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Emergency cardiovascular care

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https://www.readbyqxmd.com/read/29033616/nationwide-trends-of-clinical-characteristics-and-economic-burden-of-emergency-department-visits-due-to-acute-ischemic-stroke
#1
Mark Stuntz, Katsiaryna Busko, Shumaila Irshad, Taylor Paige, Veranika Razhkova, Tim Coan
We aimed to provide estimates of the volume and associated charges of acute ischemic stroke (AIS) visits in the US, as well as to assess predictors of patient disposition following an emergency department (ED) visit for AIS. Our study was conducted using the 2010-2013 data from the Nationwide Emergency Department Sample. We identified adult visits with AIS as the primary diagnosis. A generalized linear model was used to calculate mean charges per visit after adjusting for covariates. Multinomial logistic regression was used to assess predictors of patient disposition following an ED visit for AIS...
2017: Open Access Emergency Medicine: OAEM
https://www.readbyqxmd.com/read/29029109/early-diagnosis-of-acute-coronary-syndrome
#2
Hugo Katus, André Ziegler, Okan Ekinci, Evangelos Giannitsis, Wendy Gattis Stough, Stephan Achenbach, Stefan Blankenberg, Martina Brueckmann, Paul Collinson, Dorin Comaniciu, Filippo Crea, Wilfried Dinh, Grégory Ducrocq, Frank A Flachskampf, Keith A A Fox, Matthias G Friedrich, Kathy A Hebert, Anders Himmelmann, Mark Hlatky, Dominik Lautsch, Bertil Lindahl, Daniel Lindholm, Nicholas L Mills, Giorgio Minotti, Martin Möckel, Torbjørn Omland, Véronique Semjonow
The diagnostic evaluation of acute chest pain has been augmented in recent years by advances in the sensitivity and precision of cardiac troponin assays, new biomarkers, improvements in imaging modalities, and release of new clinical decision algorithms. This progress has enabled physicians to diagnose or rule-out acute myocardial infarction earlier after the initial patient presentation, usually in emergency department settings, which may facilitate prompt initiation of evidence-based treatments, investigation of alternative diagnoses for chest pain, or discharge, and permit better utilization of healthcare resources...
October 3, 2017: European Heart Journal
https://www.readbyqxmd.com/read/29026885/emergency-department-point-of-care-ultrasonography-improves-time-to-pericardiocentesis-for-clinically-significant-effusions
#3
Evan Avraham Alpert, Uri Amit, Larisa Guranda, Rafea Mahagna, Shamai A Grossman, Ariel Bentancur
OBJECTIVE: Our objective was to determine the utility of point-of-care ultrasound (POCUS) to identify and guide treatment of tamponade or clinically significant pericardial effusions in the emergency department (ED). METHODS: This was a retrospective cohort study of non-trauma patients who were diagnosed with large pericardial effusions or tamponade by the ED physician using POCUS. The control group was composed of those patients later diagnosed on the medical wards or incidentally in the ED by other means such as a computed tomography...
September 2017: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/29017643/-chinese-consensus-on-cpr-and-american-guidelines-on-cpr
#4
Lixiang Wang, Qingyi Meng, Tao Yu
In the article, we compared "2016 national consensus on cardiopulmonary resuscitation in China" and "2015 American Heart Association guidelines on cardiopulmonary resuscitation and emergency cardiovascular care" with their definition, orientation, characterization, quantifying and thinking mode. Chinese consensus on cardiopulmonary resuscitation (CPR) emphasizes the concept of "survival cycle" and focuses on the victim, it defines the rate of survival in its broad sense, and the thinking mode of the document is typically oriental style...
October 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28984172/analysis-of-mortality-in-the-emergency-department-at-a-university-hospital-in-pleven
#5
Petko Hristov Stefanovski, Radev Vladimir Radkov, Tsankov Lyubomir Ilkov, Tonchev Pencho Tonchev, Todorova Yoana Mladenova, Kovachev Vihar Manchev, Radev Radko Nikolov
Objective To identify the demographic patterns of mortality, the time spent before death in the emergency department (ED), and the causes of fatal outcomes. Methods We performed a 5-year (01/01/2011 to 01/01/2016) retrospective analysis of all non-traumatic deaths in the ED of the UMHAT - Pleven. To extract the necessary information, we used the registers in the ED until the patients' death. Results Among 156,848 patients in the study period, 381 died and the mortality rate was 2.4/100000. The male:female ratio was 1...
October 2017: Journal of International Medical Research
https://www.readbyqxmd.com/read/28975959/challenges-of-congenital-heart-disease-in-grown-up-patients
#6
Markus Schwerzmann, Fabienne Schwitz, Corina Thomet, Alexander Kadner, Jean-Pierre Pfammatter, Kerstin Wustmann
Nowadays, more than 90% of all children born with congenital heart disease (CHD) reach adult life. Although initially considered to be cured, the majority of them continue to need specialised follow-up because they require re-do interventions or are at increased risk of cardiovascular complications and premature death. Arrhythmias are the most common cause of unscheduled hospital visits for grown-up CHD (GUCH) patients, accounting for one third of emergency admissions in these patients. Some GUCH patients are also at increased risk for sudden cardiac death...
October 4, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/28956084/biomarkers-of-cardiovascular-disease-contributions-to-risk-prediction-in-individuals-with-diabetes
#7
REVIEW
Katherine N Bachmann, Thomas J Wang
Cardiovascular disease is a leading cause of death, especially in individuals with diabetes mellitus, whose risk of morbidity and mortality due to cardiovascular disease is markedly increased compared with the general population. There has been growing interest in the identification of biomarkers of cardiovascular disease in people with diabetes. The present review focuses on the current and potential contributions of these biomarkers to predicting cardiovascular risk in individuals with diabetes. At present, certain biomarkers and biomarker combinations can lead to modest improvements in the prediction of cardiovascular disease in diabetes beyond traditional cardiovascular risk factors...
September 28, 2017: Diabetologia
https://www.readbyqxmd.com/read/28956075/-polytrauma-following-a-truck-accident-how-to-save-lives-by-guideline-oriented-emergency-care
#8
M Kippnich, Y Jelting, C Markus, M Kredel, T Wurmb, P Kranke
BACKGROUND: Identification and immediate treatment of life-threatening conditions is fundamental in patients with multiple trauma. In this context, the S3 guidelines on polytrauma and the S1 guidelines on emergency anesthesia provide the scientific background on how to handle these situations. CASE STUDY: This case report deals with a seriously injured driver involved in a truck accident. The inaccessible patient showed a scalping injury of the facial skeleton with massive bleeding and partially blocked airway but with spontaneous breathing as well as centralized cardiovascular circulation conditions and an initial Glasgow coma scale (GCS) of 8...
September 27, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28949393/troponinniv%C3%A3-er-ger-nu-b%C3%A3-ttre-hj%C3%A3-lp-vid-misst%C3%A3-nkt-hj%C3%A3-rtinfarkt-l%C3%A3-ga-niv%C3%A3-er-kan-med-h%C3%A3-g-s%C3%A3-kerhet-utesluta-hj%C3%A3-rtinfarkt-%C3%A2-nya-analysmetoder-%C3%A3-kar-den-medicinska-s%C3%A3-kerheten
#9
Ola Hammarsten, Christian Bjurman, Martin Holzmann, Bertil Lindahl
Assessment of troponin levels on the emergency ward  Patients with myocardial infarction are at a high risk of sudden death and new cardiovascular events. For this reason, it is important to identify these patients and device treatment to reduce the risk. Patients who seek care with symptoms indicative of myocardial infarction, mainly chest pain, constitute a large proportion of patients at our emergency departments. However, only 5-10 % of these patients have myocardial infarction, whereas the majority has benign causes of their symptoms...
September 25, 2017: Läkartidningen
https://www.readbyqxmd.com/read/28944588/left-ventricular-perforation-after-impella%C3%A2-placement-in-a-patient-with-cardiogenic-shock
#10
David C Peritz, Lee Linstroth, Craig H Selzman, Edward M Gilbert
Mechanical cardiovascular support devices are now widely used both in the setting of cardiogenic shock as well as during high risk cardiac catheterization procedures. We report a case of a young female patient who presented with presumed myocarditis and rapidly deteriorating decompensated heart failure requiring the implantation of an Impella Circulatory Support System. Upon transfer to our facility it was discovered that during transport, the Impella device had migrated through the left ventricle. She was emergently taken to the operating room where the Impella was surgically removed and biventricular support devices were placed...
September 25, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28941947/heart-failure-in-young-adults-is-associated-with-high-mortality-a-contemporary-population-level-analysis
#11
Chih M Wong, Nathaniel M Hawkins, Justin A Ezekowitz, Pardeep S Jhund, Anamaria Savu, Michael R MacDonald, Søren L Kristensen, Mark C Petrie, John J V McMurray, Finlay A McAlister, Padma Kaul
BACKGROUND: Data on young patients with heart failure (HF) are sparse. We examined the characteristics, health care use, and survival of younger vs older patients with HF. METHODS: We performed an analysis of linked administrative databases in Alberta, Canada. We identified 34,548 patients who had a first hospitalization for HF as the principal diagnosis from 2002-2014. Patients were stratified into 4 age groups: 20-44, 45-54, 55-64, and ≥ 65 years. RESULTS: Of the 34,548 patients, 496 (1...
June 19, 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28939923/-thyroid-emergencies-thyroid-storm-and-myxedema-coma
#12
REVIEW
C Spitzweg, M Reincke, R Gärtner
Thyroid emergencies are rare life-threatening endocrine conditions resulting from either decompensated thyrotoxicosis (thyroid storm) or severe thyroid hormone deficiency (myxedema coma). Both conditions develop out of a long-standing undiagnosed or untreated hyper- or hypothyroidism, respectively, precipitated by an acute stress-associated event, such as infection, trauma, or surgery. Cardinal features of thyroid storm are myasthenia, cardiovascular symptoms, in particular tachycardia, as well as hyperthermia and central nervous system dysfunction...
September 22, 2017: Der Internist
https://www.readbyqxmd.com/read/28934836/pregnancy-in-women-with-hypertrophic-cardiomyopathy-data-from-the-european-society-of-cardiology-initiated-registry-of-pregnancy-and-cardiac-disease-ropac
#13
S Goland, I M van Hagen, G Elbaz-Greener, U Elkayam, A Shotan, W M Merz, S C Enar, I R Gaisin, P G Pieper, M R Johnson, R Hall, A Blatt, J W Roos-Hesselink
Aims: We report the maternal and foetal outcomes at birth and after 6 months in a cohort of pregnant women with hypertrophic cardiomyopathy (HCM). Although most women with HCM tolerate pregnancy well, there is an increased risk of obstetric and cardiovascular complications. Methods and results: All pregnant women with HCM entered into the prospective worldwide Registry of Pregnancy and Cardiac disease (ROPAC) were included in this analysis. The primary endpoint was a major adverse cardiovascular event (MACE), which included death, heart failure (HF), thrombo-embolic event, and arrhythmia...
September 14, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28933782/cardiovascular-disease-in-the-eastern-mediterranean-region-epidemiology-and-risk-factor-burden
#14
REVIEW
Karam Turk-Adawi, Nizal Sarrafzadegan, Ibtihal Fadhil, Kathryn Taubert, Masoumeh Sadeghi, Nanette K Wenger, Nigel S Tan, Sherry L Grace
The Eastern Mediterranean region (EMR) comprises 22 countries or territories spanning from Morocco in the west to Pakistan in the east, and contains a population of almost 600 million people. Like many other developing regions, the burden of disease in the EMR has shifted in the past 30 years from primarily communicable diseases to noncommunicable diseases such as cardiovascular disease (CVD). Cardiovascular mortality in the EMR, mostly attributable to ischaemic heart disease, is expected to increase more dramatically in the next decade than in any other region except Africa...
September 21, 2017: Nature Reviews. Cardiology
https://www.readbyqxmd.com/read/28928588/patient-with-persistent-low-oxygen-saturation-for-emergency-cesarean-section
#15
Shivali Panwar, Kirti Nath Saxena, Prachi Gaba
A 24-year-old woman with previous undiagnosed congenital methemoglobinemia presented for the emergency cesarean section in view of fetal distress. The patient had a persistent low oxygen saturation on pulse oximetry with normal heart rate and blood pressure. Arterial blood gas values were normal. The patient was asymptomatic and respiratory and cardiovascular system examination was normal. The patient underwent cesarean section under general anesthesia and was shifted to the Intensive Care Unit postoperatively...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28928558/oral-clonidine-premedication-attenuates-hemodynamic-responses-of-ketamine-during-total-intravenous-anesthesia
#16
Pulak Tosh, Sunil Rajan, Nitu Puthenveettil, Lakshmi Kumar
BACKGROUND: The most commonly used drug for total intravenous anesthesia (TIVA) is ketamine which results in cardiovascular stimulation. AIMS: The primary aim of this study was to assess the effect of oral clonidine premedication on attenuating the hemodynamic responses following ketamine administration. SETTINGS AND DESIGNS: This was a prospective, observational, comparative study conducted in a tertiary care institution. SUBJECTS AND METHODS: A total of 40 female patients aged 18-55 years who were posted for elective short gynecological procedures under TIVA were recruited for this study...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28923845/high-sensitivity-cardiac-troponin-i-as-a-gatekeeper-for-coronary-computed-tomography-angiography-and-stress-testing-in-patients-with-acute-chest-pain
#17
Maros Ferencik, Thomas Mayrhofer, Michael T Lu, Pamela K Woodard, Quynh A Truong, W Frank Peacock, Fabian Bamberg, Benjamin C Sun, Jerome L Fleg, John T Nagurney, James E Udelson, Wolfgang Koenig, James L Januzzi, Udo Hoffmann
BACKGROUND: Most patients presenting to the emergency department (ED) with suspected acute coronary syndrome (ACS) undergo noninvasive cardiac testing with a low diagnostic yield. We determined whether a combination of high-sensitivity cardiac troponin I (hs-cTnI) and cardiovascular risk factors might improve selection of patients for cardiac testing. METHODS: We included patients from the Rule Out Myocardial Infarction/Ischemia Using Computer Assisted Tomography (ROMICAT) I and II trials who presented to the ED with acute chest pain and were referred for cardiac testing...
September 18, 2017: Clinical Chemistry
https://www.readbyqxmd.com/read/28923106/impact-of-nursing-home-admission-on-health-care-use-and-disease-status-elderly-dependent-people-one-year-before-and-one-year-after-skilled-nursing-home-admission-based-on-2012-2013-sniiram-data
#18
A Atramont, I Bourdel-Marchasson, D Bonnet-Zamponi, I Tangre, A Fagot-Campagna, P Tuppin
BACKGROUND: The aim of this study was to compare disease status and health care use 1 year before and 1 year after skilled nursing home (SNH) admission. METHODS: People over the age of 65 years admitted to SNH during the first quarter of 2013, covered by the national health insurance general scheme (69% of the population of this age), and still alive 1 year after admission were identified (n = 14,487, mean age: 86 years, women: 76%). Their reimbursed health care was extracted from the Système National d'Information Interrégimes de l'Assurance Maladie (SNIIRAM) [National Health Insurance Information System]...
September 18, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28917226/energy-intake-in-the-first-week-in-an-emergency-intensive-care-unit-may-not-influence-clinical-outcomes-in-critically-ill-overweight-japanese-patients
#19
Satomi Ichimaru, Maren Sono, Ryutaro Seo, Koichi Ariyoshi, Teruyoshi Amagai
BACKGROUND AND OBJECTIVES: The American Society for Parenteral and Enteral Nutrition recommends hypocaloric feeding for critically ill patients with a BMI of >=30.0 kg/m2. However, the cut-off value of obesity in Japan is BMI >25.0 kg/m2, due to the higher prevalence of type 2 diabetes mellitus, and cardiovascular risk factors, even at a lower BMI than in Western populations. Thus, the optimal energy intake for critically ill, overweight Asian patients is unknown. METHODS AND STUDY DESIGN: A retrospective chart review was conducted in patients with BMI of >=25...
2017: Asia Pacific Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/28914276/appropriate-reconciliation-of-cardiovascular-medications-after-elective-surgery-and-postdischarge-acute-hospital-and-ambulatory-visits
#20
Jonathan S Lee, Ralph Gonzales, Eric Vittinghoff, Kitty K Corbett, Kirsten E Fleischmann, Neil Sehgal, Andrew D Auerbach
OBJECTIVE: To describe appropriate discharge reconciliation of cardiovascular medications and assess associations with postdischarge healthcare utilization in surgical patients. DESIGN: Retrospective cohort study from January 2007 to December 2011. SETTING: An academic medical center. PATIENTS: Seven hundred and fifty-two adults undergoing elective noncardiac surgery and taking antiplatelet agents, beta-blockers, renin-angiotensin system inhibitors, or statin lipid-lowering agents before surgery...
September 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
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