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Cardiac emergencies

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https://www.readbyqxmd.com/read/28811213/hemodynamic-characteristics-of-suspected-stroke-in-the-emergency-department
#1
Joseph B Miller, Richard M Nowak, Brian P Reed, Salvatore DiSomma, Prabath Nanayakkara, Michele Moyer, Scott Millis, Harish Kinni, Phillip Levy
BACKGROUND: Systemic hemodynamic characteristics of patients with suspected acute ischemic stroke are poorly described. The objective of this study was to identify baseline hemodynamic characteristics of emergency department (ED) patients with suspected acute stroke. METHODS: This was a planned analysis of the stroke cohort from a multicenter registry of hemodynamic profiling of ED patients. The registry prospectively collected non-invasive hemodynamic measurements of patients with suspicion for acute stroke within 12h of symptom onset...
August 8, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28810994/comparison-of-point-of-care-versus-laboratory-troponin-testing-in-an-emergency-department-setting
#2
Michael Juliano, Courtney Wason
BACKGROUND: There have been concerns regarding troponin results accuracy between point-of-care (POC) testing preformed in an emergency department (ED) setting and laboratory testing. The purpose of this study was to compare the results of cardiac troponin I testing as concerns POC testing and laboratory analysis as a way to show that these results are interchangeable. METHODS: A retrospective chart review was performed from October 2012 through September 2013 to identify all patients who presented to the ED that received both a POC and laboratory troponin associated with the same blood draw...
July 2017: Military Medicine
https://www.readbyqxmd.com/read/28810931/a-comprehensive-regional-clinical-and-educational-ecpr-protocol-decreases-time-to-ecmo-in-patients-with-refractory-out-of-hospital-cardiac-arrest
#3
Brian Grunau, Sarah Carrier, Jamil Bashir, William Dick, Luke Harris, Robert Boone, Dan Kalla, Frank Scheuermeyer, Brian Twaites, Ron Straight, James Abel, Ken McDonald, Ruth MacRedmond, David Agulnik, Joe Finkler, Jeanne MacLeod, Jim Christenson, Anson Cheung
OBJECTIVE: Extracorporeal membrane oxygenation within CPR (ECPR) may improve survival for refractory out-of-hospital cardiac arrest (OHCA). We developed a prehospital, emergency department (ED), and hospital-based clinical and educational protocol to improve the key variable of time-to-ECPR (TTE). METHODS: In a single urban health region we involved key prehospital, clinical, and administrative stakeholders over a 2-year period, to develop a regional ECPR program with destination to a single urban tertiary care hospital...
August 16, 2017: CJEM
https://www.readbyqxmd.com/read/28810445/enduring-somatic-threat-perceptions-and-post-traumatic-stress-disorder-symptoms-in-survivors-of-cardiac-events
#4
Laura Meli, Carmela Alcántara, Jennifer A Sumner, Brendan Swan, Bernard P Chang, Donald Edmondson
Post-traumatic stress disorder due to acute cardiovascular events may be uniquely defined by enduring perceptions of somatic threat. We tested whether post-traumatic stress disorder at 1 month post-acute coronary syndrome indeed required both high peritraumatic threat during the acute coronary syndrome and ongoing cardiac threat perceptions. We assessed peritraumatic threat during emergency department enrollment of 284 patients with a provisional acute coronary syndrome diagnosis and cardiac threat perceptions and post-traumatic stress disorder symptoms 1 month post-discharge...
April 1, 2017: Journal of Health Psychology
https://www.readbyqxmd.com/read/28810369/a-closer-look-at-the-relationships-between-panic-attacks-emergency-department-visits-and-non-cardiac-chest-pain
#5
Guillaume Foldes-Busque, Isabelle Denis, Julien Poitras, Richard P Fleet, Patrick Archambault, Clermont E Dionne
This study examined the prevalence of emergency department visits prompted by panic attacks in patients with non-cardiac chest pain. A validated structured telephone interview was used to assess panic attacks and their association with the emergency department consultation in 1327 emergency department patients with non-cardiac chest pain. Patients reported at least one panic attack in the past 6 months in 34.5 per cent (95% confidence interval: 32.0%-37.1%) of cases, and 77.1 per cent (95% confidence interval: 73...
January 1, 2017: Journal of Health Psychology
https://www.readbyqxmd.com/read/28810115/current-guidelines-on-syncope
#6
Maheedhar Gedela, Naveen Rajpurohit, Kashif A Shaikh, Muhammad Omar, Scott Pham
Syncope is a very commonly encountered clinical problem in general practice and in the emergency department. In the evaluation of syncope, it is important to identify the specific cause to determine the treatment, to estimate the precise risk to a patient, and to reduce recurrence. Sometimes, making a diagnosis of syncope is difficult, as different mechanisms may often coexist. Syncope causes a significant impact on quality of life due to associated risk of physical injury. In particular, syncope can be a precursor to sudden cardiac death in patients with underlying cardiac disease...
November 2016: South Dakota Medicine: the Journal of the South Dakota State Medical Association
https://www.readbyqxmd.com/read/28810055/impact-of-mir-26b-on-cardiomyocyte-differentiation-in-p19-cells-through-regulating-canonical-non-canonical-wnt-signalling
#7
Duo Wang, Chang Liu, Yumei Wang, Wenjing Wang, Kang Wang, Xiujuan Wu, Zhigang Li, Cuimei Zhao, Li Li, Luying Peng
BACKGROUND AND OBJECTIVES: The control of cardiomyocyte differentiation is tightly linked to microRNAs (miRNAs), which have been emerging as important players in heart development. However, the regulation mechanisms mediated by miRNAs in early heart development remains speculative. Here, we evaluated the impact of miR-26b during the progression of cardiomyocyte differentiation from the P19 cell line. MATERIALS AND METHODS: The overexpression of miR-26b in P19 cells was performed by transduction with lentivirus vector...
August 15, 2017: Cell Proliferation
https://www.readbyqxmd.com/read/28808991/light-chain-al-amyloidosis-the-journey-to-diagnosis
#8
Kristen L McCausland, Michelle K White, Spencer D Guthrie, Tiffany Quock, Muriel Finkel, Isabelle Lousada, Martha S Bayliss
BACKGROUND: Light chain (AL) amyloidosis is a rare, complex disease associated with significant morbidity and mortality. Delays in diagnosis are common and may have detrimental consequences on patients' prognosis. Too little is known regarding the patient journey to diagnosis. OBJECTIVE: The objective of this study was to describe the patient-reported journey to a correct diagnosis for AL amyloidosis. METHODS: Using a mixed-methods approach, data were collected from clinician (n = 4) and patient (n = 10) interviews and a survey of community-based patients with AL amyloidosis (n = 341)...
August 14, 2017: Patient
https://www.readbyqxmd.com/read/28808936/-envenomation-by-micrurus-psyches-in-french-guiana
#9
X Heckmann, C Marty, F Starace, J-D Louembé, S Larréché
We report here the first known envenomation by Micrurus psyches, the so-called Carib coral snake, which occurred on April 2016 in the surroundings of Saint- Laurent-du-Maroni, Western French Guiana. Besides local neurological symptoms, it featured unexpected electrocardiogram changes, which were emergence of a first-degree atrioventricular block and biphasic T waves, both transient. NewWorld elapid venoms were not known for being cardiotoxic so far. The possible reasons of this cardiac injury are discussed.
August 14, 2017: Bulletin de la Société de Pathologie Exotique
https://www.readbyqxmd.com/read/28808363/incidence-characteristics-and-survival-trend-of-cardiopulmonary-resuscitation-following-in-hospital-compared-to-out-of-hospital-cardiac-arrest-in-northern-jordan
#10
Liqaa A Raffee, Shaher M Samrah, Hani Najih Al Yousef, Mahmoud Abu Abeeleh, Khaled Z Alawneh
BACKGROUND: Cardiac arrest remains a leading cause of mortality worldwide. Early cardiopulmonary resuscitation (CPR) is the cornerstone intervention to optimize the survival rates. OBJECTIVES: The main aim of this study was to determine and compare the incidence, characteristics, risk factors, and outcomes of CPR in a referral university hospital following in-hospital cardiac arrests (IHCAs) and out-of-hospital cardiac arrest (OHCA) in Northern Jordan. PATIENTS AND METHODS: Retrospective observational study of adults referred to King Abdulla University Hospital who received CPR between January 2014 and January 2015...
July 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28807713/opioid-drug-use-and-acute-cardiac-events-among-pregnant-women-in-the-united-states
#11
Hamisu M Salihu, Jason L Salemi, Anjali Aggarwal, Beverly F Steele, Ross C Pepper, Mulubrhan F Mogos, Muktar H Aliyu
BACKGROUND: Cardiovascular disease remains a leading cause of pregnancy-associated deaths in the United States (US). The extent to which increasing opioid use among pregnant women contributes to fatal cardiovascular events is unknown. We examine trends in opioid use among pregnant women over the previous decade, and the association between changes in temporal trends in opioid drug use and the incidence of acute cardiac events among mothers. METHODS: In this retrospective analysis of the Healthcare and Cost Utilization Project (HCUP), we utilized a two-stage stratified cluster sampling of all inpatient hospital discharges from non-federal hospitals between 01/01/2002 through 12/31/2014...
August 11, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28807442/age-is-related-to-neurological-outcome-in-patients-with-out-of-hospital-cardiac-arrest-ohca-receiving-therapeutic-hypothermia-th
#12
Se Jong Oh, Jin Joo Kim, Jae Ho Jang, In Cheol Hwang, Jae Hyuk Woo, Yong Su Lim, Hyuk Jun Yang
INTRODUCTION: In this study, we retrospectively reviewed the patients' outcomes after cardiac arrest based on age in one center, to determine whether geriatric patients had worse outcomes. METHODS: This was a single-center, retrospective cohort study. The patients admitted to the intensive care unit on successful resuscitation after OHCA were retrospectively identified and evaluated. RESULTS: This was a retrospective cohort study of patients over 18years of-age with return of spontaneous circulation (ROSC) (>24h) after cardiac arrest who were admitted to the emergency intensive care unit (EICU) and received post-cardiac arrest care between March 2007 and December 2013...
July 29, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28806444/eliminating-creatine-kinase-myocardial-band-testing-in-suspected-acute-coronary-syndrome-a-value-based-quality-improvement
#13
Matthew D Alvin, Allan S Jaffe, Roy C Ziegelstein, Jeffrey C Trost
Cardiac biomarker testing is estimated to occur in nearly 30 million emergency department visits nationwide each year in the United States. The American College of Cardiology/European Society of Cardiology indicate that cardiac troponin is the biomarker of choice owing to its nearly absolute myocardial tissue specificity and high clinical sensitivity for myocardial injury. Multiple academic medical centers have implemented interventions to eliminate the routine ordering of creatine kinase-myocardial band tests, with published patient safety outcomes data; however, creatine kinase-myocardial band testing is still ordered in many hospitals and emergency departments...
August 14, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28806270/new-clinical-paradigms-for-treating-and-preventing-antiplatelet-gastrointestinal-bleeding
#14
Neena S Abraham
PURPOSE OF REVIEW: To quantify antiplatelet-related gastrointestinal bleeding (GIB), characterize patients at greatest risk and summarize risk-management strategies emphasizing evolving knowledge in acute management of antiplatelet-related bleeding. RECENT FINDINGS: New paradigms for acute management of antiplatelet-related GIB exist in the domains of resuscitation and the transfusion of blood products, strategic use of proton pump therapy and identification and eradication of Helicobacter pylori...
August 12, 2017: Current Opinion in Gastroenterology
https://www.readbyqxmd.com/read/28806185/graft-quality-verification-in-coronary-artery-bypass-graft-surgery-how-when-and-why
#15
Teresa M Kieser
PURPOSE OF REVIEW: The coronary artery bypass graft (CABG) operation is one of the few remaining operations/interventions on diseased arteries that are not routinely verified during or immediately after the procedure. This review answers the 'how', 'when' and 'why' of intraoperative CABG assessment. RECENT FINDINGS: More recent than new literature on this topic, is the increased interest in quality assurance of CABG. This is most likely due to reports in the last 5 years suggesting CABG superiority to percutaneous coronary intervention (PCI) for improved mid-term and long-term outcomes; for example, for patients with diabetes mellitus (Freedom Trial by Farkouh in 2012), and for patients with SYNTAX score ≥ 33 (SYNTAX Trial by Mohr in 2013)...
August 12, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28805455/the-effect-of-a-peer-support-intervention-on-early-recovery-outcomes-in-men-recovering-from-coronary-bypass-surgery-a-randomized-controlled-trial
#16
Tracey Jf Colella, Kathryn King-Shier
BACKGROUND AND AIM: Examine the effect of a professionally-guided telephone peer support intervention on recovery outcomes including depression, perceived social support, and health services utilization after coronary artery bypass graft surgery (CABG). METHODS: A randomized controlled trial was conducted with post-coronary artery bypass graft surgery men ( N=185) who were randomized before hospital discharge. The intervention arm received telephone-based peer support through weekly telephone calls from a peer volunteer over six weeks, initiated within 3-4 days of discharge...
August 1, 2017: European Journal of Cardiovascular Nursing
https://www.readbyqxmd.com/read/28804814/factors-associated-with-cardiovascular-target-organ-damage-in-children-after-renal-transplantation
#17
Bianca Borchert-Mörlins, Daniela Thurn, Bernhard M W Schmidt, Anja K Büscher, Jun Oh, Tanja Kier, Elena Bauer, Sabrina Baig, Nele Kanzelmeyer, Markus J Kemper, Rainer Büscher, Anette Melk
BACKGROUND: Cardiovascular disease is the second-most common cause of death in pediatric renal transplant recipients. The aim of this study was to evaluate subclinical cardiovascular target organ damage defined as the presence of arterio- and atherosclerotic lesions and cardiac remodeling and to analyze contributing risk factors in a large cohort of children after renal transplantation (RT). METHODS: A total of 109 children aged 13.1 ± 3.3 years who had undergone RT at one of three German transplant centers were enrolled in this study...
August 13, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28804656/pneumomediastinum-and-mediastinal-hematoma-secondary-to-right-brachiocephalic-vein-thrombectomy-mimicking-stemi
#18
Prem Shukla, Prudence Dy, Rishi Raj, Sayee Sundar Alagusundaramoorthy, Noel Nivera
A 50-year-old male with a history of hemodialysis dependent chronic kidney disease presented to our emergency department with acute midsternal crushing chest pain. Patient was diagnosed with acute anterolateral wall Myocardial Infraction due to the presence of corresponding ST segment elevations in EKG and underwent emergent cardiac catheterization which revealed normal patent coronaries without any disease. He continued to have chest pain for which CT of the chest was done which revealed pneumomediastinum with mediastinal hematoma, due to the recent attempted thrombectomy for thrombus in his right brachiocephalic vein...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/28803961/the-99th-percentile-and-imprecision-of-point-of-care-cardiac-troponin-i-in-comparison-to-central-laboratory-tests-in-a-large-reference-population
#19
Anne Greiser, Theresa Winter, Hala Mahfoud, Anders Kallner, Till Ittermann, Annette Masuch, Norbert Lubenow, Thomas Kohlmann, Andreas Greinacher, Matthias Nauck, Astrid Petersmann
OBJECTIVES: Determination of cardiac troponin (cTn) is central in the emergency department (ED) for the diagnosis of myocardial infarction. In view of adverse effects of long waiting time on patient outcome, implementation of point-of-care-testing (POCT) is suggested if the turn-around-time is longer than 60min. The present study aimed to determine the 99th percentile and imprecision of two POCT in a healthy population measuring cTnI and cTnT and compare these analytical characteristics against three central laboratory test (CLT) for cTnI...
August 10, 2017: Clinical Biochemistry
https://www.readbyqxmd.com/read/28803801/st-elevation-myocardial-infarction-in-patients-with-anomalous-left-main-coronary-artery-case-series-and-review-of-the-literature
#20
REVIEW
Nicholas J Whitehead, Allan J Davies, Michael McGee, Nicholas J Collins
Anomalous left main coronary artery is rare. We present four cases where anomalous left main coronary artery was diagnosed during emergent cardiac catheterization for ST elevation myocardial infarction. Procedural characteristics, technical challenges, and relevant literature are discussed.
July 14, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
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