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Emergency cardiology

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https://www.readbyqxmd.com/read/28513209/caregiver-determinants-of-patient-clinical-event-risk-in-heart-failure
#1
Julie T Bidwell, Ercole Vellone, Karen S Lyons, Fabio D'Agostino, Barbara Riegel, Marco Paturzo, Shirin O Hiatt, Rosaria Alvaro, Christopher S Lee
BACKGROUND: Preventing hospitalization and improving event-free survival are primary goals of heart failure (HF) treatment according to current European Society of Cardiology guidelines; however, substantial uncertainty remains in our ability to predict risk and improve outcomes. Although caregivers often assist patients to manage their HF, little is known about their influence on clinical outcomes. AIMS: To quantify the influence of patient and caregiver characteristics on patient clinical event risk in HF...
May 1, 2017: European Journal of Cardiovascular Nursing
https://www.readbyqxmd.com/read/28513114/when-cardioversion-may-be-complicated
#2
Marina Leitman, Vladimir Tyomkin, Eli Peleg, Therese Fuchs, Ziad Gabara, Zvi Vered
BACKGROUND: In recent years cardioversion of atrial fibrillation has become a routine procedure, enabling symptomatic functional improvement in most cases. However, some patients develop complications after cardioversion. Identifying these individuals is an important step toward improving patient outcome. OBJECTIVES: To characterize those patients who may not benefit from cardioversion or who may develop complications following cardioversion. METHODS: We retrospectively analyzed 186 episodes of cardioversion in 163 patients with atrial fibrillation who were admitted to our cardiology department between 2008 and 2013 based on their clinical and echocardiographic data...
May 2017: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/28507228/understanding-principles-of-integration-and-segregation-using-whole-brain-computational-connectomics-implications-for-neuropsychiatric-disorders
#3
REVIEW
Louis-David Lord, Angus B Stevner, Gustavo Deco, Morten L Kringelbach
To survive in an ever-changing environment, the brain must seamlessly integrate a rich stream of incoming information into coherent internal representations that can then be used to efficiently plan for action. The brain must, however, balance its ability to integrate information from various sources with a complementary capacity to segregate information into modules which perform specialized computations in local circuits. Importantly, evidence suggests that imbalances in the brain's ability to bind together and/or segregate information over both space and time is a common feature of several neuropsychiatric disorders...
June 28, 2017: Philosophical Transactions. Series A, Mathematical, Physical, and Engineering Sciences
https://www.readbyqxmd.com/read/28507227/when-two-wrongs-make-a-right-synchronized-neuronal-bursting-from-combined-electrical-and-inhibitory-coupling
#4
Reimbay Reimbayev, Kevin Daley, Igor Belykh
Synchronized cortical activities in the central nervous systems of mammals are crucial for sensory perception, coordination and locomotory function. The neuronal mechanisms that generate synchronous synaptic inputs in the neocortex are far from being fully understood. In this paper, we study the emergence of synchronization in networks of bursting neurons as a highly non-trivial, combined effect of electrical and inhibitory connections. We report a counterintuitive find that combined electrical and inhibitory coupling can synergistically induce robust synchronization in a range of parameters where electrical coupling alone promotes anti-phase spiking and inhibition induces anti-phase bursting...
June 28, 2017: Philosophical Transactions. Series A, Mathematical, Physical, and Engineering Sciences
https://www.readbyqxmd.com/read/28503386/mechanical-thrombectomy-for-acute-ischemic-stroke-after-cardiac-surgery
#5
Ali S Haider, Prabhat Garg, Ian T Watson, Dean Leonard, Umair Khan, Ahmed Haque, Phu Nguyen, Kennith F Layton
Ischemic stroke is a rare yet devastating complication that may occur following cardiothoracic surgery. Fibrinolytic treatment is contraindicated due to elevated risk for hemorrhage. Mechanical thrombectomy entails a catheterized approach wherein the thrombus is physically removed from the vessel without the use of fibrinolytics, minimizing the possibility of intracranial hemorrhage. Here, we present two original cases of mechanical thrombectomy as treatment for patients experiencing emergent large vessel occlusion following cardiothoracic surgery...
April 11, 2017: Curēus
https://www.readbyqxmd.com/read/28498904/the-acef-ii-risk-score-for-cardiac-surgery-updated-but-still-parsimonious
#6
Marco Ranucci, Valeria Pistuddi, Sabino Scolletta, Carlo de Vincentiis, Lorenzo Menicanti
Aims: The age, creatinine, and ejection fraction (ACEF) score was introduced in 2009 and is presently included in the guidelines for myocardial revascularization of the European Society of Cardiology and Association for Cardio-Thoracic Surgery as a risk stratification tool for surgical and percutaneous myocardial revascularization. The present study introduces an updated version of the ACEF (ACEF II) inclusive of emergency surgery and pre-operative anaemia. Methods and results: The development series includes 7011 consecutive cardiac surgery patients operated at a single institution...
May 12, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28498030/prevalence-of-anemia-and-its-influence-on-hospital-readmissions-and-emergency-department-visits-in-outpatients-with-heart-failure
#7
Youn-Jung Son, Bo Hwan Kim
BACKGROUND: Anemia is a frequent comorbidity in patients with heart failure. However, the incidence of anemia in patients with heart failure varies widely, and there is limited evidence on the association between anemia and rehospitalization and on the health consequences of anemia in patients with heart failure. AIMS: We aimed to identify the prevalence of anemia and its influence on hospital readmissions and emergency department visits in outpatients with heart failure...
May 1, 2017: European Journal of Cardiovascular Nursing
https://www.readbyqxmd.com/read/28472598/supportive-cardiology-moving-palliative-care-upstream-for-patients-living-with-advanced-heart-failure
#8
Warren Harris Lewin, Wendy Cheung, A Nina Horvath, Shana Haberman, Archna Patel, Dorothy Sullivan
Heart failure (HF) affects ∼600,000 Canadians and is a chronic, life-limiting illness marked by exacerbations of distressing symptoms requiring acute medical management, typically sought in Canada's emergency departments. HF often has an unpredictable illness trajectory and is a chronic terminal illness with a poor prognosis. Patients living with advanced HF have difficulty in accessing palliative care (PC) supports, which can result in unnecessary suffering as their HF progresses and they near end of life (EOL)...
May 4, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28471545/eleven-year-trends-of-inpatient-pacemaker-implantation-in-patients-diagnosed-with-sick-sinus-syndrome
#9
Avirup Guha, Xiao Xiang, Devin Haddad, Benjamin Buck, Xu Gao, Michael Dunleavy, Ellen Liu, Dilesh Patel, Vadim V Fedorov, Emile G Daoud
BACKGROUND: Pacemakers (PM) are used for managing sick sinus syndrome (SSS). This study evaluates predictors and trends of PM implantation for SSS. METHODS: Patients were identified from the National Inpatient Sample dataset (2003-13). Included patients were ≥18 years old, had a diagnosis of sinus node dysfunction and atrial arrhythmia (i.e., SSS). Patients who died, transferred out, who had prior device or had a defibrillator or resynchronization therapy device implanted were excluded...
May 4, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28460039/prognostic-value-of-elevated-high-sensitivity-cardiac-troponin-t-in-patients-admitted-to-an-emergency-department-with-atrial-fibrillation
#10
Kiril M Stoyanov, Evangelos Giannitsis, Moritz Biener, Matthias Mueller-Hennessen, Katharina Arens, Hugo A Katus, Mehrshad Vafaie
Aims: Elevated levels of high-sensitivity cardiac troponin T (hsTnT) indicate underlying heart disease and are known to predict adverse outcomes in various patient populations. Their role in atrial fibrillation (AF) is still under debate. Methods and results: This retrospective study included 2898 consecutive patients presenting with AF to the emergency department of the Department of Cardiology, Heidelberg University Hospital. Multivariable Cox regression was used to assess associations between hsTnT and mortality...
April 27, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28458558/impact-of-around-the-clock-in-house-cardiology-fellow-coverage-on-door-to-balloon-time-in-an-academic-medical-center
#11
Luke C Kohan, Vijaiganesh Nagarajan, Michael A Millard, Michael J Loguidice, Nancy M Fauber, Ellen C Keeley
OBJECTIVES: To assess if a change in our cardiology fellowship program impacted our ST elevation myocardial infarction (STEMI) program. BACKGROUND: Fellows covering the cardiac care unit were spending excessive hours in the hospital while on call, resulting in increased duty hours violations. A night float fellow system was started on July 1, 2012, allowing the cardiac care unit fellow to sign out to a night float fellow at 5:30 pm. The night float fellow remained in-house until the morning...
2017: Vascular Health and Risk Management
https://www.readbyqxmd.com/read/28457798/cardiology-consultation-in-the-emergency-department-reduces-re-hospitalizations-for-low-socioeconomic-patients-with-acute-decompensated-heart-failure
#12
Corey E Tabit, Mitchell J Coplan, Kirk T Spencer, Charina F Alcain, Thomas Spiegel, Adam S Vohra, Daniel Adelman, James K Liao, Rupa Mehta Sanghani
BACKGROUND: Re-hospitalization after discharge for acute decompensated heart failure is a common problem. Low-socioeconomic urban patients suffer high rates of re-hospitalization and often over-utilize the Emergency Department (ED) for their care. We hypothesized that early consultation with a cardiologist in the ED can reduce re-hospitalization and healthcare costs for low-socioeconomic urban patients with acute decompensated heart failure. METHODS: 392 patients treated at our center for acute decompensated heart failure received standardized education and follow-up...
April 27, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28454832/rationale-and-design-of-the-coronary-computed-tomographic-angiography-for-selective-cardiac-catheterization-relation-to-cardiovascular-outcomes-cost-effectiveness-and-quality-of-life-conserve-trial
#13
Sang-Eun Lee, Fay Y Lin, Yao Lu, Hyuk-Jae Chang, James K Min
Although coronary computed tomography angiography (CCTA) has shown promise as a "gatekeeper" to invasive coronary angiography (ICA) in longitudinal cohort studies, it remains unknown whether the strategy of selective ICA by initial performance of CCTA is either safe or effective when compared with a direct ICA strategy in patients with an American Heart Association (AHA)/American College of Cardiology (ACC) guideline-directed indication for ICA. OBJECTIVES: The CONSERVE trial is a prospective randomized multicenter trial to determine the clinical effectiveness of "selective catheterization" vs "direct catheterization" strategies for stable patients with suspected but without known coronary artery disease, who meet AHA/ACC guideline indication for ICA...
April 2017: American Heart Journal
https://www.readbyqxmd.com/read/28453817/epidemiology-of-sudden-cardiac-death-in-cameroon-the-first-population-based-cohort-survey-in-sub-saharan-africa
#14
Aimé Bonny, Kemi Tibazarwa, Samuel Mbouh, Jonas Wa, Réné Fonga, Cecile Saka, Marcus Ngantcha
Background: Incidence estimates of sudden cardiac death (SCD) in sub-Saharan Africa (SSA) are unknown. Method: Over 12 months, the household administrative office and health community committee within neighbourhoods in two health areas of Douala, Cameroon, registered all deaths among 86 188 inhabitants aged >18 years. As part of an extended multi-source surveillance system, the Emergency Medical Service (EMS), local medical examiners and district hospital mortuaries were also surveyed...
April 26, 2017: International Journal of Epidemiology
https://www.readbyqxmd.com/read/28453186/emergency-physicians-are-able-to-detect-right-ventricular-dilation-with-good-agreement-compared-to-cardiology
#15
Matt A Rutz, Julie M Clary, Jeffrey A Kline, Frances M Russell
OBJECTIVE: Focused cardiac ultrasound (FOCUS) is a useful tool in evaluating patients presenting to the emergency department (ED) with acute dyspnea. Prior work has shown that right ventricular (RV) dilation is associated with repeat hospitalizations and shorter life expectancy. Traditionally, RV assessment has been evaluated by cardiologist-interpreted comprehensive echocardiography. The primary goal of this study was to determine the interrater reliability between emergency physicians (EPs) and a cardiologist for determining RV dilation on FOCUS performed on ED patients with acute dyspnea...
April 28, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28451824/heart-failure-guidelines-on-pharmacotherapy
#16
Lampros Papadimitriou, Carine E Hamo, Javed Butler
Heart Failure (HF) is a serious emerging Public Health issue mainly in the high-income countries. In the USA, more than 6 million adults are affected. Despite the latest advances in device and pharmacological therapeutics, it still carries a huge burden, partially reflected in the annual healthcare cost of approximately $30 billion (2012) and the 5 year mortality rate of 50%. In this article, we review the medications, proven to significantly reduce mortality and morbidity in HF patients with structural myocardial disease and past or current symptoms, based on the latest North American HF guidelines...
April 28, 2017: Handbook of Experimental Pharmacology
https://www.readbyqxmd.com/read/28436859/in-vivo-intracardiac-vector-velocity-imaging-using-phased-array-transducers-for-pediatric-cardiology
#17
Solveig Fadnes, Morten Wigen, Siri Ann Nyrnes, Lasse Lovstakken
Two-dimensional blood speckle tracking has shown promise for measuring complex flow patterns in neonatal hearts using linear arrays and high-frame-rate plane wave imaging. For general pediatric applications, however, the need for phased array probes emerges due to the limited intercostal acoustic window available. In this work, a clinically approved real-time duplex imaging setup with phased array probes was used to investigate the potential of blood speckle tracking for 2-D vector velocity imaging of children with congenital heart disease...
April 24, 2017: IEEE Transactions on Ultrasonics, Ferroelectrics, and Frequency Control
https://www.readbyqxmd.com/read/28432194/diagnostic-value-of-prehospital-ecg-in-acute-stroke-patients
#18
Tobias Bobinger, Bernd Kallmünzer, Markus Kopp, Natalia Kurka, Martin Arnold, Stefan Heider, Stefan Schwab, Martin Köhrmann
OBJECTIVE: To investigate the diagnostic yield of prehospital ECG monitoring provided by emergency medical services in the case of suspected stroke. METHODS: Consecutive patients with acute stroke admitted to our tertiary stroke center via emergency medical services and with available prehospital ECG were prospectively included during a 12-month study period. We assessed prehospital ECG recordings and compared the results to regular 12-lead ECG on admission and after continuous ECG monitoring at the stroke unit...
April 21, 2017: Neurology
https://www.readbyqxmd.com/read/28429248/time-in-therapeutic-range-as-a-marker-for-thrombotic-and-bleeding-outcomes-in-fontan-patients
#19
Jenna M Faircloth, Kristin M Miner, Tarek Alsaied, Nicole Nelson, Julie Ciambarella, Tomoyuki Mizuno, Joseph S Palumbo, Alexander A Vinks, Gruschen R Veldtman
Fontan patients managed with warfarin are at risk not only for thrombotic events, but also for bleeding episodes as a consequence of anticoagulation treatment. The aim of this study was to determine whether time spent in patient specified therapeutic range (TTR), when managed in a cardiology-based pharmacist managed anticoagulation clinic (PMAC), is a useful target metric for monitoring, as well as improving outcomes. A single center retrospective review was conducted evaluating TTR of all Fontan patients (n = 45) on warfarin managed in our outpatient cardiology pharmacist managed anticoagulation clinic (PMAC) during a 19 month time frame...
April 20, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28414664/gonococcal-endocarditis-the-gift-that-stops-giving-an-uncommon-presentation-of-a-common-disease
#20
G Olayemi, M Oferczak, A Elagizi, I El-Abbassi, M Eschete, J Crowe
INTRODUCTION: Gonorrhea is the 2nd most common sexually transmitted disease in the US with 800,000 cases of gonorrhea each year. Disseminated gonorrhea infection occurs in 0.5 percent - 3 percent of these patients and is more frequent in woman younger than 40 years of age. CASE: A 36 year old woman with a history of polysubstance abuse presented with 10 day history of feeling generally unwell. At presentation, vitals were remarkable for tachycardia and hypotension...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
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