Austin Journal of Clinical Medicine
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Austin Journal of Clinical Medicine is an open access, peer reviewed, scholarly journal dedicated to publish articles in all areas of internal medicine. The aim of the journal is to provide a forum for researchers, physicians, and other health professionals to find most recent advances in the areas of medical sciences. Austin Journal of Clinical Medicine accepts original research articles, review articles, case reports, clinical images and rapid communication on all the aspects of internal medicine. Austin Journal of Clinical Medicine strongly supports the scientific upgradation and fortification in related scientific research community by enhancing access to peer reviewed scientific literary works. Austin Publishing Group also brings universally peer reviewed journals under one roof thereby promoting knowledge sharing, mutual promotion of multidisciplinary science. Austin Journal of Clinical Medicine is an open access, peer reviewed, scholarly journal dedicated to publish articles in all areas of internal medicine.
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Smoaj.000572
Occurrence of a mural thrombus in a diseased descending thoracic aorta (atherosclerotic or aneurysmal) is a well-known and commonly encountered vascular entity. However, thrombus formation in a normal appearing descending thoracic aorta (NADTA) is rarely reported in literature so far. We present an
unusual case report with a brief literature review of an aortic mural thrombus (AMT) in descending thoracic aorta in a young male. He presented at our center in the emergency department with acute onset abdominal pain and underwent a contrast enhanced CT scan that confirmed mural thrombus in
NADTA.
SCMR Edition – Issue 56
The article discusses new cardiac parametric mapping techniques for T1 and T2 mapping that provide pixel-based maps of myocardial relaxation times. These techniques can detect diffuse myocardial pathologies missed by conventional imaging by quantifying subtle tissue changes. T1 mapping in particular shows potential for diagnosing diseases involving diffuse fibrosis. Standardization of mapping methods is still needed to ensure consistent quantitative results. The efficient, single breath-hold nature of new mapping sequences improves clinical applicability for detecting early disease changes.
Angioplasty
The document discusses coronary angioplasty, including what it is, why it is performed, and where it should be performed. It is a minimally invasive procedure to open blocked or narrowed coronary arteries by inflating a balloon to reshape the plaque or deploying a stent. It is primarily used for myocardial infarction and chronic stable angina. The optimal treatment is primary PCI within 90 minutes of diagnosis for STEMI patients. However, challenges exist for performing primary PCI in the dispersed population served by Raigmore Hospital due to its small cardiology team and long drive times for some patients.
ST-segment Depression: All are Not Created Equal!
ST depression on an electrocardiography can be from various causes including ischemia, acute coronary syndrome, electrolyte imbalance, posterior myocardial infarction, pulmonary embolism and others. Making the right diagnosis and therefore the right treatment is of paramount importance. This article goes into depth explaining why all ST-segment depressions are not created equal.
Left Ventricular Apical Ballooning, Catecholamine Toxicity, and Cardiomyopathy
Case reports and clinical experiences have implicated catecholamine. Excess likely contributes to the pathophysiologic process as a cause of cardiac dysfunction, impaired hemodynamic function, and poor outcomes. Cardiac dysfunction has also been described in many other diseases; there is likely a common underlying pathophysiology. In this review, we will examine the pathophysiology of cardiac dysfunction after catecholamine surge and discuss the evidence surrounding cardiac dysfunction.
European Journal of Heart Failure's year in Cardiology
This document contains information about Prof. Fausto J. Pinto who is the Head of Cardiology at University Hospital Sta Maria-HPV and University of Lisbon in Portugal. It discloses that he has received consultancy fees and lecture fees from various pharmaceutical companies. It also contains several figures and images from various medical studies and publications related to cardiology.
Out flow tract ventricular tachycardia
A woman in her late 40s with a history of hypertension presented to the emergency department after multiple episodes of palpitations with near syncope. While in the
emergency department, she developed monomorphic ventricular tachycardia (VT) with hemodynamic instability and was successfully cardioverted. She continued to have nonsustained monomorphic VT, so intravenous amiodarone and oral metoprolol were initiated. She was admitted for further evaluation. Results of tests of electrolyte levels and coronary angiography were normal. Cardiac magnetic resonance imaging with
gadolinium contrast revealed normal-sized cardiac chambers and normal biventricular
function without delayed enhancement. The presenting electrocardiogram (ECG)
is shown in Figure 1.
Acute aortic syndrome
Prevalence and factors associated with false positive suspicion of acute aortic syndrome: experience in a patient population transferred to a specialized aortic treatment center
Authors: Chad E. Raymond, et al.
http://www.ncbi.nlm.nih.gov/pubmed/24400203
http://www.thecdt.org/article/view/3120
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Smoaj.000572
Occurrence of a mural thrombus in a diseased descending thoracic aorta (atherosclerotic or aneurysmal) is a well-known and commonly encountered vascular entity. However, thrombus formation in a normal appearing descending thoracic aorta (NADTA) is rarely reported in literature so far. We present an
unusual case report with a brief literature review of an aortic mural thrombus (AMT) in descending thoracic aorta in a young male. He presented at our center in the emergency department with acute onset abdominal pain and underwent a contrast enhanced CT scan that confirmed mural thrombus in
NADTA.
SCMR Edition – Issue 56
The article discusses new cardiac parametric mapping techniques for T1 and T2 mapping that provide pixel-based maps of myocardial relaxation times. These techniques can detect diffuse myocardial pathologies missed by conventional imaging by quantifying subtle tissue changes. T1 mapping in particular shows potential for diagnosing diseases involving diffuse fibrosis. Standardization of mapping methods is still needed to ensure consistent quantitative results. The efficient, single breath-hold nature of new mapping sequences improves clinical applicability for detecting early disease changes.
Angioplasty
The document discusses coronary angioplasty, including what it is, why it is performed, and where it should be performed. It is a minimally invasive procedure to open blocked or narrowed coronary arteries by inflating a balloon to reshape the plaque or deploying a stent. It is primarily used for myocardial infarction and chronic stable angina. The optimal treatment is primary PCI within 90 minutes of diagnosis for STEMI patients. However, challenges exist for performing primary PCI in the dispersed population served by Raigmore Hospital due to its small cardiology team and long drive times for some patients.
ST-segment Depression: All are Not Created Equal!
ST depression on an electrocardiography can be from various causes including ischemia, acute coronary syndrome, electrolyte imbalance, posterior myocardial infarction, pulmonary embolism and others. Making the right diagnosis and therefore the right treatment is of paramount importance. This article goes into depth explaining why all ST-segment depressions are not created equal.
Left Ventricular Apical Ballooning, Catecholamine Toxicity, and Cardiomyopathy
Case reports and clinical experiences have implicated catecholamine. Excess likely contributes to the pathophysiologic process as a cause of cardiac dysfunction, impaired hemodynamic function, and poor outcomes. Cardiac dysfunction has also been described in many other diseases; there is likely a common underlying pathophysiology. In this review, we will examine the pathophysiology of cardiac dysfunction after catecholamine surge and discuss the evidence surrounding cardiac dysfunction.
European Journal of Heart Failure's year in Cardiology
This document contains information about Prof. Fausto J. Pinto who is the Head of Cardiology at University Hospital Sta Maria-HPV and University of Lisbon in Portugal. It discloses that he has received consultancy fees and lecture fees from various pharmaceutical companies. It also contains several figures and images from various medical studies and publications related to cardiology.
Out flow tract ventricular tachycardia
A woman in her late 40s with a history of hypertension presented to the emergency department after multiple episodes of palpitations with near syncope. While in the
emergency department, she developed monomorphic ventricular tachycardia (VT) with hemodynamic instability and was successfully cardioverted. She continued to have nonsustained monomorphic VT, so intravenous amiodarone and oral metoprolol were initiated. She was admitted for further evaluation. Results of tests of electrolyte levels and coronary angiography were normal. Cardiac magnetic resonance imaging with
gadolinium contrast revealed normal-sized cardiac chambers and normal biventricular
function without delayed enhancement. The presenting electrocardiogram (ECG)
is shown in Figure 1.
Acute aortic syndrome
Prevalence and factors associated with false positive suspicion of acute aortic syndrome: experience in a patient population transferred to a specialized aortic treatment center
Authors: Chad E. Raymond, et al.
http://www.ncbi.nlm.nih.gov/pubmed/24400203
http://www.thecdt.org/article/view/3120
Whom to refer for mitral valve repair and whom not
This document discusses the treatment of mitral regurgitation in patients with heart failure. It describes the mechanisms of functional and ischemic mitral regurgitation. While medical therapy can improve symptoms and survival, cardiac resynchronization therapy may also help reduce mitral regurgitation severity and improve outcomes. Surgery to repair the mitral valve is an option but the risk of recurrence of mitral regurgitation is high, especially with more advanced left ventricular remodeling. Randomized trials are still needed to determine whether surgical correction provides clear benefits over medical therapy alone in high-risk patients. Percutaneous mitral valve repair may be a lower risk option for inoperable patients to reduce symptoms.
Takayasu arteritis
Takayasu's arteritis is an inflammatory disease that causes stenosis of the aorta and its main branches. It most commonly affects young women in Asia. Symptoms vary depending on the arteries affected but may include headaches, fatigue, limb claudication, and hypertension. Diagnosis involves assessing symptoms, physical exam findings like blood pressure differences between limbs, and imaging tests like angiograms. Treatment consists of corticosteroids and immunosuppressive drugs to control inflammation, with surgery as needed for complications from narrowed arteries. Strict management of cardiovascular risk factors is also important.
Upper limb ischemia – case presentation
This document presents a case study of an 8-year-old male patient who presented with acute ischemia in his left upper limb. Further examination revealed a large mobile mass in both the patient's left and right atria, which was protruding through the mitral and tricuspid valves. The patient underwent an emergency thrombembolectomy of the left upper limb arteries to treat the acute ischemia. Additional imaging showed an atrial thrombus lodged in a patent foramen ovale. The patient later underwent open heart surgery to remove the thrombus and close the foramen ovale. The surgical treatment was staged with the initial focus on resolving the acute limb ischemia, followed by cardiac intervention to address the source of embolism
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This document discusses animal models for studying vulnerable plaque and atherosclerosis. It describes how the chicken, pig, mouse, and rabbit models each have advantages and limitations for replicating human disease. The mouse has been genetically modified to better model plaque development. No current animal model fully captures plaque rupture seen in humans. The rabbit model with an embedded inflatable balloon shows promise for experimentally inducing plaque rupture.
Thermal Imaging for the Diagnosis of Early Vascular Dysfunctions: A Case Report
Diseases of blood vessels (referred in this article as vascular dysfunction) cause more morbidity and mortality, than combined impact of any other major non-communicable disease including cancer. We strongly feel that the development of a therapy system based on the management of disease of the vessel than management of the risk factors will yield better results and provide greater opportunity for individualized therapy. Detection of early vascular changes before clinical manifestations of endothelial dysfunction, hardening of the arteries, increased intima-media thickness, is of great importance for early identification of individuals with increased risk of accelerated atherosclerosis.
International Journal of Cardiovascular Diseases & Diagnosis
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Papillary fibroelastoma, a primary cardiac tumour commonly found on the cardiac valves is less frequently found on the non-valvular myocardium. Most non-valvular papillary fibroelastomas are confined to the left ventricle and the atrial origin of this tumour is rare. We present a case of papillary fibroelastoma originating from the left atrial ridge or the Coumadin ridge (the confluence of the long axis of the left upper pulmonary vein with the roof of the left atrial appendage). There are a few sporadic reports of the origin of papillary fibroelastomas from the left atrial ridge and the majority of these have presented with cerebral embolism. These uncommon tumours have a predilection to cause embolic phenomenon, especially those arising from the left atrial ridge. Devices and intervention in heart failure.
- The document discusses the speaker's receipt of honoraria and research support from numerous pharmaceutical and device companies.
- It summarizes several journal articles and studies related to left ventricular remodeling post-myocardial infarction, baroreflex activation therapy for heart failure, and the effects of bi-ventricular pacing on left ventricular ejection fraction and end-systolic volume.
- Key findings from the PACE trial are highlighted showing improvements in left ventricular ejection fraction and end-systolic volume up to 2 years with bi-ventricular pacing compared to right ventricular pacing alone.
Wv8 2 comparison of edta ct, cabg, ptca (10)cvfp
EDTA, Chelation Therapy, Bypass Surgery, Angioplasty, Cardiovascular Disease, Atherosclerosis, Heart Attack
recommandations ESC 2012 sur les pathologies valvulaires cardiaques
This document summarizes the results of the ACCESS-EUROPE study on the MitraClip procedure for treating mitral regurgitation. The study found that at 1 year follow up:
- Mitral regurgitation was reduced to ≤2+ in 79% of patients and NYHA functional class was I/II in 72% of patients.
- Quality of life scores improved significantly and 6-minute walk distance increased by an average of 59.5 meters.
- Adverse events rates were consistent with the high risk nature of the study patients, with death occurring in 17.3% of patients at 1 year.
Aortic ulcer intramural hematoma aortic dissection
Aortic ulcer intramural hematoma aortic dissectionSociety for Heart Attack Prevention and Eradication
An intramural hematoma (IMH) is a thickening of the aortic wall due to bleeding within the media in the absence of an intimal tear. It is considered a precursor to aortic dissection and is classified as a class 2 aortic dissection. A penetrating atherosclerotic ulcer (PAU) is caused by the erosion of an atherosclerotic plaque through the internal elastic lamina into the media. It is classified as a class 4 aortic dissection. Both IMH and PAU can lead to complications like intramural hematoma expansion, pseudoaneurysm formation, aortic dissection, and rupture. Imaging modalities like CT, MRI, TEE, and IVUSHow to assess reversible ischemia in lv dysfunction
Andres Iñiguez presented on assessing reversible ischemia in left ventricular dysfunction. The optimal treatment for severe coronary artery disease and reduced left ventricular function is controversial, with debate around whether revascularization by CABG or PCI improves survival in patients with left ventricular dysfunction. The STICH trial found no significant difference in mortality between medical therapy alone versus medical therapy plus CABG, though patients with viable myocardium had lower mortality. Complete revascularization is recommended when viable myocardium is present. Worse left ventricular function predicts higher mortality, especially for PCI in STEMI patients, though the impact of dysfunction on mortality is attenuated in elderly patients. New onset congestive heart failure after revascularization is linked to higher mortality rates. Hemodynamic support during
Can we afford heart failure management in the future
Heart failure is a major global health problem, affecting 26 million people worldwide. It accounts for 1-3% of hospital admissions in Europe and North America. Hospitalization is the main driver of the high economic costs of heart failure management, which is estimated to rise significantly in the coming decade. To better manage heart failure costs in the future, new models of coordinated and integrated care will need to be implemented, with a focus on preventing hospitalizations and readmissions through improved education, care transitions, and treatment of comorbidities.
Pti
This document provides guidelines for the diagnosis and management of immune thrombocytopenia (ITP) based on a rigorous review of evidence. It summarizes changes since the American Society of Hematology's previous guidelines in 1996. The guidelines use the GRADE system to present recommendations and identify areas where high-quality evidence is lacking. For children with ITP, the guidelines recommend observation alone for mild cases, and first-line treatment with intravenous immunoglobulin or corticosteroids. For adults, they suggest treatment if the platelet count is <30 x 109/L and recommend corticosteroids, intravenous immunoglobulin, or anti-D immunoglobulin as first-line options. The guidelines identify a need for
Basics of pci
Coronary heart disease is a major cause of mortality worldwide. Percutaneous coronary intervention (PCI), also known as coronary angioplasty, is a non-surgical procedure used to treat blockages within the coronary arteries of the heart. During PCI, a catheter is inserted into an artery and guided to the site of blockage where a balloon is inflated to open the artery. Often a stent is placed to keep the artery open. PCI has become a common revascularization treatment for acute coronary syndromes and stable angina. While generally safe, complications from PCI occur in less than 2% of patients and include adverse reactions, acute myocardial infarction, bleeding, and death in less than 0.08% of patients.
file 1 siloamlv
This document discusses aortic dissection, its symptoms, risk factors, screening recommendations, mortality rates, and treatment options. It begins with definitions of angina and discusses its causes. It then reviews studies on the prevalence and causes of emergency room visits for chest pain. Risk factors for aortic dissection are described. The document outlines complications, mortality rates, and reintervention rates for different types and treatments of aortic dissection. Both open and endovascular surgical options are presented, along with their complications. Management recommendations for suspected aortic dissection are provided. The conclusion emphasizes the importance of considering aortic dissection for any chest pain and promptly consulting cardiothoracic surgery.
Should functional mr be fixed in heart failure
This document discusses functional mitral regurgitation (FMR) in heart failure patients. It presents evidence that even mild FMR results in poor survival outcomes, and that FMR is not just a late marker but also a cause of worse prognosis. Surgical mitral repair using a small, complete, rigid ring to reduce the mitral annulus has been shown to improve survival, ventricular remodeling, and functional status compared to no repair or incomplete repairs that do not fully correct FMR. Ongoing studies are exploring newer percutaneous approaches to treating FMR, but surgical repair remains the standard treatment when anatomically feasible to fully correct FMR.
Ojchd.000550
This case report describes a 37-year-old man who presented with sudden onset severe left-sided neck pain and ST elevations on his ECG. He was incorrectly diagnosed with an anterior wall myocardial infarction and thrombolyzed. Further examination revealed differential blood pressures between his upper and lower extremities, suggesting an underlying aortic coarctation. Imaging confirmed severe coarctation of the aorta. The atypical presentation of neck pain and ECG changes were likely due to vasospasm and compression related to the coarctation. This case highlights the importance of a full clinical assessment prior to thrombolytic therapy to avoid unnecessary procedures.
EHJ-CR-Slide-Set (1).pptx
This case series presents 7 cases of congenital aortic diseases assessed using cardiac computed tomography angiography (CCTA). CCTA provided detailed visualization of vascular structures and spatial relationships that were important for diagnosis and surgical planning. The cases included vascular rings, interrupted arches, coarctation and hypoplasia. CCTA allowed early diagnosis and treatment. Multi-imaging is important for assessing these complex anomalies and guiding management, like surgical or endovascular interventions. Three-dimensional CCTA images provided valuable information for optimal diagnosis and surgical planning.
American Journal of Urology Research.
A 49-year-old asymptomatic man presents for a vasectomy
evaluation. His past medical history is noncontributory, and his
family history is remarkable for prostate cancer in his father. On
genitourinary examination, his left testicle is notably larger than
his right testicle, with concern for a firm, nontender upper pole
mass palpated on the left side.
First in man endovascular treatementaodinchildrenbec-2017 [autosaved]
The first two children with type B aortic dissection treated by endovascular stent graft implanttaion in the worldwide medical practice
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Whom to refer for mitral valve repair and whom not
This document discusses the treatment of mitral regurgitation in patients with heart failure. It describes the mechanisms of functional and ischemic mitral regurgitation. While medical therapy can improve symptoms and survival, cardiac resynchronization therapy may also help reduce mitral regurgitation severity and improve outcomes. Surgery to repair the mitral valve is an option but the risk of recurrence of mitral regurgitation is high, especially with more advanced left ventricular remodeling. Randomized trials are still needed to determine whether surgical correction provides clear benefits over medical therapy alone in high-risk patients. Percutaneous mitral valve repair may be a lower risk option for inoperable patients to reduce symptoms.
Takayasu arteritis
Takayasu's arteritis is an inflammatory disease that causes stenosis of the aorta and its main branches. It most commonly affects young women in Asia. Symptoms vary depending on the arteries affected but may include headaches, fatigue, limb claudication, and hypertension. Diagnosis involves assessing symptoms, physical exam findings like blood pressure differences between limbs, and imaging tests like angiograms. Treatment consists of corticosteroids and immunosuppressive drugs to control inflammation, with surgery as needed for complications from narrowed arteries. Strict management of cardiovascular risk factors is also important.
Upper limb ischemia – case presentation
This document presents a case study of an 8-year-old male patient who presented with acute ischemia in his left upper limb. Further examination revealed a large mobile mass in both the patient's left and right atria, which was protruding through the mitral and tricuspid valves. The patient underwent an emergency thrombembolectomy of the left upper limb arteries to treat the acute ischemia. Additional imaging showed an atrial thrombus lodged in a patent foramen ovale. The patient later underwent open heart surgery to remove the thrombus and close the foramen ovale. The surgical treatment was staged with the initial focus on resolving the acute limb ischemia, followed by cardiac intervention to address the source of embolism
Aortic Dissection for the Vascular Surgeon
Review of aortic dissection focusing on type B dissection with literature review of important treatment therapies.
Centralization of flow in aortic dissection
New concept of totally endovascular treatment of complex cases of type A and B aortic dissection.
Modern minimally invasive approach to treat aortic dissection.
Percutaneous coronary intervention by hossein
This document discusses animal models for studying vulnerable plaque and atherosclerosis. It describes how the chicken, pig, mouse, and rabbit models each have advantages and limitations for replicating human disease. The mouse has been genetically modified to better model plaque development. No current animal model fully captures plaque rupture seen in humans. The rabbit model with an embedded inflatable balloon shows promise for experimentally inducing plaque rupture.
Thermal Imaging for the Diagnosis of Early Vascular Dysfunctions: A Case Report
Diseases of blood vessels (referred in this article as vascular dysfunction) cause more morbidity and mortality, than combined impact of any other major non-communicable disease including cancer. We strongly feel that the development of a therapy system based on the management of disease of the vessel than management of the risk factors will yield better results and provide greater opportunity for individualized therapy. Detection of early vascular changes before clinical manifestations of endothelial dysfunction, hardening of the arteries, increased intima-media thickness, is of great importance for early identification of individuals with increased risk of accelerated atherosclerosis.
International Journal of Cardiovascular Diseases & Diagnosis
International Journal of Cardiovascular Diseases & DiagnosisSciRes Literature LLC. | Open Access Journals
Papillary fibroelastoma, a primary cardiac tumour commonly found on the cardiac valves is less frequently found on the non-valvular myocardium. Most non-valvular papillary fibroelastomas are confined to the left ventricle and the atrial origin of this tumour is rare. We present a case of papillary fibroelastoma originating from the left atrial ridge or the Coumadin ridge (the confluence of the long axis of the left upper pulmonary vein with the roof of the left atrial appendage). There are a few sporadic reports of the origin of papillary fibroelastomas from the left atrial ridge and the majority of these have presented with cerebral embolism. These uncommon tumours have a predilection to cause embolic phenomenon, especially those arising from the left atrial ridge. Devices and intervention in heart failure.
- The document discusses the speaker's receipt of honoraria and research support from numerous pharmaceutical and device companies.
- It summarizes several journal articles and studies related to left ventricular remodeling post-myocardial infarction, baroreflex activation therapy for heart failure, and the effects of bi-ventricular pacing on left ventricular ejection fraction and end-systolic volume.
- Key findings from the PACE trial are highlighted showing improvements in left ventricular ejection fraction and end-systolic volume up to 2 years with bi-ventricular pacing compared to right ventricular pacing alone.
Wv8 2 comparison of edta ct, cabg, ptca (10)cvfp
EDTA, Chelation Therapy, Bypass Surgery, Angioplasty, Cardiovascular Disease, Atherosclerosis, Heart Attack
recommandations ESC 2012 sur les pathologies valvulaires cardiaques
This document summarizes the results of the ACCESS-EUROPE study on the MitraClip procedure for treating mitral regurgitation. The study found that at 1 year follow up:
- Mitral regurgitation was reduced to ≤2+ in 79% of patients and NYHA functional class was I/II in 72% of patients.
- Quality of life scores improved significantly and 6-minute walk distance increased by an average of 59.5 meters.
- Adverse events rates were consistent with the high risk nature of the study patients, with death occurring in 17.3% of patients at 1 year.
Aortic ulcer intramural hematoma aortic dissection
Aortic ulcer intramural hematoma aortic dissectionSociety for Heart Attack Prevention and Eradication
An intramural hematoma (IMH) is a thickening of the aortic wall due to bleeding within the media in the absence of an intimal tear. It is considered a precursor to aortic dissection and is classified as a class 2 aortic dissection. A penetrating atherosclerotic ulcer (PAU) is caused by the erosion of an atherosclerotic plaque through the internal elastic lamina into the media. It is classified as a class 4 aortic dissection. Both IMH and PAU can lead to complications like intramural hematoma expansion, pseudoaneurysm formation, aortic dissection, and rupture. Imaging modalities like CT, MRI, TEE, and IVUSHow to assess reversible ischemia in lv dysfunction
Andres Iñiguez presented on assessing reversible ischemia in left ventricular dysfunction. The optimal treatment for severe coronary artery disease and reduced left ventricular function is controversial, with debate around whether revascularization by CABG or PCI improves survival in patients with left ventricular dysfunction. The STICH trial found no significant difference in mortality between medical therapy alone versus medical therapy plus CABG, though patients with viable myocardium had lower mortality. Complete revascularization is recommended when viable myocardium is present. Worse left ventricular function predicts higher mortality, especially for PCI in STEMI patients, though the impact of dysfunction on mortality is attenuated in elderly patients. New onset congestive heart failure after revascularization is linked to higher mortality rates. Hemodynamic support during
Can we afford heart failure management in the future
Heart failure is a major global health problem, affecting 26 million people worldwide. It accounts for 1-3% of hospital admissions in Europe and North America. Hospitalization is the main driver of the high economic costs of heart failure management, which is estimated to rise significantly in the coming decade. To better manage heart failure costs in the future, new models of coordinated and integrated care will need to be implemented, with a focus on preventing hospitalizations and readmissions through improved education, care transitions, and treatment of comorbidities.
Pti
This document provides guidelines for the diagnosis and management of immune thrombocytopenia (ITP) based on a rigorous review of evidence. It summarizes changes since the American Society of Hematology's previous guidelines in 1996. The guidelines use the GRADE system to present recommendations and identify areas where high-quality evidence is lacking. For children with ITP, the guidelines recommend observation alone for mild cases, and first-line treatment with intravenous immunoglobulin or corticosteroids. For adults, they suggest treatment if the platelet count is <30 x 109/L and recommend corticosteroids, intravenous immunoglobulin, or anti-D immunoglobulin as first-line options. The guidelines identify a need for
Basics of pci
Coronary heart disease is a major cause of mortality worldwide. Percutaneous coronary intervention (PCI), also known as coronary angioplasty, is a non-surgical procedure used to treat blockages within the coronary arteries of the heart. During PCI, a catheter is inserted into an artery and guided to the site of blockage where a balloon is inflated to open the artery. Often a stent is placed to keep the artery open. PCI has become a common revascularization treatment for acute coronary syndromes and stable angina. While generally safe, complications from PCI occur in less than 2% of patients and include adverse reactions, acute myocardial infarction, bleeding, and death in less than 0.08% of patients.
file 1 siloamlv
This document discusses aortic dissection, its symptoms, risk factors, screening recommendations, mortality rates, and treatment options. It begins with definitions of angina and discusses its causes. It then reviews studies on the prevalence and causes of emergency room visits for chest pain. Risk factors for aortic dissection are described. The document outlines complications, mortality rates, and reintervention rates for different types and treatments of aortic dissection. Both open and endovascular surgical options are presented, along with their complications. Management recommendations for suspected aortic dissection are provided. The conclusion emphasizes the importance of considering aortic dissection for any chest pain and promptly consulting cardiothoracic surgery.
Should functional mr be fixed in heart failure
This document discusses functional mitral regurgitation (FMR) in heart failure patients. It presents evidence that even mild FMR results in poor survival outcomes, and that FMR is not just a late marker but also a cause of worse prognosis. Surgical mitral repair using a small, complete, rigid ring to reduce the mitral annulus has been shown to improve survival, ventricular remodeling, and functional status compared to no repair or incomplete repairs that do not fully correct FMR. Ongoing studies are exploring newer percutaneous approaches to treating FMR, but surgical repair remains the standard treatment when anatomically feasible to fully correct FMR.
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Thermal Imaging for the Diagnosis of Early Vascular Dysfunctions: A Case Report
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International Journal of Cardiovascular Diseases & Diagnosis
International Journal of Cardiovascular Diseases & Diagnosis
recommandations ESC 2012 sur les pathologies valvulaires cardiaques
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Aortic ulcer intramural hematoma aortic dissection
Aortic ulcer intramural hematoma aortic dissection
How to assess reversible ischemia in lv dysfunction
How to assess reversible ischemia in lv dysfunction
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Ojchd.000550
This case report describes a 37-year-old man who presented with sudden onset severe left-sided neck pain and ST elevations on his ECG. He was incorrectly diagnosed with an anterior wall myocardial infarction and thrombolyzed. Further examination revealed differential blood pressures between his upper and lower extremities, suggesting an underlying aortic coarctation. Imaging confirmed severe coarctation of the aorta. The atypical presentation of neck pain and ECG changes were likely due to vasospasm and compression related to the coarctation. This case highlights the importance of a full clinical assessment prior to thrombolytic therapy to avoid unnecessary procedures.
EHJ-CR-Slide-Set (1).pptx
This case series presents 7 cases of congenital aortic diseases assessed using cardiac computed tomography angiography (CCTA). CCTA provided detailed visualization of vascular structures and spatial relationships that were important for diagnosis and surgical planning. The cases included vascular rings, interrupted arches, coarctation and hypoplasia. CCTA allowed early diagnosis and treatment. Multi-imaging is important for assessing these complex anomalies and guiding management, like surgical or endovascular interventions. Three-dimensional CCTA images provided valuable information for optimal diagnosis and surgical planning.
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A 49-year-old asymptomatic man presents for a vasectomy
evaluation. His past medical history is noncontributory, and his
family history is remarkable for prostate cancer in his father. On
genitourinary examination, his left testicle is notably larger than
his right testicle, with concern for a firm, nontender upper pole
mass palpated on the left side.
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Spontaneous coronary artery dissection
SCAD is a rare, sometimes fatal, traumatic condition with approximately eighty percent of cases affecting women. The coronary artery can suddenly develop a tear, causing blood to flow between the layers which forces them apart, potentially causing a blockage of blood flow through the artery and a resulting heart attack. The condition may be related to female hormone levels, as it is often seen in post-partum women, or in women during or very near menstruation, but not always. It is not uncommon for SCAD to occur in people in good physical shape and with no known prior history of heart related illness. It is also not uncommon for SCAD to occur in people in their 20's, 30's, and 40's, as well as older.
Cardiac Metastases from Solid Papillary Carcinoma of the Breast: Analysis of ...
Cardiac Metastases from Solid Papillary Carcinoma of the Breast: Analysis of ...ANALYTICAL AND QUANTITATIVE CYTOPATHOLOGY AND HISTOPATHOLOGY
This document describes a case study of a rare case of cardiac metastases from solid papillary carcinoma (SPC) of the breast. A 67-year-old woman with a history of breast cancer underwent surgery to remove a tumor in her right atrium. Pathological examination of the tumor found that it was an invasive SPC of the breast that had metastasized to the heart. Immunohistochemical staining confirmed the diagnosis. Analysis of this case improves understanding of the diagnosis and treatment of metastatic SPC of the breast to rare sites like the heart.Clinical Profile of Patients with Coronary Tortuosity and its Relation with C...
Coronary tortuosity is a common angiographic finding. This study was done to observe the clinical profile of patients with coronary tortuosity (CT) and its relation with coronary artery disease (CAD). Method: A total 224 patients undergoing angiography for suspected CAD were included in the study. Coronary tortuosity was defined by the presence of ≥3 consecutive bends of > 45 degree, measured at end-diastole in an epicardial artery ≥2 mm in diameter. Coronary tortuosity was present in 45(20.1%) patients (CT group) in the study and another 45 patients without coronary tortuosity was randomly selected as control (NCT group). Clinical profile of CT and NCT group was compared. Results: Incidence of coronary tortuosity was significantly higher in females (p=0.000) and hypertensives (p=0.001) patients. Coronary tortuosity was most commonly seen in Left circumflex coronary artery. Incidence of CAD was significantly lower in CT group as compare to NCT group (0.02). Risk factors for CAD was associated with reduced incidence of Coronary tortuosity. Majority (88.5%) patient with CT without CAD presented with chronic stable angina out of which (65.2%) had an objective evidence of myocardial ischemia. Conclusion: Coronary tortuosity is more commonly seen females and hypertensive patients. It has negative correlation with CAD but can lead to myocardial ischemia. Risk factors of CAD do not predict CT.
Ojchd.000532
Coronary angioplasty has revolutionized the management of coronary artery disease. It has not ceased to develop to become the reference method of myocardial revascularization. The aim of our study is to evaluate the ultrasound parameters of left ventricular function after coronary angioplasty. This is a prospective analytical study including patients with stable coronary artery disease with a known coronary artery anatomy programmed for coronary angioplasty. Transthoracic echocardiography was performed four hours before and seven days after myocardial revascularization.
Brachial artery pseudoaneurysm rupture and repair
This is a presentation about a Bilateral brachial artery pseudoaneurysm acute rupture and repair with reverse saphenous vein graft.
International Journal of Clinical Cardiology & Research
International Journal of Clinical Cardiology & ResearchSciRes Literature LLC. | Open Access Journals
Congenital anomalies of the coronary vasculature are usually asymptomatic and rare with an incidence of less than 1% and there are few cases reported of congenital absence of the left circumflex artery. It is important to recognize this anomaly and define the anatomy by left heart catheterization or coronary angiography by computerized tomography when considering percutaneous intervention or coronary artery bypass surgery on patients without a left circumfl ex artery.Septic cmp poster
This study evaluated the feasibility of transthoracic echocardiography (TTE) for assessing cardiac function in 76 patients with septic shock. TTE was able to determine left ventricular systolic function in 90% of patients, right ventricular function in 99%, and left ventricular diastolic function in 73%. Diastolic dysfunction was present in 50% of patients. Factors like obesity, mechanical ventilation, age, and illness severity did not impact the ability of TTE to evaluate cardiac function. TTE is therefore a reliable tool for comprehensive cardiac assessment, including diastolic function, in critically ill septic shock patients.
Right Ventricular Infarction
A 61-year-old man presented with chest pain and was found to have ST-segment elevation in multiple leads on his electrocardiogram (ECG), indicating a heart attack. Additional ECG views showed involvement of the right ventricle. Coronary angiography revealed a 100% blockage of the right coronary artery near the branch supplying the right ventricle. The blockage was opened with a percutaneous coronary intervention, restoring blood flow. The man's condition improved with treatment, and follow-up testing showed his left ventricle function was normal but there was mild dysfunction of the right ventricle.
Contemporary management of acute type b aortic dissections
This document summarizes key findings from a study on endovascular repair of type B aortic dissection. The study found that adding thoracic endovascular aortic repair (TEVAR) to optimal medical treatment (OMT) reduced aorta-specific mortality by 12.4% and disease progression by 6.9% compared to OMT alone over 5 years. TEVAR also prevented late aortic expansion and encouraged aortic remodeling. However, uncertainty remains on optimal management for high-risk uncomplicated type B aortic dissection, though early intervention may be reasonable in several scenarios described. An additional well-designed randomized trial is still needed.
Thoracic Outlet Syndrome
Thoracic outlet syndrome is caused by compression of the neurovascular structures passing through the thoracic outlet. It has three subtypes depending on whether the brachial plexus, subclavian vein, or subclavian artery is compressed. Diagnosis involves clinical maneuvers to reproduce symptoms and imaging like ultrasound, MRI, CT or angiography. Ultrasound is useful for assessing blood flow changes during maneuvers but other modalities show the full thoracic outlet anatomy. Treatment depends on subtype but may include surgery or endovascular procedures, with follow-up ultrasound to monitor outcomes.
IJA_140116
This document presents a rare case report of a 30-year-old woman diagnosed with Takayasu arteritis who presented with both aneurysmal dilation and stenosis of the right common carotid artery. Imaging revealed aneurysmal dilation of the right innominate and proximal right common carotid arteries as well as a 75% focal stenosis in the right common carotid artery distal to the dilation. Treatment with prednisone resulted in improvement of symptoms and normalization of inflammation markers. The concurrent presence of aneurysmal dilation and stenosis from Takayasu arteritis in the same vessel is an exceptionally rare finding.
Paget schroetter syndrome presentation
- Paget-Schroetter syndrome (PSS), also known as effort thrombosis, involves spontaneous subclavian vein thrombosis that is often associated with repetitive arm motions. It was first described in the late 19th century and is caused by abnormal anatomy at the thoracic outlet that compresses the subclavian vein. Symptoms include swelling and dilated veins in the affected arm. Treatment involves blood thinners, catheter-directed thrombolysis, and potentially surgical decompression of the thoracic outlet to relieve compression. Outstanding questions remain regarding optimal treatment approaches and long-term outcomes.
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Radiological evaluation of takayasu arteritis Dr. muhammad Bin Zulfiqar Servi...
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Cardiac Metastases from Solid Papillary Carcinoma of the Breast: Analysis of ...
Cardiac Metastases from Solid Papillary Carcinoma of the Breast: Analysis of ...
Clinical Profile of Patients with Coronary Tortuosity and its Relation with C...
Clinical Profile of Patients with Coronary Tortuosity and its Relation with C...
International Journal of Clinical Cardiology & Research
International Journal of Clinical Cardiology & Research
Contemporary management of acute type b aortic dissections
Contemporary management of acute type b aortic dissections
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The Importance of Black Women Understanding the Chemicals in Their Personal C...
Certain chemicals, such as phthalates and parabens, can disrupt the body's hormones and have significant effects on health. According to data, hormone-related health issues such as uterine fibroids, infertility, early puberty and more aggressive forms of breast and endometrial cancers disproportionately affect Black women. Our guest speaker, Jasmine A. McDonald, PhD, an Assistant Professor in the Department of Epidemiology at Columbia University in New York City, discusses the scientific reasons why Black women should pay attention to specific chemicals in their personal care products, like hair care, and ways to minimize their exposure.
Emotional and Behavioural Problems in Children - Counselling and Family Thera...
A proprietary approach developed by bringing together the best of learning theories from Psychology, design principles from the world of visualization, and pedagogical methods from over a decade of training experience, that enables you to: Learn better, faster!
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A Fit-to-Fly PCR Test is a crucial service for travelers needing to meet the entry requirements of various countries or airlines. This test involves a polymerase chain reaction (PCR) test for COVID-19, which is considered the gold standard for detecting active infections. At our travel clinic in Leeds, we offer fast and reliable Fit to Fly PCR testing, providing you with an official certificate verifying your negative COVID-19 status. Our process is designed for convenience and accuracy, with quick turnaround times to ensure you receive your results and certificate in time for your departure. Trust our professional and experienced medical team to help you travel safely and compliantly, giving you peace of mind for your journey.www.nxhealthcare.co.uk
一比一原版(EUR毕业证)鹿特丹伊拉斯姆斯大学毕业证如何办理
EUR毕业证offer【微信95270640】《鹿特丹伊拉斯姆斯大学毕业证书原版制作EUR成绩单》【Q微信95270640】《仿制EUR毕业证成绩单鹿特丹伊拉斯姆斯大学学位证书pdf电子图》，A.为什么留学生需要操作留信认证?
留信认证全称全国留学生信息服务网认证,隶属于北京中科院。①留信认证门槛条件更低,费用更美丽,并且包过,完单周期短,效率高②留信认证虽然不能去国企,但是一般的公司都没有问题,因为国内很多公司连基本的留学生学历认证都不了解。这对于留学生来说,这就比自己光拿一个证书更有说服力,因为留学学历可以在留信网站上进行查询!
B.为什么我们提供的毕业证成绩单具有使用价值？
查询留服认证是国内鉴别留学生海外学历的唯一途径，但认证只是个体行为，不是所有留学生都操作，所以没有办理认证的留学生的学历在国内也是查询不到的，他们也仅仅只有一张文凭。所以这时候我们提供的和学校颁发的一模一样的毕业证成绩单，就有了使用价值。
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Austin Journal of Clinical Medicine
- 1. Citation: Lu X, Shi H, Cao D and Sun Y. CT Angiographic Diagnosis and Explanation of Unusual Four-Limb Blood Pressures. Austin J Clin Med. 2018; 5(2): 1036. Austin J Clin Med - Volume 5 Issue 2 - 2018 ISSN : 2381-9146 | www.austinpublishinggroup.com Sun et al. © All rights are reserved Austin Journal of Clinical Medicine Open Access Keywords IAA: Interrupted Aortic Arch; Adult; Imaging Clinical Image A 40-year-old man came to our hospital for his mysterious hypertension and his blood pressure returned to normal level after exertional activity. Except for symptoms above, his past medical history is unremarkable. The four-limb blood pressure showed a 50 mmHg gradient between the right and left arm (160/80 vs. 110/70 mmHg, respectively) but insignificant gradient with the both leg (100/70 vs.110/70 mmHg). Aortic CT angiography revealed type B interruption with tortuous cervical collateral vessels to the left subclavian artery and descendent aorta (Figure 1-2). Dilated intercostal arteries were also seen. The patient declined to further sugery and was regularly followed up. Interrupted Aortic Arch (IAA) is classified into three types according to the site of aortic interruption: Type A: the arch is interrupted distal to the left subclavian artery at the level of the aortic isthmus, which comprises 15% of IAAs. Type B: the arch is interrupted between the left common carotid and left subclavian arteries, which is the most common presentation of IAA and comprises 80% of all IAAs. Type C: the arch is interrupted between the innominate and the left common carotid artery, which is Clinical Image CT Angiographic Diagnosis and Explanation of Unusual Four-Limb Blood Pressures Xiaoqian Lu1 , Hongkun Shi1 , Dianbo Cao2 and Yutian Sun1 * 1 Department of Radiology, The First Hospital of JiLin University, Chang Chun 2 Pharmaceutical Department, China-Japan Union Hospital of Jilin University, Changchun *Corresponding author: Yutian Sun, Pharmaceutical Department, China-Japan Union Hospital of Jilin University, Changchun 130033, China Received: June 11, 2018; Accepted: July 02, 2018; Published: July 09, 2018 the least common presentation of IAA and comprises 5% of all IAAs. Transthoracic echocardiography is often the initial imaging modality used to evaluate cardiovascular anomalies. CT angiography is a noninvasive technique that enables rapid and high-spatial-resolution evaluation of vascular anomalies, in addition to assessment of tracheal or esophageal compression in the same study. The discrepancy of the four-limb blood pressure depends on interrupted location and collateral circulation in those affected patients. Knowledge of aortic anatomy and identification of arch anomalies allows for accurate surgical and intervention planning. Figure 1: Figure 2: