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The impact of provider-specific report cards on coronary artery bypass graft volume. 提供者特定报告卡对冠状动脉旁路移植术容量的影响。
The American heart hospital journal Pub Date : 2010-01-01 DOI: 10.15420/ahhj.2010.8.1.14
Thomas R McLean
{"title":"The impact of provider-specific report cards on coronary artery bypass graft volume.","authors":"Thomas R McLean","doi":"10.15420/ahhj.2010.8.1.14","DOIUrl":"https://doi.org/10.15420/ahhj.2010.8.1.14","url":null,"abstract":"<p><strong>Purpose: </strong>Reporting states (RS) publish hospital-specific report cards for coronary artery bypass graft (CABG) (MS-DRG 235 and 236) surgery. When RS are compared with non-reporting states (NRS), do report cards influence the volume of CABG surgery performed?</p><p><strong>Methods: </strong>Using publicly available Medicare data (hospitalcompare.hhs.gov) for CABG-only procedures, the volume of CABG procedures performed in RS (CA, MA, NJ, NYS, and PA) was compared with the volume of these procedures performed in NRS.</p><p><strong>Results: </strong>In the continental US during the financial year 2008 a total of 41,589 Medicare patients underwent a CABG (33,318 CABGs in NRS versus 8,272 CABGs in RS). A similar percentage of states in each group regulated their markets with certificate-of need statutes (30% NRS versus 40% RS). Per million capita (pmc), the number of CABG providers in the two groups was similar with respect to hospitals (4.1±1.6 hospitals pmc in NRS versus 2.9±1.2 hospitals pmc in RS); cardiac surgeons (2.4±1.5 surgeons pmc in NRS versus 5.1±2.9 surgeons pmc in RS); and interventional cardiologists (ICs) (18.3±5.5 ICs pmc in NRS versus 21.2±5.0 ICs pmc in RS). However, pmc, NRS performed significantly more CABG procedures (152.0±62.6 CABGs pmc in NRS versus 113.8±31.6 CABG pmc in RS; p=0.05).</p><p><strong>Conclusions: </strong>States that publish hospital-specific report cards perform significantly fewer CABGs per capita than states without report cards. As the government's national hospital-specific report card becomes more popular, the per capita performance of CABGs in NRS could fall to the level found in RS due to the reputational incentives created by the use of hospital-specific report cards.</p>","PeriodicalId":87149,"journal":{"name":"The American heart hospital journal","volume":"8 1","pages":"14-8"},"PeriodicalIF":0.0,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29565667","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}
引用次数: 1
A grossly abnormal electrocardiogram with multiple abnormalities. 一种伴有多重异常的严重异常的心电图。
The American heart hospital journal Pub Date : 2010-01-01 DOI: 10.15420/ahhj.2010.8.2.102
David H Spodick
{"title":"A grossly abnormal electrocardiogram with multiple abnormalities.","authors":"David H Spodick","doi":"10.15420/ahhj.2010.8.2.102","DOIUrl":"https://doi.org/10.15420/ahhj.2010.8.2.102","url":null,"abstract":"","PeriodicalId":87149,"journal":{"name":"The American heart hospital journal","volume":"8 2","pages":"E102"},"PeriodicalIF":0.0,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30149263","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}
引用次数: 0
Management of acute stroke and transient ischemic stroke-an integrated, systematic approach from the emergency department to the inpatient setting to discharge. 急性中风和短暂性缺血性中风的管理-从急诊科到住院到出院的综合系统方法。
The American heart hospital journal Pub Date : 2010-01-01 DOI: 10.15420/ahhj.2010.8.2.91
Kiwon Lee
{"title":"Management of acute stroke and transient ischemic stroke-an integrated, systematic approach from the emergency department to the inpatient setting to discharge.","authors":"Kiwon Lee","doi":"10.15420/ahhj.2010.8.2.91","DOIUrl":"https://doi.org/10.15420/ahhj.2010.8.2.91","url":null,"abstract":"<p><p>In the past two decades, we have seen major advances in the treatment of transient ischemic attack (TIA) and acute ischemic stroke. Unfortunately, these advances have not benefited the majority of TIA and stroke patients. Reasons vary and include the failure of patients and providers to recognize the severity of early symptoms, resulting in critical delays in treatment. Other reasons include the inability of isolated emergency departments (EDs) to acquire life-saving technology or enhance provider expertise in recent medical advances. Effective treatment of TIA and stroke requires an integrated, systematic approach that begins in the ED, continues in the inpatient setting, and is maintained after discharge.</p>","PeriodicalId":87149,"journal":{"name":"The American heart hospital journal","volume":"8 2","pages":"E91-8"},"PeriodicalIF":0.0,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30150150","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}
引用次数: 0
Right coronary ostial stent-whether or not to use computed tomographic angiography. 右冠状动脉口支架-是否使用计算机断层血管造影。
The American heart hospital journal Pub Date : 2010-01-01 DOI: 10.15420/ahhj.2010.8.2.99
Shoeb J Sitafalwalla, Edward Passen, Ravi Gurujal, Samuel Wann
{"title":"Right coronary ostial stent-whether or not to use computed tomographic angiography.","authors":"Shoeb J Sitafalwalla,&nbsp;Edward Passen,&nbsp;Ravi Gurujal,&nbsp;Samuel Wann","doi":"10.15420/ahhj.2010.8.2.99","DOIUrl":"https://doi.org/10.15420/ahhj.2010.8.2.99","url":null,"abstract":"","PeriodicalId":87149,"journal":{"name":"The American heart hospital journal","volume":"8 2","pages":"E99-101"},"PeriodicalIF":0.0,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30150151","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}
引用次数: 0
Tachycardia-induced cardiomyopathy- a fully reversible phenomenon. 心动过速引起的心肌病——完全可逆的现象。
The American heart hospital journal Pub Date : 2010-01-01 DOI: 10.15420/ahhj.2010.8.2.115
Michael C Y Nam, Adarsh Aravind, Koo Chan, Simon James, Nigel Brown
{"title":"Tachycardia-induced cardiomyopathy- a fully reversible phenomenon.","authors":"Michael C Y Nam,&nbsp;Adarsh Aravind,&nbsp;Koo Chan,&nbsp;Simon James,&nbsp;Nigel Brown","doi":"10.15420/ahhj.2010.8.2.115","DOIUrl":"https://doi.org/10.15420/ahhj.2010.8.2.115","url":null,"abstract":"<p><p>Tachycardia induced cardiomyopathy (TIC) is a rare but potentially reversible cause of heart failure. The case of a patient with severe tachycardiomyopathy who had a favorable outcome following treatment of tachyarrythmia is presented here.</p>","PeriodicalId":87149,"journal":{"name":"The American heart hospital journal","volume":"8 2","pages":"E115-7"},"PeriodicalIF":0.0,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30150275","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}
引用次数: 5
Left ventricular non-compaction–when are trabeculations excessive? 左心室不紧致——什么时候小梁过度?
The American heart hospital journal Pub Date : 2010-01-01 DOI: 10.15420/ahhj.2010.8.2.105
Karen K Stout
{"title":"Left ventricular non-compaction–when are trabeculations excessive?","authors":"Karen K Stout","doi":"10.15420/ahhj.2010.8.2.105","DOIUrl":"https://doi.org/10.15420/ahhj.2010.8.2.105","url":null,"abstract":"","PeriodicalId":87149,"journal":{"name":"The American heart hospital journal","volume":"8 2","pages":"E105-7"},"PeriodicalIF":0.0,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30227565","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}
引用次数: 0
Reversible electrocardiogram changes and cardiomyopathy secondary to baclofen withdrawal syndrome. 可逆心电图改变和继发于巴氯芬戒断综合征的心肌病。
The American heart hospital journal Pub Date : 2010-01-01 DOI: 10.15420/ahhj.2010.8.1.52
Dmitriy Kireyev, Kian-Keong Poh
{"title":"Reversible electrocardiogram changes and cardiomyopathy secondary to baclofen withdrawal syndrome.","authors":"Dmitriy Kireyev,&nbsp;Kian-Keong Poh","doi":"10.15420/ahhj.2010.8.1.52","DOIUrl":"https://doi.org/10.15420/ahhj.2010.8.1.52","url":null,"abstract":"Baclofen withdrawal syndrome is a rare and potentially life-threatening condition manifesting with autonomic dysreflexia, high fevers, spasticity, seizures, and multiorgan failure. Reversible cardiomyopathy due to this condition is extremely rare. A high level of suspicion is needed to recognize this condition and start an early intervention to improve patient outcome. Electrocardiographic ST-segment elevation in lead aVR was previously described in association with left main, left anterior descending, and triple-vessel coronary artery disease as well as Takotsubo cardiomyopathy. In this article we present a rare case of reversible cardiomyopathy due to baclofen withdrawal syndrome associated with diffuse ST-segment depressions and ST-segment elevation in lead aVR.","PeriodicalId":87149,"journal":{"name":"The American heart hospital journal","volume":"8 1","pages":"52-4"},"PeriodicalIF":0.0,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29565589","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}
引用次数: 10
Acute change in left ventricle end-diastolic pressure after primary percutaneous coronary intervention in patients with ST segment elevation myocardial infarction. ST段抬高型心肌梗死患者经皮冠状动脉介入治疗后左室舒张末期压的急性变化。
The American heart hospital journal Pub Date : 2010-01-01
Omer Satıroğlu, Yüksel Ciçek, Mehmet Bostan, Mustafa Cetin, Engin Bozkurt
{"title":"Acute change in left ventricle end-diastolic pressure after primary percutaneous coronary intervention in patients with ST segment elevation myocardial infarction.","authors":"Omer Satıroğlu,&nbsp;Yüksel Ciçek,&nbsp;Mehmet Bostan,&nbsp;Mustafa Cetin,&nbsp;Engin Bozkurt","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Unlabelled: </strong>ST segment elevation myocardial infarction (STEMI) causes decreasing left ventricle compliance, increasing left ventricle end-diastolic pressure (LVEDP), and diastolic dysfunctioning. It is known that primary percutaneous coronary intervention (PCI) has an acute effect on left ventricle compliance.</p><p><strong>Aims: </strong>This study aims to determine whether left ventricle diastolic function improves and LVEDP decreases post-PCI in patients with STEMI.</p><p><strong>Methods: </strong>Twenty-nine patients (21 male, mean age 62 ± 12) diagnosed with a first anterior or inferior STEMI and hospitalized in the first six hours were enrolled. Coronary angiography (CAG) showed occlusion of the right coronary artery (RCA), circumflex (Cx), or left anterior descending (LAD) coronary artery. Aortic pressure and LVEDP were measured and compared before and after PCI.</p><p><strong>Results: </strong>After successful reperfusion, left ventricle diastolic function improved and LVEDP decreased significantly. Decrease in mean LVEDP was 5.7 ± 2.9 mmHg (p=0.0005) and 4.9 ± 6.5 mmHg (p=0.026) in inferior and anterior MI, respectively. Clinical and electrocardiographic (ECG) findings improved quickly.</p><p><strong>Conclusion: </strong>Primary PCA provides rapid improvement of LVEDP and diastolic functions in both anterior and inferior MI. Left ventricular pressure (before and after PCI) can be measured during the procedure without any complication, so it can be used for quick evaluation of left ventricular diastolic function improvement.</p>","PeriodicalId":87149,"journal":{"name":"The American heart hospital journal","volume":"8 2","pages":"E86-90"},"PeriodicalIF":0.0,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30150284","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}
引用次数: 0
Cardiac tamponade as a rare form of presentation of rheumatic carditis. 心包填塞是风湿性心炎的一种罕见表现形式。
The American heart hospital journal Pub Date : 2010-01-01
Fátima Derlene Rocha Araújo, Kelly Nascimento Brandão, Fabiana Arantes Araújo, Gláucia Maria Vasconcelos Severiano, Zilda Maria Alves Meira
{"title":"Cardiac tamponade as a rare form of presentation of rheumatic carditis.","authors":"Fátima Derlene Rocha Araújo,&nbsp;Kelly Nascimento Brandão,&nbsp;Fabiana Arantes Araújo,&nbsp;Gláucia Maria Vasconcelos Severiano,&nbsp;Zilda Maria Alves Meira","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In this article the authors describe a clinical case of acute rheumatic fever (according to revised Jones criteria, American Heart Association [AHA], 1992) with cardiac tamponade, emphasizing this uncommon presentation. An adolescent patient with a clinical picture of cardiac tamponade was seen in the emergency department. Clinical progression and tests demonstrated rheumatic carditis with an initial manifestation of pericarditis with cardiac tamponade. This report aims to warn physicians about the diagnosis of rheumatic carditis in an unusual clinical presentation, in cases of cardiac tamponade, particularly in school-aged children and adolescents in countries with a high prevalence of rheumatic fever. The literature contains only two documented cases of cardiac tamponade related to acute rheumatic fever, and this case represents a third.</p>","PeriodicalId":87149,"journal":{"name":"The American heart hospital journal","volume":"8 1","pages":"55-7"},"PeriodicalIF":0.0,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29565590","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}
引用次数: 0
Rotational atherectomy to facilitate stent expansion after deployment in ST-segment-elevation myocardial infarction. 旋转动脉粥样硬化切除术促进st段抬高型心肌梗死部署后支架扩张。
The American heart hospital journal Pub Date : 2010-01-01 DOI: 10.15420/ahhj.2010.8.1.66
Rasoul Mokabberi, James C Blankenship
{"title":"Rotational atherectomy to facilitate stent expansion after deployment in ST-segment-elevation myocardial infarction.","authors":"Rasoul Mokabberi,&nbsp;James C Blankenship","doi":"10.15420/ahhj.2010.8.1.66","DOIUrl":"https://doi.org/10.15420/ahhj.2010.8.1.66","url":null,"abstract":"<p><p>We describe successful rotational atherectomy performed in the setting of two relative contraindications to the procedure. A 77- year-old female presented with ST-segment-elevation myocardial infarction due to 100% right coronary artery thrombosis. With high pressure dilatation (22 atmospheres) and cutting balloon angioplasty, the lesion dissected but did not fully dilate. After stenting and high-pressure post-dilatation at 25 atmospheres the dissection resolved, but a 70% waist remained. Rotational atherectomy allowed full dilatation of the lesion at 22 atmospheres. In this case, after stenting removed angiographically evident thrombus and dissection, rotational atherectomy effectively and safely treated residual stenosis at an undilatable lesion.</p>","PeriodicalId":87149,"journal":{"name":"The American heart hospital journal","volume":"8 1","pages":"66-9"},"PeriodicalIF":0.0,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29565593","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}
引用次数: 20
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