European heart journal. Acute cardiovascular care
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Eur Heart J Acute Cardiovasc Care · Aug 2015
Value of syncope in patients with high-to-intermediate risk pulmonary artery embolism.
Syncope may develop in 9-35% of patients with pulmonary embolism (PE). Despite its severity and importance, the prognostic value of syncope in PE is unclear. We aimed to assess the value of syncope in patients with high-to-intermediate risk PE. ⋯ The history of syncope in patients with suspected PE should be considered as a possible criterion of high risk of fatal complications of in-hospital period due to frequent embolism of the pulmonary trunk and its main branches. The use of thrombolytic therapy showed a tendency in improving outcomes.
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Eur Heart J Acute Cardiovasc Care · Aug 2015
Randomized Controlled TrialAcute intraoperative effect of intravenous amiodarone on right ventricular function in patients undergoing valvular surgery.
Amiodarone is commonly used in the acute care setting. However the acute hemodynamic and echocardiographic effect of intravenous amiodarone administered intraoperatively on right ventricular (RV) systolic and diastolic function using transesophageal echocardiography (TEE) has not been described. ⋯ Acute administration of amiodarone is associated with alteration in RV diastolic properties and has minimal negative inotropic effect on RV systolic function in cardiac surgical patients with valvular disease.
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Eur Heart J Acute Cardiovasc Care · Aug 2015
Impact of patient positioning on lung ultrasound findings in acute heart failure.
The purpose of this study was to compare lung ultrasound findings in both the supine and upright positions in heart failure patients presenting with dyspnea or chest pain. ⋯ Our findings suggest that patient positioning may impact the number of B-lines on lung ultrasound in a heart failure population. A consistent approach to patient positioning during lung ultrasonography may be necessary in order to monitor dynamic changes in heart failure.
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Eur Heart J Acute Cardiovasc Care · Aug 2015
Impact of time to cooling initiation and time to target temperature in patients treated with hypothermia after cardiac arrest.
Little is known about the role of time to initiation of therapeutic hypothermia and time to target temperature (TTT) in the prognosis of patients resuscitated from cardiac arrest. ⋯ The most important prognostic factors for death or lack of neurological recovery in patients with cardiac arrest treated with therapeutic hypothermia are initial-rhythm, time from cardiac arrest to return of spontaneous circulation and arterial-pH at admission. Although the speed of cooling initiation and the time to reach target temperature may play a role, its influence on prognosis seems to be less important.
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Eur Heart J Acute Cardiovasc Care · Aug 2015
Observational StudyImportance of primary percutaneous coronary intervention for reducing mortality in ST-elevation myocardial infarction complicated by out of hospital cardiac arrest.
Current recommendations are for primary percutaneous coronary intervention (pPCI) in ST-elevation myocardial infarction (STEMI) complicated by out of hospital cardiac arrest (OHCA). However, information about longer-term outcomes is sparse, particularly among high-risk patients who do not regain consciousness promptly after resuscitation. ⋯ In patients with STEMI who are conscious after OHCA, high rates of survival can be achieved with pPCI, depending in part on the time it takes for ROSC. Prognosis is less good in the subgroup brought to hospital unconscious but even in this high risk group neurologically intact survival can be achieved in about one-third of cases, suggesting the benefit of immediate pPCI in STEMI patients successfully resuscitated after OHCA.