, Nicolas Mongardon, Quentin Morelot, Nicolas Pichon, David Grimaldi, Lauriane Bordenave, Alexis Soummer, Bertrand Sauneuf, Sybille Merceron, Sylvie Ricome, Benoit Misset, Cedric Bruel, David Schnell, Julie Boisramé-Helms, Etienne Dubuisson, Jennifer Brunet, Sigismond Lasocki, Pierrick Cronier, Belaid Bouhemad, Serge Carreira, Emmanuelle Begot, Benoit Vandenbunder, Gilles Dhonneur, Philippe Jullien, Matthieu Resche-Rigon, Jean-Pierre Bedos, Claire Montlahuc, Stephane Legriel
PURPOSE: Few outcome data are available about temperature management after intraoperative cardiac arrest (IOCA). We describe targeted temperature management (TTM) (32-34 °C) modalities, adverse events, and association with 1-year functional outcome in patients with IOCA. METHODS: Patients admitted to 11 ICUs after IOCA in 2008-2013 were studied retrospectively. The main outcome measure was 1-year functional outcome. RESULTS: Of the 101 patients [35 women and 66 men; median age, 62 years (interquartile range, 42-72)], 68 (67...
February 20, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28217821/physicians-experiences-as-patients-with-statin-side-effects-a-case-series
#5
Hayley J Koslik, Athena Hathaway Meskimen, Beatrice Alexandra Golomb
Physicians are among those prescribed statins and therefore, subject to potential statin adverse effects (AEs). There is little information on the impact of statin AEs on physicians affected by them. We sought to assess the character and impact of statin AEs occurring in physicians and retired physicians, and to ascertain whether/how personal experience of AEs moderated physicians' attitude toward statin use. Seven active or retired physicians from the United States communicated with the Statin Effects Study group regarding their personal experience of statin AEs...
December 2017: Drug Safety—Case Reports
https://www.readbyqxmd.com/read/28217690/iatrogenic-acute-ascending-aortic-dissection-with-intramural-hematoma-during-coronary-artery-stenting-a-case-report
#6
Mohamad El-Haress, Hicham Daadaa, Shima Shahjouei, Firas El-Bitar, Hisham Bahmad
BACKGROUND: Iatrogenic acute ascending aortic dissection during percutaneous coronary intervention (PCI) is an exceptionally rare and life-threatening sequel that requires early and accurate diagnosis along with rapid management. No guidelines have yet been established to direct decisions on the different treatment options that can be employed in the setting of acute aortic dissections caused by PCI. However, similar cases have been treated either by intracoronary stenting and conservative management as in localized aortocoronary dissections or by surgical intervention in cases of extensive aortic dissections...
2017: Frontiers in Surgery
https://www.readbyqxmd.com/read/28216496/-clinical-value-of-the-evolution-of-left-ventricular-global-strain-in-anterior-myocardial-infarction-patients-treated-with-emergency-percutaneous-coronary-intervention
#7
Zurong Yang, Qichang Zhou, Zhenfei Fang, Danming Cao, Jiawei Zhou, Xiankui Tan
To investigate the evolution of left ventricular global strain in anterior myocardial infarction patients treated with emergency percutaneous coronary intervention (PCI).
 Methods: A total of 54 patients with PCI were enrolled as a PCI group. Forty healthy subjects were enrolled as a control group. Dynamic cardiac images were collected. All of these images were analyzed off-line by velocity vector imaging (VVI) software. N-terminal pro-B-type natriuretic peptide (NT-proBNP) was measured with an electrochemiluminescence immunoassay through the Elecsys 1010/2010 system...
January 28, 2017: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
https://www.readbyqxmd.com/read/28215188/high-school-cardiac-emergency-response-plans-and-sudden-cardiac-death-in-the-young
#8
Michelle J White, Emefah C Loccoh, Monica M Goble, Sunkyung Yu, Folafoluwa O Odetola, Mark W Russell
: Introduction Sudden cardiac death (SCD) is responsible for 5%-10% of all deaths among children 5-19 years-of-age. The incidence of SCD in youth in Michigan (USA) and nationwide is higher in racial/ethnic minorities and in certain geographic areas. School cardiac emergency response plans (CERPs) increase survival after cardiac arrest. However, school cardiac emergency preparedness remains variable. Studying population-level factors associated with school cardiac emergency preparedness and incidence of SCD in the young may improve understanding of disparities in the incidence of SCD...
February 20, 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/28215153/engineered-muscle-tissues-for-disease-modeling-and-drug-screening-applications
#9
Mohammad Hossein Mohammadi, Raquel Obregón, Samad Ahadian, Javier Ramón-Azcón, Milica Radisic
Animal models have been the main resources for drug discovery and prediction of drugs' pharmacokinetic responses in the body. However, noticeable drawbacks associated with animal models include high cost, low reproducibility, low physiological similarity to humans, and ethical problems. Engineered tissue models have recently emerged as an alternative or substitute for animal models in drug discovery and testing and disease modeling. In this review, we focus on skeletal muscle and cardiac muscle tissues by first describing their characterization and physiology...
February 15, 2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/28213888/transfusion-in-critical-care-a-uk-regional-audit-of-current-practice
#10
J O M Plumb, M G Taylor, E Clissold, M P W Grocott, R Gill
A consistent message within critical care publications has been that a restrictive transfusion strategy is non-inferior, and possibly superior, to a liberal strategy for stable, non-bleeding critically ill patients. Translation into clinical practice has, however, been slow. Here, we describe the degree of adherence to UK best practice guidelines in a regional network of nine intensive care units within Wessex. All transfusions given during a 2-month period were included (n = 444). Those given for active bleeding or within 24 h of major surgery, trauma or gastrointestinal bleeding were excluded (n = 148)...
February 18, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28213587/emergency-extracorporeal-life-support-and-ongoing-resuscitation-a-retrospective-comparison-for-refractory-out-of-hospital-cardiac-arrest
#11
A Schober, F Sterz, H Herkner, C Wallmueller, C Weiser, P Hubner, C Testori
BACKGROUND: In refractory cardiac arrest, with cardiopulmonary resuscitation (CPR) for more than 30 min, chances of survival are small. Extracorporeal cardiopulmonary resuscitation (ECPR) is an option for certain patients with cardiac arrest. The aim of this study was to evaluate characteristics of patients selected for ECPR. METHODS: Anonymised data of adult patients suffering refractory cardiac arrest, transported with ongoing CPR to an ED of a tertiary care centre between 2002 and 2012 were analysed...
February 17, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28213377/interventional-treatment-of-pulmonary-embolism
#12
David M Dudzinski, Jay Giri, Kenneth Rosenfield
Pulmonary embolism (PE) is a serious and prevalent cause of vascular disease. Nevertheless, optimal treatment for many phenotypes of PE remains uncertain. Treating PE requires appropriate risk stratification as a first step. For the highest-risk PE, presenting as shock or arrest, emergent systemic thrombolysis or embolectomy is reasonable, while for low-risk PE, anticoagulation alone is often chosen. Normotensive patients with PE but with indicia of right heart dysfunction (by biomarkers or imaging) constitute an intermediate-risk group for whom there is controversy on therapeutic strategy...
February 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28211486/motor-phenotype-is-not-associated-with-vascular-dysfunction-in-symptomatic-huntington-s-disease-transgenic-r6-2-160-cag-mice
#13
A Di Pardo, A Carrizzo, A Damato, S Castaldo, E Amico, L Capocci, M Ambrosio, F Pompeo, C De Sanctis, C C Spinelli, A A Puca, P Remondelli, V Maglione, C Vecchione
Whereas Huntington's disease (HD) is unequivocally a neurological disorder, a critical mass of emerging studies highlights the occurrence of peripheral pathology like cardiovascular defects in both animal models and humans. The overt impairment in cardiac function is normally expected to be associated with peripheral vascular dysfunction, however whether this assumption is reasonable or not in HD is still unknown. In this study we functionally characterized the vascular system in R6/2 mouse model (line 160 CAG), which recapitulates several features of human pathology including cardiac disease...
February 17, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28210569/infant-acute-myocarditis-mimicking-acute-myocardial-infarction
#14
Maher Jedidi, Samia Tilouche, Tasnim Masmoudi, Maha Sahnoun, Youssef Chkirbène, Sarra Mestiri, Lamia Boughamoura, Mohamed Ben Dhiab, Mohamed Kamel Souguir
Myocarditis is an inflammatory disease of the myocardium with heterogeneous clinical manifestations and progression. In clinical practice, although there are many methods of diagnosis of acute myocarditis, the diagnosis remains an embarrassing dilemma for clinicians. The authors report the case of 9-month-old infant who was brought to the Pediatric Emergency Department with sudden onset dyspnea. Examination disclosed heart failure and resuscitation was undertaken. The electrocardiogram showed an ST segment elevation in the anterolateral leads with a mirror image...
October 2016: Autopsy & case reports
https://www.readbyqxmd.com/read/28209718/demethylation-of-h3k27-is-essential-for-the-induction-of-direct-cardiac-reprogramming-by-mir-combo
#15
Sophie Dal-Pra, Conrad P Hodgkinson, Maria Mirotsou, Imke Kirste, Victor J Dzau
Rationale: Direct reprogramming of cardiac fibroblasts to cardac omyocytes has recently emerged as a novel and promising approach to regenerate the injured myocardium. We have previously demonstrated the feasibility of this approach in vitro and in vivo using a combination of four microRNAs (miR-1, miR-133, miR-208 and miR-499) that we named miR combo. However, the mechanism of miR combo mediated direct cardiac reprogramming is currently unknown. Objective: Here we investigated the possibility that miR combo initiated direct cardiac reprogramming through an epigenetic mechanism...
February 16, 2017: Circulation Research
https://www.readbyqxmd.com/read/28207539/role-of-coronary-angiography-for-out-of-hospital-cardiac-arrest-survivors-according-to-postreturn-of-spontaneous-circulation-on-an-electrocardiogram
#16
Tae Rim Lee, Sung Yeon Hwang, Won Chul Cha, Tae Gun Shin, Min Seob Sim, Ik Joon Jo, Keun Jeong Song, Joong Eui Rhee, Yeon Kwon Jeong
Survivors of out-of-hospital cardiac arrest (OHCA) have high mortality and morbidity. An acute coronary event is the most common cause of sudden cardiac death. For this reason, coronary angiography is an important diagnostic and treatment strategy for patients with postcardiac arrest. This study aimed to identify the correlation between postreturn of spontaneous circulation (ROSC) on an electrocardiogram (ECG) and results of coronary angiography of OHCA survivors.We collected data from our OHCA registry from January 2010 to November 2014...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28205276/positive-t-wave-in-lead-avr-as-an-independent-predictor-for-1-year-major-adverse-cardiac-events-in-patients-with-first-anterior-wall-st-segment-elevation-myocardial-infarction
#17
Akihiro Kobayashi, Naoki Misumida, Shunsuke Aoi, Yumiko Kanei
BACKGROUND: Positive T wave in lead aVR has been shown to predict an adverse in-hospital outcome in patients with anterior wall ST-segment elevation myocardial infarction (STEMI). However, the prognostic value of positive T wave in lead aVR on a long-term outcome has not been fully explored. METHODS: We performed a retrospective analysis of 190 consecutive patients with first anterior wall STEMI who underwent an emergent coronary angiogram. Patients were divided into those with positive T wave > 0 mV and those with negative T wave ≦ 0 mV in lead aVR...
February 16, 2017: Annals of Noninvasive Electrocardiology
https://www.readbyqxmd.com/read/28205213/haemodynamic-changes-to-a-midazolam-fentanyl-rocuronium-protocol-for-pre-hospital-anaesthesia-following-return-of-spontaneous-circulation-after-cardiac-arrest
#18
M Miller, C Groombridge, R Lyon
Following the return of spontaneous circulation after out-of-hospital cardiac arrest, neurological dysfunction, airway or ventilatory compromise can impede transport to early percutaneous coronary intervention, necessitating pre-hospital or emergency department anaesthesia to facilitate this procedure. There are no published reports of the ideal induction agents in these patients. We sought to describe haemodynamic changes associated with induction of anaesthesia using a midazolam (0.1 mg.kg(-1) ), fentanyl (2 μg...
February 15, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28202420/out-of-hospital-cardiac-arrest-ohca-attended-by-mobile-emergency-teams-with-a-physician-on-board-results-of-the-spanish-ohca-registry-oshcar
#19
Fernando Rosell-Ortiz, José M Navalpotro-Pascual, Patricia Fernández Del Valle, Luis Sánchez-Santos, Xavier Escalada-Roig, Alfredo Echarri-Sucunza, José M Adsuar-Quesada, Isabel Ceniceros-Rozalén, José I Ruiz-Azpiazu, Karlos Ibarguren-Olalde, Nuria López-Cabeza, María V Mier-Ruiz, Enrique Martín-Sánchez, Marta Martínez Del Valle, Guadalupe Inza-Muñoz, Juan A Cordero Torres, María J García-Ochoa, José A Cortés-Ramas, Raúl Canabal-Berlanga, Rafael Zoyo López-Navarro, Juan B López-Messa, Javier García Del Águila, Daniel Alonso-Moreno, Carmen Pozo-Pérez, José Bravo-Castello, Natividad Ramos-García, Ignacio Gómez-Larrosa, Francisco J Mellado-Vergel
: Most survival outcomes in out-of-hospital cardiac arrest (OHCA) are provided by emergency medical services (EMS) without a doctor on board. Our objective was to determine such outcomes in a whole country with public physician-led EMS. METHODS: We analyzed data from a nationwide prospective registry of OHCA cases attended by emergency medical teams (EMS) of 19 Public EMS in Spain, covering the period from 1 October 2013 to 30-October 2014 (13 months). RESULTS: Advanced life support (ALS) was initiated in 9347 cases (incidence of 18...
February 12, 2017: Resuscitation
https://www.readbyqxmd.com/read/28202338/a-new-strategy-for-emergency-department-crowding-high-turnover-utility-bed-intervention
#20
I-Hsin Lee, Chung-Ting Chen, Yi-Tzu Lee, Yueh-Shuang Hsu, Chia-Ling Lu, Hsien-Hao Huang, Teh-Fu Hsu, Chorng-Kuang How, David Hung-Tsang Yen, Ueng-Cheng Yang
BACKGROUND: This study applied a new strategy, termed high-turnover utility bed intervention, to offer early admission chances for emergency department (ED) patients and alleviate ED crowding. METHODS: This before-and-after observational cohort study was conducted at the ED of an urban tertiary hospital. On January 1, 2012, 14 utility beds were prepared exclusively for ED patient use. A strict 48-hour course limit for each patient was formulated to govern these high-turnover beds...
February 12, 2017: Journal of the Chinese Medical Association: JCMA
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