Clinical cardiology
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Clinical cardiology · Mar 2009
Review Case ReportsRegional pericarditis: a review of the pericardial manifestations of acute myocardial infarction.
Regional pericarditis has been described in several settings, but occurs most frequently after transmural myocardial infarction. While the diagnosis remains elusive, it must be considered in all patients with recurrent chest pain following acute myocardial infarction (AMI). ⋯ Given the magnitude and frequency of AMI, it is imperative to be aware of the myriad of pericardial manifestations of myocardial injury. An illustrative case and a comprehensive review of the literature will be provided.
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Clinical cardiology · Mar 2009
Clinical diagnosis of posttraumatic stress disorder after myocardial infarction.
Clinician-rated large-scale studies estimating the prevalence of posttraumatic stress disorder (PTSD) related to myocardial infarction (MI) and identifying predictors of clinical PTSD are currently lacking. ⋯ Clinical PTSD is prevalent in post-MI patients. Demographic and particularly psychological variables related to the subjective experience of the event were stronger predictors of PTSD status than were objective measures of MI severity.
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Clinical cardiology · Jan 2009
ReviewElevated serum cardiac troponin in non-acute coronary syndrome.
Cardiac troponins (CTn) are the most sensitive and specific biochemical markers of myocardial injury and risk stratification. The assay for troponin T (cTnI) is standardized, and results obtained from different institutions are comparable. This is not the case with troponin I (cTnT), and clinicians should be aware that each institution must analyze and standardize its own results. ⋯ The cause of these elevations may involve serious medical conditions that require meticulous diagnostic evaluation and aggressive therapy. At present, there are no guidelines to treat patients with elevated troponin levels and no coronary disease. The current strategy of treatment of patients with elevated troponin and non-ACS involves treating the underlying causes.
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Clinical cardiology · Dec 2008
Randomized Controlled TrialEffects of levosimendan on left atrial functions in patients with ischemic heart failure.
With further progression of left ventricular (LV) dysfunction, the left atrial (LA) contribution to LV filling gradually decreases, and LA dysfunction deteriorates the decreased LV filling in patients with heart failure (HF). ⋯ Left atrial functions respond better to levosimendan than to dobutamine in decompensated HF.
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Clinical cardiology · Dec 2008
Biomarkers on admission for the prediction of cardiovascular events after primary stenting in patients with ST-elevation myocardial infarction.
Several cardiac biomarkers have been shown to have predictive values for the development of cardiovascular disease and clinical outcome after events, and are now broadly used by clinicians. Little is known about the utility of these biomarker values on admission in ST-elevation myocardial infarction (STEMI) cases of primary drug-eluting stent (DES) implantation and intense medical therapy. ⋯ The use of cardiac biomarkers on admission, in each or in combination, had only a minimal impact for the prediction of long-term cardiovascular events after primary stenting in STEMI patients.