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Syncope review

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https://www.readbyqxmd.com/read/27913770/cor-triatriatum-a-review
#1
REVIEW
Ajay Kumar Jha, Neeti Makhija
Cor triatriatum is a rare congenital cardiac anomaly defined by an abnormal septation within the atrium (left or right) leading to inflow obstruction to the respective ventricles. It exists either in isolated classical form or may be associated with simple to complex congenital cardiac anomalies. Several anatomical variants exist even in the classical form, and therefore, it may require multimodal diagnostic modalities to characterize and differentiate for better percutaneous interventional or surgical planning...
December 2, 2016: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/27911975/transfusion-requirements-in-esrd-patients-admitted-with-gi-hemorrhage-undergoing-inpatient-endoscopy
#2
Conor McCartney, Shrihari Santosh, Setu Patolia, Sadashiv Santosh
OBJECTIVES: To date there are no studies evaluating the utilization of blood products in patients with end-stage renal disease (ESRD) with gastrointestinal (GI) hemorrhage. This study estimated transfusion needs and determined predictors available at the time of admission for patients with ESRD admitted to a university hospital with GI bleeding requiring inpatient endoscopy. METHODS: A retrospective chart review was performed on all patients with ESRD who underwent inpatient endoscopy for suspected GI bleeding between 2009 and 2015...
December 2016: Southern Medical Journal
https://www.readbyqxmd.com/read/27909531/brugada-syndrome-risk-stratification-and-management
#3
REVIEW
Konstantinos P Letsas Md Fesc, Stamatis Georgopoulos Md, Konstantinos Vlachos Md, Nikolaos Karamichalakis Md, Ioannis Liatakis Md, Panagiotis Korantzopoulos Md PhD, Tong Liu Md PhD, Michael Efremidis Md, Antonios Sideris Md
The Brugada syndrome (BrS) is an arrhythmogenic disease associated with an increased risk of ventricular fibrillation and sudden cardiac death. The risk stratification and management of BrS patients, particularly of asymptomatic ones, still remains challenging. A previous history of aborted sudden cardiac death or arrhythmic syncope in the presence of spontaneous type 1 ECG pattern of BrS phenotype appear to be the most reliable predictors of future arrhythmic events. Several other ECG parameters have been proposed for risk stratification...
August 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/27904611/selective-serotonin-reuptake-inhibitors-and-cardiovascular-events-a-systematic-review
#4
REVIEW
Mohammad Hassan Nezafati, Ali Eshraghi, Mohammad Vojdanparast, Saeed Abtahi, Pouya Nezafati
BACKGROUND: Given the importance of the role of depression in predicting the outcome of cardiovascular disorders, current medications for treating depression, particularly selective serotonin reuptake inhibitors (SSRIs), are taken into consideration. This study aimed to systematically review the published findings in the use of SSRIs and the risk for cardiac events. MATERIALS AND METHODS: An independent review of the Web of Science, PubMed, Scopus, Cochrane, CINAHL, index Copernicus, and Google Scholar, up to 2014, was performed...
2016: Journal of Research in Medical Sciences: the Official Journal of Isfahan University of Medical Sciences
https://www.readbyqxmd.com/read/27900081/small-cell-lung-cancer-with-recurrent-syncope-as-the-initial-symptom-a-case-report-and-literature-review
#5
Xi Jiang, Jiayi Zhao, Chengguang Bai, Enhong Xu, Zhenhao Chen, Yiping Han
Small-cell lung cancer (SCLC) presenting with syncope as the initial symptom is rare in adults. This onset of tumour-induced syncope cannot be screened or differentiated by coronary angiography, magnetic resonance angiography of the neck or 24-hour dynamic electrocardiogram. We herein describe the case of a 61-year-old man who presented with recurrent syncope that resolved after the first course of chemotherapy (carboplatin plus etoposide) for SCLC. A mass measuring 57×53 mm was identified in the left hilum, and a diagnosis of limited-disease SCLC (T4N2M0, IIIB) was made...
November 2016: Molecular and Clinical Oncology
https://www.readbyqxmd.com/read/27896702/safety-of-regadenoson-stress-testing-in-patients-with-pulmonary-hypertension
#6
Victor M Moles, Thomas Cascino, Ashraf Saleh, Krasimira Mikhova, John J Lazarus, Michael Ghannam, Hong J Yun, Matthew Konerman, Richard L Weinberg, Edward P Ficaro, James R Corbett, Vallerie V McLaughlin, Venkatesh L Murthy
OBJECTIVES: We sought to determine the safety of regadenoson stress testing in patients with PH. BACKGROUND: PH is increasingly recognized at more advanced ages. As many as one-third of patients with PH have coronary artery disease. Because of their physical limitations, patients with PH are unable to adequately exercise. Regadenoson can potentially have an adverse impact due to their tenuous hemodynamics. Current guidelines suggest performing a coronary angiography in patients with PH who have angina or multiple coronary risk factors...
November 28, 2016: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
https://www.readbyqxmd.com/read/27844191/-indications-for-implantable-loop-recorders-in-patients-with-channelopathies-and-ventricular-tachycardias
#7
Julia Köbe, Kristina Wasmer, Florian Reinke, Lars Eckardt
Implantable loop recorders (ILR) do not play a pivotal role in the current guidelines on ventricular arrhythmias except in identifying rhythm-symptom correlations if ventricular arrhythmias are assumed. Before a decision for a pure diagnostic implantable device is made, a thorough arrhythmic risk assessment is of major importance due to the potential lethal outcome of ventricular arrhythmias. Nevertheless, some clinical circumstances exist where long-term monitoring by an ILR may add significant information in electrical heart diseases, in patients with ventricular arrhythmias, or structural heart diseases and a potential risk of ventricular arrhythmias...
November 14, 2016: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/27843098/the-heart-of-epilepsy-current-views-and-future-concepts
#8
S Shmuely, M van der Lende, R J Lamberts, J W Sander, R D Thijs
Cardiovascular (CV) comorbidities are common in people with epilepsy. Several mechanisms explain why these conditions tend to co-exist including causal associations, shared risk factors and those resulting from epilepsy or its treatment. Various arrhythmias occurring during and after seizures have been described. Ictal asystole is the most common cause. The converse phenomenon, arrhythmias causing seizures, appears extremely rare and has only been reported in children following cardioinihibitory syncope. Arrhythmias in epilepsy may not only result from seizure activity but also from a shared genetic susceptibility...
October 26, 2016: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/27833675/utility-of-chest-radiography-in-emergency-department-patients-presenting-with-syncope
#9
Matthew L Wong, David Chiu, Nathan I Shapiro, Shamai A Grossman
INTRODUCTION: Syncope has myriad etiologies, ranging from benign to immediately life threatening. This frequently leads to over testing. Chest radiographs (CXR) are among these commonly performed tests despite their uncertain diagnostic yield. The objective is to study the distribution of normal and abnormal chest radiographs in patients presenting with syncope, stratified by those who did or did not have an adverse event at 30 days. METHODS: We performed a post-hoc analysis of a prospective cohort of consecutive patients presenting to an urban tertiary care academic medical center with a chief complaint of syncope from 2003-2006...
November 2016: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27826707/diagnostic-yield-of-outpatient-pediatric-echocardiograms-impact-of-indications-and-specialty
#10
Sean M Lang, Elijah Bolin, Sarah Hardy, Xinyu Tang, R Thomas Collins
Multiple reports have shown that echocardiograms are neither cost-effective nor of high diagnostic yield for a number of indications. This study sought to evaluate the impact of indications and provider type on the diagnostic yield of first-time outpatient pediatric echocardiograms. All initial echocardiograms interpreted at our institution from February 2009 to December 2014 were reviewed retrospectively. Positive findings were defined as any abnormality of structure or function. Ordering physicians were grouped as Primary Care, Subspecialist, or Cardiologist...
November 8, 2016: Pediatric Cardiology
https://www.readbyqxmd.com/read/27819409/interventions-for-chronic-kidney-disease-associated-restless-legs-syndrome
#11
REVIEW
Seerapani Gopaluni, Mohamed Sherif, Naim A Ahmadouk
BACKGROUND: Restless legs syndrome (RLS) is defined as the spontaneous movement of the limbs (mainly legs) associated with unpleasant, sometimes painful sensation which is relieved by moving the affected limb. Prevalence of RLS among people on dialysis has been estimated between 6.6% and 80%. RLS symptoms contribute to impaired quality of life and people with RLS are shown to have increased cardiovascular morbidity and mortality.Various pharmacological and non-pharmacological interventions have been used to treat primary RLS...
November 7, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27812742/-implantable-loop-recorders-in-the-diagnosis-of-syncope
#12
B M Kaess, J R Ehrlich
In syncope patients, it is essential to make the right diagnosis with respect to underlying etiology. Cardiac (arrhythmic and structural) syncopal episodes carry untoward prognostic implication compared with reflex syncope. While rhythm-symptom correlation of a spontaneous syncopal episode is key to making the correct diagnosis, in case of unclear syncope the early implantation of a loop recorder leads to faster, more efficacious, and more cost-effective diagnosis. This review article summarizes the current data regarding diagnostic accuracy and clinical role of implantable loop recorders...
November 3, 2016: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/27803018/possible-complication-of-bee-stings-and-a-review-of-the-cardiac-effects-of-bee-stings
#13
Prabha Nini Gupta, B Krishna Kumar, Praveen Velappan, M D Sudheer
We report the case of a patient who, ∼3 weeks after multiple bee stings, developed a prolonged heart block, syncope and cardiac arrest. This required a temporary pacemaker to be implanted, which was later replaced with a permanent pacemaker. An ECG taken following surgery for a fractured humerus 6 years earlier was reportedly normal. The patient had been a rubber tapper who walked ∼1.5 km/day, but after the bee attack he was no longer able to walk or get up from the bed without experiencing syncope...
November 1, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27802864/glucokinase-mutation-a-rare-cause-of-recurrent-hypoglycemia-in-adults-a-case-report-and-literature-review
#14
Oluremi N Ajala, David M Huffman, Ibrahim I Ghobrial
BACKGROUND: Hypoglycemia occurs frequently in patients both in the inpatient and outpatient settings. While most hypoglycemia unrelated to diabetes treatment results from excessive endogenous insulin action, rare cases involve functional and congenital mutations in glycolytic enzymes of insulin regulation. CASE: A 21-year-old obese woman presented to the emergency department with complaints of repeated episodes of lethargy, syncope, dizziness, and sweating. She was referred from an outside facility on suspicion of insulinoma, with severe hypoglycemia unresponsive to repeated dextrose infusions...
2016: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/27784771/long-term-follow-up-of-psychogenic-pseudosyncope
#15
Dirk P Saal, M Jolein Overdijk, Roland D Thijs, Irene M van Vliet, J Gert van Dijk
OBJECTIVE: To determine the outcome of patients with psychogenic pseudosyncope (PPS) after communication of the diagnosis. METHODS: This was a retrospective cohort study of patients with PPS referred in 2007 to 2015 to a tertiary referral center for syncope. We reviewed patient records and studied attack frequency, factors affecting attack frequency, health care use, and quality of life using a questionnaire. We explored influences on attack freedom and attack frequency in the 6 months before follow-up for age, sex, education level, duration until diagnosis, probability of diagnosis, additional syncope, and acceptance of diagnosis...
November 22, 2016: Neurology
https://www.readbyqxmd.com/read/27780653/clinical-mimics-an-emergency-medicine-focused-review-of-stroke-mimics
#16
Brit Long, Alex Koyfman
BACKGROUND: Stroke is a leading cause of death and disability and most commonly presents with focal neurologic deficit within a specific vascular distribution. Several other conditions may present in a similar manner. OBJECTIVES: This review provides emergency providers with an understanding of stroke mimics, use of thrombolytics in these mimics, and keys to differentiate true stroke from mimic. DISCUSSION: Stroke has significant morbidity and mortality, and the American Heart Association emphasizes rapid recognition and aggressive treatment for patients with possible stroke-like symptoms, including thrombolytics...
October 22, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27761165/catheter-ablation-for-ventricular-tachyarrhythmia-in-patients-with-channelopathies
#17
REVIEW
Nobuyuki Murakoshi, Kazutaka Aonuma
Drug treatment and/or implantable cardioverter defibrillator (ICD) implantation are the most widely accepted first-line therapies for channelopathic patients who have recurrent syncope, sustained ventricular tachycardia (VT), or documented ventricular fibrillation (VF), or are survivors of cardiac arrest. In recent years, there have been significant advances in mapping techniques and ablation technology, coupled with better understanding of the mechanisms of ventricular tachyarrhythmia in channelopathies. Catheter ablation has provided important insights into the role of the Purkinje network and the right ventricular outflow tract in the initiation and perpetuation of VT/VF, and has evolved as a promising treatment modality for ventricular tachyarrhythmia even in channelopathies...
October 2016: Journal of Arrhythmia
https://www.readbyqxmd.com/read/27738530/aortic-dissection-in-a-healthy-male-athlete-a-unique-case-with-comprehensive-literature-review
#18
Balraj Singh, Jennifer M Treece, Ghulam Murtaza, Samit Bhatheja, Steven J Lavine, Timir K Paul
A young otherwise healthy 27-year-old male who has been using anabolic steroids for a long time developed Type I aortic dissection associated with heavy weightlifting. The patient did not have a recent history of trauma to the chest, no history of hypertension, and no illicit drug use. He presented with severe chest pain radiating to back and syncopal event with exertion. Initial vitals were significant for blood pressure of 80/50 mmHg, pulse of 80 beats per minute, respirations of 24 per minute, and oxygen saturation of 92% on room air...
2016: Case Reports in Cardiology
https://www.readbyqxmd.com/read/27723019/requests-for-emergency-hyperbaric-oxygen-treatment-for-carbon-monoxide-poisoning-in-ankara-turkey
#19
Münïre Kübra Özgök-Kangal, Iclal Karatop-Cesur, Gökhan Akcali, Senol Yildiz, Günalp Uzun
BACKGROUND: Carbon monoxide (CO) poisoning is common in Turkey. Our department is the main provider of emergency hyperbaric oxygen therapy (HBOT) in Ankara and neighboring cities. In this study, we analyzed the characteristics of CO-poisoned patients who were referred by phone to our department for emergency HBOT. METHODS: We retrospectively reviewed the records of phone consultations with emergency departments regarding the need for treatment of CO-poisoned patients with HBOT between 14 January 2014 and 14 January 2015...
September 2016: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
https://www.readbyqxmd.com/read/27707621/predictors-of-intervention-and-mortality-in-patients-with-uncomplicated-acute-type-b-aortic-dissection
#20
Hunter M Ray, Christopher A Durham, Daniel Ocazionez, Kristofer M Charlton-Ouw, Anthony L Estrera, Charles C Miller, Hazim J Safi, Ali Azizzadeh
OBJECTIVE: Patients with uncomplicated acute type B aortic dissection (uATBAD) have historically been managed with medical therapy. Recent studies suggest that high-risk patients with uATBAD may benefit from thoracic endovascular aortic repair. This study aims to determine the predictors of intervention and mortality in patients with uATBAD. METHODS: All patients admitted with uATBAD from 2000 to 2014 were reviewed, and those with computed tomographic angiography imaging were included...
October 1, 2016: Journal of Vascular Surgery
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