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Syncope review

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https://www.readbyqxmd.com/read/29448152/the-clinical-utility-of-qualitative-electroencephalography-during-tilt-table-testing-a-retrospective-study
#1
Srikanth Muppidi, Babak Razavi, Mitchell G Miglis, Safwan Jaradeh
OBJECTIVE: To assess electroencephalography (EEG) changes during tilt table testing in syncope and other orthostatic syndromes. METHODS: We retrospectively reviewed consecutive tilt table studies with simultaneous EEG from April 2014 to May 2016 at our center. All patients had video EEG during tilt table. All patients had at least 10 min of head up tilt unless they had syncope or did not tolerate the study. Video EEG was interpreted by epileptologists. RESULTS: Eighty-seven patients met the inclusion criteria...
February 3, 2018: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
https://www.readbyqxmd.com/read/29440244/acute-rheumatic-fever-presenting-as-complete-heart-block-report-of-an-adolescent-case-and-review-of-literature
#2
Sridharan Umapathy, Anita Saxena
A 14-year-old boy suffering from chronic rheumatic heart disease came to the emergency department with recurrent episodes of presyncope and syncope. He was found to have complete heart block (CHB) and required temporary pacemaker insertion. Further workup revealed that CHB was secondary to acute rheumatic carditis. His atrioventricular (AV) conduction abnormalities recovered in a stepwise fashion over 5 days while he was being treated with corticosteroids, without the need for permanent pacemaker insertion...
February 11, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29436489/-cryptogenic-drop-attacks-revisited-evidence-of-overlap-with-functional-neurological-disorder
#3
Ingrid Hoeritzauer, Alan J Carson, Jon Stone
OBJECTIVE: In their 1973 BMJ paper 'Cryptogenic Drop Attacks', Stevens and Matthews described 40, mostly middle-aged, female patients with drop attacks of unknown cause. Although clinically common, there has been little on this topic since. We aimed to determine clinical features, comorbidity and outcome of patients with drop attacks. METHODS: We carried out a retrospective review of patients with cryptogenic drop attacks seen consecutively by one clinician (JS) between 2006 and 2016...
February 7, 2018: Journal of Neurology, Neurosurgery, and Psychiatry
https://www.readbyqxmd.com/read/29433586/a-case-report-of-clonidine-induced-syncope-a-review-of-central-actions-of-an-old-cardiovascular-drug
#4
Alexander J Sandweiss, Christopher M Morrison, Anne Spichler, John Rozich
BACKGROUND: Clonidine is an imidazoline sympatholytic, acting on both α 2 -adrenergic and imidazoline receptors in the brainstem to induce antihypertensive and negative chronotropic effects in the vasculature and heart respectively. CASE PRESENTATION: A 69-year-old gentleman with hypertension presented to the emergency department after multiple syncopal episodes over the past 12 months. Electrocardiogram demonstrated sinus bradycardia with a heart rate of 42 beats per minute...
February 13, 2018: BMC Pharmacology & Toxicology
https://www.readbyqxmd.com/read/29408436/predicting-arrhythmic-risk-in-arrhythmogenic-right-ventricular-cardiomyopathy-a-systematic-review-and-meta-analysis
#5
Laurens P Bosman, Arjan Sammani, Cynthia A James, Julia Cadrin-Tourigny, Hugh Calkins, J Peter van Tintelen, Richard N W Hauer, Folkert W Asselbergs, Anneline S J M Te Riele
While many studies evaluate predictors for ventricular arrhythmias in Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC), a systematic review consolidating this evidence is currently lacking. Therefore, we searched MEDLINE and Embase for studies analyzing predictors for ventricular arrhythmias (sustained ventricular tachycardia/fibrillation (VT/VF), appropriate implantable cardioverter-defibrillator therapy, or sudden cardiac death) in definite ARVC patients, borderline ARVC patients, and ARVC-associated mutation carriers...
February 2, 2018: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/29406940/heart-disease-in-children
#6
REVIEW
Richard U Garcia, Stacie B Peddy
The pediatric cardiology field has developed rapidly over the past few decades. More children than ever born with congenital heart disease (CHD) are growing into adulthood. Primary care providers play a key role in diagnosis, management, and referral of children with CHD because many common cardiac complaints (eg, feeding intolerance, cyanosis, chest pain, palpitations, and syncope) are first addressed in the primary care setting. The spectrum of heart disease in children ranges from common complaints to complex single-ventricle physiology, acute myocarditis, and heart transplantation...
March 2018: Primary Care
https://www.readbyqxmd.com/read/29404360/access-site-complications-in-transcutaneous-aortic-valve-replacement-frequency-outcomes-prevention-and-treatment
#7
REVIEW
Samuel Latham, Tamunoinemi Bob-Manuel, Arindam Sharma, Amit Nanda, Devareshi Ardeshna, Rami N Khouzam
Aortic stenosis (AS) is a common cause of valvular heart disease with heavy disease burden in elderly patients. It is present in almost 7% of patients older than 65. The mortality rate increases significantly once it becomes symptomatic with average life expectancy of around 1-year. Symptoms include angina, syncope, or heart failure. This requires either surgical or transcutaneous replacement. Transcutaneous aortic valve replacement (TAVR) use has increased in recent years from high risk patients to now even including intermediate risk patients...
January 2018: Annals of Translational Medicine
https://www.readbyqxmd.com/read/29368226/lateral-medullary-infarction-with-cardiovascular-autonomic-dysfunction-an-unusual-presentation-with-review-of-the-literature
#8
REVIEW
Tridu R Huynh, Barbara Decker, Timothy J Fries, Ajay Tunguturi
PURPOSE: We report an unusual case of lateral medullary infarction presenting with orthostatic hypotension with pre-syncope without vertigo or Horner's syndrome. METHODS: Case report with review of the literature. RESULTS: A 67-year-old man presented with pre-syncope and ataxia without vertigo. Initial brain CT and MRI were normal. Neurological evaluation revealed right-beating nystagmus with left gaze, vertical binocular diplopia, right upper-extremity dysmetria, truncal ataxia with right axial lateropulsion, and right-facial and lower extremity hypoesthesia...
January 24, 2018: Clinical Autonomic Research: Official Journal of the Clinical Autonomic Research Society
https://www.readbyqxmd.com/read/29354176/outcome-of-surgical-embolectomy-in-patients-with-massive-pulmonary-embolism-with-and-without-cardiopulmonary-resuscitation
#9
Reza Hajizadeh, Samad Ghaffari, Afshin Habibzadeh, Naser Safaei, Kamran Mohammadi, Abdolmohammad Ranjbar, Sahar Ghodratizadeh
Introduction: Pulmonary embolism is a challenging critical cardiovascular disease with high morbidity and mortality. Surgical embolectomy has favorable results in patients with massive pulmonary embolism. Aim: To study the outcome of embolectomy in patients with massive pulmonary embolism. Material and methods: In this single-center, retrospective study, 36 patients including 14 male and 22 female patients with a mean age of 50.80 ±18.89 years with acute pulmonary embolism who underwent surgical pulmonary embolectomy from January 2011 to January 2016 were included...
December 2017: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
https://www.readbyqxmd.com/read/29349639/outcomes-in-syncope-research-a-systematic-review-and-critical-appraisal
#10
Monica Solbiati, Viviana Bozzano, Franca Barbic, Giovanni Casazza, Franca Dipaola, James V Quinn, Matthew J Reed, Robert S Sheldon, Win-Kuang Shen, Benjamin C Sun, Venkatesh Thiruganasambandamoorthy, Raffaello Furlan, Giorgio Costantino
Syncope is the common clinical manifestation of different diseases, and this makes it difficult to define what outcomes should be considered in prognostic studies. The aim of this study is to critically analyze the outcomes considered in syncope studies through systematic review and expert consensus. We performed a systematic review of the literature to identify prospective studies enrolling consecutive patients presenting to the Emergency Department with syncope, with data on the characteristics and incidence of short-term outcomes...
January 18, 2018: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/29349399/subclavian-steal-syndrome-without-subclavian-stenosis
#11
Matt Cwinn, Sudhir Nagpal, Prasad Jetty
Subclavian steal syndrome (SSS) has been well described in the setting of subclavian stenosis. We describe an unusual case of SSS caused by a high-flow arteriovenous dialysis fistula in the absence of subclavian stenosis, provide a review of the literature, and propose that arteriovenous fistula-induced SSS is an underdiagnosed cause of syncope in this population of patients.
September 2017: Journal of Vascular Surgery Cases and Innovative Techniques
https://www.readbyqxmd.com/read/29343965/postural-tachycardia-syndrome-current-perspectives
#12
REVIEW
Rachel Wells, Andrew J Spurrier, Dominik Linz, Celine Gallagher, Rajiv Mahajan, Prashanthan Sanders, Amanda Page, Dennis H Lau
Postural tachycardia syndrome (POTS) is the combination of an exaggerated heart rate response to standing, in association with symptoms of lightheadedness or pre-syncope that improve when recumbent. The condition is often associated with fatigue and brain fog, resulting in significant disruptions at a critical time of diagnosis in adolescence and young adulthood. The heterogeneity of the underlying pathophysiology and the variable response to therapeutic interventions make management of this condition challenging for both patients and physicians alike...
2018: Vascular Health and Risk Management
https://www.readbyqxmd.com/read/29326833/ganglionated-plexi-ablation-physiology-and-clinical-applications
#13
Stavros Stavrakis, Sunny Po
Ganglionated plexi (GP), consisting of conglomerations of autonomic ganglia on the epicardial surface of the heart, have been shown to play a significant role in different arrhythmias, including atrial fibrillation. GP ablation has become an adjunctive procedure in the treatment of atrial fibrillation, while it has been used successfully in preliminary studies in vasovagal syncope. This review will present the current data on the physiology and clinical applications of GP ablation in the treatment of atrial fibrillation and other diseases...
December 2017: Arrhythmia & Electrophysiology Review
https://www.readbyqxmd.com/read/29325363/-related-factors-for-the-development-of-fulminant-myocarditis-in-adults
#14
L J Sun, L J Guo, M Cui, Y Li, B D Zhou, J L Han, Z Zhang, Y Z Zhang, W Gao
Objective: To determine the early recognizable factors related to patients with fulminant myocarditis. Methods: Medical records from 60 adult patients who were diagnosed with acute viral myocarditis from January 2003 to September 2016 in our hospital were retrospectively reviewed, and divided into the fulminant group (n=9) and the non-fulminant group (n=51). Clinical presentations, biochemical markers, electrocardiography and echocardiography features on admission were analyzed. Results: Prevalence of syncope (33...
December 24, 2017: Zhonghua Xin Xue Guan Bing za Zhi
https://www.readbyqxmd.com/read/29315719/oversensing-of-transthoracic-excitation-stimuli-in-contemporary-pacemakers
#15
James D Ryan, Nathan D Tempel, Dean D Engle, David L Hayes, Yong-Mei Cha, Samuel J Asirvatham
BACKGROUND: Transthoracic impedance measurements (TIM) is primarily used for minute ventilation (MV) rate adaptive sensors in pacemakers. With elevated impedance the TIM electrical signal itself is oversensed causing device malfunction. OBJECTIVE: We report an increased incidence of TIM oversensing. METHOD: Retrospective chart review. We review existing records of 18 patients who have demonstrated device malfunction with TIM oversensing. RESULTS: We have found a 1...
January 5, 2018: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/29315367/sudden-death-in-patients-with-ebstein-anomaly
#16
Christine H Attenhofer Jost, Nicholas Y Tan, Abdalla Hassan, Emily R Vargas, David O Hodge, Joseph A Dearani, Heidi Connolly, Samuel J Asirvatham, Christopher J McLeod
Aims: Ventricular dysfunction or structural alteration of either ventricle is a well-established risk factor for sudden death (SD). Ebstein anomaly (EA) can present with both right and left heart abnormalities; however, predictors of SD have not been described. We therefore sought to characterize the incidence and risk factors of SD among a large cohort of patients with EA. Methods and results: All EA patients who underwent evaluation at a high-volume institution over a 4-decade period were retrospectively reviewed...
January 5, 2018: European Heart Journal
https://www.readbyqxmd.com/read/29306267/role-of-emergency-department-observation-units-in-the-management-of-patients-with-unexplained-syncope-a-critical-review-and-meta-analysis
#17
REVIEW
Filippo Numeroso, Gianluigi Mossini, Giuseppe Lippi, Gianfranco Cervellin
This meta-analysis aimed to establish the role of standardized emergency department (ED) observation protocols in the management of syncopal patients as an alternative to ordinary admission. A systematic electronic literature search was performed to identify randomized controlled trials or observational studies evaluating syncopal patients managed in ED observation units. Data regarding mean length of stay, rate of etiological diagnosis, admission rate, and incidence of short-term serious outcomes were extracted...
December 2017: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/29282699/dizziness-in-the-emergency-department-an-update-on-diagnosis
#18
Rainer Spiegel, Mark Kirsch, Christiane Rosin, Heiko Rust, Thomas Baumann, Raoul Sutter, Hergen Friedrich, Martina Göldlin, René Müri, Roger Kalla, Roland Bingisser, Georgios Mantokoudis
This review aims to assist emergency physicians in finding the underlying aetiology when a patient presents with dizziness to the emergency department. After reading this review, the emergency physician will be able to consider the most relevant differential diagnoses and have an idea about dangerous aetiologies that require immediate action. The emergency physician will also know what diagnostic steps need to be taken at what time, such as the three-component HINTS Test (Head Impulse, Nystagmus, and Test-of-Skew), which helps with distinguishing central from peripheral causes of the acute vestibular syndrome...
December 28, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/29278359/incomplete-penetrance-and-variable-expressivity-hallmarks-in-channelopathies-associated-with-sudden-cardiac-death
#19
REVIEW
Monica Coll, Alexandra Pérez-Serra, Jesus Mates, Bernat Del Olmo, Marta Puigmulé, Anna Fernandez-Falgueras, Anna Iglesias, Ferran Picó, Laura Lopez, Ramon Brugada, Oscar Campuzano
Sudden cardiac death is defined as an unexpected decease of cardiac origin. In individuals under 35 years old, most of these deaths are due to familial arrhythmogenic syndromes of genetic origin, also known as channelopathies. These familial cardiac syndromes commonly follow an autosomal dominant pattern of inheritance. Diagnosis, however, can be difficult, mainly due to incomplete penetrance and variable expressivity, which are hallmarks in these syndromes. The clinical manifestation of these diseases can range from asymptomatic to syncope but sudden death can sometimes be the first symptom of disease...
December 26, 2017: Biology
https://www.readbyqxmd.com/read/29273909/emergency-department-visits-among-patients-with-left-ventricular-assist-devices
#20
Christopher R Tainter, Oscar Ö Braun, Felipe Teran, Albert P Nguyen, Kimberly Robbins, Edward O O'Brien, Zeb M McMillan, Ulrich Schmidt, Angela Meier, Mat Goebel, Victor Pretorius, Michela Brambatti, Eric D Adler, Raghu Seethala
Continuous-flow left ventricular assist devices (LVADs) are increasingly implanted to support patients with end-stage heart failure. These patients are at high risk for complications, many of which necessitate emergency care. While rehospitalization rates have been described, there is little data regarding emergency department (ED) visits. We hypothesize that ED visits are frequent and often require admission after LVAD implantation. We performed a retrospective review of patients in our health-care system followed by the advanced heart failure service for LVAD management after implantation between January 2011 and July 2015...
December 22, 2017: Internal and Emergency Medicine
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