Clinical cardiology
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Clinical cardiology · Dec 2009
Serum N-terminal-pro-brain natriuretic peptide level and its clinical implications in patients with atrial fibrillation.
Brain natriuretic peptide (BNP) is increasingly being used for screening and monitoring of congestive heart failure. However, the role of BNP in patients with atrial fibrillation (AF) and normal left ventricular function has not been determined. This study investigates serum N-terminal pro-brain natriuretic peptide (NT-proBNP) level and its clinical implications in patients with AF. ⋯ Patients with AF were associated with increased serum NT-proBNP levels. Examining the change of serum NT-proBNP levels is helpful to evaluate the cardiac function in patients with AF.
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Clinical cardiology · Dec 2009
Multicenter StudyPrehospital electrocardiograms (ECGs) do not improve the process of emergency department care in hospitals with higher usage of ECGs in non-ST-segment elevation myocardial infarction patients.
This article will describe the impact of prehospital electrocardiogram (ECG) use on emergency department (ED) processes of care for non-ST-segment elevation myocardial infarction (NSTEMI) patients and assess the characteristics associated with prehospital ECG use. ⋯ Use of prehospital ECG in NSTEMI patients is uncommon. In contrast to its impact on reperfusion times in ST-segment elevation myocardial infarction (STEMI) patients, its use does not appear to be associated with an improvement in ED processes of care at the hospital level.
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Clinical cardiology · Dec 2009
Patients with metabolic syndrome have prolonged corrected QT interval (QTc).
Prolongation of corrected QT interval (QTc) increases morbidity and mortality and QTc has been found to be longer in patients with diabetes mellitus than in healthy controls. It is still inconclusive whether the metabolic syndrome results in QTc prolongation. ⋯ Metabolic syndrome is a risk factor for prolonged QTc, which may further increase cardiovascular morbidity and mortality in the subjects with metabolic syndrome.
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Clinical cardiology · Nov 2009
Case ReportsNodal rhythm and ventricular parasystole: an unusual electrocardiographic presentation of mad honey poisoning.
Mad honey poisoning syndrome has been reported in the Eastern Black Sea region and Southeastern regions of Turkey. Herein we report a case of 70-y-old man presented with syncope and severe hemodynamic instability following ingestion of one teaspoon of honey and his unusual electrocardiographic manifestations: nodal rhythm alternating with sinus bradycardia and intermittant ventricular parasystole. In this report, we also tried to explain the possible mechanism responsible for these electrocardiographic findings.
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Right to left shunting through a patent foramen ovale (PFO) or atrial septal defect (ASD) can cause platypnea-orthodeoxia even in a setting of normal pulmonary artery pressures. However, the late onset of symptoms despite the congenital origin of the anatomical defects is not well understood. We report a case series of patients presenting with dyspnea and orthodeoxia who developed right to left shunting as a result of associated anatomical changes that occur with aging such as tortuosity and elongation of the aorta. We propose that these acquired anatomical changes can favor right to left shunting in the setting of congenital abnormalities, therefore explaining the late onset of symptoms.