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https://www.readbyqxmd.com/read/29351337/a-portable-prototype-magnetometer-to-differentiate-ischemic-and-non-ischemic-heart-disease-in-patients-with-chest-pain
#1
Shima Ghasemi-Roudsari, Abbas Al-Shimary, Benjamin Varcoe, Rowena Byrom, Lorraine Kearney, Mark Kearney
BACKGROUND: Magnetocardiography (MCG) is a non-invasive technique used to measure and map cardiac magnetic fields. We describe the predictive performance of a portable prototype magnetometer designed for use in acute and routine clinical settings. We assessed the predictive ability of the measurements derived from the magnetometer for the ruling-out of healthy subjects and patients whose chest pain has a non-ischemic origin from those with ischemic heart disease (IHD). METHODS: MCG data were analyzed from a technical performance study, a pilot clinical study, and a young healthy reference group...
2018: PloS One
https://www.readbyqxmd.com/read/29347921/prospective-pre-and-post-race-evaluation-of-biochemical-electrophysiologic-and-echocardiographic-indices-in-30-racing-thoroughbred-horses-that-received-furosemide
#2
Catherine T Gunther-Harrington, Rick Arthur, Krista Estell, Beatriz Martinez Lopez, Alexandra Sinnott, Eric Ontiveros, Anita Varga, Joshua A Stern
BACKGROUND: Exercise induced cardiac fatigue (EICF) and cardiac dysrhythmias are well described conditions identified in high-level human athletes that increase in frequency with intensity and duration of exercise. Identification of these conditions requires an understanding of normal pre- and post-race cardiac assessment values. The objectives of this study were to (1) characterize selected indices of cardiac function, electrophysiologic parameters, and biochemical markers of heart dysfunction prior to and immediately after high level racing in Thoroughbred horses receiving furosemide; and (2) create pre- and post-race reference values in order to make recommendations on possible screening practices for this population in the future...
January 18, 2018: BMC Veterinary Research
https://www.readbyqxmd.com/read/29345112/low-nt-probnp-levels-in-overweight-and-obese-patients-do-not-rule-out-a-diagnosis-of-heart-failure-with-preserved-ejection-fraction
#3
Leo F Buckley, Justin M Canada, Marco G Del Buono, Salvatore Carbone, Cory R Trankle, Hayley Billingsley, Dinesh Kadariya, Ross Arena, Benjamin W Van Tassell, Antonio Abbate
BACKGROUND: Heart failure with preserved ejection fraction (HFpEF) is a heterogeneous syndrome that presents clinicians with a diagnostic challenge. The use of natriuretic peptides to exclude a diagnosis of HFpEF has been proposed. We sought to compare HFpEF patients with N-terminal pro-brain natriuretic peptide (NT-proBNP) level above and below the proposed cut-off. METHODS: Stable patients (n = 30) with left ventricular (LV) ejection fraction ≥ 50% were eligible if they had a diagnosis of HF according to the European Society of Cardiology diagnostic criteria...
January 18, 2018: ESC Heart Failure
https://www.readbyqxmd.com/read/29342012/diffuse-chorioretinopathy-without-serous-detachment-associated-with-cardiac-transplantation
#4
Michael F Marmor
PURPOSE: To analyze an unusual case of widespread chorioretinopathy after cardiac transplantation for its potential etiology and clinical significance. METHODS: Clinical examinations included widefield and macular color and fundus autofluorescence photography, spectral domain optical coherence tomography, fluorescein angiography and indocyanine green angiography, full-field electroretinography, and Goldmann visual fields. PATIENT: A 44-year-old Hispanic woman was referred to rule out retinitis pigmentosa...
January 16, 2018: Retinal Cases & Brief Reports
https://www.readbyqxmd.com/read/29324828/correction-economic-evaluation-of-the-one-hour-rule-out-and-rule-in-algorithm-for-acute-myocardial-infarction-using-the-high-sensitivity-cardiac-troponin-t-assay-in-the-emergency-department
#5
Apoorva Ambavane, Bertil Lindahl, Evangelos Giannitsis, Julie Roiz, Joan Mendivil, Lutz Frankenstein, Richard Body, Michael Christ, Roland Bingisser, Aitor Alquezar, Christian Mueller
[This corrects the article DOI: 10.1371/journal.pone.0187662.].
2018: PloS One
https://www.readbyqxmd.com/read/29315657/dysautonomy-in-different-death-risk-groups-rassi-score-in-patients-with-chagas-heart-disease
#6
Catherine Masiel Merejo Peña, Michel Silva Reis, Basílio de Bragança Pereira, Emília Matos do Nascimento, Roberto Coury Pedrosa
BACKGROUND: It has been difficult to prove that the "catecholamine-induced cardiomyopathy" contributes to the mechanism of sudden cardiac death in Chagas heart disease. Also, it is almost impossible to rule out the possibility that is not involved in the process. More importantly, the vagal-cholinergic pathway in the ventricle plays a direct role in the prevention of the initiation of complex ventricular arrhythmias, including non-sustained ventricular tachycardia, ventricular fibrillation responsible for sudden death...
January 5, 2018: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/29306269/sealone-safety-and-efficacy-of-coronary-computed-tomography-angiography-with-low-dose-in-patients-visiting-emergency-room-trial-study-protocol-for-a-randomized-controlled-trial
#7
Joonghee Kim, Joon-Won Kang, Kyuseok Kim, Sang Il Choi, Eun Ju Chun, Yeo Goon Kim, Won Young Kim, Dong Woo Seo, Jonghwan Shin, Huijai Lee, Kwang-Nam Jin, Soyeon Ahn, Seung Sik Hwang, Kwang Pyo Kim, Ru-Bi Jeong, Sang Ook Ha, Byungho Choi, Chang-Hwan Yoon, Jung-Won Suh, Hack-Lyoung Kim, Ju Kyoung Kim, Sujin Jang, Ji Seon Seo
OBJECTIVE: Chest pain is one of the most common complaints in the emergency department (ED). Cardiac computed tomography angiography (CCTA) is a frequently used tool for the early triage of patients with low- to intermediate-risk acute chest pain. We present a study protocol for a multicenter prospective randomized controlled clinical trial testing the hypothesis that a low-dose CCTA protocol using prospective electrocardiogram (ECG)-triggering and limited-scan range can provide sufficient diagnostic safety for early triage of patients with acute chest pain...
December 2017: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/29275346/clinical-features-and-prognosis-of-patients-with-acute-non-specific-chest-pain-in-emergency-and-cardiology-departments-after-the-introduction-of-high-sensitivity-troponins-a-prospective-cohort-study
#8
Nivethitha Ilangkovan, Hans Mickley, Axel Diederichsen, Annmarie Lassen, Thomas L Sørensen, Hussam Mahmoud Sheta, Peter B Stæhr, Christian Backer Mogensen
OBJECTIVES: To determine the incidence of clinical, cardiac-related endpoints and mortality among patients presenting to an emergency or cardiology department with non-specific chest pain (NSCP), and who receive testing with a high-sensitivity troponin. A second objective was to identify risk factors for the above-noted endpoints during 12 months of follow-up. DESIGN: A prospective multicentre study. SETTING: Emergency and cardiology departments in Southern Denmark...
December 22, 2017: BMJ Open
https://www.readbyqxmd.com/read/29274930/immediate-stress-echocardiography-for-low-risk-chest-pain-patients-in-the-emergency-department-a-prospective-observational-cohort-study
#9
Gregory Jasani, Mia Papas, Avkash J Patel, Neil Jasani, Brian Levine, Yuanyuan Zhang, Erik S Marshall
BACKGROUND: Evaluation and disposition of low-risk chest pain (CP) patients in the emergency department (ED) is time consuming and expensive. Low-risk CP often results in hospital admission to rule out myocardial infarction, which leads to additional costs and delays. OBJECTIVE: Our aim was to assess whether an immediate exercise stress echocardiogram (IESE) in the ED will allow safe, efficient, and cost-effective evaluation and discharge of patients with low-risk CP...
December 20, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29273259/contemporary-application-of-point-of-care-echocardiography-in-the-emergency-department
#10
REVIEW
Jordan Chenkin, Clare L Atzema
Point-of-care echocardiography is revolutionizing the management of patients presenting with undifferentiated shock and cardiac arrest in the emergency department (ED). Its primary purpose is to aid the clinician in rapidly ruling in and ruling out life-threatening diagnoses at the bedside. In addition, it has become an important component of the clinical examination for stable patients seen in the ED with nonspecific signs and symptoms such as shortness of breath or syncope. Although first described to facilitate the diagnosis of pericardial effusions and cardiac standstill, ED echocardiography has since evolved and is now widely used by emergency physicians to help diagnose other important cardiovascular pathologic conditions that may be contributing to undifferentiated shock, such as left ventricular failure and right ventricular dilatation resulting from pulmonary embolism...
September 1, 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/29260921/high-sensitivity-troponins-in-contemporary-cardiology-practice-are-we-turning-a-corner
#11
Nick Curzen, Mark Mariathas, Bartosz Olechowski, Michael Mahmoudi
Troponin is considered to be the gold standard biomarker for ruling out MI. There has been a drive to improve the diagnostic speed, and as such the high sensitivity cardiac troponin (Hs-cTn) assays have been introduced into clinical practice and are now part of international guidelines. Their novel value in clinical practice more generally is becoming apparent. Areas covered: In this review we will evaluate the evidence for the use of Hs-cTn assays in clinical practice, the issues with the assay and how the Hs-cTn can be utilized in the future as a biomarker of cardiovascular risk...
December 20, 2017: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/29260577/coronary-computed-tomography-in-heart-transplant-patients-detection-of-significant-stenosis-and-cardiac-allograft-vasculopathy-image-quality-and-radiation-dose
#12
Anne Günther, Lars Aaberge, Andreas Abildgaard, Asgrimur Ragnarsson, Thor Edvardsen, Jarl Jakobsen, Rune Andersen
Background Cardiac allograft vasculopathy (CAV) is an accelerated form of atherosclerosis unique to heart transplant (HTX) patients. Purpose To investigate the detection of significant coronary artery stenosis and CAV, determinants of image quality, and the radiation dose in coronary computed tomography angiography (CCTA) of HTX patients with 64-slice multidetector CT (64-MDCT). Material and Methods Fifty-two HTX recipients scheduled for invasive coronary angiography (ICA) were prospectively enrolled and underwent CCTA before ICA with intravascular ultrasound (IVUS)...
January 1, 2017: Acta Radiologica
https://www.readbyqxmd.com/read/29248657/comprehensive-cardiac-ct-with-myocardial-perfusion-imaging-versus-functional-testing-in-suspected-coronary-artery-disease-the-multicenter-randomized-crescent-ii-trial
#13
Marisa Lubbers, Adriaan Coenen, Marcel Kofflard, Tobias Bruning, Bas Kietselaer, Tjebbe Galema, Marc Kock, Andre Niezen, Marco Das, Marco van Gent, Ewout-Jan van den Bos, Leon van Woerkens, Paul Musters, Suze Kooij, Fay Nous, Ricardo Budde, Miriam Hunink, Koen Nieman
OBJECTIVES: This study sought to assess the effectiveness, efficiency, and safety of a tiered, comprehensive cardiac computed tomography (CT) protocol in comparison with functional testing. BACKGROUND: Although CT angiography accurately rules out coronary artery disease (CAD), incorporation of CT myocardial perfusion imaging as part of a tiered diagnostic approach could improve the clinical value and efficiency of cardiac CT in the diagnostic work-up of patients with angina pectoris...
December 8, 2017: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/29248654/value-of-myocardial-perfusion-assessment-with-coronary-computed-tomography-angiography-in-patients-with-recent-acute-onset-chest-pain
#14
Mathias H Sørgaard, Jesper J Linde, J Tobias Kühl, Henning Kelbæk, Jens D Hove, Gitte G Fornitz, Tem B S Jørgensen, Merete Heitmann, Charlotte Kragelund, Thomas F Hansen, Jawdat Abdulla, Thomas Engstrøm, Jan S Jensen, Yaffah T Wiegandt, Dan E Høfsten, Lars V Køber, Klaus F Kofoed
OBJECTIVES: The authors sought to perform a randomized controlled trial to evaluate the clinical efficacy of combined examination with coronary computed tomography angiography (CTA) and computed tomography perfusion imaging (CTP) compared to coronary CTA alone. BACKGROUND: Stress myocardial CTP may increase diagnostic specificity when added to coronary CTA in patients suspected of having ischemic heart disease. METHODS: Patients recently hospitalized for acute-onset chest pain, in whom acute coronary syndrome had been ruled out by normal electrocardiograms, normal troponin levels, and relief of symptoms, and who had a clinical indication for outpatient noninvasive testing, were screened for inclusion in the CATCH-2 (CArdiac cT in the treatment of acute CHest pain 2) trial (NCT02014311)...
December 8, 2017: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/29238804/efficacy-of-high-sensitivity-troponin-t-in-identifying-very-low-risk-patients-with-possible-acute-coronary-syndrome
#15
W Frank Peacock, Brigette M Baumann, Deborah Bruton, Thomas E Davis, Beverly Handy, Christopher W Jones, Judd E Hollander, Alexander T Limkakeng, Abhi Mehrotra, Martin Than, Andre Ziegler, Carina Dinkel
Importance: Physicians need information on how to use the first available high-sensitivity troponin (hsTnT) assay in the United States to identify patients at very low risk for 30-day adverse cardiac events (ACE). Objective: To determine whether a negative hsTnT assay at 0 and 3 hours following emergency department presentation could identify patients at less than 1% risk of a 30-day ACE. Design, Setting, and Participants: A prospective, observational study at 15 emergency departments in the United States between 2011 and 2015 that included individuals 21 years and older, presenting to the emergency department with suspected acute coronary syndrome...
December 13, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/29238364/age-related-differences-and-outcome-of-patients-with-takotsubo-syndrome
#16
Aydin Huseynov, Ibrahim El-Battrawy, Uzair Ansari, Katja Schramm, Xiaobo Zhou, Siegfried Lang, Martin Borggrefe, Ibrahim Akin
Background: Takotsubo syndrome (TS) is an important cardiac disease that affects predominantly postmenopausal women. This study was conducted to determine the impact of age on the short- and long-term outcome of TS patients. Methods & Results: The data from a collective of 114 TS patients with a mean follow-up of 1591 ± 1079 days was retrospectively analysed. The study population was divided into two groups (≤ 65 and > 65 years) so as to evaluate the impact of age on the short- and long-term mortality of TS patients...
October 2017: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/29235746/clinical-problem-solving-a-tobacco-merchant-who-can-t-spit
#17
Sandra Benizri, Nancy Agmon-Levin, Noam D Kitrey, Dan Carter, Elinor Goshen, Yehonathan Sharabi
A 47 year old man presented with a combination of dry mouth and lightheadedness while standing. His medical background was unremarkable except for cigarette smoking and hyperlipidemia. Sjögren's syndrome was ruled out, and he was referred for evaluation of orthostatic hypotension, which by then included syncopal episodes and injuries. Additional symptoms included dry eyes, constipation, reduced sweating, and erectile dysfunction. After excluding medications and structural cardiac abnormalities as causes of orthostatic hypotension, a clinical autonomic evaluation was performed...
December 2017: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/29233098/intractable-ascites-associated-with-mycophenolate-in-a-simultaneous-kidney-pancreas-transplant-patient-a-case-report
#18
Nina T Weber, Ali Sigaroudi, Alexander Ritter, Andreas Boss, Kuno Lehmann, David Goodman, Stefan Farese, Stefan Weiler, Thomas F Mueller
BACKGROUND: Mycophenolic acid (MPA), either given as an ester pro-drug or as an enteric-coated sodium salt, is the most commonly prescribed anti-proliferative immunosuppressive agent used following organ transplantation and widely applied in immune-mediated diseases. Clinicians are well aware of common adverse reactions related to MPA treatment, in particular diarrhea, leukopenia and infections. Here we report a case of severe, persistent ascites associated with MPA treatment. The otherwise unexplained and intractable ascites, requiring repeated paracenteses for more than 8 months, rapidly ceased with stopping the MPA treatment...
December 12, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/29232194/persistent-ventricular-bigeminy-during-anesthesia-in-pediatric-patients-a-case-report-of-an-11-year-old-child
#19
Sheetal Dalal, Vikas Chaudhari
An 11-year-old male child with fractures in both bones in his left forearm presented for open reduction and internal fixation. The pre-anesthetic check-up and investigations did not reveal any pre-existing underlying cardio-respiratory disease. The patient had an uneventful peri-operative period during the operation and was comfortable without any anxiety or restlessness. After an uneventful induction and intubation as per routine protocol, the patient received 600 mg of amoxicillin+clavunate intravenously as an antibiotic...
December 12, 2017: Journal of Basic and Clinical Physiology and Pharmacology
https://www.readbyqxmd.com/read/29225848/delayed-diagnosis-of-brugada-syndrome-in-a-patient-with-aborted-sudden-cardiac-death-and-initial-negative-flecainide-challenge
#20
Samuel Chauveau, Olivier Le Vavasseur, Philippe Chevalier
A negative flecainide challenge does not rule out Brugada syndrome even in the presence of nonfatal cardiac arrest as the first manifestation of the disease. This should prompt clinicians to ensure long-term ECG follow-up and consider repeating a drug test with another sodium channel blocker.
December 2017: Clinical Case Reports
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