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Syncope review

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https://www.readbyqxmd.com/read/28623036/-arrhythmogenic-right-ventricular-cardiomyopathy-dysplasia-literature-review-and-case-report
#1
William Alejandro Camargo-Ariza, Silvia Juliana Galvis-Blanco, Tatiana Del Pilar Camacho-Enciso, Carlos Alberto Quiroz-Romero, Juan José Bermudez-Echeverry
Arrhythmogenic right ventricular cardiomyopathy/dysplasia is an inherited autosomal dominant pathology with an estimated prevalence of 1:2,500 to 1:5,000, being higher in males (3:1). It is characterized histologically by replacement of cardiomyocytes by fibro-adipose tissue, which predisposes to ventricular arrhythmias, right ventricular failure, and sudden cardiac death. The main goal of treatment is to reduce the risk of sudden death and improve the quality of life of patients. We present the case of a 23 year old woman whose clinical symptoms started with palpitations, chest pain with physical activity, syncope and headache 6 years ago during her first pregnancy...
June 13, 2017: Archivos de Cardiología de México
https://www.readbyqxmd.com/read/28616731/renal-nerve-stimulation-for-treatment-of-neurocardiogenic-syncope-a-review-from-perspective-of-commercialization-potential
#2
REVIEW
B O'Brien, H Zafar, F Sharif
A strong evidence of outcomes for vasovagal syncope is not easily identified. It would seem reasonable that the proposed Mayo Clinic technology would be reserved for cases with severe recurrent or refractory syncope. However, recurrence levels are relatively low, and while some predictive methods have been proposed, recurrence is also influenced by the interaction that occurs during screening and examinations, i.e. recurrence diminishes once an initial diagnosis has been made. Finally, a key factor in being able to identify suitable patients relates to understanding the relative significance of the vasodepression and cardioinhibitory components-the therapy is best suited to patients that have a significant level of both components...
June 14, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28611366/safety-of-acupuncture-overview-of-systematic-reviews
#3
Malcolm W C Chan, Xin Yin Wu, Justin C Y Wu, Samuel Y S Wong, Vincent C H Chung
Acupuncture is increasingly used worldwide. It is becoming more accepted by both patients and healthcare providers. However, the current understanding of its adverse events (AEs) is fragmented. We conducted this overview to collect all systematic reviews (SRs) on the AEs of acupuncture and related therapies. MEDLINE and EMBASE were searched from inception to December 2015. Methodological quality of included reviews was assessed with a validated instrument. Evidence was narratively reported. Seventeen SRs covering various types of acupuncture were included...
June 13, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28602247/different-clinical-features-of-anaphylaxis-according-to-cause-and-risk-factors-for-severe-reactions
#4
Sang-Yoon Kim, Min-Hye Kim, Young-Joo Cho
BACKGROUND: Anaphylaxis is a life-threatening allergic reaction. Several studies reported different anaphylactic reactions according to the causative substances. However, a comparison of anaphylaxis for each cause has not been done. This study was conducted to identify common causes of anaphylaxis, characteristics of anaphylactic reaction for each cause and to analyze the factors related to the severity of the reaction. METHODS: Medical records of patients who visited the emergency room of Ewha Womans University Mokdong Hospital from March 2003 to April 2016 and diagnosed with anaphylactic shock were retrospectively reviewed...
June 8, 2017: Allergology International: Official Journal of the Japanese Society of Allergology
https://www.readbyqxmd.com/read/28599947/an-elderly-man-with-pancreatic-neuroendocrine-tumor-and-a-cavitary-right-upper-lobe-lung-mass
#5
Palla DeSilva, Adarsha Selvachandra, Jennifer Kanaan, Debapriya Datta
An elderly man presented to the ED from a nursing care facility after transient loss of consciousness. Three weeks previously, the patient had been diagnosed with a high-grade pancreatic neuroendocrine tumor (NET) with metastases to the liver after being hospitalized for weakness. A chest radiograph at that time had revealed a right upper lobe mass that was presumed to represent a metastatic lesion (Fig 1); CT of the chest demonstrated similar findings (Fig 2). The patient had recovered consciousness on arrival to the ED and was diagnosed clinically as having had a syncopal episode from dehydration due to poor intake...
June 2017: Chest
https://www.readbyqxmd.com/read/28595994/-news-techniques-of-pacing-in-congenital-heart-diseases
#6
Mathieu Le Bloa, Jean-Benoît Thambo
The number of children and adult with congenital heart disease requiring implantation of cardiac pacemaker or cardioverter defibrillator is constantly increasing. The lead between stimulation/defibrillation site and the generator constitutes the main weakpoint of those devices despite the numerous recent technological advances: use of bipolar probes, corticoid elution electrodes, insulation improvement, magnetic resonance imaging (MRI) compatibility. Risk of device failure remains high in this population. Long term adverse events with endovascular devices remain high...
June 5, 2017: La Presse Médicale
https://www.readbyqxmd.com/read/28594339/cardiac-dysrhythmias-associated-with-substitutive-use-of-loperamide-a-systematic-review
#7
Irbaz Bin Riaz, Muhammad Shahzeb Khan, Muhammad Umar Kamal, Qurat-Ul-Ain Riaz Sipra, Anum Riaz, Umar Zahid, Sandipan Bhattacharjee
BACKGROUND: Recently, several deaths secondary to cardiac arrhythmias have been reported in association with substitutive use of loperamide. Therefore, we conducted a systematic review of all reported cases to overview the epidemiologic patterns and clinical outcomes to better elucidate loperamide-induced cardiac complications. AREAS OF UNCERTAINTY: Association between substitutive use of loperamide and cardiac arrhythmias. DATA SOURCES: A comprehensive literature search was conducted across 6 databases using variety of keywords to identify all reports of cardiac side effects associated with loperamide abuse...
April 27, 2017: American Journal of Therapeutics
https://www.readbyqxmd.com/read/28567077/idiopathic-polymorphic-ventricular-tachycardia-a-benign-disease-with-a-touch-of-bad-luck
#8
REVIEW
Sami Viskin
Ventricular extrasystole originating from the right ventricular outflow tract or the left ventricular outflow tract are the most commonly encountered ventricular arrhythmias recorded in ostensibly healthy individuals with no evidence of heart disease. These ventricular arrhythmias have a distinctive electrocardiographic morphology. The morphology is so distinctive that it is common practice to accept the diagnosis of "idiopathic benign ventricular arrhythmias from the outflow tract" based on this unique morphology when the electrocardiogram during sinus rhythm and the echocardiogram are normal, sometimes removing the need to perform invasive tests in patients...
May 2017: Korean Circulation Journal
https://www.readbyqxmd.com/read/28564488/noninvasive-beat-to-beat-finger-arterial-pressure-monitoring-during-orthostasis-a-comprehensive-review-of-normal-and-abnormal-responses-at-different-ages
#9
REVIEW
V K van Wijnen, C Finucane, M P M Harms, H Nolan, R L Freeman, B E Westerhof, R A Kenny, J C Ter Maaten, W Wieling
Over the past 30 years, noninvasive beat-to-beat blood pressure (BP) monitoring has provided great insight into cardiovascular autonomic regulation during standing. Although traditional sphygmomanometric measurement of BP may be sufficient for detection of sustained orthostatic hypotension, it fails to capture the complexity of the underlying dynamic BP and heart rate responses. With the emerging use of noninvasive beat-to-beat BP monitoring for the assessment of orthostatic BP control in clinical and population studies, various definitions for abnormal orthostatic BP patterns have been used...
May 31, 2017: Journal of Internal Medicine
https://www.readbyqxmd.com/read/28545873/reveal-linq-versus-reveal-xt-implantable-loop-recorders-intra-and-post-procedural-comparison
#10
Hoang H Nguyen, Ian H Law, Michael W Rudokas, Jennifer Lampe, Tammy M Bowman, George F Van Hare, Jennifer N Avari Silva
OBJECTIVES: To compare the procedure, recovery, hospitalization times, and costs along with patient/parent satisfaction after newer-generation cardiac implantable loop recorder (Reveal LINQ; Medtronic Inc, Minneapolis, Minnesota) and previous-generation implantable loop recorder (Reveal XT; Medtronic Inc). STUDY DESIGN: A prospective study of patients undergoing LINQ implantations between April 2014 and October 2015 was performed. Retrospective chart review of patients undergoing XT implantations was performed for comparison...
May 22, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28539561/predictors-of-mortality-rehospitalization-for-syncope-and-cardiovascular-events-in-patients-with-cardiovascular-syncope
#11
Tatsuya Onuki, Makoto Shoji, Yuya Nakamura, Ko Ogawa, Akinori Ochi, Koichiro Inokuchi, Shiro Kawasaki, Yoshimi Onishi, Yoshimasa Onuma, Yumi Munetsugu, Miwa Kikuchi, Hiroyuki Ito, Yoshino Minoura, Norikazu Watanabe, Taro Adachi, Mitsuharu Kawamura, Taku Asano, Kaoru Tanno, Youichi Kobayashi
BACKGROUND: Predictors of poor outcomes remain unknown for cardiovascular syncope patients after discharge.Methods and Results:We reviewed the medical records of consecutive patients admitted to hospital with cardiovascular syncope. We then performed Cox stepwise logistic regression analysis to identify significant independent factors for death, rehospitalization for syncope, and cardiovascular events. The study group was 206 patients with cardiovascular syncope. Of them, bradycardia was diagnosed in 50%, tachycardia in 27%, and structural disease in 23%...
May 25, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28529059/a-review-of-human-neuroimaging-investigations-involved-with-central-autonomic-regulation-of-baroreflex-mediated-cardiovascular-control
#12
Derek S Kimmerly
Effective regulation of central blood volume and arterial pressure is critical for optimal cardiovascular homeostasis. Inadequate regulation of mean arterial pressure has important pathophysiological implications including syncope, end organ damage, and stroke. Such regulation requires appropriate central integration of barosensory afferents and reflex autonomic control of the heart and blood vessels. The neural pathways involved with the baroreflex include brainstem nuclei that receive modulatory input from higher brain centres...
May 15, 2017: Autonomic Neuroscience: Basic & Clinical
https://www.readbyqxmd.com/read/28524130/-creation-of-extracranial-intracranial-microvascular-anastomosis-under-regional-anesthesia-a-case-report-and-a-review-of-the-literature
#13
D Yu Usachev, V A Lukshin, A V Shmigel'skiy, A D Akhmedov, A D Sosnin, K A Kozlova
The article describes a case of successful surgical treatment of an 81-year-old male patient with symptomatic occlusion of the internal carotid artery that led to severe impairment of cerebral hemodynamics and was accompanied by severe gait and equilibrium disorders. Given the patient's age and his positive medical history, he underwent surgery for the creation of an extracranial-intracranial microvascular anastomosis under regional anesthesia, with spontaneous breathing and a baseline level of consciousness being maintained...
2017: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
https://www.readbyqxmd.com/read/28523341/cost-of-unnecessary-testing-in-the-evaluation-of-pediatric-syncope
#14
Connor Redd, Cameron Thomas, Martha Willis, Michelle Amos, Jeffrey Anderson
Syncope is a common and a typically benign clinical problem in children and adolescents. The majority of tests ordered in otherwise healthy pediatric patients presenting with syncope have low diagnostic yield. This study quantifies testing and corresponding patient charges in a group of pediatric patients presenting for outpatient evaluation for syncope. Patients seen between 3/2011 and 4/2013 in the multi-disciplinary Syncope Clinic at Cincinnati Children's Hospital Medical Center were enrolled in a registry which was reviewed for patient information...
May 18, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28506439/clinical-review-loperamide-toxicity
#15
REVIEW
Peter E Wu, David N Juurlink
Loperamide is a nonprescription opioid widely used for the treatment of diarrhea. Although it is relatively safe at therapeutic doses, increasing reports describe its misuse and abuse at very high doses either for euphoric effects or to attenuate symptoms of opioid withdrawal. Life-threatening loperamide toxicity can result from the relatively new clinical syndrome of loperamide-induced cardiac toxicity. These patients are often young and may present in cardiac arrest or with unheralded, recurrent syncope in conjunction with ECG abnormalities, including marked QT-interval prolongation, QRS-interval widening, and ventricular dysrhythmias...
May 13, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28499865/implication-of-altered-autonomic-control-for-orthostatic-tolerance-in-sci
#16
REVIEW
Jill Maria Wecht, William A Bauman
Neural output from the sympathetic and parasympathetic branches of the autonomic nervous system (ANS) are integrated to appropriately control cardiovascular responses during routine activities of daily living including orthostatic positioning. Sympathetic control of the upper extremity vasculature and the heart arises from the thoracic cord between T1 and T5, whereas splanchnic bed and lower extremity vasculature receive sympathetic neural input from the lower cord between segments T5 and L2. Although the vasculature is not directly innervated by the parasympathetic nervous system, the SA node is innervated by post-ganglionic vagal nerve fibers via cranial nerve X...
May 3, 2017: Autonomic Neuroscience: Basic & Clinical
https://www.readbyqxmd.com/read/28496938/brugada-syndrome-risk-stratification-and-management
#17
REVIEW
Yoshifusa Aizawa
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...
October 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/28496553/does-syncope-predict-mortality-in-patients-with-acute-pulmonary-embolism-a-retrospective-review
#18
Umair Iqbal, Ayesha Jameel, Hafsa Anwar, Melissa B Scribani, Edward Bischof, Ahmad Chaudhary
BACKGROUND: Acute pulmonary embolism (APE) is a potentially fatal disease with high mortality. Prior studies have shown an increased frequency of central localization of the clot, right ventricular dysfunction and elevated troponin in patients who present with syncope and APE. Existing evidence regarding mortality and length of hospital stay in these patients is unclear. METHODS: We retrospectively reviewed electronic medical records of patients who were admitted in a tertiary care hospital in rural Upstate New York and diagnosed with APE from July 2014 to July 2016...
June 2017: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/28490286/loss-of-consciousness-collapse-and-associated-driving-restrictions-a-retrospective-case-note-review-an-important-reminder-regarding-driving-restrictions
#19
Adam Williamson, Scott Muir
Background and aims National guidelines outlining medical standards for fitness to drive are provided by The Driver and Vehicle Licensing Agency. We aimed to establish whether patients presenting with collapse or loss of consciousness received documented advice regarding driving restrictions, if appropriate for their working diagnosis. Methods and results A retrospective case note review was undertaken over a four-month period for emergency patients clinically coded as seizure/convulsion (R568) and collapse/syncope (R55X); 163 patients had a primary or working diagnosis on discharge that suggested driving status and restrictions could have been reviewed...
January 1, 2017: Scottish Medical Journal
https://www.readbyqxmd.com/read/28482693/risk-factors-for-sudden-cardiac-death-in-childhood-hypertrophic-cardiomyopathy-a-systematic-review-and-meta-analysis
#20
Gabrielle Norrish, Nicoletta Cantarutti, Eleni Pissaridou, Deborah A Ridout, Giuseppe Limongelli, Perry M Elliott, Juan Pablo Kaski
Aims To perform a systematic literature review and meta-analysis of clinical risk factors for sudden cardiac death (SCD) in childhood hypertrophic cardiomyopathy. Methods Medline and PubMed databases were searched for original articles published in English from 1963 through to December 2015 that included patients under 18 years of age with a primary or secondary end-point of either SCD or SCD-equivalent events (aborted cardiac arrest or appropriate implantable cardioverter-defibrillator discharge) or cardiovascular death (CVD)...
January 1, 2017: European Journal of Preventive Cardiology
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