Acute cardiac care最新文献

Mayo registry for telemetry efficacy in arrest study: An evaluation of the feasibility of the do not intubate code status. 梅奥注册中心在心脏骤停研究中的遥测疗效:评估不插管码状态的可行性。

Acute cardiac care Pub Date : 2016-12-01 Epub Date: 2017-12-06 DOI: 10.1080/17482941.2017.1408917

David Snipelisky, Adrian Dumitrascu, Jordan Ray, Archana Roy, Gautam Matcha, Dana Harris, Tyler Vadeboncoeur, Fred Kusumoto, M Caroline Burton

{"title":"Mayo registry for telemetry efficacy in arrest study: An evaluation of the feasibility of the do not intubate code status.","authors":"David Snipelisky, Adrian Dumitrascu, Jordan Ray, Archana Roy, Gautam Matcha, Dana Harris, Tyler Vadeboncoeur, Fred Kusumoto, M Caroline Burton","doi":"10.1080/17482941.2017.1408917","DOIUrl":"https://doi.org/10.1080/17482941.2017.1408917","url":null,"abstract":"Introduction: Guidelines recommend discussing code status with patients on hospital admission. No study has evaluated the feasibility of a full code with do not intubate (DNI) status. Methods: A retrospective analysis of patients who experienced a cardiopulmonary arrest was performed between May 1, 2008 and June 20, 2014. A descriptive analysis was created based on whether patients required mechanical ventilatory support during the hospitalization and comparisons were made between both patient subsets. Results: A total of 239 patients were included. Almost all (n = 218, 91.2%) required intubation during the hospitalization. Over half (n = 117, 53.7%) were intubated on the same day as the cardiopulmonary arrest and 91 patients (41.7%) were intubated at the time of arrest. Comparisons between intubated and non-intubated patients showed little differences in clinical characteristics, except for a higher proportion of medical cardiac etiology for admission in patients who did not require intubation (n = 10, 47.6% versus n = 55, 25.2%; p = 0.18) and initial arrest rhythm of ventricular tachycardia/fibrillation (n = 8, 38.1% versus n = 50, 22.9%; p = 0.37). No differences in 24-hour and posthospital survivals were present. Conclusion: Mechanical ventilatory support is commonly utilized in patients who experience a cardiopulmonary arrest. The DNI status may not be a feasible code status option for most patients.","PeriodicalId":87385,"journal":{"name":"Acute cardiac care","volume":"18 4","pages":"79-84"},"PeriodicalIF":0.0,"publicationDate":"2016-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/17482941.2017.1408917","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35621305","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

Acute pneumopericardium: when echocardiography is not enough. 急性心包:超声心动图不充分时。

Acute cardiac care Pub Date : 2016-12-01 Epub Date: 2018-02-16 DOI: 10.1080/17482941.2017.1363394

Manuel Oliveira-Santos, Elisabete Jorge, Rui Baptista Luís Leite, Rui Martins, João Calisto, Vítor Matos, Mariano Pego

{"title":"Acute pneumopericardium: when echocardiography is not enough.","authors":"Manuel Oliveira-Santos, Elisabete Jorge, Rui Baptista Luís Leite, Rui Martins, João Calisto, Vítor Matos, Mariano Pego","doi":"10.1080/17482941.2017.1363394","DOIUrl":"https://doi.org/10.1080/17482941.2017.1363394","url":null,"abstract":"A 46-year-old female with metastasized rectal adenocarcinoma complained of progressive exertional dyspnea. The physical exam was remarkable for low blood pressure (98/54 mmHg) and tachycardia (115 bpm). A severe pericardium effusion with right chambers’ collapse was identified, and the patient was submitted to echocardiography-guided pericardiocentesis by a subxiphoid approach, employing a handheld ultrasound device, with fluoroscopy available. The puncture was undertaken uneventfully, with prompt drainage of serous fluid (500 cc) through a 6Fr pigtail catheter paralleled by pericardial effusion reduction on echo. However, it was impossible to obtain an ultrasound window to visualize the heart at the end of the procedure. Diagnosis: Immediate fluoroscopy showed a pneumopericardium (image and video 1), which explained the imaging finding on transthoracic ultrasound. The air was instantly drained with a 50-cc syringe (video 2). The patient remained asymptomatic and the discharge chest radiography was normal. Pneumopericardium is a rare complication of pericardiocentesis, and we hypothesize that it was due to air leakage to the pericardial drainage system (1). Conservative management is reasonable in hemodinamically stable patients (2); however, we proceeded to aspiration as the catheter was in position. Fluoroscopy was crucial for this clinically inapparent diagnosis.","PeriodicalId":87385,"journal":{"name":"Acute cardiac care","volume":"18 4","pages":"85"},"PeriodicalIF":0.0,"publicationDate":"2016-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/17482941.2017.1363394","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35838179","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

A multi-hospital analysis of predictors of oral anticoagulation prescriptions for patients with actionable atrial fibrillation who attend the emergency department. 多家医院对急诊科可操作心房颤动患者口服抗凝处方预测因素的分析

Acute cardiac care Pub Date : 2016-12-01 Epub Date: 2017-11-29 DOI: 10.1080/17482941.2017.1406954

Joel A Scott-Herridge, Colette M Seifer, Ron Steigerwald, Glen Drobot, William F McIntyre

{"title":"A multi-hospital analysis of predictors of oral anticoagulation prescriptions for patients with actionable atrial fibrillation who attend the emergency department.","authors":"Joel A Scott-Herridge, Colette M Seifer, Ron Steigerwald, Glen Drobot, William F McIntyre","doi":"10.1080/17482941.2017.1406954","DOIUrl":"https://doi.org/10.1080/17482941.2017.1406954","url":null,"abstract":"Atrial fibrillation (AF) is the most common arrhythmia and is associated with an increase in the risk of ischemic stroke. The risk of stroke can be significantly decreased by oral anticoagulation (OAC). Our objective was to characterize the filling of OAC prescriptions for patients with actionable AF (new or existing AF with an indication for OAC but not prescribed) and determine the prevalence and predictors of guideline-appropriate therapy at 30 days. This is a multi-hospital, retrospective cohort study of patients who visited the Emergency Department (ED) and had a discharge diagnosis of AF. Patient records were examined to identify demographics, risk factors, and prescription data. Predictors of filling a prescription at 30 days were analyzed. 788 patients with AF were reviewed. 257 patients had actionable AF. Forty one percent (104) had newly diagnosed AF. The mean CHADS2 score was 2 ± 1. At 30 days after discharge, 25.7% of patients filled a prescription for OAC therapy. Large numbers of patients attending the ED have actionable AF, but rates of guideline-directed OAC at thirty days are low. Only a prescription written by the ED physician (OR 9.89) and documentation of stroke risk stratification in the patients' chart (OR 4.09) were associated with the primary outcome.","PeriodicalId":87385,"journal":{"name":"Acute cardiac care","volume":"18 4","pages":"71-78"},"PeriodicalIF":0.0,"publicationDate":"2016-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/17482941.2017.1406954","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35599110","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: 4

Double guide double wrist 5F left coronary artery transradial percutaneous coronary intervention and the X-Kiss technique. 双导双腕5F左冠状动脉经桡动脉经皮冠状动脉介入治疗及X-Kiss技术。

Acute cardiac care Pub Date : 2016-09-01 Epub Date: 2017-11-08 DOI: 10.1080/17482941.2017.1369126

Dangoisse Vincent, Schroëder Erwin, Claude Hanet, Antoine Guédès, Pancholy Samir

引用次数: 3

Severe burns in a patient after out-of-hospital CPR. 院外心肺复苏术后严重烧伤患者。

Acute cardiac care Pub Date : 2016-09-01 Epub Date: 2017-10-25 DOI: 10.1080/17482941.2017.1382704

Nir Biterman, Arthur Kerner, Doron Aronson, Yaron BarLavie, Yehuda Ullmann, Michael Kapeliovich

引用次数: 0

Demographic and clinical features of atrial myxomas: A case series analysis. 心房黏液瘤的人口学和临床特征:一个病例系列分析。

Acute cardiac care Pub Date : 2016-09-01 DOI: 10.1080/17482941.2017.1398827

Rafael Garcia-Carretero, Blanca Beamonte Vela, Gabriel Martínez-Quesada, Blanca San Jose Montano

{"title":"Demographic and clinical features of atrial myxomas: A case series analysis.","authors":"Rafael Garcia-Carretero, Blanca Beamonte Vela, Gabriel Martínez-Quesada, Blanca San Jose Montano","doi":"10.1080/17482941.2017.1398827","DOIUrl":"https://doi.org/10.1080/17482941.2017.1398827","url":null,"abstract":"Aim: Cardiac myxomas are uncommon tumors and have a wide clinical spectrum. Their diagnosis can therefore be elusive because symptoms are nonspecific and misleading. Our aim was to characterize and analyze the clinical findings in patients presenting with cardiac myxomas.Methods: We conducted a retrospective, hospital-based case study using the electronic records of a Spanish general hospital, caring for a population of 155,000. Patients' data were collected for the period between 2000 and 2016. Demographic data and clinical features were analyzed.Results: Our series included 22 patients over a 15-year period (annual incidence of 0.94 patients per 100,000 inhabitants). Men were predominant (68%) and the median age was 69 years. Cardiac (40.9%), systemic (27.3%), and neurological manifestations (13.6%) were the main clinical features. Left atrium (81.8%) was the predominant location. Surgical treatment was performed in all patients and the overall outcome was good in all cases.Conclusions: Cardiac myxomas are uncommon, benign tumors, predominantly located in the left atrium and mainly affecting middle-aged and elderly male patients. Congestive heart failure, stroke, and systemic symptoms, although misleading and nonspecific, are the most frequent forms of clinical presentation.","PeriodicalId":87385,"journal":{"name":"Acute cardiac care","volume":"18 3","pages":"65-69"},"PeriodicalIF":0.0,"publicationDate":"2016-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/17482941.2017.1398827","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35583143","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: 8

Pregnant women with heart disease: Placental characteristics and their association with fetal adverse events. 患有心脏病的孕妇:胎盘特征及其与胎儿不良事件的关系

Acute cardiac care Pub Date : 2016-09-01 Epub Date: 2017-11-22 DOI: 10.1080/17482941.2017.1397699

Fabio V Lima, Paraskevi Koutrolou-Sotiropoulou, Puja B Parikh, Cecilia Avila, Javed Butler, Kathleen Stergiopoulos

{"title":"Pregnant women with heart disease: Placental characteristics and their association with fetal adverse events.","authors":"Fabio V Lima, Paraskevi Koutrolou-Sotiropoulou, Puja B Parikh, Cecilia Avila, Javed Butler, Kathleen Stergiopoulos","doi":"10.1080/17482941.2017.1397699","DOIUrl":"https://doi.org/10.1080/17482941.2017.1397699","url":null,"abstract":"Background: Pregnant women with heart disease (HD) have higher rates of adverse fetal outcomes. We describe placental pathologic characteristics and their association with fetal events.Methods: In pregnant women, known HD were categorized into: (1) cardiomyopathy (CM) or (2) other HD (congenital, coronary, arrhythmia, or valvular). Outcomes were maternal major adverse cardiac events (MACE), fetal adverse clinical events (FACE), a composite of infant death, prematurity, underweight status, intracranial hemorrhage, and respiratory distress. Only pathologically reported placental analyses were included.Results: We studied 86 pregnancies in women with CM and HD, with pathologic analyses on 35 CM and 52 HD placentas. CM placentas, compared with those with HD, were more likely to have ischemic changes (65.7% vs. 37%, p 0.008), demonstrate immaturity (62.90% vs. 10%, p < 0.001), and have a lower weight (p < 0.001), despite similar gestational age. CM was independently associated with increased risk for MACE (OR 7.38, 95%CI 2.20-24.76). Ischemic placental changes were associated with increased odds of FACE (OR 24.78, 95%CI 2.37-259.03).Conclusions: Women with CM were more likely to have ischemic placentas, with lower placental and fetal weights, and evidence of immaturity compared with those with other forms of HD, and an increased odds of MACE.","PeriodicalId":87385,"journal":{"name":"Acute cardiac care","volume":"18 3","pages":"56-64"},"PeriodicalIF":0.0,"publicationDate":"2016-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/17482941.2017.1397699","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35577141","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: 8

Early left ventricular ejection fraction as a predictor of survival after cardiac arrest. 早期左心室射血分数作为心脏骤停后生存的预测因子。

Acute cardiac care Pub Date : 2016-06-01 Epub Date: 2017-03-22 DOI: 10.1080/17482941.2017.1293831

Barry Burstein, Dev Jayaraman, Regina Husa

{"title":"Early left ventricular ejection fraction as a predictor of survival after cardiac arrest.","authors":"Barry Burstein, Dev Jayaraman, Regina Husa","doi":"10.1080/17482941.2017.1293831","DOIUrl":"https://doi.org/10.1080/17482941.2017.1293831","url":null,"abstract":"Background: Cardiopulmonary resuscitation and early defibrillation have been shown to improve outcomes of cardiac arrest. The significance of the post-arrest echocardiogram, specifically the left ventricular ejection fraction (LVEF) is unknown.Methods: We performed a retrospective cohort study of patients who suffered from cardiac arrest between 1 January 2009 and 31 December 2013. We included all patients who achieved return of spontaneous circulation (ROSC), and were admitted to the intensive care unit (ICU) or coronary care unit (CCU) of a tertiary care academic center. Patients who underwent echocardiography within 24 h of cardiac arrest were included for analysis. The primary outcome was survival.Results: We identified 151 patients who achieved ROSC of which 97 underwent post-arrest echocardiogram within 24 h. 70.8% were males and the mean age was 67.8 years (SD: 15.9). The mean LVEF at 24 h was 35.7 (SD: 17.8). LVEF > 40% was not a predictor of survival at 30 days or hospital discharge. The only significant predictors on multivariate analyses were age, presence of shockable rhythm and time to ROSC.Conclusion: Although echocardiograms are frequently ordered, LVEF greater than 40% in patients who are resuscitated after a cardiac arrest is not a predictor of survival.","PeriodicalId":87385,"journal":{"name":"Acute cardiac care","volume":"18 2","pages":"35-39"},"PeriodicalIF":0.0,"publicationDate":"2016-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/17482941.2017.1293831","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34842776","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: 9

Cannon A-waves due to pacemaker syndrome. 心脏起搏器综合征引起的a波。

Acute cardiac care Pub Date : 2016-06-01 Epub Date: 2017-03-20 DOI: 10.1080/17482941.2017.1293832

Jackson J Liang, John W Hirshfeld

{"title":"Cannon A-waves due to pacemaker syndrome.","authors":"Jackson J Liang, John W Hirshfeld","doi":"10.1080/17482941.2017.1293832","DOIUrl":"https://doi.org/10.1080/17482941.2017.1293832","url":null,"abstract":"A 67-year-old woman underwent orthotopic heart transplantation for end-stage familial cardiomyopathy. Epicardial pacing wires were placed during the transplant surgery and remained in situ. Sixteen days after transplant, she was referred for right heart catheterization and surveillance endomyocardial biopsy. Throughout the procedure, her epicardial ventricular pacing wire asynchronously paced her ventricle at 80 beats per minute. Physical examination prior to and immediately following the biopsy procedure demonstrated cannon A-waves of her right jugular venous impulse (Video 1). Right atrial hemodynamic pressure tracings demonstrated a mean right atrial pressure of 5 mmHg with A-waves to over 20 mmHg (Figure 1A), which differed from right atrial tracings measured during her previous right heart catheterization one week prior in the presence of atrioventricular synchrony (mean right atrial pressure 3 mmHg with A-waves to 5 mmHg) (Figure 1B). Following the uncomplicated procedure, epicardial ventricular pacing was discontinued and the cannon A-waves resolved completely (Video 2). She subsequently underwent implantation of dual chamber pacemaker for sinus dysfunction. Cannon A-waves are giant jugular venous pulsations classically thought to occur due to right atrial contraction against a closed tricuspid valve. Most frequently seen in conditions with atrioventricular dissociation (i.e. complete heart block, ventricular tachycardia, or atrioventricular nodal re-entry tachycardia), cannon A-waves may also be caused by ‘pacemaker syndrome’, due to loss of normal atrioventricular synchrony. With asynchronous ventricular pacing, retrograde ventriculoatrial conduction may cause atrial contraction against a closed tricuspid valve resulting in the formation of cannon A-waves. Treatment for cannon A-waves due to pacemaker syndrome is to restore atrioventricular synchrony, either by pacing the atria and ventricles synchronously, or as in our patient,","PeriodicalId":87385,"journal":{"name":"Acute cardiac care","volume":"18 2","pages":"40-41"},"PeriodicalIF":0.0,"publicationDate":"2016-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/17482941.2017.1293832","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34834261","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

Intrapulmonary artery balloon pulsation improves circulatory function after acute myocardial infarction in pigs. 肺内动脉球囊搏动改善猪急性心肌梗死后的循环功能。

Acute cardiac care Pub Date : 2016-06-01 Epub Date: 2017-03-22 DOI: 10.1080/17482941.2017.1293830

Rahma Ouardani, Nikos Magkoutis, Philippe Bonnin, Chantal Kang, Antoni W Kedra, Georgios Sideris, Michel Bonneau, Sebastian Voicu

{"title":"Intrapulmonary artery balloon pulsation improves circulatory function after acute myocardial infarction in pigs.","authors":"Rahma Ouardani, Nikos Magkoutis, Philippe Bonnin, Chantal Kang, Antoni W Kedra, Georgios Sideris, Michel Bonneau, Sebastian Voicu","doi":"10.1080/17482941.2017.1293830","DOIUrl":"https://doi.org/10.1080/17482941.2017.1293830","url":null,"abstract":"Aim: To examine whether pulmonary artery balloon pulsation (PABP) could improve circulatory function in acute myocardial infarction (AMI) in pigs.Methods/results: Ten downsize pigs were sedated and ventilated. AMI was induced by inserting a plug into the left anterior descending artery. A pulsation balloon was placed in the pulmonary artery in all animals. In the treatment group (TG), pulsations began when life-threatening arrhythmia or > 30% drop in mean blood pressure (MBP) or > 40% decrease in cardiac output compared to baseline occurred. Pulsation rate was 120/min, independent of the heartbeat, maintained for 10 min. The control group (CG) received no pulsation. In the TG (n = 5), mean BP after the AMI improved by 7 ± 12 mmHg after 150 min while in the CG, MBP decreased by 17 ± 25 mmHg, P < 0.05; coronary perfusion pressure improved by 8 ± 7 mmHg in the TG but decreased by 15 ± 12 in the CG (P < 0.05). In the CG, cardiac output did not change but in the TG it improved from 3.5 ± 0.9 after the AMI to 4.2 ± 1.1 l/min 150 min after AMI (P < 0.05). The TG required 1.8 ± 0.4 electric shocks for ventricular fibrillation versus 0.8 ± 0.4 in the pulsation group (P < 0.05).Conclusion: PABP could be useful in the management of AMI due to improved mean arterial BP, coronary perfusion pressure, cardiac output and electrical stability. The mechanism of this effect remains to be determined.","PeriodicalId":87385,"journal":{"name":"Acute cardiac care","volume":"18 2","pages":"42-44"},"PeriodicalIF":0.0,"publicationDate":"2016-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/17482941.2017.1293830","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34842444","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