Clinical cardiology
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Clinical cardiology · Jul 2010
ReviewThe effectiveness and cost effectiveness of public-access defibrillation.
Many sudden cardiac deaths are due to ventricular fibrillation (VF). The use of defibrillators in hospitals or by outpatient emergency medical services (EMS) personnel can save many cardiac-arrest victims. Automated external defibrillators (AEDs) permit defibrillation by trained first responders and laypersons. ⋯ AEDs save very few lives in residential units such as private homes or apartment complexes. AEDs are cost effective at sites where there is a high density of both potential victims and resuscitators. Placement at golf courses, health clubs, and similar venues is not cost effective; however, the visible devices are good for public awareness of the problem of sudden cardiac death and provide reassurance to patrons.
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Clinical cardiology · Jun 2010
Review Meta AnalysisEfficacy and safety of intracoronary autologous bone marrow-derived cell transplantation in patients with acute myocardial infarction: insights from randomized controlled trials with 12 or more months follow-up.
Until now there was no systematic review concerning the chronic effects of intracoronary bone marrow-derived cell (BMC) transplantation in patients with acute myocardial infarction (MI). ⋯ Beneficial effects of intracoronary BMC transplantation could last more than 12 months in acute MI patients.
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Clinical cardiology · Jun 2010
ReviewLoop diuretic therapy in heart failure: the need for solid evidence on a fluid issue.
Heart failure (HF) is a common condition associated with substantial cost, morbidity, and mortality. Because results of clinical trials in the acute decompensated heart failure (ADHF) setting have been mostly neutral, loop diuretics remain the mainstay of treatment. ⋯ Loop diuretics still prove useful in HF treatment, but risk-benefit analysis of these agents in the treatment of ADHF requires a well-designed prospective study.
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Clinical cardiology · Apr 2010
Review Case ReportsInverted-Takotsubo pattern cardiomyopathy secondary to pheochromocytoma: a clinical case and literature review.
Takotsubo cardiomyopathy is an increasingly recognized clinical syndrome of transient left ventricular dysfunction, commonly with apical ballooning, in the context of physical or emotional stress. Recently, an inverted-Takotsubo contractile pattern has been described with hypokinesis of the basal and mid-ventricular segments and sparing of the apex. We report a case of a 30-year-old man presenting with transient left ventricular dysfunction in an inverted-Takotsubo contractile pattern, associated with a newly discovered pheochromocytoma, and present a literature review of the inverted-Takotsubo contractile pattern cardiomyopathy.
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Infectious thoracic aortitis (IA) remains a rare disease, especially after the appearance of antibiotics. However, if left untreated it is always lethal. It usually affects patients with atherosclerotic aortic disease and/or infective endocarditis. ⋯ It is extremely important to establish an early diagnosis of IA, because this condition is potentially life-threatening. However, diagnosis is frequently delayed since clinical manifestations are usually nonspecific. Antibiotherapy in combination with complete surgical excision of the infected aorta is the best choice of treatment.