International journal of cardiology
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In atrial fibrillation (AF) patients stroke is nearly twice as likely to be fatal as non-AF patients and functional deficits are more likely to be severe among survivors. The incidence of stroke among AF patients is greatly reduced by oral anticoagulant treatment (OAT). However, fluctuation of anticoagulation levels is intrinsically related to OAT and often international normalized ratio (INR) is out of the therapeutic range. ⋯ The severity of stroke was not related to the whole quality of anticoagulation or to INR at the event.
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Letter Case Reports
Delayed cardiac tamponade in a patient with previous minor blunt chest trauma.
Hemopericardium with cardiac tamponade after non-penetrating chest trauma is a very rare but life-threatening condition. If this complication develops after an interval of several weeks following the non-penetrating chest trauma, the causal relation with the traumatic event is less evident, which may delay proper diagnosis and adequate treatment. We describe diagnosing and therapeutic management of a patient in shock who suffered from cardiac tamponade four weeks after a minor blunt chest trauma.
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Letter Case Reports
Patent foramen ovale and ascending aortic aneurysm with platypnea-orthodeoxia syndrome.
Platypnea-orthodeoxia is a rare syndrome characterized by dyspnea induced by the upright position and relieved by supine position and an arterial deoxygenation increased by the upright position which improves during recumbency. Several anatomical factors that can alter the atrial anatomy and facilitate shunting through an interatrial defect have been related with this syndrome. ⋯ Rarely platypnea-orthodeoxia syndrome has been described associated with an aortic aneurysm too. We present a case of platypnea-orthodeoxia syndrome in a 76-year-old Italian man with patent foramen ovale and ascending aortic aneurysm.
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Randomized Controlled Trial Multicenter Study Comparative Study
Multicenter randomised trial on home-based telemanagement to prevent hospital readmission of patients with chronic heart failure.
Chronic heart failure (CHF) remains a common cause of disability, death and hospital admission. Several investigations support the usefulness of programs of disease management for improving clinical outcomes. However, the effect of home-based telemanagement programs on the rate of hospital readmission is still unclear and the cost-effectiveness ratio of such programs is unknown. The aim of the study was to determine whether a home-based telemanagement (HBT) programme in CHF patients decreased hospital readmissions and hospital costs in comparison with the usual care (UC) follow-up programme over a one-year period. ⋯ This study suggests that one-year HBT programme reduce hospital readmissions and costs in CHF patients.
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Torsade de pointes is a form of polymorphic ventricular tachycardia occurring in a setting of prolonged QT interval on surface electrocardiogram. Several drugs have been shown to prolong cardiac repolarization predisposing to torsade de pointes ventricular tachycardia. We present a case of torsade de pointes in a 72-year-old Italian woman in treatment with sotalol, sertraline, digoxin and acenocumarine.