Clinical cardiology
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Clinical cardiology · Jul 2004
Comparative StudyTransthoracic echocardiography for precardioversion screening during atrial flutter/fibrillation in young patients.
Transthoracic echocardiography (TTE) is reliable for detection of thrombi in the left ventricle and right atrium, but not in the left atrial appendage. Therefore, transesophageal echocardiography (TEE) is routinely performed in adults prior to electric cardioversion for atrial flutter/fibrillation (AFF). Whether young survivors of congenital heart disease repair with AFF need routine TEE prior to electric cardioversion is unknown. ⋯ These findings suggest that TTE may be an effective imaging tool for precardioversion screening in young patients with AFF.
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Patients who experience a stroke or transient ischemic attack (TIA) are at high risk for subsequent vascular events, most commonly stroke. This article focuses on clinical trials examining secondary prevention of stroke and reviews the various commonly used methods of stroke prevention: surgical approaches, antihypertensive treatment, lipid- and cholesterol-lowering medications, anticoagulant therapies, and antiplatelet therapies.
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Clinical cardiology · Mar 2004
Case ReportsA case of paradoxical embolism "in situ" associated with massive pulmonary embolism: role of echocardiography.
A 49-year-old man was admitted in transfer for further management of a pulmonary embolism (PE) and possible mitral valve vegetation. Transthoracic echocardiography performed at our institution showed evidence of right ventricular (RV) enlargement and dysfunction. Within the right atrium was a serpentine mobile thrombus which traversed the interatrial septum at the level of the fossa ovalis and extended into the left atrium to the level of the anterior mitral valve leaflet. ⋯ We believe that all patients should undergo echocardiography prior to receiving thrombolytic therapy for pulmonary emboli. Careful interrogation of the interatrial septum for the presence of a thrombus in situ is warranted. Thrombectomy should be considered in individuals with PE who have a thrombus in situ.
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Clinical cardiology · Feb 2004
A population-based evaluation of the thrombolysis in myocardial infarction risk score for unstable angina and non-ST elevation myocardial infarction.
The Thrombolysis in Myocardial Infarction risk score (TIMI-RS) for unstable angina/non-ST elevation myocardial infarction (MI) was developed in patients presenting with unstable angina accompanied by high-risk features or non-ST elevation MI to determine early risk stratification. ⋯ The TIMI-RS successfully differentiates early risk for major adverse cardiac events in a general population presenting with symptoms suggestive of acute coronary syndrome. A simple bedside calculation of the TIMI-RS provides rapid risk stratification, allowing facilitation of therapeutic decision making in patients with symptoms suggestive of ACS.