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https://www.readbyqxmd.com/read/28936964/-a-case-of-large-pulmonary-embolism-in-trunk-and-branches-with-main-manifestation-of-syncope-vomiting-and-shock
#1
Rongbo Wen, Sheng Zhang, Linfeng He, Xiufeng Ji, Peng Wang, Qiuxiang Zhou, Jinlong Qu, Jun Guan, Zhaofen Lin
Pulmonary embolism (PE) refers to the endogenous or exogenous emboli blocking pulmonary trunk or branches, causing clinical and pathophysiological syndrome of pulmonary circulation disorder, the incidence rate is high. Sometimes PE patients were lack of specific symptoms and signs, or without any symptoms, which often result in misdiagnosis, un-timely diagnosis, and the delay of treatment. A PE case with syncope, vomiting and shock, which was proved to be pulmonary artery trunk and branch wide embolism later, was presented so as to improve the understanding of the disease...
September 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28931939/survival-and-prognostic-factors-in-hypertrophic-cardiomyopathy-a-meta-analysis
#2
Qun Liu, Diandian Li, Alan E Berger, Roger A Johns, Li Gao
Hypertrophic cardiomyopathy (HCM) is a clinically and genetically heterogeneous disorder but data on survival rates are still conflicting and have not so far been quantitatively reviewed. The aim of this study is to conduct a meta-analysis of cohort studies to assess pooled survival rates and prognostic factors for survival in patients with HCM. Nineteen studies were included representing 12,146 HCM patients. The pooled 1-, 3-, 5- and 10-year survival rates were 98.0%, 94.3%, 82.2% and 75.0%, respectively. Among patients with HCM, age, NYHA functional class, family history of sudden death (FHSD), syncope, atrial fibrillation, non-sustained ventricular tachycardia (nsVT), maximum left ventricular wall thickness and obstruction were significant prognostic factors for cardiovascular death...
September 20, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28930892/costs-and-trends-in-utilization-of-low-value-services-among-older-adults-with-commercial-insurance-or-medicare-advantage
#3
Elizabeth A Carter, Pamela E Morin, Keith D Lind
BACKGROUND: Overutilization of low-value services (unnecessary or minimally beneficial tests or procedures) has been cited as a large contributor to the high costs of health care in the United States. OBJECTIVES: To analyze trends in utilization of low-value services from 2009 to 2014 among commercial and Medicare Advantage (MA) enrollees 50 and older. RESEARCH DESIGN: A retrospective analysis of deidentified claims obtained from the OptumLab Data Warehouse...
September 19, 2017: Medical Care
https://www.readbyqxmd.com/read/28928046/new-directions-for-ambulatory-monitoring-following-2017-hrs-ishne-expert-consensus
#4
Emanuela T Locati
The main role of ambulatory electrocardiography (AECG) in clinical practice is to detect and characterize the behavior of cardiac electrical activity during ordinary daily life activities. Because certain rhythm abnormalities may be infrequent and paroxysmal, and may occur only during sleep or in association with mental, emotional, or exercise-induced perturbation in cardiac function, AECG needs to be recorded over a long period of time, originally lasting 24h and now expanding up to several weeks and even to months...
August 12, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/28926844/atypical-presentation-of-a-pediatric-cerebellar-ganglioglioma
#5
Richard Bram, Roberta J Seidman, David Chesler
BACKGROUND/AIMS: Gangliogliomas (GGs) are rare central nervous system tumors occurring primarily in the supratentorial compartment with infratentorial instances most often involving the brain stem. Infratentorial GGs typically present with signs and symptoms of increased intracranial pressure (ICP), cranial nerve deficits, or focal cerebellar findings; rarely, these tumors have been associated with focal seizures. METHODS: In this report, we describe an atypical presentation of a cerebellar GG in a 20-month-old male who initially presented with syncope and emesis in the absence of electrographic evidence of seizures, radiographic evidence of hydrocephalus, or elevated ICP...
September 20, 2017: Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28925543/stressful-medical-explanation-may-cause-syncope-in-patients-with-emotion-triggered-neurocardiogenic-syncope
#6
Kazuhiro Kato, Yosuke Kakisaka, Kazutaka Jin, Mayu Fujikawa, Miki Nakamura, Natsumi Suzuki, Masateru Kondo, Koji Fukuda, Hiroaki Shimokawa, Nobukazu Nakasato
No abstract text is available yet for this article.
September 19, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28925476/late-onset-pompe-disease-in-a-54-year-old-sportsman-with-an-episode-of-syncope-a-case-report
#7
M Walczak-Galezewska, D Skrypnik, M Szulinska, K Musialik, K Skrypnik, P Bogdanski
Pompe disease is an extra-rare metabolic storage disease with deficiency of acid-alpha-glucosidase (GAA) enzyme activity, which leads to the pathologic accumulation of glycogen in target tissues (skeletal muscles, heart, brain). Clinical features and severity vary by the age of onset, rate of extent of organ involvement. In the late-onset Pompe disease (LOPD) form, essential cardiomyopathy seems to be uncommon. Muscles weakness and respiratory failure are the main symptoms of adult patient with Pompe disease...
August 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28923660/factors-influencing-short-term-outcomes-for-older-patients-accessing-emergency-departments-after-a-fall-the-role-of-fall-dynamics
#8
Caterina Trevisan, Patrizia Di Gregorio, Eugenio Debiasi, Martina Pedrotti, Mario La Guardia, Enzo Manzato, Giuseppe Sergi, Albert March
BACKGROUND: While the relevance of falls in raising the risk of fractures, hospitalization and disability in older age is well recognized, the factors influencing the onset of fractures and the need for ward admission after a fall have yet to be fully elucidated. We investigated which factors and fall dynamics were mainly associated with fall-related injuries and hospitalization among elderly persons accessing the Emergency Department (ED) following a fall. METHODS: The study involved 2144 older subjects who accessed the ED after a fall...
September 13, 2017: Gait & Posture
https://www.readbyqxmd.com/read/28916422/watchful-waiting-in-aortic-stenosis-the-problem-of-acute-decompensation
#9
David S Wald, Sam Williams, Fatima Bangash, Jonathan P Bestwick
BACKGROUND: Acute decompensation with heart failure, angina or syncope may be the first indication of undiagnosed aortic stenosis, but should be uncommon when the disorder is known and managed by watchful waiting. There is a lack of information on the proportion of patients with acute decompensated aortic stenosis with and without a prior diagnosis and their outcomes. METHODS: We examined the records of patients with aortic stenosis (ICD code 135.0) admitted to three UK hospitals between January 2015 and January 2016...
September 12, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28912182/hypertrophic-obstructive-cardiomyopathy-surgical-myectomy-and-septal-ablation
#10
REVIEW
Rick A Nishimura, Hubert Seggewiss, Hartzell V Schaff
Hypertrophic cardiomyopathy is a genetic disorder characterized by marked hypertrophy of the myocardium. It is frequently accompanied by dynamic left ventricular outflow tract obstruction and symptoms of dyspnea, angina, and syncope. The initial therapy for symptomatic patients with obstruction is medical therapy with β-blockers and calcium antagonists. However, there remain a subset of patients who have continued severe symptoms, which are unresponsive to medical therapy. These patients can be treated with septal reduction therapy, either surgical septal myectomy or alcohol septal ablation...
September 15, 2017: Circulation Research
https://www.readbyqxmd.com/read/28912181/hypertrophic-cardiomyopathy-genetics-pathogenesis-clinical-manifestations-diagnosis-and-therapy
#11
REVIEW
Ali J Marian, Eugene Braunwald
Hypertrophic cardiomyopathy (HCM) is a genetic disorder that is characterized by left ventricular hypertrophy unexplained by secondary causes and a nondilated left ventricle with preserved or increased ejection fraction. It is commonly asymmetrical with the most severe hypertrophy involving the basal interventricular septum. Left ventricular outflow tract obstruction is present at rest in about one third of the patients and can be provoked in another third. The histological features of HCM include myocyte hypertrophy and disarray, as well as interstitial fibrosis...
September 15, 2017: Circulation Research
https://www.readbyqxmd.com/read/28906147/carbon-monoxide-poisoning-from-waterpipe-smoking-a-retrospective-cohort-study
#12
Lars Eichhorn, Dirk Michaelis, Michael Kemmerer, Björn Jüttner, Kay Tetzlaff
OBJECTIVE: Waterpipe smoking may increasingly account for unintentional carbon monoxide poisoning, a serious health hazard with high morbidity and mortality. We aimed at identifying waterpipe smoking as a cause for carbon monoxide poisoning in a large critical care database of a specialty care referral center. METHODS: This retrospective cohort study included patients with a history of exposure to waterpipe smoking and carbon monoxide blood gas levels >10% or presence of clinical symptoms compatible with CO poisoning admitted between January 2013 and December 2016...
September 14, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28905210/impact-of-pharmacological-spasm-provocation-test-in-patients-with-a-history-of-syncope
#13
Shozo Sueda, Hiroaki Kohno
Coronary artery spasm is involved in the pathogenesis of various cardiac disorders. We investigated patients with a history of syncope who underwent elective coronary angiography. We retrospectively analyzed 5781 consecutive patients who had diagnostic or follow-up angiography during a 26-year period. During this period, we found 95 patients with a history of syncope before elective coronary angiography. Pharmacological spasm provocation testing was performed in 64 patients with a history of syncope (<1 year)...
September 13, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/28904457/delayed-orthostatic-hypotension-a-pilot-study-from-india
#14
Arun Grace Roy, Siby Gopinath, Suresh Kumar, Sudheeran Kannoth, Anand Kumar
INTRODUCTION: Orthostatic hypotension is defined as a sustained decrease in systolic blood pressure of 20 mm Hg or a decrease in diastolic blood pressure of 10 mm Hg within three minutes of standing compared with blood pressure from the sitting or supine position or by head-up tilt-table testing (1). When sustained blood pressure (BP) drop is after three minutes of upright posture it is called delayed orthostatic hypotension (delayed OH) (2). AIM OF THE STUDY: To detect the incidence of delayed orthostatic hypotension in patients referred to our autonomic lab...
July 2017: Annals of Indian Academy of Neurology
https://www.readbyqxmd.com/read/28903327/pericardial-effusion-is-correlated-with-clinical-outcome-after-pulmonary-artery-denervation-for-pulmonary-arterial-hypertension
#15
Shao-Liang Chen, Hang Zhang, Du-Jiang Xie, Juan Zhang, Ling Zhou, Meng-Xuan Chen, Gregg W Stone
OBJECTIVES: Pericardial effusion (PE) is correlated with outcomes in patients with pulmonary arterial hypertension (PAH). Pulmonary artery denervation (PADN) was used for treatment of PAH. The present study aimed to analyze the prognostic value of PE for outcomes after PADN in patients with WHO Group I, Group II and Group IV PAH. RESULTS: PE, frequently seen in patients with connective tissue disease, was featured by fast heart rate, decreased exercise capacity, more syncope, worsening pulmonary arterial hemodynamic and right atrium size...
August 15, 2017: Oncotarget
https://www.readbyqxmd.com/read/28901628/total-cosine-r-to-t-for-predicting-ventricular-arrhythmic-and-mortality-outcomes-a-systematic-review-and-meta-analysis
#16
Gary Tse, Mengqi Gong, Cheuk Wai Wong, Cynthia Chan, Stamatis Georgopoulos, Yat Sun Chan, Bryan P Yan, Guangping Li, Paula Whittaker, Ana Ciobanu, Sadeq Ali-Hasan-Al-Saegh, Sunny H Wong, William K K Wu, George Bazoukis, Konstantinos Lampropoulos, Wing Tak Wong, Lap Ah Tse, Adrian M Baranchuk, Konstantinos P Letsas, Tong Liu
BACKGROUND: The total cosine R-to-T (TCRT), a vectorcardiographic marker reflecting the spatial difference between the depolarization and repolarization wavefronts, has been used to predict ventricular tachycardia/fibrillation (VT/VF) and sudden cardiac death (SCD) in different clinical settings. However, its prognostic value has been controversial. OBJECTIVE: This systematic review and meta-analysis evaluated the significance of TRCT in predicting arrhythmic and/or mortality endpoints...
September 12, 2017: Annals of Noninvasive Electrocardiology
https://www.readbyqxmd.com/read/28900842/early-postictal-serum-lactate-concentrations-are-superior-to-serum-creatine-kinase-concentrations-in-distinguishing-generalized-tonic-clonic-seizures-from-syncopes
#17
Oliver Matz, Jan Heckelmann, Sebastian Zechbauer, Jens Litmathe, Jörg C Brokmann, Klaus Willmes, Jörg B Schulz, Manuel Dafotakis
Concentrations of serum creatine kinase (CK) and serum lactate are frequently measured to help differentiate between generalized tonic-clonic seizures (GTCS) and syncope. The aim of this prospective cohort study was to systematically compare these two markers. The primary outcome is the measurement of serum lactate and CK in blood samples drawn within 2 h of the event in patients admitted with either a GTCS (n = 49) or a syncope (n = 36). Furthermore, the specificity and sensitivity of serum lactate and CK are determined as diagnostic markers in distinguishing between GTCS and syncope...
September 12, 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28900547/chagas-cardiomyopathy-presenting-as-symptomatic-bradycardia-an-underappreciated-emerging-public-health-problem-in-the-united-states
#18
Richard Jesse Durrance, Tofura Ullah, Zulekha Atif, William Frumkin, Kaushik Doshi
Chagas cardiomyopathy (CCM) is traditionally considered a disease restricted to areas of endemicity. However, an estimated 300,000 people living in the United States today have CCM, of which its majority is undiagnosed. We present a case of CCM acquired in an endemic area and detected in its early stage. A 42-year-old El Salvadoran woman presented with recurrent chest pain and syncopal episodes. Significant family history includes a sister in El Salvador who also began suffering similar episodes. Physical exam and ancillary studies were only remarkable for sinus bradycardia...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/28895151/role-of-closed-loop-stimulation-pacing-cls-in-vasovagal-syncope
#19
REVIEW
Mohammed Ruzieh, Zaid Ammari, Osama Dasa, Saima Karim, Blair Grubb
Vasovagal syncope (VVS) or neurocardiogenic syncope is defined by transient loss of consciousness with spontaneous and rapid recovery. Recently, a closed loop stimulation pacing system (CLS) has emerged as a new strategy which appears superior to conventional pacing for patients with refractory syncope. However, it's efficacy remains of considerable debate and large randomized controlled clinical trials are needed. Between 2002 and 2017, 12 total studies evaluated the use of CLS pacing in patients with refractory VVS, and are summarized in this article...
September 12, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28891553/hyperthyroidism-and-sick-sinus-syndrome-a-rare-but-challenging-association-a-study-of-three-cases
#20
M Tudoran, C Tudoran
Hyperthyroidism is usually associated with sinus tachycardia or supraventricular tachyarrhythmias, but rarely with dysfunction of the sinus node or other conduction disturbances. Evidence of bradyarrhythmia in patients with hyperthyroidism is clinically relevant, but the fact that several drugs with negative chronotropic effects (beta-blockers and calcium channel antagonists) are frequently used in the management of these patients must be taken into account. In the presence of sick sinus syndrome (SSS) or other conductance disturbances, therapy with agents that delay the activity of sinus node or atrioventricular conduction can lead to extreme bradycardia with syncope...
August 2017: Nigerian Journal of Clinical Practice
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