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Cardiac rule out

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https://www.readbyqxmd.com/read/27906915/the-value-of-ct-cardiac-angiography-and-ct-calcium-score-testing-in-a-modern-cardiology-service-in-new-zealand-a-report-of-a-single-centre-eight-year-experience-from-5-237-outpatient-procedures
#1
Chris Ellis, Greg Gamble, Colin Edwards, Niels van Pelt, Ruvin Gabriel, Boris Lowe, Jonathan Christiansen, Andrew To, Helen Winch, Mark Osborne, John Ormiston, Malcolm Legget
BACKGROUND: Computed tomographic (CT) cardiac angiography is of increasing value in several areas of patient management in cardiology. We assessed the ability of CT cardiac angiography to effectively 'rule out' severe coronary stenoses in patients presenting with 'atypical' symptoms and/or an equivocal stress test, which offers a new approach to the management of coronary artery disease. We also examined the use of the CT calcium score test in cardiovascular (CVS) risk assessment. METHODS: From a large single centre (Mercy Hospital) in Auckland, using a prospectively acquired, comprehensive database, we audited the entire eight-year experience of 5,169 patients (7/8/06 to 31/1/14) who underwent 5,237 64-slice computed tomographic (CT) cardiac angiogram or CT calcium score tests (GE Lightspeed scanner)...
December 2, 2016: New Zealand Medical Journal
https://www.readbyqxmd.com/read/27903076/the-potential-of-optimizing-prehospital-triage-of-patients-with-suspected-acute-myocardial-infarction-using-high-sensitivity-cardiac-troponin-t-and-copeptin
#2
Carsten Stengaard, Jacob T Sørensen, Søren A Ladefoged, Jens F Lassen, Martin B Rasmussnen, Claus Kjær Pedersen, Antoine Ayer, Hans Erik Bøtker, Christian J Terkelsen, Kristian Thygesen
PURPOSE: In patients with a suspected acute myocardial infarction (AMI), to evaluate the potential for early triage based on measurement of high-sensitivity cardiac troponin T (hs-cTnT) and copeptin in blood samples collected in the prehospital phase. MATERIALS AND METHODS: In this retrospective study, we measured hs-cTnT and copeptin in blood samples collected in the ambulance form 962 patients with suspected AMI. The diagnostic accuracy was estimated by receiver-operating characteristics curve area under the curve (AUC) for both biomarkers and a combined model...
December 1, 2016: Biomarkers: Biochemical Indicators of Exposure, Response, and Susceptibility to Chemicals
https://www.readbyqxmd.com/read/27890686/cardiac-and-skeletal-muscles-metastases-from-squamous-cell-carcinoma-of-the-bladder-pet-ct-findings
#3
Luis Gorospe, Ernesto García-Santana, Pablo Jane-Soler, María Del Val Gómez-Martínez, Victoria Gómez-Dos-Santos, Isabel García-Gómez-Muriel, Raquel García-Latorre
We describe the PET/CT findings of a patient who underwent a radical cystectomy six months earlier because of a squamous cell carcinoma of the bladder (SCCB) that presented to the ER with chest pain and palpitations. Cardiac catheterization ruled out coronary artery occlusion, but PET/CT showed multiple FDG-avid lesions involving multiple skeletal muscles and the heart, consistent with metastases. A CT-guided biopsy of one skeletal muscle lesion confirmed a metastasis with the same pathologic features as the SCCB...
November 24, 2016: Urology
https://www.readbyqxmd.com/read/27886161/cardiac-ct-in-the-emergency-department-in-the-era-of-highly-sensitive-troponins-is-there-still-a-role
#4
Admir Dedic, Koen Nieman, Udo Hoffmann, Maros Ferencik
INTRODUCTION: Physicians practicing cardiovascular medicine are every day confronted with patients presenting with symptoms suggestive of an acute coronary syndrome (ACS). Over the years, there have been substantial technical advances, such as the introduction of new non-invasive imaging techniques and the introduction of new highly sensitive cardiac biomarkers. EVIDENCE ACQUISITION AND SYNTHESIS: Physicians have adopted these new assets and have become more experienced with them thus improving medical care...
November 25, 2016: Minerva Cardioangiologica
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/27882404/reduced-trans-mitral-a-wave-velocity-predicts-the-presence-of-wild-type-transthyretin-amyloidosis-in-elderly-patients-with-left-ventricular-hypertrophy
#6
Satoru Yamamura, Yasuhiro Izumiya, Toshifumi Ishida, Yoshiro Onoue, Yuichi Kimura, Shinsuke Hanatani, Satoshi Araki, Koichiro Fujisue, Daisuke Sueta, Hisanori Kanazawa, Seiji Takashio, Hiroki Usuku, Koichi Sugamura, Kenji Sakamoto, Eiichiro Yamamoto, Megumi Yamamuro, Hisayo Yasuda, Sunao Kojima, Koichi Kaikita, Seiji Hokimoto, Hisao Ogawa, Kenichi Tsujita
Wild-type transthyretin amyloidosis (ATTRwt) is often overlooked in elderly patients with left ventricular hypertrophy (LVH). Impaired atrial function, in addition to ventricular diastolic dysfunction, is one of the hallmarks of cardiac amyloidosis. Here, we assessed the hypothesis that atrial function evaluated by A-velocity in pulse Doppler echocardiography is useful to differentiate ATTRwt in elderly patients with LVH. We analyzed 133 consecutive patients who underwent tissue biopsy to rule out infiltrative cardiomyopathy in our institute...
November 23, 2016: Heart and Vessels
https://www.readbyqxmd.com/read/27847253/necessity-of-hospitalization-and-stress-testing-in-low-risk-chest-pain-patients
#7
Neil Beri, Nicholas A Marston, Lori B Daniels, Richard M Nowak, Donald Schreiber, Christian Mueller, Allan Jaffe, Deborah B Diercks, Nicholas Wettersten, Christopher DeFilippi, W Frank Peacock, Alexander T Limkakeng, Inder Anand, James McCord, Judd E Hollander, Alan H B Wu, Fred S Apple, John T Nagurney, Cecilia Berardi, Chad M Cannon, Paul Clopton, Sean-Xavier Neath, Robert H Christenson, Christopher Hogan, Gary Vilke, Alan Maisel
BACKGROUND: Copeptin is a marker of endogenous stress including early myocardial infarction(MI) and has value in early rule out of MI when used with cardiac troponin I(cTnI). OBJECTIVES: The goal of this study was to demonstrate that patients with a normal electrocardiogram and cTnI<0.040μg/l and copeptin<14pmol/l at presentation and after 2 h may be candidates for early discharge with outpatient follow-up potentially including stress testing. METHODS: This study uses data from the CHOPIN trial which enrolled 2071 patients with acute chest pain...
October 29, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27823689/safety-and-efficacy-of-the-0-h-3-h-protocol-for-rapid-rule-out-of-myocardial-infarction
#8
Karin Wildi, Berit Nelles, Raphael Twerenbold, Maria Rubini Giménez, Tobias Reichlin, Hélène Singeisen, Sophie Druey, Philip Haaf, Zaid Sabti, Petra Hillinger, Cedric Jaeger, Isabel Campodarve, Philip Kreutzinger, Christian Puelacher, Zoraida Moreno Weidmann, Mathias Gugala, Gilles Pretre, Stephanie Doerflinger, Max Wagener, Fabio Stallone, Michael Freese, Claudia Stelzig, Katharina Rentsch, Stefano Bassetti, Roland Bingisser, Stefan Osswald, Christian Mueller
BACKGROUND: The early and accurate diagnosis of acute myocardial infarction (AMI) is an important medical and economic challenge. We aimed to prospectively evaluate the performance of the new European Society of Cardiology rapid 0-hour/3-hour (0 h/3 h) rule out protocol for AMI. METHODS: We enrolled 2,727 consecutive patients presenting with suspected AMI without persistent ST-segment elevation to the emergency department in a prospective international multicenter study...
November 2016: American Heart Journal
https://www.readbyqxmd.com/read/27811206/economic-considerations-of-early-rule-in-rule-out-algorithms-for-the-diagnosis-of-myocardial-infarction-in-the-emergency-department-using-cardiac-troponin-and-glycemic-biomarkers
#9
Colleen Shortt, Feng Xie, Richard Whitlock, Jinhui Ma, Natasha Clayton, Jonathan Sherbino, Stephen A Hill, Guillaume Pare, Matthew McQueen, Shamir R Mehta, P J Devereaux, Andrew Worster, Peter Kavsak
BACKGROUND: We have previously demonstrated the utility of a rule-in/rule-out strategy for myocardial infarction (MI) using glycemic biomarkers in combination with cardiac troponin in the emergency department (ED). Given that the cost of assessing patients with possible MI in the ED is increasing, we sought to compare the health services cost of our previously identified early rule-in/rule-out approaches for MI among patients who present to the ED with symptoms suggestive of acute coronary syndrome (ACS)...
November 3, 2016: Clinical Chemistry
https://www.readbyqxmd.com/read/27811203/rapid-rule-out-of-acute-myocardial-injury-using-a-single-high-sensitivity-cardiac-troponin-i-measurement
#10
Yader Sandoval, Stephen W Smith, Anoop S V Shah, Atul Anand, Andrew R Chapman, Sara A Love, Karen Schulz, Jing Cao, Nicholas L Mills, Fred S Apple
BACKGROUND: Rapid rule-out strategies using high-sensitivity cardiac troponin assays are largely supported by studies performed outside the US in selected cohorts of patients with chest pain that are atypical of US practice, and focused exclusively on ruling out acute myocardial infarction (AMI), rather than acute myocardial injury, which is more common and associated with a poor prognosis. METHODS: Prospective, observational study of consecutive patients presenting to emergency departments [derivation (n = 1647) and validation (n = 2198) cohorts], where high-sensitivity cardiac troponin I (hs-cTnI) was measured on clinical indication...
November 3, 2016: Clinical Chemistry
https://www.readbyqxmd.com/read/27806176/abrupt-onset-of-refractory-heart-failure-associated-with-light-chain-amyloidosis-in-hypertrophic-cardiomyopathy
#11
Benedetta Tomberli, Francesco Cappelli, Federico Perfetto, Iacopo Olivotto
Importance: The natural history of hypertrophic cardiomyopathy (HCM) is complex and may include progressive heart failure and severe left ventricular dysfunction. When disease progression is abrupt, however, other coexisting diseases should be ruled out. This may be difficult in the case of amyloidosis, which classically mimics HCM. Results: We present an example of severe clinical deterioration in a patient with HCM due to superimposed amyloid light-chain amyloidosis...
November 2, 2016: JAMA Cardiology
https://www.readbyqxmd.com/read/27794491/vegf-regulates-relative-allocation-of-isl1-cardiac-progenitors-to-myocardial-and-endocardial-lineages
#12
Zhiheng He, Myriam Grunewald, Yuval Dor, Eli Keshet
A fundamental issue in organogenesis is how dichotomous fate decisions are made securing proper allocation of multipotent progenitors to their respective descendants. Previous lineage tracing analyses showing Isl1(+)/VEGFR2(+) cardiac progenitors in the second heart field give rise to both endocardium and myocardium suggest VEGF plays a role in this fate decision, conceivably promoting an endocardial fate. Isl1(+) multipotent progenitors and lineage-committed descendants thereof were visualized and quantified within their transition zone in the outflow tract...
October 26, 2016: Mechanisms of Development
https://www.readbyqxmd.com/read/27794025/effect-of-contrast-dose-in-the-quantification-of-myocardial-extra-cellular-volume-in-adenosine-stress-rest-perfusion-cardiac-magnetic-resonance-examinations
#13
Meylin Caballeros, Pablo Bartolomé, Óscar Fernández González, Andreas Greiser, Loreto García Del Barrio, Jesús Pueyo, Gorka Bastarrika
BACKGROUND: Diffuse myocardial fibrosis can be quantified by calculating extra-cellular volume (ECV) from native and post-contrast T1 values using dedicated single bolus contrast medium injection protocols. PURPOSE: To evaluate differences in T1 maps and myocardial ECV measurements in routine stress/rest perfusion cardiovascular magnetic resonance (CMR) examinations after injection of single and double dose of contrast medium. MATERIAL AND METHODS: Thirty-seven consecutive patients (30 men; mean age, 62 ± 13 years) underwent clinically indicated adenosine stress/rest perfusion CMR examination to rule out myocardial ischemia following a conventional split-dose contrast medium injection strategy...
October 28, 2016: Acta Radiologica
https://www.readbyqxmd.com/read/27793865/unilateral-macrostomia-in-the-newborn-a-rare-congenital-anomaly-of-the-oral-commissure
#14
Eva Simonse, Bianca Panis, Jamiu O Busari
Macrostomia is a rare medical condition, defined as an enlargement of the mouth at the oral commissure. The incidence varies between 1 in 60 000 to 1 in 300 000 live births. Macrostomia is a form of a facial cleft. Macrostomia can present as a unilateral or bilateral anomaly with a partial or complete cleft. Associated anomalies of the surrounding bone, muscle and soft tissue can also be present with or without the presence of a syndrome. Macrostomia results in aesthetic disharmony and also in functional problems...
October 28, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27754881/assessment-of-the-european-society-of-cardiology-0-hour-1-hour-algorithm-to-rule-out-and-rule-in-acute-myocardial-infarction
#15
John W Pickering, Jaimi H Greenslade, Louise Cullen, Dylan Flaws, William Parsonage, Sally Aldous, Peter George, Andrew Worster, Peter A Kavsak, Martin P Than
BACKGROUND: The new European Society of Cardiology guidelines to rule-in and rule-out acute myocardial infarction (AMI) in the emergency department include a rapid assessment algorithm based on high-sensitivity cardiac troponin and sampling at 0 and 1 hour. Emergency department physicians require high sensitivity to confidently rule-out AMI, whereas cardiologists aim to minimize false-positive results. METHODS: High-sensitivity troponin I and T assays were used to measure troponin concentrations in patients presenting with chest-pain symptoms and being investigated for possible acute coronary syndrome at hospitals in New Zealand, Australia, and Canada...
November 15, 2016: Circulation
https://www.readbyqxmd.com/read/27754880/ruling-in-myocardial-injury-and-ruling-out-myocardial-infarction-with-the-european-society-of-cardiology-1-hour-algorithm
#16
EDITORIAL
Allan S Jaffe, Harvey White
No abstract text is available yet for this article.
November 15, 2016: Circulation
https://www.readbyqxmd.com/read/27754552/a-prospective-study-of-patients-with-refractory-angina-outcomes-and-the-role-of-high-sensitivity-troponin-t
#17
Nilson T Poppi, Luís H W Gowdak, Luciana O C Dourado, Eduardo L Adam, Thiago N P Leite, Bruno M Mioto, José E Krieger, Luiz A M César, Alexandre C Pereira
BACKGROUND: The predictors of cardiovascular events in patients with chronic refractory angina are limited. High-sensitivity cardiac troponin T (hs-cTnT) assays are biomarkers that may be used to determine the prognosis of patients with stable coronary artery disease. HYPOTHESIS: Hs-cTnT is a predictor of death and nonfatal myocardial infarction (MI) in patients with refractory angina. METHODS: We prospectively enrolled 117 consecutive patients in this study...
October 18, 2016: Clinical Cardiology
https://www.readbyqxmd.com/read/27744207/prevalence-and-incidence-of-q-wave-unrecognized-myocardial-infarction-in-general-population-diagnostic-value-of-the-electrocardiogram-the-regicor-study
#18
Rafel Ramos, Xavier Albert, Joan Sala, Maria Garcia-Gil, Roberto Elosua, Jaume Marrugat, Anna Ponjoan, María Grau, Manel Morales, Antoni Rubió, Pedro Ortuño, Lia Alves-Cabratosa, Ruth Martí-Lluch
BACKGROUND: Diagnosis of unrecognized myocardial infarction (UMI) remains an open question in epidemiological and clinical studies, inhibiting effective secondary prevention of myocardial infarction. We aimed to determine the prevalence and incidence of Q-wave UMI in asymptomatic individuals aged 35 to 74years, and to ascertain the positive predictive value (PPV) of asymptomatic Q-wave to diagnose UMI. METHODS: Two population-based cross-sectional studies were conducted, in 2000 (with 10-year follow-up) and in 2005...
October 5, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27738505/depression-masquerading-as-chest-pain-in-a-patient-with-wolff-parkinson-white-syndrome
#19
Rajashree Madabushi, Anil Agarwal, Saipriya Tewari, Sujeet K S Gautam, Sandeep Khuba
Wolff Parkinson White (WPW) syndrome is a condition in which there is an aberrant conduction pathway between the atria and ventricles, resulting in tachycardia. A 42-year-old patient, who was treated for WPW syndrome previously, presented with chronic somatic pain. With her cardiac condition in mind, she was thoroughly worked up for a recurrence of disease. As part of routine screening of all patients at our pain clinic, she was found to have severe depression as per the Patient Health Questionnaire-9 (PHQ-9) criteria...
October 2016: Korean Journal of Pain
https://www.readbyqxmd.com/read/27717538/non-invasive-assessment-of-low-and-intermediate-risk-patients-with-chest-pain
#20
Pelbreton C Balfour, Jorge A Gonzalez, Christopher M Kramer
Coronary artery disease (CAD) remains a significant global public health burden despite advancements in prevention and therapeutic strategies. Common non-invasive imaging modalities, anatomic and functional, are available for the assessment of patients with stable chest pain. Exercise electrocardiography is a long-standing method for evaluation for CAD and remains the initial test for the majority of patients who can exercise adequately with a baseline interpretable electrocardiogram. The addition of cardiac imaging to exercise testing provides incremental benefit for accurate diagnosis for CAD and is particularly useful in patients who are unable to exercise adequately and/or have uninterpretable electrocardiograms...
September 12, 2016: Trends in Cardiovascular Medicine
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