An Insight Into Pathophysiology, Epidemiology, and Management of Cardiovascular Complications of SARS-CoV-2 Infection, Post-acute COVID Syndrome, and COVID Vaccine
Coronavirus disease 2019 (COVID-19), the disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was declared a pandemic health emergency in March 2020. Elderly patients and those with pre-existing medical conditions including cardiovascular disease are at increased risk of developing severe disease. Not only is the viral infection with SARS-CoV-2 associated with higher mortality in patients with underlying cardiovascular disease, but development of cardiovascular complications is also common in patients with COVID-19. Even after recovery from the acute illness, post-acute COVID syndrome with cardio...
Source: Critical Pathways in Cardiology - August 29, 2022 Category: Cardiology Tags: Review Article Source Type: research
International Perspectives on the Impact of the COVID-19 Pandemic on Adherence to Prescribed Dual Antiplatelet Therapy: A Window Into Acute Cardiovascular Care
An international panel of expert clinicians and researchers in acute cardiac care was convened to review, describe, and contextualize their varied experiences delivering care and maintaining ongoing research during the first year of the COVID-19 pandemic and beyond. A proposed perspective from which care and outcomes could be viewed was the possibility that without routine follow-up and as-accustomed interactions with their care team, patients at risk of acute atherothrombotic events might be less adherent to prescribed antiplatelet medications. This might be manifested by more emergency coronary events or by an increased ...
Source: Critical Pathways in Cardiology - August 29, 2022 Category: Cardiology Tags: Review Article Source Type: research
Development of a Care Pathway for Atrial Fibrillation Patients in the Emergency Department
Atrial fibrillation (AF) is the most common cardiac arrhythmia and its prevalence is continuously increasing in the United States, leading to a progressive rise in the number of disease-related emergency department (ED) visits and hospitalizations. Although optimal long-term outpatient management for AF is well defined, the guidelines for optimal ED management of acute AF episodes is less clear. Studies have demonstrated that discharging patients with AF from the ED after acute stabilization is both safe and cost effective; however, the majority of these patients in the United States and in our institution are admitted to ...
Source: Critical Pathways in Cardiology - August 29, 2022 Category: Cardiology Tags: Pathway Source Type: research
Clinical Features and Prognoses of Middle-Aged Women With ST-Elevation Myocardial Infarction With a Focus on Spontaneous Coronary Artery Dissection: erratum
No abstract available (Source: Critical Pathways in Cardiology)
Source: Critical Pathways in Cardiology - May 28, 2022 Category: Cardiology Tags: Erratum Source Type: research
The Patient Pathway Review for Atrial Fibrillation
The care pathway for patients with atrial fibrillation (AF) is variable and this variability is explored in a patient pathway review. This review describes events that may take place for a patient with AF considering the “ideal” and the “real-world” pathway and attempts to rationalize them by considering the patient, clinician, health service, and societal perspective. In the “ideal” pathway, AF in a patient is either identify before or after stroke. The “real-world” pathway introduces the concepts that symptoms may influence patient decision-making to seek help, AF may be identified incidentally, and healt...
Source: Critical Pathways in Cardiology - May 28, 2022 Category: Cardiology Tags: Review Article Source Type: research
The E/e′ Ratio: As “Critical” As the Left Ventricular Ejection Fraction?
We describe herein, what is to our knowledge, the first description of a critically elevated Doppler ratio of mitral inflow peak E-wave velocity to the mean mitral annular velocity as a harbinger of sudden death from pulmonary edema in a patient treated with aggressive intravenous fluids as part of the “sepsis bundle.” This is utilized as a springboard for proposing a clinical algorithm focused on expedited echocardiography. It emphasized the potential value of advancing markedly the diastolic assessment of filling pressure (ratio of mitral inflow peak E-wave velocity to the mean mitral annular velocity) in the acute c...
Source: Critical Pathways in Cardiology - May 28, 2022 Category: Cardiology Tags: Pathway Source Type: research
In-hospital and 1-Year Outcomes of Repeated Percutaneous Coronary Intervention for In-stent Restenosis With Acute Coronary Syndrome Presentation
Conclusions:
Multivessel disease, primary PCI, and history of non–ST-segment elevation MI were the predictors of higher 1-year MACE, whereas Ad-hoc PCI and diabetes mellitus had a protective effect on MACE. (Source: Critical Pathways in Cardiology)
Source: Critical Pathways in Cardiology - May 28, 2022 Category: Cardiology Tags: Original Study Source Type: research
Very Low Risk for In-hospital Adverse Outcome Such as ST-elevation or Non-ST-elevation Myocardial Infarction in Patients Undergoing Knee Surgery
Conclusions:
Inpatients’ adverse outcome of patients undergoing knee surgery is very low suggesting that extensive cardiac workup for knee surgery may not be warranted. (Source: Critical Pathways in Cardiology)
Source: Critical Pathways in Cardiology - May 28, 2022 Category: Cardiology Tags: Original Study Source Type: research
Developing a Risk Prediction Model for Early Atrial Fibrillation Recurrence After Maze Procedure
Conclusions:
Being older, multivalvular surgery, and persistent preoperative AF were the predictors of higher risk of early recurrent AF, whereas concomitant coronary artery bypass grafting and using beta-blocker had a protective effect. This model based on preoperative and operative characteristics can help us to better evaluate if the patient benefits from maze procedure coincide with valvular surgery. (Source: Critical Pathways in Cardiology)
Source: Critical Pathways in Cardiology - May 28, 2022 Category: Cardiology Tags: Original Study Source Type: research
Clinician Perception of Risk As a Barrier to Implementation of a High-sensitivity Troponin Accelerated Diagnostic Protocol
Conclusions:
ED clinicians accustomed to the HEART Pathway demonstrated limited willingness to discharge patients from the ED categorized as moderate risk by the HEART score despite simultaneous classification as low risk by the 0-/1-hour HST-ADP. Willingness to discharge was higher with lower HEART scores but not affected by the presence of CAD and did not vary between clinician types. (Source: Critical Pathways in Cardiology)
Source: Critical Pathways in Cardiology - May 28, 2022 Category: Cardiology Tags: Original Study Source Type: research
Machine Learning to Assess for Acute Myocardial Infarction Within 30 Minutes
Variations in high-sensitivity cardiac troponin I by age and sex along with various sampling times can make the evaluation for acute myocardial infarction (AMI) challenging. Machine learning integrates these variables to allow a more accurate evaluation for possible AMI. The goal was to test the diagnostic and prognostic utility of a machine learning algorithm in the evaluation of possible AMI. We applied a machine learning algorithm (myocardial-ischemic-injury-index [MI3]) that incorporates age, sex, and high-sensitivity cardiac troponin I levels at time 0 and 30 minutes in 529 patients evaluated for possible AMI in a sin...
Source: Critical Pathways in Cardiology - May 28, 2022 Category: Cardiology Tags: Original Study Source Type: research
Comparison of Pulmonary Emboli Management Between Pulmonary Emboli Response Team and the Conventional Method: The First Study From Iran
Background:
We aimed to evaluate the effectiveness of the Pulmonary Embolism Response Team (PERT) for intermediate-high risk and high-risk pulmonary embolism (PE) patients.
Methods:
This single-blind clinical trial was performed in 2019–2021, evaluating patients with intermediate-high risk and high risk of PE. Patients in the intervention group were managed by the PERT team, and treatment plans were implemented as soon as possible. Patients in the other group received conventional PE treatments based on the hospital protocols. We compared the primary outcome of short-term mortality between the 2 groups and sec...
Source: Critical Pathways in Cardiology - May 28, 2022 Category: Cardiology Tags: Original Study Source Type: research
Patient Pathways in Cardiology: Should Pharmaceutical and Medical Device Companies Care?
A shared goal of patients, providers, and the companies that produce new therapies is to have these therapies used according to guidelines. Health services specialize in patient care and may lack the capabilities to take a product from conception through to everyday use. This results in a mutually beneficial relationship between health services and industry. The market for cardiovascular drugs is significant, which results in competition between companies. While traditional methods of observational analysis may be able to determine to what extent drugs and devices are being prescribed or implanted by health providers, ther...
Source: Critical Pathways in Cardiology - February 22, 2022 Category: Cardiology Tags: Review Article Source Type: research
Therapeutic Hypothermia Is Associated With a Decrease in All-cause Mortality in Cardiac Arrest Due to Shockable Rhythm
Conclusions:
TH may be beneficial in reducing mortality and poor neurological outcomes in comatose postcardiac arrest patients with shockable rhythms. (Source: Critical Pathways in Cardiology)
Source: Critical Pathways in Cardiology - February 22, 2022 Category: Cardiology Tags: Original Study Source Type: research
Prevalence and Predictors of Cardiovascular Disease and Risk Factors in Transgender Persons in the United States
Conclusions:
In this contemporary cross-sectional nationally representative survey, CVD was prevalent in nearly 14% of TGD persons. Further studies examining interventions to reduce CV risk and enhance access to medical care in the TGD population are warranted. (Source: Critical Pathways in Cardiology)
Source: Critical Pathways in Cardiology - February 22, 2022 Category: Cardiology Tags: Original Study Source Type: research
