Volume 15 - Issue 10 - October, 2007
Cerebral Vascular Accident Following a Pulmonary Embolism: Search for the Hidden Patent Foramen Ovale
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Case Report
An 83-year-old male with multiple medical problems was admitted to the hospital for intravenous antibiotic treatment of a severe lower extremity cellulitis. He suffered from longstanding diabetes mellitus and resultant chronic kidney disease with nephrotic range proteinuria and hypoalbuminemia. In addition, he was a former smoker and has mild chronic obstructive pulmonary disease (COPD) as well as heart failure with preserved left ventricular ejection fraction. On the third day of his hospitalization, he became progressively short of breath and hypoxic. Physical examinati
What Do You Think?
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Re: Question Gauging Interest in Cardiology Physician Extender Program
Dear Sir or Ma'am,
I would definitely have an interest in the development of a cardiology physician extender program. I supervise a cath lab in an Army Medical Center, and I know that my staff, as well as other US Army Cath Techs, would be very much interested in any higher education they may receive pertinent this field.
The Army is typically supportive of our efforts to further our education with tuition assistance for accredited programs, so please do forward what information you have, and note my per
Your patient has low platelets. Think about bleeding before and after cath.
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Hemoglobin is 10.6mg/dl;
White blood cell count (WBC) is 11,000 cell/mm3;
K+ (potassium) is 3.4meq/dl, platelet count of 65,000;
Blood urea nitrogen (BUN) is 28mg/dl;
Creatinine is 1.4mg/dl;
International Normalized Ratio (INR) is 1.5.
Should this patient continue in the lab or should you consult the physician and stop the procedure? In view of the unknown risks that these blood values portend, this patient’s procedure should wait until the physician has a clear understanding of the problems and the potential risk/benefits of performing angiography/percutaneous coronary
A Virtual Cath Lab Viewer (VCL):The Development of an Online 3D C-arm Simulator and Coronary Anatomy Viewer
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By combining a realistic environment for fluoroscopy with a radiological/ cross-sectional anatomical reference tool, Vycaria's virtual cath lab viewer (VCL) may help to:
Increase the efficiency and safety of diagnostic and interventional procedures.
Reduce the radiation dose to both staff and patients.
Increase lab throughput.
VCL Fluoroscopy and MRI
VCLs are computer-based fluoroscopy simulators and anatomical viewers. They use a real-time, interactive, 3D games-rendering engine (similar to Playstation and Xbox) to deliver a PC-based virtual catheterization laborato
Radiation Tracking in the Cardiac Catheterization Lab
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Patient safety is always a primary goal in any hospital and radiation safety ranks high on the list of safety items for a catheterization laboratory. The U.S. Nuclear Regulatory Commission (NCR) and the Food and Drug Association (FDA) regulate the use of radioactive materials in medicine and the manufacture of devices that emit radiation, respectively. The Joint Commission (TJC), more commonly referred to as the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), also regulates safety through its accreditation process. JCAHO has made the statement that prolonged fluoroscopy
Clinical and Industry News for October 2007
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Few Americans Aware of Dangerous Peripheral Arterial Disease
Three out of four people aren't aware of peripheral arterial disease (PAD), affecting approximately 8 million Americans, according to a new study published in Circulation: Journal of the American Heart Association.
In a cross-sectional, population-based telephone survey of 2,501 adults over age 50, researchers found that public awareness of PAD (25 percent) is markedly lower than for other cardiovascular diseases such as stroke (74 percent), coronary artery disease (67 percent) and heart failure (67 percent). Yet,
Letter to the Editor
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Unfortunately, I believe he accurately summarizes the current views of many cardiologists, especially those trained since the early 1990’s. Without question, echocardiography, Doppler, and nuclear testing are excellent clinical tools for assessing left ventricular function and aortic valve disease. Without doubt, contrast ventriculography and trans-aortic pressure measurements have limitations. However, these techniques continue to provide useful hemodynamic information, especially in situations when non-invasive techniques may be inaccurate. Optimal clinical decision making recognizes that
Cost-Effectiveness of the Radial versus Femoral Artery Approach to Diagnostic Cardiac Catheterization
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Carotid Stenting: An update
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What are the latest developments in carotid stenting trials and research?
In July of this year, Kensey Nash Corporation announced a Board of Directors decision to cease all activities involving the marketing and regulatory approval process of the flow occlusion and aspiration TriActiv® System platforms. The system had received CE Mark approval in Europe for use as an embolic protection device (EPD) during coronary saphenous vein bypass graft (SVG) and carotid artery stenting (CAS) procedures and in the United States for SVG percutaneous coronary intervention (PCI). A Phase I clinica
Patient Management Guidelines
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What are patient management guidelines, and how are they set?
In cardiology, guidelines are typically set by an organization when a sufficient body of evidence exists for the treatment of a specific disease state. Guidelines are also used as guiding principles for a certain procedure or procedural group, such as percutaneous intervention. A working group is then established that includes representatives from all of the major groups that have influence upon or interest in that particular area. The working group reviews available data and weighs it in terms of how helpful the data is,
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