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https://www.readbyqxmd.com/read/27899427/a-56-year-old-woman-with-breathlessness
#1
Alastair J Moss, Marc R Dweck, Peter D O'Kane
CLINICAL INTRODUCTION: A 56-year-old female with adult-onset asthma was admitted to the cardiology service with intermittent left-sided chest pain and progressive dyspnoea. Twelve months prior to this admission, she had received a course of prednisolone for bilateral anterior uveitis. Physical examination was unremarkable with blood sampling revealing a marked eosinophilia (eosinophil count 17.3×10(9)/L) and a perinuclear antineutrophil cytoplasmic antibody staining pattern on indirect immunofluorescence microscopy (myeloperoxidase antibodies 83 IU/mL)...
November 29, 2016: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/27895830/development-of-a-subspecialty-cardiology-curriculum-for-paediatric-registrars-in-malawi-implementation-of-a-long-distance-hybrid-model
#2
Laura Newberry, Neil Kennedy, Elizabeth A Greene
BACKGROUND: Malawi has a high burden of paediatric cardiac disease but a limited number of health providers familiar with these chronic diseases. Given the rising number of Malawian postgraduate paediatric trainees at the University of Malawi College of Medicine, we sought to remedy this lack of basic cardiology training with a long-distance, module-based curriculum that could be utilised independently, as needed, with on-site teaching. We also wished to evaluate the initial modules for utility and improvement in knowledge and confidence in each topic...
June 2016: Malawi Medical Journal: the Journal of Medical Association of Malawi
https://www.readbyqxmd.com/read/27881009/late-cardiac-effect-of-anthracycline-therapy-in-physically-active-breast-cancer-survivors-a-prospective-study
#3
A C Nagy, P GulAcsi-BArdos, Z CserEp, L Hangody, T Forster
The late-onset cardiotoxic effect of anthracycline is known, however the early detection and prevention of subclinical myocardial damage has not been fully understood yet. Besides medical therapy regular physical activities may also play a role in the prevention and reduction of side effects of chemotherapy. The aim of our present study was to detect the effect of regular physical activities on the diastolic function and on the symptoms of late heart failure in case of anthracycline chemotherapy. The prospective study included 55 female patients (age 31-65 year, average 49...
November 24, 2016: Neoplasma
https://www.readbyqxmd.com/read/27863351/abnormal-heart-rate-response-during-cardiopulmonary-exercise-testing-identifies-cardiac-dysfunction-in-symptomatic-patients-with-non-obstructive-coronary-artery-disease
#4
Sundeep Chaudhry, Naresh Kumar, Hushyar Behbahani, Akshay Bagai, Binoy K Singh, Nick Menasco, Gregory D Lewis, Laurence Sperling, Jonathan Myers
BACKGROUND: Symptomatic non-obstructive coronary artery disease is a growing clinical dilemma for which contemporary testing is proving to be of limited clinical utility. New methods are needed to identify cardiac dysfunction. METHODS AND RESULTS: This is a prospective observational cohort study conducted from December 2013 to August 2015 in two outpatient cardiology clinics (symptomatic cohort) and 24 outpatient practices throughout the US (healthy cohort) with centralized methodology and monitoring to compare heart-rate responses during cardiopulmonary exercise testing (CPET)...
November 14, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27858115/-the-new-esc-guidelines-for-acute-and-chronic-heart-failure-2016
#5
C U Oeing, C Tschöpe, B Pieske
The new guidelines for the diagnosis and treatment of acute and chronic heart failure (HF) were presented in May 2016 during the congress of the Heart Failure Association (HFA) of the European Society of Cardiology (ESC) in Florence. An important amendment affects the classification of HF which now differentiates between HF with preserved ejection fraction (HFpEF) and left ventricular EF (LVEF) > 50%, HF with reduced ejection fraction (HFrEF, LVEF < 40%) and the new entity HF with mid-range ejection fraction (HFmrEF, LVEF 40-49%)...
November 17, 2016: Herz
https://www.readbyqxmd.com/read/27847557/thoracic-ultrasound-a-complementary-diagnostic-tool-in-cardiology
#6
REVIEW
Guglielmo M Trovato
Clinical assessment and workup of patients referred to cardiologists may need an extension to chest disease. This requires more in-depth examination of respiratory co-morbidities due to uncertainty or severity of the clinical presentation. The filter and integration of ecg and echocardiographic information, addressing to the clues of right ventricular impairment, pulmonary embolism and pulmonary hypertension, and other less frequent conditions, such as congenital, inherited and systemic disease, usually allow more timely diagnosis and therapeutic choice...
October 26, 2016: World Journal of Cardiology
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/27793103/the-sphinx-s-riddle-cardiovascular-involvement-in-autoimmune-rheumatic-disease
#8
REVIEW
Sophie Mavrogeni, George Markousis-Mavrogenis, Genovefa Kolovou
Factors leading to Cardiovascular Disease (CVD) in Autoimmune Rheumatic Diseases (ARD) include: a) atherosclerosis and macro-microvascular coronary artery disease b) pericardial, myocardial and vascular inflammation c) heart valve disease d) heart failure and e) pulmonary hypertension.Cardiology utilizes various non-invasive imaging modalities, such as rest/stress Electrocardiogram (ECG), echocardiography, nuclear imaging and more recently Cardiovascular Magnetic Resonance (CMR) to detect ischemic or inflammatory disease in ARD...
October 28, 2016: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/27773412/pulmonary-hypertension-registry-of-kerala-prokerala-rationale-design-and-methods
#9
S Harikrishnan, G Sanjay, M Ashishkumar, Jaideep Menon, G Rajesh, R Krishna Kumar
BACKGROUND: Pulmonary hypertension (PH) is a disease associated with a high morbidity and mortality. There is paucity of data regarding PH from the developing countries including India. Idiopathic pulmonary arterial hypertension is the most important etiological factor in the western world, but PH secondary to rheumatic heart disease, chronic obstructive pulmonary disease and untreated congenital heart disease could well be the predominant causes in developing countries like India. The main objective of the PROKERALA study - Pulmonary hypertension Registry Of Kerala is to collect data regarding the etiology, practice patterns and one-year outcomes of patients diagnosed to have PH...
September 2016: Indian Heart Journal
https://www.readbyqxmd.com/read/27767408/a-case-of-acute-pericarditis-following-intravenous-injection-of-crushed-morphine-tablets
#10
Ryan J Anderson, Bryan Corbett, Binh T Ly
A 37-year-old male presented with sharp, severe chest pain following seven days of intravenous injection of crushed morphine tablets. The chest pain was positional and pleuritic in nature and resolved with leaning forward. Work-up was notable for an ECG with inferior and anterolateral PR depressions as well as a CT chest with diffuse centrilobular nodules. Per radiology, the CT findings along with the patient's history were concerning for pulmonary granulomatosis from deposition of talc or some other foreign body...
November 2016: Journal of Psychoactive Drugs
https://www.readbyqxmd.com/read/27762510/long-term-mortality-in-patients-with-permanent-pacemaker-implantation
#11
Abraham Speedie, Cinosh Mathew, Ramgopal S Shahi, Rajneesh Calton
INTRODUCTION: The development of implantable technology for cardiac rhythm management remains one of the seminal achievements of the second half of the 20th century. The development of artificial pacemakers for the electrical control of the cardiac rhythm has greatly enhanced the physician's ability to treat cardiac dysrhythmias. An ageing population and the extension of indications will in all probability result in an increasing number of cardiac device implantations. OBJECTIVE OF STUDY: To study mortality and morbidity in patients with permanent pacemaker implantation at a tertiary care hospital in North India...
September 2016: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/27747725/high-dose-verapamil-in-episodic-and-chronic-cluster-headaches-and-cardiac-adverse-events-is-it-as-safe-as-we-think
#12
Joachim Alexandre, Xavier Humbert, Marion Sassier, Paul Milliez, Antoine Coquerel, Sophie Fedrizzi
Cluster headache (CH) is a primary headache disorder with relatively effective treatments. Although few sufficiently controlled trials are available, verapamil is recommended as the first-line prophylactic drug for CH by the French Headache Society (with a low level of evidence, level B) and by the EFNS (European Federation of Neurological Societies, level A). Daily doses of more than 480 mg (and up to 1200 mg daily) are frequently used off-label, while 360 mg daily is the only dosage to have demonstrated its effectiveness in a double-blind trial against placebo, and the usual label posology used by cardiologists is 240 mg daily in hypertension...
December 2015: Drug Safety—Case Reports
https://www.readbyqxmd.com/read/27734807/robust-qrs-peak-detection-by-multimodal-information-fusion-of-ecg-and-blood-pressure-signals
#13
Quan Ding, Yong Bai, Yusuf Bugra Erol, Rebeca Salas-Boni, Xiaorong Zhang, Xiao Hu
QRS peak detection is a challenging problem when ECG signal is corrupted. However, additional physiological signals may also provide information about the QRS position. In this study, we focus on a unique benchmark provided by PhysioNet/Computing in Cardiology Challenge 2014 and Physiological Measurement focus issue: robust detection of heart beats in multimodal data, which aimed to explore robust methods for QRS detection in multimodal physiological signals. A dataset of 200 training and 210 testing records are used, where the testing records are hidden for evaluating the performance only...
October 13, 2016: Physiological Measurement
https://www.readbyqxmd.com/read/27714717/annual-prognostic-factors-in-chronic-heart-failure-in-patients-over-80-years-old
#14
Anna Cichocka-Radwan, Małgorzata Lelonek
BACKGROUND: In the elderly the most common cause of hospitalization and the leading cause of death is heart failure. AIM: The purpose was to determine prognostic factors in chronic heart failure (CHF) in octogenarians and nonagenarians. METHODS: The analysis included 197 consecutive patients older than 80 years old (mean age 83.63+3.01 years; 46.19% of men) hospitalized in 2010-2013 in the Department of Cardiology due to CHF. Sixty two parameters were investigated such as: age, gender, NYHA functional class, body mass index, blood pressure, other comorbidities, the parameters of the 12-lead resting ECG and the echocardiography, the results of basic laboratory tests and selected biomarkers, including N-terminal pro-B-type natriuretic peptide (NT-proBNP), high-sensitive troponin T (hs-TnT), high-sensitive C-reactive protein (hs-CRP)...
October 7, 2016: Kardiologia Polska
https://www.readbyqxmd.com/read/27708487/the-use-of-continuous-electrocardiographic-holter-monitoring-in-pediatric-cardiology
#15
Zijo Begic, Edin Begic, Senka Mesihovic-Dinarevic, Izet Masic, Senad Pesto, Mirza Halimic, Almira Kadic, Amra Dobraca
OBJECTIVE: To show the place and role of continuous electrocardiographic twenty-four-hour ECG monitoring in daily clinical practice of pediatric cardiologists. METHODS: According to protocol, 2753 patients underwent dynamic continuous ECG Holter monitoring (data collected from the "Register of ECG Holter monitoring" of Pediatric Clinic, UCC Sarajevo in period April 2003- April 2015). RESULTS: There were 50,5% boys and 49,5% girls, aged from birth to 19 years (1,63% - neonates and infants, 2,6% - toddlers, 9,95% - preschool children, 35,5% - gradeschoolers and 50,3% children in puberty and adolescence)...
July 16, 2016: Acta Informatica Medica: AIM
https://www.readbyqxmd.com/read/27665859/left-ventricular-diastolic-dysfunction-in-normotensive-postmenopausal-women-with-type-2-diabetes-mellitus
#16
Maria Maiello, Annapaola Zito, Annagrazia Cecere, Marco Matteo Ciccone, Pasquale Palmiero
BACKGROUND: The prevalence of heart failure among diabetic patients is high, also in those with normal blood pressure and without coronary artery disease, even when electrocardiogram (ECG) is normal. The goal of our study was to assess the prevalence of left ventricular diastolic dysfunction (LVDD) among diabetic women (DW) and its correlation with glycosylated hemoglobin (HbA1c) levels, obesity status, and ECG parameters. METHODS: A group of 456 consecutive normotensive postmenopausal women affected by type 2 diabetes, diagnosed over 5 years, were enrolled...
September 26, 2016: Cardiology Journal
https://www.readbyqxmd.com/read/27665532/multi-window-detection-for-p-wave-in-electrocardiograms-based-on-bilateral-accumulative-area
#17
Riqing Chen, Yingsong Huang, Jian Wu
BACKGROUND AND OBJECTIVE: P-wave detection is one of the most challenging aspects in electrocardiograms (ECGs) due to its low amplitude, low frequency, and variable waveforms. This work introduces a novel multi-window detection method for P-wave delineation based on the bilateral accumulative area. METHOD: The bilateral accumulative area is calculated by summing the areas covered by the P-wave curve with left and right sliding windows. The onset and offset of a positive P-wave correspond to the local maxima of the area detector...
September 15, 2016: Computers in Biology and Medicine
https://www.readbyqxmd.com/read/27660369/amssm-position-statement-on-cardiovascular-preparticipation-screening-in-athletes-current-evidence-knowledge-gaps-recommendations-and-future-directions
#18
Jonathan A Drezner, Francis G O'Connor, Kimberly G Harmon, Karl B Fields, Chad A Asplund, Irfan M Asif, David E Price, Robert J Dimeff, David T Bernhardt, William O Roberts
Cardiovascular screening in young athletes is widely recommended and routinely performed prior to participation in competitive sports. While there is general agreement that early detection of cardiac conditions at risk for sudden cardiac arrest and death (SCA/D) is an important objective, the optimal strategy for cardiovascular screening in athletes remains an issue of considerable debate. At the centre of the controversy is the addition of a resting ECG to the standard preparticipation evaluation using history and physical examination...
September 22, 2016: British Journal of Sports Medicine
https://www.readbyqxmd.com/read/27642739/-an-unexpected-cause-of-dyspnea-and-degradation-of-performance
#19
Peter Seizer, Michaela Rockenstiehl, Suzanne Fateh-Moghadam, Susanne Haen, Ferruh Artunc, Martin R Müller, Azadeh Ebrahimi, Reimer Riessen, Meinrad Gawaz, Falko Fend, Michael Haap
HISTORY AND ADMISSION FINDINGS: A 55-year old man suffers from progressive, distinctive dyspnoea and physical weakness since 5 days. Due to ST-segment changes in the ECG and a positive troponin-test, the primary care physician initiates an hospitalization. INVESTIGATIONS: After admission, the laboratory tests confirm the elevated troponin-values, and show additionally elevated pro-brain-natriuric-peptide-values. The coronary angiography presents a highly reduced left ventricular function, an aortic insufficiency III° and a coronary heart disease...
September 2016: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/27639971/management-of-suspected-acute-heart-failure-dyspnea-in-the-emergency-department-results-from-the-french-prospective-multicenter-defssica-survey
#20
Tahar Chouihed, Stéphane Manzo-Silberman, Nicolas Peschanski, Sandrine Charpentier, Meyer Elbaz, Dominique Savary, Eric Bonnefoy-Cudraz, Said Laribi, Patrick Henry, Nicolas Girerd, Faiez Zannad, Carlos El Khoury
BACKGROUND: An appropriate diagnostic process is crucial for managing patients with acute heart failure (AHF) in emergency department (ED). Our study aims to describe the characteristics and therapeutic management of patients admitted to the ED for dyspnea suspected to have AHF, their in-hospital pathway of care and their in-hospital outcome. METHODS: Consecutive patients admitted in 26 French ED for dyspnea suspected to be the consequence of AHF, prior to in hospital diagnostic test, were prospectively included at the time of their admission in the DeFSSICA Survey...
September 17, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
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