The Canadian journal of cardiology
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The 2012 Canadian Cardiovascular Society Heart Failure (HF) Guidelines Update provides management recommendations for acute and chronic HF. In 2006, the Canadian Cardiovascular Society HF Guidelines committee first published an overview of HF management. ⋯ With this in mind and in response to stakeholder feedback, the Guidelines Committee in 2012 has updated the overview of both acute and chronic heart failure diagnosis and management. The 2012 Update also includes recommendations, values and preferences, and practical tips to assist the medical practitioner manage their patients with HF.
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Inherited heart rhythm disorders are uncommon conditions that have emerged as a challenge to recognize and treat for the practicing clinician. The common electrical forms are long QT and Brugada syndrome, catecholaminergic ventricular tachycardia, and early repolarization syndrome. Inherited cardiomyopathies, including hypertrophic cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy, dilated cardiomyopathy, and left ventricular noncompaction can also cause serious cardiac rhythm disturbances and sudden death. ⋯ These heterogenous conditions can be challenging to diagnose with equally difficult management decisions. However, some common measures can be applied that will assist health care providers and reduce risk for patients. Condition-specific treatment strategies that are deployed in regional clinics are discussed, including the role of the referring health care team.
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Multicenter Study Comparative Study
Survival from in-hospital cardiac arrest on the Internal Medicine clinical teaching unit.
There is a paucity of data on patient outcomes following in-hospital cardiac arrest (IHCA) on the Internal Medicine clinical teaching unit (CTU). Accurate outcome data enhances discussions between patients, surrogates, and physicians, and assists in their management. ⋯ IHCA in Internal Medicine CTU patients is characterized by a high rate of PEA/asystole and a minimal chance of survival to hospital discharge. Moreover, no patient with an unwitnessed arrest survived to hospital discharge. While these findings require confirmation in a larger study, they merit consideration in the context of code status discussions, particularly with respect to the response to unwitnessed arrests.
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Review
Vascular risk in chronic obstructive pulmonary disease: role of inflammation and other mediators.
Chronic obstructive pulmonary disease (COPD) is an inflammatory lung condition that affects 3 million adult Canadians aged 40 years or older. Most patients have mild to moderate disease and as such have only modest symptoms of cough and breathlessness. ⋯ Experimental and epidemiologic data from the past 20 years provide compelling evidence that chronic lung inflammation (related to COPD or exposure to irritants such as tobacco smoke or air pollution) contributes to atherosclerotic plaque progression and that acute inflammatory stimulus such as acute respiratory tract infections or acute exacerbations of COPD induce plaque rupture, leading to cardiovascular events. In this paper, we provide an overview of the epidemiologic and experimental data linking COPD with cardiovascular disease and highlight the clinical implications of this linkage for clinicians who evaluate and manage patients with COPD, cardiovascular diseases, or both.