{"title":"The arterial pulse wave and vascular compliance.","authors":"Joseph P Noon","doi":"10.1111/j.1751-7117.2009.00032.x","DOIUrl":"https://doi.org/10.1111/j.1751-7117.2009.00032.x","url":null,"abstract":"<p><p>For just over 1 century, we have relied on cuff sphygmomanometry to measure blood pressure at a peripheral (brachial) site. This measurement provides a quantitative snapshot of hemodynamic activity at 1 part of the arterial tree. Because the heart and brain are exposed to central (aortic) and not peripheral (brachial) pressure, it might be timely for nurses to start looking at alternative techniques to provide more meaningful information on central hemodynamics. The noninvasive technique of applanation tonometry allows such measurements to be performed quickly in the nursing clinic. By analyzing the pulse wave and calculating pulse wave velocity, the technique also assesses arterial \"stiffness.\" This method of cardiovascular assessment further enables nurses to monitor the central effects of antihypertensive, lipid lowering, and other drug therapy over time.</p>","PeriodicalId":77333,"journal":{"name":"Progress in cardiovascular nursing","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2009-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1751-7117.2009.00032.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28241337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Can AV dissociation masquerade as junctional rhythm?","authors":"Aimee Lee, Angela Tsiperfal, Kimberly Scheibly","doi":"10.1111/j.1751-7117.2009.00037.x","DOIUrl":"https://doi.org/10.1111/j.1751-7117.2009.00037.x","url":null,"abstract":"CAN AV DISSOCIATION MASQUERADE AS JUNCTIONAL RHYTHM L. R. is a 76-year-old Caucasian male with CAD s/p CABG in 1977 and 2004, atrial fibrillation (AF), s/p AF ablation, in 2002. Recurrence of AF prompted a failed direct current cardioversion and subsequent reablation of the pulmonary veins. The postoperative course was complicated by left femoral and right neck hematoma. This prompted hospital readmission 5 days post-procedure. The night of the admission patient awoke with palpitations and the electrocardiogram showed AF at a rate of 90 to 110 bpm with stable blood pressures. The patient was given Metoprolol 5 mg IV, subsequently started on a BID course of Metoprolol 25 mg PO, and IV Amiodarone was also initiated as an anti-arrhythmic. The patient converted to sinus rhythm but had postconversion pauses up to 6.8 seconds, followed by junctional bradycardia (Figure 1). Not long after the conversion, the patient became hypotensive with SBP in the70s and developed shortness of breath, nausea, and diaphoresis. IV Amiodarone was immediately discontinued and the patient was given 1/2-amp of Atropine, with noted improvement of the heart rate into the 40s.","PeriodicalId":77333,"journal":{"name":"Progress in cardiovascular nursing","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2009-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1751-7117.2009.00037.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28241342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Acquired QT prolongation.","authors":"William D Cahoon","doi":"10.1111/j.1751-7117.2009.00021.x","DOIUrl":"https://doi.org/10.1111/j.1751-7117.2009.00021.x","url":null,"abstract":"","PeriodicalId":77333,"journal":{"name":"Progress in cardiovascular nursing","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2009-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1751-7117.2009.00021.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28022005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Cardiovascular nursing in South Africa.","authors":"Ronel Pretorius, Liz Macera","doi":"10.1111/j.1751-7117.2009.00022.x","DOIUrl":"https://doi.org/10.1111/j.1751-7117.2009.00022.x","url":null,"abstract":"","PeriodicalId":77333,"journal":{"name":"Progress in cardiovascular nursing","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2009-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1751-7117.2009.00022.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28021587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Evidence-based practices for patients with cardiac disease.","authors":"S Jill Ley","doi":"10.1111/j.1751-7117.2009.00024.x","DOIUrl":"https://doi.org/10.1111/j.1751-7117.2009.00024.x","url":null,"abstract":"Mortality rates from coronary heart disease have declined by 25% since 1999, not so much from new designer drugs or improved technology, but through the determined enforcement of basic standards of care that are important enough to be deemed ‘‘guidelines’’ based on ‘‘evidence.’’ Aspirin, patented in 1900, is a medication that is now ubiquitous to the cardiac patient, at least for the last 20 years since we learned it could relieve pain and prevent a heart attack. Statin medications, originally embraced for their cholesterol-lowering effects, also exert substantial benefits through antioxidant, anti-inflammatory, and direct endothelial actions, thus securing their place as a cornerstone of primary and secondary preventive efforts. Both medications are now considered so vital to the prevention of cardiac events, that they have been included in virtually every cardiovascular guideline to date. With over 1000 cardiac-related articles published monthly, the ability to keep pace with new findings while differentiating fact from fancy has become increasingly challenging, even for the most savvy research consumer. Fortunately, the American Heart Association (AHA) has been a leader in disseminating evidence-based cardiovascular practices based on the strength of the literature. Recommendations from the AHA range from Class I (a treatment/procedure that should be used based on current evidence), Class IIa (where it is reasonable to recommend the treatment) or Class IIb (where a treatment may be considered), but additional studies are needed for both, to Class III (where the risks outweigh the benefits and the treatment should not be performed). Class I recommendations that are based on multiple randomized controlled trials or a meta-analysis represent the highest level of evidence, and often proceed along a ‘‘fast-track’’ for dissemination by the AHA. Once such recommendations have been made, it is critically important to then apply the myriad available treatments to a particular patient at a specific point in time. Thus, the concept of evidence-based practice (EBP) comes to fruition. EBP is the integration of the best available evidence with clinical expertise and patient preferences to achieve desired outcomes. It does not necessarily mean implementing research studies to answer a question, but indicates use of a systematic method for using available evidence to guide patient care decisions. For patients with cardiac disease, the AHA and the American College of Cardiology (ACC) offer systematic reviews, Class I guidelines based on the highest level of evidence, to optimize care management. For example, following acute myocardial infarction (AMI), aspirin on arrival, statins and b blocker therapy, smoking cessation advice and a discharge referral to cardiac rehabilitation (new for 2008) are critical performance measures. For the chronic heart failure (CHF) patient, diuretics and salt restriction, angiotensin-converting enzyme (ACE) inhibitors, and b block","PeriodicalId":77333,"journal":{"name":"Progress in cardiovascular nursing","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2009-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1751-7117.2009.00024.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28022006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Judith H Lichtman, J Thomas Bigger, James A Blumenthal, Nancy Frasure-Smith, Peter G Kaufmann, François Lespérance, Daniel B Mark, David S Sheps, C Barr Taylor, Erika Sivarajan Froelicher
{"title":"AHA science advisory. Depression and coronary heart disease. Recommendations for screening, referral, and treatment. A science advisory from the American Heart Association Prevention Committee to the Council on Cardiovascular Nursing, Council on Clinical Cardiology, Council on Epidemiology and Prevention, and Interdisciplinary Council on Quality of Care Outcomes Research. Endorsed by the American Psychiatric Association.","authors":"Judith H Lichtman, J Thomas Bigger, James A Blumenthal, Nancy Frasure-Smith, Peter G Kaufmann, François Lespérance, Daniel B Mark, David S Sheps, C Barr Taylor, Erika Sivarajan Froelicher","doi":"10.1111/j.1751-7117.2009.00028.x","DOIUrl":"https://doi.org/10.1111/j.1751-7117.2009.00028.x","url":null,"abstract":"<p><p>Depression is commonly present in patients with coronary heart disease (CHD) and is independently associated with increased cardiovascular morbidity and mortality. Screening tests for depressive symptoms should be applied to identify patients who may require further assessment and treatment. This multispecialty consensus document reviews the evidence linking depression with CHD and provides recommendations for healthcare providers for the assessment, referral, and treatment of depression.</p>","PeriodicalId":77333,"journal":{"name":"Progress in cardiovascular nursing","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2009-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1751-7117.2009.00028.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28021586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Recipe for Torsades de Pointes.","authors":"Kimberly Scheibly, Angela Tsiperfal","doi":"10.1111/j.1751-7117.2009.00030.x","DOIUrl":"https://doi.org/10.1111/j.1751-7117.2009.00030.x","url":null,"abstract":"Mrs L is a 59-year-old woman transferred to the hospital from another facility due to increasing hypoxia resistant to treatment. It was felt that she had pneumonia. Her history is significant for end-stage renal disease, dialysis, amyloidosis; 2 months postautologous bone marrow transplant, left ventricular hypertrophy, and hypertension. Upon admission, she was examined by many services including pulmonology, cardiology, infectious disease, and nephrology. Each service added medications they felt would improve the health of the patient. Their combined efforts resulted in the patient being prescribed azithromycin (antibiotic), voriconazole (antifungal), and haldol (antipsychotic) all of which can prolong the QT interval. 1. 12 lead electrocardiograph (ECG) 2 months before admission showed QTc of 491 ms.","PeriodicalId":77333,"journal":{"name":"Progress in cardiovascular nursing","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2009-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1751-7117.2009.00030.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28022008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Teresita Corvera-Tindel, Lynn V Doering, Janice Roper, Kathleen Dracup
{"title":"Emotional functioning drives quality of life in men with heart failure.","authors":"Teresita Corvera-Tindel, Lynn V Doering, Janice Roper, Kathleen Dracup","doi":"10.1111/j.1751-7117.2009.00026.x","DOIUrl":"https://doi.org/10.1111/j.1751-7117.2009.00026.x","url":null,"abstract":"<p><p>The purpose of this study was to examine the relative contributions of physical and emotional functioning to overall quality of life (QOL) in men with heart failure (HF). In 76 men with HF (age 63+/-11 years; left ventricular ejection fraction 27+/-9%; 20% NYHA III/IV), initial correlations of Cardiac-Quality of Life Index (C-QLI) scores with sociodemographic/clinical variables, physical functioning (6-minute walk test and Heart Failure Functional Status Inventory), and emotional functioning (depression, anxiety, and hostility, as measured by the Multiple Affect Adjective Checklist) were followed by multivariate stepwise regression. After controlling for sociodemographic/clinical variables, younger age (variance=9%, P=.008), higher depressive symptoms (variance=16%, P=or<.001), and lower self-reported physical functioning (variance=4%, P=.03) accounted for lower C-QLI scores (R2=0.33, P=.03). Compared with physical functioning, emotional functioning and younger age have a stronger relationship to QOL in men with HF.</p>","PeriodicalId":77333,"journal":{"name":"Progress in cardiovascular nursing","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2009-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1751-7117.2009.00026.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28021584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Irma B Ancheta, Mary Evans, Alan B Miller, Jun R Chiong, Cindy Battie
{"title":"Does clinician's knowledge of B-type natriuretic peptide levels translate to improvement of quality of life and less hospitalization days in patients with heart failure?","authors":"Irma B Ancheta, Mary Evans, Alan B Miller, Jun R Chiong, Cindy Battie","doi":"10.1111/j.1751-7117.2009.00025.x","DOIUrl":"https://doi.org/10.1111/j.1751-7117.2009.00025.x","url":null,"abstract":"<p><p>This pilot study was conducted to determine whether clinicians' knowledge of b-type natriuretic peptide (BNP) levels in individuals with heart failure (HF) correlates with better outcomes including quality of life (QOL) and hospital length of stay (LOS) over a 90-day period. HF clinic patients were randomized into 2 groups: clinician aware (BNP group; n=50) or blinded to BNP levels (control group; n=42). BNP levels were measured at baseline using the BNP Immunoassay Kit. QOL was measured by the Minnesota Living with Heart Failure (MLWHF) questionnaire, and hospital LOS were measured at baseline and 90 days. There was no significant difference in BNP levels between groups. Compared with baseline scores (46.87+/-29.63), mean QOL scores at 90 days (37.46+/-28.67) were not significantly different for both groups. Hospital LOS was also similar for both groups (mean=3 days). BNP levels were significantly correlated with New York Heart Association classification (P=.05), ejection fraction (P=0.0001), creatinine levels (P=0.05), and overall Minnesota Living with Heart Failure Questionnaire scores (P=.01). Clinician's knowledge of BNP levels is not associated with better outcomes of QOL or hospital LOS in HF patients. However, BNP levels are correlated with functional status and physiological parameters. Further research is needed to determine whether other factors influence QOL and hospital LOS of HF patients.</p>","PeriodicalId":77333,"journal":{"name":"Progress in cardiovascular nursing","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2009-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1751-7117.2009.00025.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28021585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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