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Emergency cardiology

S Tatishvili, M Sinitsa, R Jorbendaze, G Kavtaradze
Severe infarction or its consequences are considered as triggering factors of incidental depression. The aim of our study was to reveal factors associated with depressive episode in patients hospitalized with acute coronary syndrome (acute myocardial infarction, unstable angina). The Beck Depression inventory (BDI) was used for assessment of depressive symptoms in patients with coronary disease in Emergency Cardiology Clinic Tbilisi, Georgia. The study sample included 84 patients. The clinical Information was collected from hospital recordings...
September 2016: Georgian Medical News
Alison S Witkin, Savanah Harshbarger, Christopher Kabrhel
Pulmonary embolism is a common and often life-threatening event. Treatment options include anticoagulation alone, catheter-directed therapies, and surgical thromboembolectomy. While guidelines exist, there is often controversy over which treatment is most appropriate, particularly for intermediate-risk patients. The traditional care model, in which the primary team is responsible for consulting the appropriate specialists, may be inadequate and inefficient for emergent situations, as ensuring coordination and communication between various consulting services can be a time consuming and confusing process...
October 21, 2016: Seminars in Thrombosis and Hemostasis
Afsin Emre Kayipmaz, Orcun Ciftci, Cemil Kavalci, Emir Karacaglar, Haldun Muderrisoglu
BACKGROUND: This study aimed to explore the ST segment elevation myocardial infarction (STEMI) management practices of emergency medicine specialists working in various healthcare institutions of seven different geographical regions of Turkey, and to examine the characteristics of STEMI presentation and patient admissions in these regions. METHODS: We included 225 emergency medicine specialists working in all geographical regions of Turkey. We e-mailed them a 20-item questionnaire comprising questions related to their STEMI management practices and characteristics of STEMI presentation and patient admissions...
2016: PloS One
Shirley J Ingram, Gabrielle McKee, Mary B Quirke, Niamh Kelly, Ashling Moloney
BACKGROUND: Chest pain is a common presentation to emergency departments (EDs). Pathways for patients with non-acute coronary syndrome (ACS) chest pain are not optimal. An advanced cardiology nurse-led chest pain service was commenced to address this. The aim of the study was to assess the outcomes of non-ACS patients discharged from ED to an advanced cardiology nurse-led chest pain clinic and compare by referral type (nurse or ED physician). METHODS: The service consisted of advanced cardiology nurse or ED physician consultation in the ED and discharge to advanced nurse-led chest pain clinic review less than 72 hours after discharge...
October 14, 2016: Journal of Cardiovascular Nursing
John W Pickering, Jaimi H Greenslade, Louise Cullen, Dylan Flaws, William Parsonage, Sally Aldous, Peter George, Andrew Worster, Peter A Kavsak, Martin P Than
BACKGROUND: -The European Society of Cardiology (ESC) new guidelines to rule-in and rule-out acute myocardial infarction (AMI) in the emergency department (ED) include a rapid assessment algorithm based on high-sensitivity cardiac troponin and sampling at zero and one hour. ED physicians require very high sensitivity to confidently rule-out AMI, while cardiologists aim to minimise false positive results. METHODS: -High-sensitivity troponin I (hs-cTnI) and T (hs-cTnT) assays were used to measure troponin concentrations in patients presenting with chest-pain symptoms and being investigated for possible acute coronary syndrome at hospitals in New Zealand, Australia and Canada...
October 17, 2016: Circulation
W Kelly Wu, Maame Yaa A B Yiadom, Sean P Collins, Wesley H Self, Ken Monahan
INTRODUCTION: A triage cardiology program, in which cardiologists provide consultation to the Emergency Department (ED), may safely reduce admissions. For patients with chest pain, the HEART Pathway may obviate the need for cardiology involvement, unless there is a difference between ED and cardiology assessments. Therefore, in a cohort concurrently evaluated by both specialties, we analyzed discordance between ED and cardiology HEART scores. METHODS: We performed a single-center, cross-sectional, retrospective study of adults presenting to the ED with chest pain who had a documented bedside evaluation by a triage cardiologist...
September 28, 2016: American Journal of Emergency Medicine
Judith Barasche, Fabiola Stollar, Marcel M Bergmann, Jean-Christoph Caubet
In infants, the causes of acute repetitive vomiting and severely altered-consciousness status include a broad differential diagnosis, that is, primarly sepsis, infectious gastroenteritis, head injury, and intoxication, as well as neurologic, metabolic, and cardiologic condition diseases. In patients developing such symptoms, allergy as an etiological cause is often not considered by primary care physicians. With this case report, we aim to draw the attention of general pediatricians, emergency physicians, and intensivists to the fact that non-immunoglobulin E-mediated food allergic gastrointestinal disorders such as food protein-induced enterocolitis syndrome should be considered in patients with sepsis-like symptoms...
October 6, 2016: Pediatric Emergency Care
Géraldine Layani, Richard Fleet, Renée Dallaire, Fatoumata K Tounkara, Julien Poitras, Patrick Archambault, Jean-Marc Chauny, Mathieu Ouimet, Josée Gauthier, Gilles Dupuis, Alain Tanguay, Jean-Frédéric Lévesque, Geneviève Simard-Racine, Jeannie Haggerty, France Légaré
BACKGROUND: Evidence-based indicators of quality of care have been developed to improve care and performance in Canadian emergency departments. The feasibility of measuring these indicators has been assessed mainly in urban and academic emergency departments. We sought to assess the feasibility of measuring quality-of-care indicators in rural emergency departments in Quebec. METHODS: We previously identified rural emergency departments in Quebec that offered medical coverage with hospital beds 24 hours a day, 7 days a week and were located in rural areas or small towns as defined by Statistics Canada...
July 2016: CMAJ Open
Ashley Pender, Donald M Lloyd-Jones, Neil J Stone, Philip Greenland
Guidelines from the American College of Cardiology/American Heart Association, as well as those from the Veterans Affairs/Department of Defense and the Joint British Societies all recommended treating more people with statins than previous guidelines. In each guideline, the decision-making process began with an assessment of overall cardiovascular risk. Each group proposed updated treatment thresholds, and all of them lowered the threshold compared with earlier guidelines. Since release of these new guidelines in 2013 and 2014, additional evidence has emerged to suggest a rationale for extending statin consideration to an even larger proportion of asymptomatic adults-even those with a 10-year atherosclerotic cardiovascular disease risk below 7...
October 11, 2016: Journal of the American College of Cardiology
Leah Raj, Bhavin Adhyaru
An estimated 5.1 million Americans have chronic heart failure and this is expected to increase 25% by 2030. Heart failure is a clinical syndrome that evolves from either functional or structural changes to the ventricles that lead to filling or ejection abnormalities. Thus far, pharmacotherapy has been show to be beneficial in patients only with reduced ejection fraction; however, new therapies have been developed in hopes of reducing the burden of heart failure. In this review, we will discuss current pharmacotherapies recommended in American College of Cardiology/American Heart Association guidelines, the evidence behind these recommendations as well as new and emerging therapies that have been developed...
October 5, 2016: Postgraduate Medical Journal
Francisco González-Vílchez, Javier Segovia Cubero, Luis Almenar, María G Crespo-Leiro, José M Arizón, Iago Sousa, Juan Delgado, Eulalia Roig, José Manuel Sobrino, José González-Costello
INTRODUCTION AND OBJECTIVES: The present article reports the characteristics and results of heart transplants in Spain since this therapeutic modality was first used in May 1984. METHODS: We describe the main features of recipients, donors, surgical procedures, and results of all heart transplants performed in Spain until December 31, 2015. RESULTS: A total of 299 cardiac transplants were performed in 2015, with the whole series comprising 7588 procedures...
October 1, 2016: Revista Española de Cardiología
Laura Cluzol, Jennifer Cautela, Pierre Michelet, Antoine Roch, François Kerbaul, Julien Mancini, Marc Laine, Michael Peyrol, Floriane Robin, Franck Paganelli, Laurent Bonello, Franck Thuny
BACKGROUND: Acute heart failure (AHF) is a life-threatening medical emergency for which no new effective therapies have emerged in recent decades. No previous study has exhaustively described the entire course of care of AHF patients from first medical contact to hospital discharge or assessed its impact on prognosis. AIM: To fully describe the course of care and analyze its influence on outcomes in patients hospitalized with an AHF syndrome in an academic university center...
September 29, 2016: Archives of Cardiovascular Diseases
François Delahaye
Half of patients with infectious endocarditis have surgery during the active phase of infective endocarditis (before the end of antibiotic therapy). The American Heart Association and the European Society of Cardiology, independently from each other, have published guidelines in September 2015. As regards surgical indications, these guidelines are similar. The surgical indication must be a common decision of a multidisciplinary team of experts in cardiology, cardiac surgery, imaging and infectious diseases...
September 26, 2016: La Presse Médicale
Troy Madsen, Cameron Smyres, Talmage Wood, Tamara Moores, Matthew Fuller, Virgil Davis, Kurt Bernhisel
BACKGROUND: In evaluating patients with chest pain, emergency department observation units (EDOUs) may use a staffing model in which emergency physicians determine patient testing (EP model) or a model similar to a chest pain unit (CPU) in which cardiologists determine provocative testing (CPU model). METHODS: We performed a prospective study with 30-day telephone follow-up for all chest pain patients placed in our EDOU. Halfway through the study period, our EDOU transitioned from an EP model to a CPU model...
September 17, 2016: American Journal of Emergency Medicine
Vicente Giner-Galvañ, María José Esteban-Giner, Vicente Pallarés-Carratalá
Modern medicine is characterized by a continuous genesis of evidence making it very difficult to translate the latest findings into a better clinical practice. Clinical practice guidelines (CPG) emerge to provide clinicians evidence-based recommendations for their daily clinical practice. However, the high number of existing CPG as well as the usual differences in the given recommendations usually increases the clinician's confusion and doubts. It has apparently been the case for the 2013 American College of Cardiology/American Heart Association (ACC/AHA) Guideline on the Treatment of Blood Cholesterol...
2016: Vascular Health and Risk Management
Jonathan A Drezner, Francis G O'Connor, Kimberly G Harmon, Karl B Fields, Chad A Asplund, Irfan M Asif, David E Price, Robert J Dimeff, David T Bernhardt, William O Roberts
Cardiovascular screening in young athletes is widely recommended and routinely performed prior to participation in competitive sports. While there is general agreement that early detection of cardiac conditions at risk for sudden cardiac arrest and death (SCA/D) is an important objective, the optimal strategy for cardiovascular screening in athletes remains an issue of considerable debate. At the centre of the controversy is the addition of a resting ECG to the standard preparticipation evaluation using history and physical examination...
September 22, 2016: British Journal of Sports Medicine
Markus Schwaiger, Karl Kunze, Christoph Rischpler, Stephan G Nekolla
After the successful introduction of PET/CT as a multimodality imaging technique, PET/MR has subsequently emerged as an attractive instrumentation for applications in neurology, oncology, and cardiology. Simultaneous data acquisition combining structural, functional, and molecular imaging provides a unique platform to link various aspects of cardiac performance for the non-invasive characterization of cardiovascular disease phenotypes. Specifically, tissue characterization by MR techniques with and without contrast agents allows for functional parameters such as LGE, myocardial perfusion, and T1 maps as well as an estimate of extracellular volume...
September 22, 2016: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
Shaun Mohan, Deipanjan Nandi, Paul Stephens, Mirna MʼFarrej, R Lee Vogel, Christopher P Bonafide
OBJECTIVE: To evaluate the impact of a pediatric emergency department (ED) chest pain clinical pathway on resource utilization. METHODS: Motivated by perceived overuse of cardiology consultation for non-cardiac chest pain in the ED, clinicians from the Divisions of Cardiology and Emergency Medicine collaboratively developed a chest pain clinical pathway, educated staff, and implemented the pathway on March 1, 2014. We reviewed records of children aged 3 to 18 years without prior diagnoses of heart disease who presented to the ED with chest pain between March 1, 2013, and April 22, 2015...
September 20, 2016: Pediatric Emergency Care
Marie-Pierre St-Onge, Michael A Grandner, Devin Brown, Molly B Conroy, Girardin Jean-Louis, Michael Coons, Deepak L Bhatt
Sleep is increasingly recognized as an important lifestyle contributor to health. However, this has not always been the case, and an increasing number of Americans choose to curtail sleep in favor of other social, leisure, or work-related activities. This has resulted in a decline in average sleep duration over time. Sleep duration, mostly short sleep, and sleep disorders have emerged as being related to adverse cardiometabolic risk, including obesity, hypertension, type 2 diabetes mellitus, and cardiovascular disease...
September 19, 2016: Circulation
Tahar Chouihed, Stéphane Manzo-Silberman, Nicolas Peschanski, Sandrine Charpentier, Meyer Elbaz, Dominique Savary, Eric Bonnefoy-Cudraz, Said Laribi, Patrick Henry, Nicolas Girerd, Faiez Zannad, Carlos El Khoury
BACKGROUND: An appropriate diagnostic process is crucial for managing patients with acute heart failure (AHF) in emergency department (ED). Our study aims to describe the characteristics and therapeutic management of patients admitted to the ED for dyspnea suspected to have AHF, their in-hospital pathway of care and their in-hospital outcome. METHODS: Consecutive patients admitted in 26 French ED for dyspnea suspected to be the consequence of AHF, prior to in hospital diagnostic test, were prospectively included at the time of their admission in the DeFSSICA Survey...
September 17, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
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