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https://www.readbyqxmd.com/read/28646403/routine-ct-angiography-to-detect-severe-coronary-artery-disease-prior-to-transcatheter-aortic-valve-replacement
#1
S Chava, G Gentchos, A Abernethy, B Leavitt, E Terrien, H L Dauerman
Patients undergoing TAVR undergo routine CT angiography (CTA) to assess aorto-iliac pathology and annular dimensions. While coronary CTA may exclude severe CAD in younger patients, its efficacy in defining CAD severity prior to TAVR may be limited. We retrospectively studied 50 consecutive patients undergoing both invasive coronary angiography (ICA) and routine pre-TAVR CTA. Severe CAD was defined as ≥50% stenosis by quantitative coronary angiography and compared to a blinded CTA visual estimation of ≥50% stenosis...
June 23, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28638298/uncertainty-of-myocardial-perfusion-imaging-in-chest-pain-risk-stratification
#2
Htoo Kyaw, Sivacharan Buddhavarapu, Joseph Abboud, Deepika Misra
BACKGROUND: Chest pain is a common presenting symptom in the emergency department (ED). Although the diagnostic workup for chest pain is well established, the best time to perform invasive cardiac catheterization in patients with low to moderate risk of coronary artery disease is still unclear, particularly if noninvasive tests such as the electrocardiogram (ECG) and nuclear myocardial perfusion scan show nonsignificant findings. CASE REPORT: We present the case of a 52-year-old female who presented to the ED with acute-onset chest pain that had started early in the morning while she was sleeping...
2017: Ochsner Journal
https://www.readbyqxmd.com/read/28636511/feasibility-of-low-dose-coronary-computed-tomographic-angiography-used-in-atrial-fibrillation-patients
#3
Chenglin Zhao, Mengxi Jiang, Jianxin Liu, Li Gao, Xiaoying Wang
OBJECTIVE: The diagnosis of coronary artery disease (CAD) in atrial fibrillation (AF) patients using coronary computed tomography angiography (CCTA) requires a large exposure dosage or repeated examinations. This study evaluates the feasibility of using low-dose CCTA in the double prospectively ECG-triggered high-pitch spiral acquisition mode (Double Flash Spiral mode). METHODS: Twenty-eight AF patients with suspected CAD were recruited. Double Flash Spiral mode (tube voltage 100 kVp) and iterative reconstruction was used for CCTA examination...
March 21, 2017: Acta Cardiologica
https://www.readbyqxmd.com/read/28628659/wave-intensity-of-aortic-root-pressure-as-diagnostic-marker-of-left-ventricular-systolic-dysfunction
#4
Bernhard Hametner, Stephanie Parragh, Thomas Weber, Siegfried Wassertheurer
BACKGROUND: Systolic left ventricular function strongly influences the blood pressure waveform. Therefore, pressure-derived parameters might potentially be used as non-invasive, diagnostic markers of left ventricular impairment. The aim of this study was to investigate the performance of pressure-based parameters in combination with electrocardiography (ECG) for the detection of left ventricular systolic dysfunction defined as severely reduced ejection fraction (EF). METHODS AND RESULTS: Two populations, each comprising patients with reduced EF and pressure-matched controls, were included for the main analysis (51/102 patients) and model testing (44/88 patients)...
2017: PloS One
https://www.readbyqxmd.com/read/28626854/spatial-indices-of-repolarization-correlate-with-non-st-elevation-myocardial-ischemia-in-patients-with-chest-pain
#5
Salah Al-Zaiti, Ervin Sejdić, Jan Nemec, Clifton Callaway, Prem Soman, Robert Lux
Mild-to-moderate ischemia does not result in ST segment elevation on the electrocardiogram (ECG), but rather non-specific changes in the T wave, which are frequently labeled as non-diagnostic for ischemia. Robust methods to quantify such T wave heterogeneity can have immediate clinical applications. We sought to evaluate the effects of spontaneous ischemia on the evolution of spatial T wave changes, based on the eigenvalues of the spatial correlation matrix of the ECG, in patients undergoing nuclear cardiac imaging for evaluating intermittent chest pain...
June 19, 2017: Medical & Biological Engineering & Computing
https://www.readbyqxmd.com/read/28625016/brugada-syndrome-and-exercise-practice-current-knowledge-shortcomings-and-open-questions
#6
Giuseppe Mascia, Elena Arbelo, Jaime Hernández Ojeda, Francesco Solimene, Ramon Brugada, Josep Brugada
Since its recognition as a clinical entity in 1992, the Brugada Syndrome (BrS), a hereditary disease characterized by a typical electrocardiogram (ECG) pattern potentially predisposing to sudden cardiac death (SCD), has attracted the attention of many physicians for its circadian pattern of ventricular arrhythmias (VA), mostly occurring at rest. Exercise may potentially worsen the ECG abnormalities in BrS patients, resulting in higher peak J-point amplitudes during the vasovagal reaction of the recovery period, possibly leading to an increased risk of cardiac events...
June 18, 2017: International Journal of Sports Medicine
https://www.readbyqxmd.com/read/28619766/diagnostic-performance-of-an-automatic-blood-pressure-measurement-device-microlife-watchbp-home-a-for-atrial-fibrillation-screening-in-a-real-world-primary-care-setting
#7
Pak-Hei Chan, Chun-Ka Wong, Louise Pun, Yu-Fai Wong, Michelle Man-Ying Wong, Daniel Wai-Sing Chu, Chung-Wah Siu
OBJECTIVE: To evaluate the diagnostic performance of a UK National Institute for Health and Care Excellence-recommended automatic oscillometric blood pressure (BP) measurement device incorporated with an atrial fibrillation (AF) detection algorithm (Microlife WatchBP Home A) for real-world AF screening in a primary healthcare setting. SETTING: Primary healthcare setting in Hong Kong. INTERVENTIONS: This was a prospective AF screening study carried out between 1 September 2014 and 14 January 2015...
June 15, 2017: BMJ Open
https://www.readbyqxmd.com/read/28614483/-public-health-impact-of-a-remote-diagnosis-system-implemented-in-regional-and-district-hospitals-in-paraguay
#8
Pedro Galván, Miguel Velázquez, Gualberto Benítez, José Ortellado, Ronald Rivas, Antonio Barrios, Enrique Hilario
Objective: Determine the viability of a remote diagnosis system implemented to provide health care to remote and scattered populations in Paraguay. Methods: The study was conducted in all regional and general hospitals in Paraguay, and in the main district hospitals in the country's 18 health regions. Clinical data, tomographic images, sonography, and electrocardiograms (ECGs) of patients who needed a diagnosis by a specialized physician were entered into the system...
June 8, 2017: Revista Panamericana de Salud Pública, Pan American Journal of Public Health
https://www.readbyqxmd.com/read/28611898/utility-of-the-history-and-physical-examination-in-the-detection-of-acute-coronary-syndromes-in-emergency-department-patients
#9
REVIEW
Zachary Dw Dezman, Amal Mattu, Richard Body
Chest pain accounts for approximately 6% of all emergency department (ED) visits and is the most common reason for emergency hospital admission. One of the most serious diagnoses emergency physicians must consider is acute coronary syndrome (ACS). This is both common and serious, as ischemic heart disease remains the single biggest cause of death in the western world. The history and physical examination are cornerstones of our diagnostic approach in this patient group. Their importance is emphasized in guidelines, but there is little evidence to support their supposed association...
June 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28611879/pitfalls-in-electrocardiographic-diagnosis-of-acute-coronary-syndrome-in-low-risk-chest-pain
#10
REVIEW
Semhar Z Tewelde, Amal Mattu, William J Brady
Less than half of patients with a chest pain history indicative of acute coronary syndrome have a diagnostic electrocardiogram (ECG) on initial presentation to the emergency department. The physician must dissect the ECG for elusive, but perilous, characteristics that are often missed by machine analysis. ST depression is interpreted and often suggestive of ischemia; however, when exclusive to leads V1-V3 with concomitant tall R waves and upright T waves, a posterior infarction should first and foremost be suspected...
June 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28611878/physician-variability-in-management-of-emergency-department-patients-with-chest-pain
#11
Peter B Smulowitz, Orit Barrett, Matthew M Hall, Shamai A Grossman, Edward A Ullman, Victor Novack
INTRODUCTION: Chest pain is a common emergency department (ED) presentation accounting for 8-10 million visits per year in the United States. Physician-level factors such as risk tolerance are predictive of admission rates. The recent advent of accelerated diagnostic pathways and ED observation units may have an impact in reducing variation in admission rates on the individual physician level. METHODS: We conducted a single-institution retrospective observational study of ED patients with a diagnosis of chest pain as determined by diagnostic code from our hospital administrative database...
June 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28611061/clinical-events-and-echocardiographic-lesion-progression-rate-in-subjects-with-mild-or-moderate-aortic-regurgitation
#12
Sveeta Badiani, Jet van Zalen, Saad Saheecha, Lesley Hart, Ann Topham, Nikhil Patel, Lydia Sturridge, Andrew Marshall, Neil Sulke, Stephen Furniss, Guy Lloyd
A 69 year old male, an ex-smoker, was admitted with ongoing chest pain of 11 hours duration. Past medical history included treated hypertension and gastro-oesophageal reflux disease. He delayed seeking medical attention as he assumed the pain to be due to indigestion and kept taking antacids without much symptomatic relief. Clinical examination on arrival was unremarkable. Admission 12 lead electrocardiogram (ECG) was diagnostic of a recent anterolateral myocardial infarction (MI) (Figure 1a). Bedside trans-thoracic echocardiogram (TTE) confirmed an established anterolateral MI (Video 1, Figure 1b)...
June 13, 2017: Echo Research and Practice
https://www.readbyqxmd.com/read/28593735/new-insights-into-the-clinical-signs-of-supraventricular-tachycardia-the-sign-of-lace-tying
#13
Dominique Blommaert, Fabien Dormal, Olivier Deceuninck, Olivier Xhaet, Elisabeth Ballant, Luc De Roy
BACKGROUND: Supraventricular tachycardias (SVT) are a common arrhythmia therefore an accurate diagnosis is of clinical importance. Although an ECG performed during tachycardia greatly aids diagnosis, patient history and predisposing factors also improve diagnostic accuracy. METHODS: This prospective study included 100 consecutive patients undergoing electrophysiological study for SVT with the aim to reassess their clinical characteristics and describe frequent predisposing factors, such as the "sign of lace-tying" that to our knowledge has not previously been reported...
June 8, 2017: Annals of Noninvasive Electrocardiology
https://www.readbyqxmd.com/read/28583653/prospectively-ecg-triggered-high-pitch-coronary-ct-angiography-at-70-kvp-with-30ml-contrast-agent-an-intraindividual-comparison-with-sequential-scanning-at-120-kvp-with-60ml-contrast-agent
#14
Wei Wang, Yan E Zhao, Li Qi, Xie Li, Chang Sheng Zhou, Long Jiang Zhang, Guang Ming Lu
PURPOSE: To investigate image quality, radiation dose, and diagnostic efficiency of prospectively ECG-triggered high-pitch coronary CT angiography (CCTA) at 70 kVp with 30mL contrast agent intra-individually compared with routine CCTA protocol. MATERIALS AND METHODS: One hundred and thirty eight patients with suspected coronary artery disease, body mass index (BMI)≤25kg/m(2) and heart rate (HR)≤70 beats per minute (bpm) underwent prospectively ECG-triggered high-pitch CCTA at 70 kVp and 30mL contrast agent (protocol A) and prospectively ECG-triggered sequential scanning at 120 kVp and 60mL contrast medium (protocol B)...
May 2017: European Journal of Radiology
https://www.readbyqxmd.com/read/28576437/feasibility-of-high-pitch-spiral-dual-source-ct-angiography-in-children-with-complex-congenital-heart-disease-compared-to-retrospective-gated-spiral-acquisition
#15
T Li, S Zhao, J Liu, L Yang, Z Huang, J Li, C Luo, X Li
AIM: To investigate the use of second-generation dual-source high-pitch computed tomography in obtaining confident diagnostic image quality using a low radiation dose in young patients with congenital heart disease (CHD). MATERIALS AND METHODS: From July 2014 to June 2016, 50 consecutive children <4 years with complex CHD underwent electrocardiography (ECG)-triggered dual-source computed tomography (CT). The patients were assigned randomly to two groups: high-pitch (pitch 3...
May 30, 2017: Clinical Radiology
https://www.readbyqxmd.com/read/28559636/treating-an-adolescent-with-long-qt-syndrome-for-bipolar-disorder-a-case-presentation
#16
Özlem Önen, Ayşe Kutlu, Handan Özek Erkuran
OBJECTIVES: Long QT syndrome (LQTS) is described as the development of sudden syncope attacks or death as a result of ventricular tachycardia (VT) episodes that might be observed as elongated QT interval in electrocardiography (ECG). Implantable Cardioverter Defibrillator (ICD) is recommended as first-line treatment for the condition in guidelines. We aimed to present an adolescent recently diagnosed with Bipolar Disorder (BD) who had LQTS that was treated with ICD, discussing her follow up and treatment along with relevant literature...
January 26, 2017: Psychopharmacology Bulletin
https://www.readbyqxmd.com/read/28553897/diagnostic-score-for-the-detection-of-cardiac-amyloidosis-in-patients-with-left-ventricular-hypertrophy-and-impact-on-prognosis
#17
Eve Cariou, Youssef Bennani Smires, Gérard Victor, Guillaume Robin, David Ribes, Pierre Pascal, Antoine Petermann, Pauline Fournier, Stanislas Faguer, Jérôme Roncalli, Hervé Rousseau, Dominique Chauveau, Didier Carrié, Isabelle Berry, Michel Galinier, Olivier Lairez
BACKGROUND: Among diagnosis associated with left ventricular hypertrophy (LVH), cardiac amyloidosis (CA) is a progressive disease with poor prognosis. Early noninvasive identification is of growing clinical importance. The objective of our study was to integrate clinical, biologic, electrocardiographic and echocardiographic parameters to build a diagnostic score in patients with LVH. METHODS AND RESULTS: One hundred and fourteen patients with LVH underwent a cardiac magnetic resonance (CMR) and a (99m)Tc-hydroxymethylene-diphosphonate scintigraphy ((99m)Tc-HMDP) allowing to discriminate three groups of diagnoses: CA (n = 50 including 31, 18 and 1 ATTR, AL and AA amyloidosis), hypertrophic cardiomyopathy (n = 19) and unspecific cardiomyopathy (n = 45)...
May 29, 2017: Amyloid: the International Journal of Experimental and Clinical Investigation
https://www.readbyqxmd.com/read/28549119/systematic-review-of-cost-effectiveness-of-myocardial-perfusion-scintigraphy-in-patients-with-ischaemic-heart-disease-a-report-from-the-cardiovascular-committee-of-the-european-association-of-nuclear-medicine-endorsed-by-the-european-association-of-cardiovascular
#18
Elin Trägårdh, Siok Swan Tan, Jan Bucerius, Alessia Gimelli, Oliver Gaemperli, Oliver Lindner, Denis Agostini, Christopher Übleis, Roberto Sciagrà, Riemer H Slart, S Richard Underwood, Fabien Hyafil, Marcus Hacker, Hein J Verberne
Coronary artery disease (CAD) is a major cause of death and disability. Several diagnostic tests, such as myocardial perfusion scintigraphy (MPS), are accurate for the detection of CAD, as well as having prognostic value for the prediction of cardiovascular events. Nevertheless, the diagnostic and prognostic value of these tests should be cost-effective and should lead to improved clinical outcome. We have reviewed the literature on the cost-effectiveness of MPS in different circumstances: (i) the diagnosis and management of CAD; (ii) comparison with exercise electrocardiography (ECG) and other imaging tests; (iii) as gatekeeper to invasive coronary angiography (ICA), (iv) the impact of appropriate use criteria; (v) acute chest pain, and (vi) screening of asymptomatic patients with type-2 diabetes...
May 26, 2017: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/28546862/block-sparsity-based-joint-compressed-sensing-recovery-of-multi-channel-ecg-signals
#19
Anurag Singh, Samarendra Dandapat
In recent years, compressed sensing (CS) has emerged as an effective alternative to conventional wavelet based data compression techniques. This is due to its simple and energy-efficient data reduction procedure, which makes it suitable for resource-constrained wireless body area network (WBAN)-enabled electrocardiogram (ECG) telemonitoring applications. Both spatial and temporal correlations exist simultaneously in multi-channel ECG (MECG) signals. Exploitation of both types of correlations is very important in CS-based ECG telemonitoring systems for better performance...
April 2017: Healthcare Technology Letters
https://www.readbyqxmd.com/read/28540068/serendipity-and-innovation-history-and-evolution-of-transthoracic-echocardiography
#20
REVIEW
Antonino Di Franco, Lucas B Ohmes, Mario Gaudino, Lisa Q Rong, Leonard N Girardi, Filippo M Sarullo, Ylenia Salerno, Silvia Sarullo, Jonathan W Weinsaft, Jiwon Kim
The history of echocardiography is sprinkled with many interesting episodes and anecdotes showing that devoting your life to the pursuit of one goal is praiseworthy, and that at the same time, a little luck goes a long way. Transthoracic echocardiography (TTE) has led to dramatic improvements in cardiovascular medicine, and is now the most widely used diagnostic cardiac test after electrocardiography (ECG). The present review pays tribute to the pioneering efforts of those who believed in this innovative technology despite mounted skepticism and briefly describes the evolution of TTE from its early days to the most recent developments...
April 2017: Journal of Thoracic Disease
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