Revue médicale suisse
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Revue médicale suisse · May 2009
Review[Indications for urgent coronary angiography. Part I: ST-segment elevation acute coronary syndromes].
The indications for urgent coronary angiography are stated in the guidelines for treatment of acute coronary syndromes. An invasive approach is considered the treatment of choice for patients presenting with ST elevation myocardial infarction within 12 hours of the beginning of symptoms. In the absence of contraindication, intravenous thrombolysis continues to be a valuable alternative to primary angioplasty within 3 hours of the beginning of clinical symptoms. Urgent coronary angiography continues to be recommended following the failure of thrombolysis, persistent myocardial ischemia after 12 hours of symptoms, recurrent myocardial ischemia following myocardial infarction or in the case of cardiogenic shock.
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Takotsubo syndrome (TS) also named transient left ventricular apical ballooning syndrome is a particularly entity of the acute coronary syndrome with normal coronary arteries. The predominance is neatly postmenopausal women. The aetiology and physiopathology of TS are subject to many hypothesis, sometime contradictory. ⋯ The typical image at the ventriculography is a systolic left ventricular apical ballooning reversible in a few days to weeks with an excellent prognostic. The treatment is based on supportive care. The goal of this article is to review the actual knowledge about TS to help the general practitioner, aboard this entity in the management of an ACS.
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Revue médicale suisse · May 2009
Biography Historical Article[Abraham Joly (1748-1812), a breaker of the hospital chains].
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Revue médicale suisse · May 2009
[Pulmonary rehabilitation: a multidisciplinary and comprehensive intervention].
Pulmonary rehabilitation is an evidence-based, multidisciplinary and comprehensive intervention for chronic pulmonary diseases, adressed to symptomatic patients and to patients with impairment of activities of daily life. The major outcomes of this intervention are an increased exercise capacity, a decrease in dyspnea and thereby a better quality of life. Underweight patients may benefit from a caloric and protein supplementation. Smoking cessation programs should be integrated in any pulmonary rehabilitation program.