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Cardiac emergencies

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https://www.readbyqxmd.com/read/28441614/learning-from-an-analysis-of-closed-malpractice-litigation-involving-myocardial-infarction
#1
Kuan-Han Wu, Yung-Lin Yen, Chien-Hung Wu, Chi-Yuan Hwang, Shih-Yu Cheng
OBJECTIVE: To examine the epidemiologic data, identify the pattern of dispute, and determine clinical litigious errors by analyzing closed malpractice claims involving myocardial infarction (MI) in Taiwanese courts. METHODS: A retrospective descriptive study was performed to analyze the verdicts pertaining to MI from the population-based database of the Taiwan judicial system between 2002 and 2013. The results of adjudication, involved specialists, primary dispute leading to lawsuits, and litigious errors were recorded...
April 13, 2017: Journal of Forensic and Legal Medicine
https://www.readbyqxmd.com/read/28441369/cardiac-magnetic-resonance-imaging-in-oncology
#2
Daniel Jeong, Aarti Patel, Christopher J Francois, Kenneth L Gage, Michael G Fradley
BACKGROUND: Cardiac magnetic resonance imaging (MRI) is emerging as an important diagnostic modality in the management of cardiovascular-related dysfunction in oncological diseases. Advances in imaging techniques have enhanced the detection and evaluation of cardiac masses; meanwhile, innovative applications have created a growing role for cardiac MRI for the management of cardiotoxicity caused by cancer therapies. METHODS: An overview is provided of the clinical indications and technical considerations of cardiac MRI...
April 2017: Cancer Control: Journal of the Moffitt Cancer Center
https://www.readbyqxmd.com/read/28437795/effect-of-using-the-heart-score-in-patients-with-chest-pain-in-the-emergency-department-a-stepped-wedge-cluster-randomized-trial
#3
Judith M Poldervaart, Johannes B Reitsma, Barbra E Backus, Hendrik Koffijberg, Rolf F Veldkamp, Monique E Ten Haaf, Yolande Appelman, Herman F J Mannaerts, Jan-Melle van Dantzig, Madelon van den Heuvel, Mohamed El Farissi, Bernard J W M Rensing, Nicolette M S K J Ernst, Ineke M C Dekker, Frank R den Hartog, Thomas Oosterhof, Ghizelda R Lagerweij, Eugene M Buijs, Maarten W J van Hessen, Marcel A J Landman, Roland R J van Kimmenade, Luc Cozijnsen, Jeroen J J Bucx, Clara E E van Ofwegen-Hanekamp, Maarten-Jan Cramer, A Jacob Six, Pieter A Doevendans, Arno W Hoes
Background: The HEART (History, Electrocardiogram, Age, Risk factors, and initial Troponin) score is an easy-to-apply instrument to stratify patients with chest pain according to their short-term risk for major adverse cardiac events (MACEs), but its effect on daily practice is unknown. Objective: To measure the effect of use of the HEART score on patient outcomes and use of health care resources. Design: Stepped-wedge, cluster randomized trial...
April 25, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28436929/when-not-to-rescue-an-ethical-analysis-of-best-practices-for-cardiopulmonary-resuscitation-and-emergency-cardiac-care
#4
Nancy S Jecker, Arthur R Derse
It is now a default obligation to provide cardiopulmonary resuscitation (CPR), in the absence of knowledge of a patient's or surrogate's wishes to the contrary. We submit that it is time to re-evaluate this position. Attempting CPR should be subject to the same scrutiny demanded of other medical interventions that involve balancing a great benefit against grievous harms.
2017: Journal of Clinical Ethics
https://www.readbyqxmd.com/read/28436859/in-vivo-intracardiac-vector-velocity-imaging-using-phased-array-transducers-for-pediatric-cardiology
#5
Solveig Fadnes, Morten Wigen, Siri Ann Nyrnes, Lasse Lovstakken
Two-dimensional blood speckle tracking has shown promise for measuring complex flow patterns in neonatal hearts using linear arrays and high-frame-rate plane wave imaging. For general pediatric applications, however, the need for phased array probes emerges due to the limited intercostal acoustic window available. In this work, a clinically approved real-time duplex imaging setup with phased array probes was used to investigate the potential of blood speckle tracking for 2-D vector velocity imaging of children with congenital heart disease...
April 24, 2017: IEEE Transactions on Ultrasonics, Ferroelectrics, and Frequency Control
https://www.readbyqxmd.com/read/28436207/racial-differences-in-the-association-between-heart-rate-variability-and-left-ventricular-mass
#6
LaBarron K Hill, Lana L Watkins, Alan L Hinderliter, James A Blumenthal, Andrew Sherwood
PURPOSE: Increased left ventricular mass (LVM) is an early precursor of target organ damage due to hypertension. Diminished parasympathetic cardiac control has been linked to both hypertension onset and left ventricular impairment; however, emerging evidence suggests that this pattern may be different in African Americans. The present study sought to determine if race impacts the relationship between parasympathetic cardiac control and LVM. METHODS: LVM was assessed via echocardiography in a sample (N = 148) of African American and White adults (Mean age = 33...
April 24, 2017: Experimental Physiology
https://www.readbyqxmd.com/read/28435494/the-efficacy-of-lucas-in-prehospital-cardiac-arrest-scenarios-a-crossover-mannequin-study
#7
Robert A Gyory, Scott E Buchle, David Rodgers, Jeffrey S Lubin
INTRODUCTION: High-quality cardiopulmonary resuscitation (CPR) is critical for successful cardiac arrest outcomes. Mechanical devices may improve CPR quality. We simulated a prehospital cardiac arrest, including patient transport, and compared the performance of the LUCAS™ device, a mechanical chest compression-decompression system, to manual CPR. We hypothesized that because of the movement involved in transporting the patient, LUCAS would provide chest compressions more consistent with high-quality CPR guidelines...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28435484/outcomes-by-mode-of-transport-of-st-elevation-mi-patients-in-the-united-arab-emirates
#8
Edward L Callachan, Alawi A Alsheikh-Ali, Satish Chandrasekhar Nair, Stevan Bruijns, Lee A Wallis
INTRODUCTION: The purpose of this multicenter study was to assess differences in demographics, medical history, treatment times, and follow-up status among patients with ST-elevation myocardial infarction (STEMI), who were transported to the hospital by emergency medical services (EMS) or by private vehicle, or were transferred from other medical facilities. METHODS: This multicenter study involved the collection of both retrospective and prospective data from 455 patients admitted to four hospitals in Abu Dhabi...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28435322/spinal-anesthesia-after-intraoperative-cardiac-arrest-during-general-anesthesia-in-an-infant
#9
Emmett E Whitaker, Veronica Miler, Jason Bryant, Stephanie Proicou, Rama Jayanthi, Joseph D Tobias
Although generally safe and effective, severe perioperative complications, including cardiac arrest, may occur during general anesthesia in infants. With the emergence of evidence that specific anesthetic agents may affect future neurocognitive outcomes, there has been an increased focus on alternatives to general anesthesia, including spinal anesthesia. We present a case of cardiac arrest during general anesthesia in an infant who required urologic surgery. During the subsequent anesthetic care, spinal anesthesia was offered as an alternative to general anesthesia...
2017: Local and Regional Anesthesia
https://www.readbyqxmd.com/read/28435004/improvements-in-left-ventricular-diastolic-mechanics-after-parachute-device-implantation-in-patients-with-ischemia-heart-failure-a-cardiac-ct-study
#10
Chun-Ho Yun, Jing-Yi Sun, Barry Templin, Shih-Hsuan Lin, Kuan-Ming Chen, Tung-Hsin Wu, Chung-Lieh Hung, Chun-Chieh Liu, Hsi-Hsien Hsu, Mohamad Amer Alaiti, Anas Fares, Anthony DeCicco, Hiram G Bezerra
BACKGROUND: Percutaneous ventricular restoration therapy using left ventricle (LV) partitioning Parachute device has emerged as a clinical treatment option for LV apical aneurysm post extensive anterior myocardial infarction (AMI). We assessed changes of diastolic mechanics and accompanied functional improvements following LV parachute device implantation by cardiac computed tomography (CCT). METHODS AND RESULTS: CCT data from 28 patients in the pre- and post-implantation of LV parachute device implantation...
April 20, 2017: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/28434640/imaging-guidance-for-transcatheter-aortic-valve-replacement-is-transoesophageal-echocardiography-the-gold-standard
#11
REVIEW
Bo Xu, Philip M Mottram, Siobhan Lockwood, Ian T Meredith
Transcatheter aortic valve replacement (TAVR) is traditionally performed under cardiac imaging guidance. In the early TAVR experience, intra-procedural transoesophageal echocardiography (TOE) is recommended to guide device deployment, in the context of general anaesthesia (GA). Intra-procedural TOE imaging is particularly useful during TAVR deployment as a contrast-saving strategy for patients with renal impairment. Evidence has emerged recently demonstrating that in selected patients, transthoracic echocardiography (TTE) can be used to provide intra-procedural guidance for TAVR...
March 27, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28434268/ubiquitin-c-terminal-hydrolase-l1-uch-l1-as-a-therapeutic-and-diagnostic-target-in-neurodegeneration-neurotrauma-and-neuro-injuries
#12
Kevin K Wang, Zhihui Yang, George Sarkis, Isabel Torres, Vijaya Raghavan
Since its discovery as a major CNS-abundant protein 25 years ago, Ubiquitin C-terminal hydrolase-L1 (UCH-L1) has emerged as an important enzyme in regulating brain protein metabolism, by coupling to the proteasome pathway of protein degradation. Areas covered: UCH-L1 is implicated in both familial and sporadic Parkinson disease and other chronic neurodegenerative diseases. Also, UCH-L1 has been recently emerging as a biofluid-based biomarker for various forms of acute neurotrauma and CNS injury. Expert opinion: The loss of UCH-L1 activity coupled with the gain of proteinopathy function are linked to neurodegeneration such as Parkinsonism and Alzheimer's disease...
April 24, 2017: Expert Opinion on Therapeutic Targets
https://www.readbyqxmd.com/read/28433665/advancing-the-science-of-myocardial-recovery-with-mechanical-circulatory-support-a-working-group-of-the-national-heart-lung-and-blood-institute
#13
Stavros G Drakos, Francis D Pagani, Martha S Lundberg, J Timothy Baldwin
The medical burden of heart failure (HF) has spurred interest in clinicians and scientists to develop therapies to restore the function of a failing heart. To advance this agenda, the National Heart Lung Blood Institute (NHLBI) convened a Working Group of experts on June 2-3, 2016 in Bethesda Maryland to develop recommendations for the NHLBI aimed at advancing the science of cardiac recovery in the setting of mechanical circulatory support (MCS). MSC devices effectively reduce volume and pressure overload that drives the cycle of progressive myocardial dysfunction, thereby triggering structural and functional reverse remodeling...
April 19, 2017: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/28433660/redox-regulation-of-gasotransmission-in-the-vascular-system-a-focus-on-angiogenesis
#14
REVIEW
Rajesh K Mistry, Alison C Brewer
Reactive oxygen species have emerged as key participants in a broad range of physiological and pathophysiological processes, not least within the vascular system. Diverse cellular functions which have been attributed to some of these pro-oxidants within the vasculature include the regulation of blood pressure, neovascularisation and vascular inflammation. We here highlight the emerging roles of the enzymatically-generated reaction oxygen species, O2(-) and H2O2, in the regulation of the functions of the gaseous signalling molecules: nitric oxide (NO), carbon monoxide (CO), and hydrogen sulphide (H2S)...
April 19, 2017: Free Radical Biology & Medicine
https://www.readbyqxmd.com/read/28433554/catheter-ablation-to-prevent-sudden-cardiac-death
#15
Josef Kautzner, Petr Peichl
Since ventricular arrhythmias are a common cause of sudden cardiac death (SCD), treatment for ventricular arrhythmias is the target area of interest in research field. Among different means to prevent ventricular arrhythmias, catheter ablation (CA) has emerged as an effective therapeutic method. CA can decrease the likelihood of SCD in the following arrhythmia categories: 1) idiopathic ventricular fibrillation (VF) that is usually triggered by premature ventricular beats originating in the Purkinje fibres; 2) VF in subjects with structural heart disease, especially after myocardial infarction, that is triggered by premature ventricular beats from surviving Purkinje fibres; 3) Brugada syndrome in which modification of an epicardial substrate in the right ventricular outflow tract might be the most promising strategy; 4) recurrent monomorphic ventricular tachycardias in the setting of structural heart disease; 5) ventricular preexcitation in which CA appears to be a method of choice in high risk patients, regardless of the presence or absence of symptoms...
April 1, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28433454/a-randomized-comparison-of-three-chest-compression-techniques-and-associated-hemodynamic-effect-during-infant-cpr-a-randomized-manikin-study
#16
Jacek Smereka, Lukasz Szarpak, Antonio Rodríguez-Núñez, Jerzy R Ladny, Steve Leung, Kurt Ruetzler
INTRODUCTION: Pediatric cardiac arrest is an uncommon but critical life-threatening event requiring effective cardiopulmonary resuscitation. High-quality cardio-pulmonary resuscitation (CPR) is essential, but is poorly performed, even by highly skilled healthcare providers. The recently described two-thumb chest compression technique (nTTT) consists of the two thumbs directed at the angle of 90° to the chest while having the fingers fist-clenched. This technique might facilitate adequate chest-compression depth, chest-compression rate and rate of full chest-pressure relief...
April 14, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28433359/feasibility-of-profound-hypothermia-as-part-of-extracorporeal-life-support-in-a-pig-model
#17
Christoph Weiser, Wolfgang Weihs, Michael Holzer, Christoph Testori, Anne-Margarethe Kramer, Christoph Kment, Martin Stoiber, Michael Poppe, Christian Wallmüller, Peter Stratil, Michael Hoschitz, Anton Laggner, Fritz Sterz
OBJECTIVE: To investigate the feasibility of a refined aortic flush catheter and pump system to induce emergency preservation and resuscitation before extracorporeal cardiopulmonary resuscitation in a normovolemic cardiac arrest swine model simulating near real size/weight conditions of adults. METHODS: In this feasibility study, 8 female Large White breed pigs weighing 70 to 80 kg underwent ventricular fibrillation cardiac arrest for 15 minutes, followed by 4°C aortic flush (150 mL/kg for the brain; 50 mL/kg for the spine) via a new hardware ensued by resuscitation with extracorporeal cardiopulmonary resuscitation...
March 24, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28432605/cardiac-magnetic-resonance-imaging-in-heart-failure-where-the-alphabet-begins
#18
REVIEW
Ahmed Aljizeeri, Abdulbaset Sulaiman, Naji Alhulaimi, Ahmed Alsaileek, Mouaz H Al-Mallah
Cardiac Magnetic Resonance Imaging has become a cornerstone in the evaluation of heart failure. It provides a comprehensive evaluation by answering all the pertinent clinical questions across the full pathological spectrum of heart failure. Nowadays, CMR is considered the gold standard in evaluation of ventricular volumes, wall motion and systolic function. Through its unique ability of tissue characterization, it provides incremental diagnostic and prognostic information and thus has emerged as a comprehensive imaging modality in heart failure...
April 22, 2017: Heart Failure Reviews
https://www.readbyqxmd.com/read/28432434/ventricular-androgenic-anabolic-steroid-related-remodeling-an-immunohistochemical-study
#19
Rossana Cecchi, Barbara Muciaccia, Costantino Ciallella, Natale Mario Di Luca, Akihiko Kimura, Cristina Sestili, Mizuho Nosaka, Toshikazu Kondo
BACKGROUND: Several fatal cases of bodybuilders, following a myocardial infarction after long exposure to androgenic-anabolic steroids (AAS), are reported. In recent years, evidence has emerged of cases of heart failure related to AAS consumption, with no signs of coronary or aorta atherosclerosis. This study aims to further investigate the pathogenesis of the ventricular AAS-related remodeling performing immunohistochemistry (IHC). METHOD: In order to examine innate immunity activity and myocytes and endothelial cell apoptosis, IHC analyses were performed on heart tissue of two cases of bodybuilders who died after years of supratherapeutic use of metelonone and nandrolone and where no atherosclerosis or thrombosis were found, using the following antibodies: anti-CD68, anti-iNOS, anti-CD163, anti-CD 15, anti-CD8, anti-CD4, anti-HIF1 α, and in situ TUNEL staining...
April 21, 2017: International Journal of Legal Medicine
https://www.readbyqxmd.com/read/28432194/diagnostic-value-of-prehospital-ecg-in-acute-stroke-patients
#20
Tobias Bobinger, Bernd Kallmünzer, Markus Kopp, Natalia Kurka, Martin Arnold, Stefan Heider, Stefan Schwab, Martin Köhrmann
OBJECTIVE: To investigate the diagnostic yield of prehospital ECG monitoring provided by emergency medical services in the case of suspected stroke. METHODS: Consecutive patients with acute stroke admitted to our tertiary stroke center via emergency medical services and with available prehospital ECG were prospectively included during a 12-month study period. We assessed prehospital ECG recordings and compared the results to regular 12-lead ECG on admission and after continuous ECG monitoring at the stroke unit...
April 21, 2017: Neurology
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