Cardiovascular revascularization medicine : including molecular interventions
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Cardiovasc Revasc Med · Sep 2020
ReviewImplementation of Institutional Discharge Protocols and Transition of Care Following Acute Coronary Syndrome.
Despite improvements in acute care and survival following acute coronary syndrome (ACS) hospitalization, readmission remains common. In response, individual institutions have begun to develop their own protocols to reduce variability of care and readmission rates. ⋯ TABLE OF CONTENTS This review discusses approaches for developing and implementing institutional discharge protocols for continuity of care for patients with acute coronary syndrome. The discussion revolves around key components and objectives of a discharge protocol for facilitating successful transition of care.
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Cardiovasc Revasc Med · Aug 2020
ReviewTreatment of ST-Segment Elevation Myocardial Infarction During COVID-19 Pandemic.
The number of cases of the coronavirus-induced disease-2019 (COVID-19) continues to increase exponentially worldwide. In this crisis situation, the management of ST-segment elevation myocardial infarction (STEMI) is challenging. ⋯ While thrombolysis may seem like a good choice, many patients have a contraindication and could end up using more resources. Also, with a high probability of the angiogram showing non-obstructed coronary arteries during acute infections, primary PCI should be the preferred strategy.
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Cardiovasc Revasc Med · Aug 2020
ReviewGuidelines for Balancing Priorities in Structural Heart Disease During the COVID-19 Pandemic.
During the novel coronavirus disease 2019 (COVID-19) pandemic, many hospitals have been asked to postpone elective and surgical cases. This begs the question, "What is elective in structural heart disease intervention?" The recently proposed Society for Cardiovascular Angiography and Interventions/American College of Cardiology consensus statement is, unfortunately, non-specific and insufficient in its scope and scale of response to the COVID-19 pandemic. We propose guidelines that are practical, multidisciplinary, implementable, and urgent. ⋯ During the surge phase, treatment should broadly be limited to those at increased risk of complications in the near term. During the peak phase, treatment should be limited to inpatients for whom it may facilitate discharge. Keeping our patients and ourselves safe is paramount, as well as justly rationing resources.
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Cardiovasc Revasc Med · Aug 2020
Multicenter StudyCoronary and Structural Heart Disease Interventions During COVID-19 Pandemic: A Road Map for Clinicians and Health Care Delivery Systems.
Because of the COVID-19 pandemic, cath labs have had to modify their workflow for elective and urgent patients. ⋯ Our survey of an experienced team of clinicians yielded concise guidelines to direct the management of CAD and structural heart disease patients during the initial phases of the COVID-19 pandemic.
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Cardiovasc Revasc Med · Aug 2020
Case ReportsCOVID-19 (SARS-CoV-2) and the Heart - An Ominous Association.
Coronavirus disease 2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Cardiovascular manifestations of COVID-19 are diverse and complex and include acute coronary syndrome, myocarditis masquerading as ST-segment elevation myocardial infarction, pericarditis and pericardial effusion. We present 2 cases of COVID-19 infection with myocardial involvement with distinct mechanistic pathways and outcomes. Important decision strategies such as the timing of cardiac catheterization (when indicated) and requirement of early hemodynamic support in critically ill patients are discussed.