Journal of cardiovascular medicine
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J Cardiovasc Med (Hagerstown) · Feb 2008
Management of acute ST-elevation myocardial infarction in the coronary care units of Piedmont in 2005: results from the PRIMA regionwide survey.
In Piedmont (north-western Italy) a network for emergency treatment of acute ST-elevation myocardial infarction is being implemented. To provide a baseline for care assessment and quality improvement, a regionwide survey was conducted. We describe the clinical characteristics, treatment and outcomes of patients admitted to the coronary care units (CCUs) of the Regional Health System. ⋯ In Piedmont, candidates for myocardial reperfusion treatment admitted to the CCUs of the Regional Health System are about 600 per million inhabitants/year. The 118 emergency medical system is used by about half of them, and medical contact occurs within 3 h of symptom onset in most cases. Use of reperfusion treatment is frequent, the choice is related to on-site availability rather than to risk profile, and door-to-treatment times can be improved. Use of emergency transfer is limited, poorly selected, and slow.
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J Cardiovasc Med (Hagerstown) · Jan 2008
Case ReportsCongenital hypoplasia of the inferior vena cava and inherited thrombophilia: rare associated risk factors for idiopathic deep vein thrombosis. A case report.
In young patients, acquired and genetic causes of deep vein thrombosis frequently interact. The association of congenital hypoplasia of the inferior vena cava with antithrombin III deficiency has never been described in the literature as a causal factor of proximal deep vein thrombosis in young patients. We report the case of an 18-year-old patient affected by deep vein thrombosis due to this rare association without other common risk factors.
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J Cardiovasc Med (Hagerstown) · Dec 2007
Randomized Controlled Trial Multicenter StudyPost-cardioversion transesophageal echocardiography (POSTEC) strategy with the use of enoxaparin for brief anticoagulation in atrial fibrillation patients: the multicenter POSTEC trial (a pilot study).
In patients with atrial fibrillation (AF), we sought to evaluate the feasibility and safety of a new transesophageal echocardiography (TEE)-guided strategy, aimed at selecting, 7 days post-cardioversion, those patients who are at low risk (i.e. who can terminate anticoagulation after a second TEE) and those at high risk (i.e. who have to continue it). ⋯ The pre/post-cardioversion TEE strategy with enoxaparin in AF may constitute a feasible and safe approach in selecting patients at low thromboembolic risk who can benefit from precocious termination of anticoagulation (7 days after cardioversion). It may be also useful to identify those patients in whom a life-lasting anticoagulation could be beneficial. A larger trial to confirm these findings is under way.
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J Cardiovasc Med (Hagerstown) · Nov 2007
Case ReportsRight atrial free wall rupture after blunt chest trauma.
We report the case of an 18-year-old man, victim of a car accident, presenting with severe hypotension and signs of cardiac tamponade. Transoesophageal echocardiography was suggestive of right atrial free wall rupture. ⋯ The immediate clinical outcome was favourable; the patient is in good general condition at 24-month follow-up. The right atrium is rarely involved in cardiac contusion as compared to the right ventricle or other cardiac structures, owing to its anatomical location and direction of physical forces.