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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Spontaneous coronary artery dissection (SCAD) is a rare cause of myocardial ischemia that could present as angina, acute myocardial infarction, or even sudden death. It occurs more commonly in women and it has been associated with autoimmune and collagen vascular diseases. ⋯ In this article, we report 2 cases of asymptomatic SCAD that were diagnosed on routine preoperative evaluation. The management options and clinical implications are discussed.
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Those of us who see patients with cardiovascular disorders frequently use antiplatelet and anticoagulant agents; the common agents are aspirin, clopidogrel, and warfarin. This editorial is a personal viewpoint about commonly used drugs, not so commonly used drugs, and drugs that are yet to be used clinically.