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Mashup Score: 21Shortness of breath as a diagnostic factor for acute coronary syndrome in male and female callers to out-of-hours primary care - 18 hour(s) ago
Objective Chest discomfort and shortness of breath (SOB) are key symptoms in patients with acute coronary syndrome (ACS). It is, however, unknown whether SOB is valuable for recognising ACS during telephone triage in the out-of-hours primary care (OHS-PC) setting. Methods A cross-sectional study performed in the Netherlands. Telephone triage conversations were analysed of callers with chest discomfort who contacted the OHS-PC between 2014 and 2017, comparing patients with SOB with those who did not report SOB. We determine the relation between SOB and (1) High urgency allocation, (2) ACS and (3) ACS or other life-threatening diseases. Results Of the 2195 callers with chest discomfort, 1096 (49.9%) reported SOB (43.7% men, 56.3% women). In total, 15.3% men (13.2% in those with SOB) and 8.4% women (9.2% in those with SOB) appeared to have ACS. SOB compared with no SOB was associated with high urgency allocation (75.9% vs 60.8%, OR: 2.03; 95% CI 1.69 to 2.44, multivariable OR (mOR): 2.03;
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Mashup Score: 16Augmenting reality in echocardiography - 2 day(s) ago
Echocardiography is a vital first-line imaging tool for the diagnosis and management of many cardiovascular diseases. Its availability and low cost have encouraged widespread use by clinicians for the diagnosis and management of patients with heart failure.1 Visual estimation is widely used to assess ejection fraction (EF), the percentage of blood the left ventricle pumps out during a contraction. Accurately determining the EF in patients with heart failure is crucial for the implementation of timely guideline-directed medical treatment. There is a substantial need for high-fidelity determination of EF in emergency settings. However, there is high interobserver variability with visual estimation methods, which can be compounded by inadequate quality of capture and lack of specialised training in both obtaining and interpreting echocardiograms in these settings.2 The work presented by Choi et al 3 represents an important advance in reducing the burden of time and cost constraints in mea
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Mashup Score: 1
Background Elevated heart rate (HR) predicts cardiovascular disease and mortality, but there are no established normal limits for ambulatory HR. We used data from the Swedish CArdioPulmonary Imaging Study to determine reference ranges for ambulatory HR in a middle-aged population. We also studied clinical correlates of ambulatory HR. Methods A 24-hour ECG was registered in 5809 atrial fibrillation-free individuals, aged 50–65 years. A healthy subset (n=3942) was used to establish reference values (excluding persons with beta-blockers, cardiovascular disease, hypertension, heart failure, anaemia, diabetes, sleep apnoea or chronic obstructive pulmonary disease). Minimum HR was defined as the lowest 1-minute HR. Reference ranges are reported as means±SDs and 2.5th–97.5th percentiles. Clinical correlates of ambulatory HR were analysed with multivariable linear regression. Results The average mean and minimum HRs were 73±9 and 48±7 beats per minute (bpm) in men and 76±8 and 51±7 bpm in wome
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Mashup Score: 1
The UK National Institute for Health and Care Excellence (NICE) guidance for hypertension management has recently been updated. This review article summaries the main recommendations in NICE guidelines, and compares them with the American and European guidelines. NICE and the European Society of Cardiology (ESC) recommend diagnosing hypertension at a higher level than the American College of Cardiology/American Heart Association (ACC/AHA). NICE treats to less stringent targets than both the ACC/AHA and the ESC, while using similar, although non-combination pill based, treatment regimens.
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Mashup Score: 2Augmenting reality in echocardiography - 4 day(s) ago
Echocardiography is a vital first-line imaging tool for the diagnosis and management of many cardiovascular diseases. Its availability and low cost have encouraged widespread use by clinicians for the diagnosis and management of patients with heart failure.1 Visual estimation is widely used to assess ejection fraction (EF), the percentage of blood the left ventricle pumps out during a contraction. Accurately determining the EF in patients with heart failure is crucial for the implementation of timely guideline-directed medical treatment. There is a substantial need for high-fidelity determination of EF in emergency settings. However, there is high interobserver variability with visual estimation methods, which can be compounded by inadequate quality of capture and lack of specialised training in both obtaining and interpreting echocardiograms in these settings.2 The work presented by Choi et al 3 represents an important advance in reducing the burden of time and cost constraints in mea
Source: heart.bmj.comCategories: General Medicine News, Cardiology News and JournTweet
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Mashup Score: 4Management of arrythmias during pregnancy - 5 day(s) ago
### Learning objectives A sensation of abnormal or irregular heart beating is a very common symptom in pregnancy. This is often secondary to sinus tachycardia, sinus bradycardia and sinus arrhythmia, or isolated premature atrial or ventricular arrhythmias (VAs). The overall incidence of arrhythmia documented in pregnancy is reported to be in the range of 0.03%–0.5% of pregnancies,1 making this one of the most common cardiac complications of pregnancy, in women with and without structural heart disease.2–4 The incidence of arrhythmia in pregnancy is increasing, a rise attributable to the increase in the proportion of women with structural heart disease achieving successful pregnancies in the last decade.5 Clinical evaluation of the symptomatic pregnant patient begins with a careful history, detailing the timing of onset of symptoms, frequency and potential exacerbating factors. A careful family history, probing for a history of unexplained sudden death, heart failure, cardiac transplant
Source: heart.bmj.comCategories: General Medicine News, Cardiologists1Tweet
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Mashup Score: 2Augmenting reality in echocardiography - 6 day(s) ago
Echocardiography is a vital first-line imaging tool for the diagnosis and management of many cardiovascular diseases. Its availability and low cost have encouraged widespread use by clinicians for the diagnosis and management of patients with heart failure.1 Visual estimation is widely used to assess ejection fraction (EF), the percentage of blood the left ventricle pumps out during a contraction. Accurately determining the EF in patients with heart failure is crucial for the implementation of timely guideline-directed medical treatment. There is a substantial need for high-fidelity determination of EF in emergency settings. However, there is high interobserver variability with visual estimation methods, which can be compounded by inadequate quality of capture and lack of specialised training in both obtaining and interpreting echocardiograms in these settings.2 The work presented by Choi et al 3 represents an important advance in reducing the burden of time and cost constraints in mea
Source: heart.bmj.comCategories: General Medicine News, Cardiology News and JournTweet
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Mashup Score: 3Cardiovascular sequelae of trastuzumab and anthracycline in long-term survivors of breast cancer - 7 day(s) ago
Objectives Long-term follow-up of patients treated with trastuzumab largely focuses on those with reduced left ventricular ejection fraction (LVEF) on treatment completion. This study sought to evaluate the prevalence of cardiovascular risk factors, overt cardiovascular disease and cardiac imaging abnormalities using cardiac magnetic resonance (CMR), in participants with normal LVEF on completion of trastuzumab±anthracycline therapy at least 5 years previously. Methods Participants with human epidermal growth factor receptor 2-positive breast cancer treated with trastuzumab±anthracycline ≥5 years previously were identified from a clinical database. All participants had normal LVEF prior to, and on completion of, treatment. Participants underwent clinical cardiovascular evaluation, ECG, cardiac biomarker evaluation and CMR. Left ventricular systolic dysfunction (LVSD) was defined as LVEF <50%. Results Forty participants were recruited between 15 March 2021 and 19 July 2022. Median time
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Mashup Score: 3Cardiovascular sequelae of trastuzumab and anthracycline in long-term survivors of breast cancer - 7 day(s) ago
Objectives Long-term follow-up of patients treated with trastuzumab largely focuses on those with reduced left ventricular ejection fraction (LVEF) on treatment completion. This study sought to evaluate the prevalence of cardiovascular risk factors, overt cardiovascular disease and cardiac imaging abnormalities using cardiac magnetic resonance (CMR), in participants with normal LVEF on completion of trastuzumab±anthracycline therapy at least 5 years previously. Methods Participants with human epidermal growth factor receptor 2-positive breast cancer treated with trastuzumab±anthracycline ≥5 years previously were identified from a clinical database. All participants had normal LVEF prior to, and on completion of, treatment. Participants underwent clinical cardiovascular evaluation, ECG, cardiac biomarker evaluation and CMR. Left ventricular systolic dysfunction (LVSD) was defined as LVEF <50%. Results Forty participants were recruited between 15 March 2021 and 19 July 2022. Median time
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Mashup Score: 10Regional variations in heart failure: a global perspective - 8 day(s) ago
Heart failure (HF) is a global public health concern that affects millions of people worldwide. While there have been significant therapeutic advancements in HF over the last few decades, there remain major disparities in risk factors, treatment patterns and outcomes across race, ethnicity, socioeconomic status, country and region. Recent research has provided insight into many of these disparities, but there remain large gaps in our understanding of worldwide variations in HF care. Although the majority of the global population resides across Asia, Africa and South America, these regions remain poorly represented in epidemiological studies and HF trials. Recent efforts and registries have provided insight into the clinical profiles and outcomes across HF patterns globally. The prevalence of HF and associated risk factors has been reported and varies by country and region ranges, with minimal data on regional variations in treatment patterns and long-term outcomes. It is critical to im
Source: heart.bmj.comCategories: General Medicine News, CardiologistsTweet
Shortness of breath as a diagnostic factor for acute coronary syndrome in male and female callers to out-of-hours primary care 🏥 🏥 https://t.co/Cl2Jg6dZC7 https://t.co/iSmm6xgj9e