International journal of cardiology
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The purpose of this study was to understand the trajectory of prehospital delay in patients with acute myocardial infarction (AMI) in the Japanese health care system, which offers patients a choice between seeking treatment in a neighborhood clinic/small hospital (clinic group) or a large hospital with comprehensive cardiac services, including a cardiac catheterization laboratory (hospital group). ⋯ Findings support the need for public education in Japan that focuses on the appropriate response to AMI symptoms. Moreover, regional AMI networks need to be instituted to provide for early transfer for PCI from clinic/small hospitals to tertiary centers.
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To investigate the predictive value of asymptomatic cervical bruit for detecting internal carotid artery disease in consecutive patients undergoing coronary artery bypass grafting (CABG). ⋯ Asymptomatic cervical bruit proved a highly specific clinical sign for detection of internal carotid artery stenosis, whether haemodynamically significant (> or = 50%) or otherwise, in patients undergoing myocardial revascularisation. This was matched by a high negative predictive value and overall accuracy for flow limiting atheroma (> or = 50% stenosis). Yet, steering carotid investigations on the basis of cervical bruit alone would result in > or = 80% internal carotid artery stenosis remaining undetected in 3% of overall patients, in whom cervical bruit is absent.
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Migrant South Asian population in the West, particularly women, is more predisposed to central obesity and metabolic syndromes than native Caucasians. However, the burden of coexistence of clinical risk factors for cardiovascular disease (CVD) and associated gender disparities in native population of South Asia are not known. We analyzed the National Health Survey of Pakistan (NHSP) (1990-1994) data to study the same in the population of Pakistan. ⋯ Potentially modifiable factors including obesity and saturated fat intake are associated with increased prevalence of CVD risk factors. The high burden of multiple CVD risk factors in women compared to men highlight the need for targeting this vulnerable segment of population in CVD prevention programs in Pakistan, and, possibly neighbouring countries.
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Letter Case Reports
Severe pulmonary hypertension due to pulmonary alveolar microlithiasis.
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Randomized Controlled Trial
The role of high-frequency jet ventilation in the treatment of Cheyne-Stokes respiration in patients with chronic heart failure.
Cheyne-Stokes respiration with central sleep apnea (CSR-CSA) is common in patients with severe cardiac failure. Various modes of positive airway pressure have been suggested as treatments. The authors hypothesized that high frequency jet ventilation (HFJV) can improve central sleep apnea in patients with chronic heart failure. ⋯ One night of therapy with HFJV improved nocturnal breathing pattern and sleep quality in patients with Cheyne-Stokes respiration in chronic heart failure. HFJV therapy for sleep and breathing were the same as those during a nasal CPAP night. A long-term study of the effect of HFJV on cardiovascular function is needed.