AnatomyDiseasesChemicals and DrugsAnalytical, Diagnostic and Therapeutic Techniques and EquipmentPhenomena and ProcessesAnthropology, Education, Sociology and Social PhenomenaInformation ScienceNamed GroupsHealth CareGeographicals
Death, Sudden, CardiacExercise TestRisk AssessmentRisk FactorsElectrocardiographyExercise ToleranceExerciseDeathPredictive Value of TestsPrognosisExercise TherapyCause of DeathFollow-Up StudiesArrhythmias, CardiacTime FactorsProspective StudiesPhysical ExertionProportional Hazards ModelsOxygen ConsumptionMyocardial InfarctionHeart RateTreatment OutcomeSurvival AnalysisRetrospective StudiesCohort StudiesHeart FailureHeartMyocytes, CardiacCell DeathDefibrillators, ImplantableSurvival RateKaplan-Meier EstimateHeart DiseasesStroke VolumeCoronary DiseasePhysical EnduranceCardiac OutputTachycardia, VentricularRenal DialysisBiological MarkersTroponin TMyocardial IschemiaCoronary Artery DiseaseElectrocardiography, AmbulatoryCardiovascular DiseasesAnaerobic ThresholdEchocardiographyAngina PectorisMultivariate AnalysisROC CurveKidney Failure, ChronicVentricular Dysfunction, LeftCoronary AngiographyNatriuretic Peptide, BrainPhysical FitnessChest PainSeverity of Illness IndexVentricular FibrillationAsthma, Exercise-InducedAge FactorsEchocardiography, StressCardiac Surgical ProceduresDeath, SuddenVentricular Function, LeftProtein-Energy MalnutritionBrain DeathTomography, Emission-Computed, Single-PhotonBlood PressureTroponin IBicyclingHemodynamicsBrugada SyndromePulmonary Gas ExchangeSensitivity and SpecificityMuscle, SkeletalAngina, UnstableCardiomyopathy, HypertrophicLong QT SyndromeAdrenergic beta-AntagonistsHeart ArrestRiskReproducibility of ResultsCardiac CatheterizationCardiomyopathiesSyncopeChi-Square DistributionMyocardiumUnited StatesSportsHeart VentriclesHeart Conduction SystemCardiac Pacing, ArtificialLactic AcidDipyridamoleDyspneaMyocardial Perfusion ImagingHeart Function TestsAnalysis of VarianceCardiomyopathy, DilatedErgometry
InfarctionSudden deathEchocardiographyIschemiaBiomarkersImprove risk stratificationFurther risk stratificationRevascularizationIschaemiaNuclear myocardialPerfusion reserveInfarctionsSPECTAsymptomatic patientsImplantable cardiac defibrillatorsDiagnosisBiomarkerFibrosisHypertensionAssessmentTroponinNSTEMIMajor adverse cardiac eventsUnstableArrhythmiasAdverseSyncopePatient'sCoronary eventsEventsIncidenceTreadmill exerciseAtheroscleroticAtherosclerosisCardiovascular riskDiagnosticSymptomsIncreased risk of sudden cardiPrognosisChestChronicMorbidity and mortaReducing cardiac outputDetectionMortality and cardiacNoncardiac surgeryCardiopulmonary exerciseCardiologySensitivityAdaptationsConclusionsAtrialStrokeFindingsClinical riskAssessIschemicElectrocardiogram
Infarction24
Sudden death14
  • This can present with palpitations or syncope from an atrioventricular reciprocating tachycardia or rarely sudden death secondary to ventricular fibrillation from rapid conduction of atrial fibrillation across the accessory pathway. (escardio.org)
  • It has long been associated with ventricular arrhythmias and sudden death. (wikipedia.org)
  • competitive sport activity enhances by 2.5 the risk of sudden death in adolescents and young athletes (1). (escardio.org)
  • The family history of cardiovascular diseases is considered positive in athletes when close relatives had experienced a premature heart attack or sudden death (below 55 years of age in males and 65 years in females), or suffered from cardiomyopathy, Marfan syndrome, long QT syndrome, Brugada syndrome, severe arrhythmias, coronary artery disease, or other disabling cardiovascular diseases. (escardio.org)
  • 7 In those with a family history of sudden death, HCM or a clinical exam with a resting/provocable systolic ejection murmur, a heightened suspicion and pointed discussion will be helpful. (acc.org)
  • There was no significant reduction in cardiac mortality or sudden death (OR 0.78, p=0.85, and OR 0.34, p=0.25, respectively). (bmj.com)
  • Conclusions Although there was a trend towards reduced overall mortality when comparing early AVR in patients with asymptomatic, severe AS to a symptom-driven AVR approach, there was no significant difference in cardiac mortality or sudden death. (bmj.com)
  • Observational studies have shown the annual risk of sudden death is about 1% per year. (bmj.com)
  • Non-compaction cardiomyopathy is a congenital disorder of the myocardium causing cardiomyopathy, a variety of arrhythmias, conduction disorders, and increased risk of sudden death. (msdmanuals.com)
  • and to ventricular tachyarrhythmias, cardiac arrest, and sudden death. (msdmanuals.com)
  • Patients with syncope and evidence of congestive heart failure or structural heart disease, abnormal electrocardiographic findings, or a family history of sudden death should be admitted to the hospital for emergent evaluation. (aafp.org)
  • Other clinical manifestations of myocardial ischaemia include acute pulmonary oedema, loss of consciousness and sudden death. (unboundmedicine.com)
  • Your doctor may ask you to attend more closely to changes in your heart rhythms if your family has a history of heart disease or sudden death. (hopkinsmedicine.org)
  • Long QT syndrome (LQTS) is a congenital disorder characterized by a prolongation of the QT interval on electrocardiograms (ECGs) and a propensity to ventricular tachyarrhythmias, which may lead to syncope, cardiac arrest, or sudden death. (medscape.com)
Echocardiography11
Ischemia7
  • Myocardial ischemia is a disorder that is usually caused by a critical coronary artery obstruction, which is also known as atherosclerotic coronary artery disease (CAD). (medscape.com)
  • Diagnosing myocardial ischemia prior to a heart attack is important. (medscape.com)
  • Vaccarino and colleagues present the largest (n = 918) and most diverse (34% women, 40% black individuals) observational study investigating the association between mental stress ischemia, conventional stress ischemia, and future cardiac events in patients with known CHD using contemporary myocardial perfusion SPECT imaging. (allenpress.com)
  • On admission and a three hours follow up, then you really know this patient has a low risk and he has no on-going ischemia, and you can really send this patient home without any major concern. (aacc.org)
  • Significance of silent myocardial ischemia during exercise testing in patients with diabetes mellitus: a report from the Coronary Artery Surgery Study (CASS) Registry. (ajbm.net)
  • Ischemia adds risk that is incremental to clinical risks and LV dysfunction. (diabetesjournals.org)
  • In nondiabetic patients, a number of factors may be used to stratify the level of risk of coronary disease, including clinical history, resting ventricular function, exercise capacity, the presence and extent of ischemia at single-photon emission-computed tomography (SPECT), or stress echo. (diabetesjournals.org)
Biomarkers6
  • Furthermore, identifying new biomarkers of cardiovascular risk has the potential to refine early-life prevention strategies, before atherosclerosis becomes established. (bmj.com)
  • ED stress testing, in addition to standard workup with ECG and biomarkers, led to more downstream testing (angiography) and more interventions (PCI or CABG), but this didn't translate into fewer acute myocardial infarctions at one year. (journalfeed.org)
  • The AHA recommends stress testing in the ED or within 72 hours of ED evaluation in addition to standard ED workup with ECG and biomarkers. (journalfeed.org)
  • Cardiac troponin I and T (cTnI, cTnT) biomarkers help distinguish the 2/3 of ACS patients without ST-segment elevation ( UA or NSTEMI ). (biomerieuxindia.in)
  • The scope of this section includes the evaluation of available evidence for preoperative assessment and risk stratification of patients who undergo nonurgent vascular surgery for PAD along the following themes: clinical risk indices, cardiac biomarkers, and noninvasive testing. (ccs.ca)
  • The diagnosis is confirmed if the concentration of cardiac biomarkers is increased. (unboundmedicine.com)
Improve risk stratification2
  • Aims: (1) To improve risk stratification in asymptomatic patients with AS and (2) to determine whether MPR is a better predictor of outcome than exercise testing and brain natriuretic peptide (BNP). (le.ac.uk)
  • Our ability to identify vulnerable populations, improve risk stratification, and understand nontraditional risk factors is essential to best stratify risk assessment. (allenpress.com)
Further risk stratification3
  • However, the further risk stratification of patients presenting with acute chest pain without a rise in cardiac troponin is inconsistent. (bmj.com)
  • Conversely, an incorrect diagnosis of an athlete's heart may put a young life in harm's way and waive further risk stratification and evaluation of family members for this genetic condition. (acc.org)
  • Clearly, further risk-stratification of the pool of patients considered eligible for ICDs would have broad implications for the healthcare system. (uscjournal.com)
Revascularization5
  • In patients with ischemic heart disease who undergo revascularization based on PET viability assessment with fludeoxyglucose F-18 (F-18 FDG), those with a low myocardial perfusion reserve were at an increased risk of adverse cardiac events. (medscape.com)
  • The anatomical SYNTAX (Synergy between percutaneous coronary intervention with taxus and cardiac surgery) score (SxS) is an angiographic scoring system for assessing the complexity of coronary artery disease (CAD) [ 1 ] advocated for decision making in the latest ESC/EACTS guidelines on myocardial revascularization [ 2 ]. (hindawi.com)
  • A further strategy would be to screen patients for existing evidence of coronary disease, with the intent of myocardial revascularization in those at greatest risk. (diabetesjournals.org)
  • Patients who require emergency lower extremity arterial revascularization should not have their surgery delayed by a preoperative risk assessment. (ccs.ca)
  • Conversely, patients who undergo scheduled, nonemergency lower extremity arterial revascularization surgery should undergo cardiac risk assessment. (ccs.ca)
Ischaemia7
  • Cardiac imaging is central to the diagnosis and risk stratification of coronary artery disease, beyond symptoms and clinical risk factors, by providing objective evidence of myocardial ischaemia and characterisation of coronary artery plaque. (bmj.com)
  • However, coronary artery disease risk is also driven by biological processes, such as inflammation, that are not fully reflected by severity of stenosis, myocardial ischaemia or by coronary plaque features. (bmj.com)
  • New cardiac CT techniques can assess coronary artery inflammation by imaging perivascular fat, and this may represent an important step forward in identifying the 'residual risk' that is not detected by plaque or ischaemia imaging. (bmj.com)
  • Historically, evaluation of CAD was guided by symptoms, and crude measures of myocardial ischaemia with limited sensitivity and specificity from exercise ECG (ExECG) and other stress tests. (bmj.com)
  • First, two-dimensional imaging cannot assess haemodynamic consequences of stenoses, in terms of myocardial ischaemia. (bmj.com)
  • Imbalance between the myocardial oxygen need and the availability of oxygen, and consequently myocardial ischaemia may also be caused, in the absence of an acute coronary stenosis (plaque rupture), by tachycardia and bradycardia, coronary spasm, hypotension, anaemia, respiratory insufficiency or other severe disease. (unboundmedicine.com)
  • Acute myocardial ischaemia causes chest pain. (unboundmedicine.com)
Nuclear myocardial1
  • Currently, nuclear myocardial scans include both perfusion and gated wall motion images. (medscape.com)
Perfusion reserve2
  • One potentially important physiologic parameter obtained by these newer technologies is the myocardial perfusion reserve (MPR). (medscape.com)
  • Cardiac MRI (CMR), including myocardial perfusion reserve (MPR) may be a novel imaging biomarker in AS. (le.ac.uk)
Infarctions2
  • It is most often used in patients who have had myocardial infarctions (heart attacks) or other heart damage to see if they are at high risk of developing a potentially lethal cardiac arrhythmia. (wikipedia.org)
  • 2 The steadily increasing incidence of this disorder is due, in part, to the increasing age of the population, hypertension and number of patients surviving myocardial infarctions. (elitelearning.com)
SPECT7
  • Conclusions - In modern era where imagistic stress testing seems to have a better sensitivity, the old fashioned electrocardiographic stress test continues to have a good sensitivity and remains, due to the larger accessibility and lower cost compared with other techniques (stress echography, stress SPECT, myocardial perfusion imaging) the first option in the diagnostic algorithm of coronary artery disease. (romanianjournalcardiology.ro)
  • Transient ischemic dilation (TID) in the setting of abnormal stress-rest cardiac SPECT myocardial perfusion imaging (MPI) has been linked with increased cardiovascular risk. (snmjournals.org)
  • In this study, cardiac CT was used to evaluate the prevalence of atherosclerotic lesions and the severity of coronary artery stenosis in patients with TID of the left ventricle with or without associated myocardial perfusion defects on SPECT MPI. (snmjournals.org)
  • The study population consisted of 1,553 consecutive patients who had undergone both cardiac CT and SPECT MPI within 1 mo between January 1, 2006, and September 1, 2011. (snmjournals.org)
  • The presence of TID with an otherwise normal SPECT MPI study does not translate into a greater extent of coronary artery disease as assessed by cardiac CT or increased risk for future major adverse cardiac events. (snmjournals.org)
  • Transient ischemic dilation (TID) on stress SPECT myocardial perfusion imaging (MPI) is defined as the apparent presence of left ventricular (LV) dilation on poststress relative to rest images. (snmjournals.org)
  • TID in the setting of an abnormal SPECT MPI study has also been linked with increased cardiovascular risk and poor cardiovascular outcomes ( 8 - 11 ). (snmjournals.org)
Asymptomatic patients3
  • Exercise testing can identify asymptomatic patients at increased risk of death and symptom development, but with limited specificity, especially in older adults. (le.ac.uk)
  • 4 Current guidelines do not recommend intervention in asymptomatic patients unless they are in certain high-risk groups such as those with very severe asymptomatic AS or those with haemodynamic changes on exercise. (bmj.com)
  • A summary of available imaging tests for low-, intermediate-, and high-risk asymptomatic patients is outlined in this document. (bvsalud.org)
Implantable cardiac defibrillators2
  • citation needed] Microvolt T wave alternans testing acts as a risk stratifier between patients who need implantable cardiac defibrillators (ICDs) and those who do not. (wikipedia.org)
  • 221 Implantable Cardiac Defibrillators: Who Needs Them and Who Does Not? (scienceopen.com)
Diagnosis4
  • Depending on which disorder you are looking to identify, Holter monitoring, exercise testing and cross-sectional imaging can be invaluable in reaching a diagnosis. (escardio.org)
  • Coronary artery disease risk assessment that incorporates clinical factors, plaque characteristics and perivascular inflammation offers a more comprehensive individualised approach to quantify and stratify coronary artery disease risk, with potential healthcare benefits for prevention, diagnosis and treatment recommendations. (bmj.com)
  • Diagnosis includes ECG, cardiac imaging, and genetic testing. (msdmanuals.com)
  • Implantable loop recorders increase diagnostic yield, reduce time to diagnosis, and are cost-effective for suspected cardiac syncope and unexplained syncope. (aafp.org)
Biomarker2
  • Establishing the link between myocardial fibrosis (measured on CMR and validated through histology), with early ventricular dysfunction, will offer physicians a novel non-invasive biomarker that can further inform the timing of surgery. (biomedcentral.com)
  • Cardiac troponin is the preferred cardiac necrosis biomarker, while CK-MB is an acceptable alternative when cTn is not available 7 . (biomerieuxindia.in)
Fibrosis5
  • Subclinical reduction in LV strain before mitral repair predicts a fall in LV ejection fraction following surgery and is thought to reflect the development of myocardial fibrosis in response to chronic volume overload. (biomedcentral.com)
  • Myocardial fibrosis can be detected non-invasively using cardiac magnetic resonance (CMR) imaging techniques as an expansion of the extracellular volume (ECV). (biomedcentral.com)
  • Patients undergoing surgery will have cardiac biopsies performed at the time of mitral valve repair for histological quantification of fibrosis. (biomedcentral.com)
  • In non-compaction cardiomyopathy, the disordered myocardial architecture and associated microvascular abnormalities lead to myocardial fibrosis. (msdmanuals.com)
  • According to research - Association of Cardiorespiratory Fitness with Long-term Mortality Among Adults Undergoing Exercise Treadmill Testing - which appears on JAMA Network Open Cardiology in October 2018, "newer evidence has suggested associations between habitual vigorous exercise and potentially pathologic cardiovascular findings, including atrial fibrillation, coronary artery calcification, myocardial fibrosis, and aortic dilation. (maxwellnutrition.com)
Hypertension3
  • Strength-based sporting activities (e.g., track and field throwing events, weightlifting, karate/judo, American football) result in a normal or slightly increased cardiac output, an increase in peripheral vascular resistance, and transient hypertension, imposing a significant pressure load on both the left ventricle and the right ventricle. (scienceopen.com)
  • Control risk factors like hypertension, diabetes and cholesterol. (hopkinsmedicine.org)
  • Genes That Extend Lifespan May Do So by Mitigating the Increased Risk of Death Posed by Having Hypertension. (cdc.gov)
Assessment6
  • The assessment of myocardial perfusion and function using PET and hybrid positron emission tomography (PET)/CT imaging is becoming more available as the cost of the technology decreases and as positron-emitting radiopharmaceuticals become more available. (medscape.com)
  • See algorithm for preoperative cardiac assessment below. (medscape.com)
  • Algorithm for preoperative cardiac assessment. (medscape.com)
  • Sensitive and specific cardiac marker tests with a rapid turnaround time are essential to global risk assessment and treatment of all patients presenting with ACS. (biomerieuxindia.in)
  • Since the publication of the 2017 CCS guidelines on perioperative cardiac risk assessment and management for patients who undergo noncardiac surgery, [90] new evidence has emerged for evaluating clinical risk indices specific to patients who undergo peripheral vascular surgery. (ccs.ca)
  • Physicians or surgeons with training and competency in cardiac risk assessment should perform preoperative assessments. (ccs.ca)
Troponin9
  • Conclusions The use of troponin as a diagnostic test and risk stratification tool appears to be used universally in England. (bmj.com)
  • Cardiac troponin is a cardio specific protein that is detectable in the blood of patients with myocardial injury with sensitive and specific assays. (aacc.org)
  • In the January 2012, issue of Clinical Chemistry , Dr. Evangelos Giannitsis and Dr. Hugo Katus from the University of Heidelberg joined with Dr. Christian Mueller, an Associate Professor and Head of the Outcomes Research and Processes at the University Hospital Basel, in Basel, Switzerland in a point- counterpoint feature on the importance of screening for cardiac troponin. (aacc.org)
  • So always when troponin is elevated, it indicates myocardial injury, and so it is really challenging for the clinician to really be certain that this injury is clinic or has any other causes. (aacc.org)
  • So what needs to be done is that as we have done it also in past is that we need to do additional testing to understand the cause of troponin elevations, and that is what we have done in clinical practice anyway. (aacc.org)
  • So you do need additional testing to account for the many possibilities of troponin elevation such as heart failure or toxic injury or inflammation and so forth. (aacc.org)
  • More sensitive troponin identify acute and chronic cardiovascular disease, including ACS and non-ACS conditions earlier and at earlier stages of disease, how far can management of high sensitivity cardiac troponin improve management of patients? (aacc.org)
  • Are there differences between more sensitive cardiac troponin assays regarding diagnostic or prognostic performance? (aacc.org)
  • In adult patients without evidence of ST-elevation acute coronary syndrome, the History, ECG, Age, Risk factors, Troponin (HEART)* score can be used as a clinical prediction instrument for risk stratification. (tomwademd.net)
NSTEMI2
  • Except in STEMI and unstable NSTEMI, cardiac stents do not have convincing evidence of benefit, and may be harmful. (tomwademd.net)
  • The 2018 ACEP clinical policy paper on suspected non ST elevation ACS* asks: "In adult patients with suspected NSTEMI ACS in whom acute MI has been excluded, does further diagnostic testing for ACS prior to discharge reduce 30-day MACE? (tomwademd.net)
Major adverse cardiac events2
  • In adult patients without evidence of ST-elevation acute coronary syndrome, can initial risk stratification be used to predict a low rate of 30-day major adverse cardiac events? (tomwademd.net)
  • In addition, there was no significant difference in the incidence of major adverse cardiac events when comparing both the TID-positive patients and the TID-negative control cohort and when comparing patients who were TID-positive with normal perfusion with patients who were TID-negative with normal perfusion. (snmjournals.org)
Unstable2
  • The treatment goals for patients with coronary artery atherosclerosis are to relieve symptoms of coronary artery disease (CAD) and to prevent future cardiac events, such as unstable angina, AMI, and death. (medscape.com)
  • 90 mmHg the population-attributable risk of a ACS, including unstable angina and on at least 2 occasions. (who.int)
Arrhythmias8
  • Following on last week's article reviewing the general approach to screening for inherited cardiac diseases, see here the disorder-specific approach to screening from detecting conduction and structural disorders through to arrhythmias and channelopathies. (escardio.org)
  • Journal of Interventional Cardiac Electrophysiology : An International Journal of Arrhythmias and Pacing. (ottawaheart.ca)
  • The majority of sudden cardiac death events in athletes are due to ventricular arrhythmias as a result of underlying molecular and/or structural level pathologic substrate. (scienceopen.com)
  • In this article, we will review the physiologic cardiac adaptations to exercise along with arrhythmias seen in athletes with a focus on those commonly associated with sudden cardiac death. (scienceopen.com)
  • Unfortunately, the precise cause of death is frequently not determined definitively, but it is well accepted that the root cause frequently stems from ventricular arrhythmias as a result of an underlying molecular and/or structural level pathologic substrate. (scienceopen.com)
  • Overview of Arrhythmogenic Cardiomyopathies Although any dilated or hypertrophic cardiomyopathy (see Overview of Cardiomyopathies) can produce cardiac and systemic factors that predispose to a number of different arrhythmias, including. (msdmanuals.com)
  • Overview of Arrhythmias The normal heart beats in a regular, coordinated way because electrical impulses generated and spread by myocytes with unique electrical properties trigger a sequence of organized myocardial. (msdmanuals.com)
  • Initial symptoms are usually those of heart failure (eg, exertional dyspnea, fatigue, peripheral edema) although some patients present with symptoms of heart blocks and/or arrhythmias, including palpitations and/or syncope, or sometimes cardiac arrest. (msdmanuals.com)
Adverse2
  • Background Patients presenting with acute chest pain without a rise in cardiac troponins are considered to be at low risk of adverse cardiac events and are often considered for early discharge without further inpatient investigation. (bmj.com)
  • Patients with syncope who are at low risk of adverse events (e.g., those with symptoms consistent with vasovagal or orthostatic hypotension syncope, no history of heart disease, no family history of sudden cardiac death, and normal electrocardiographic findings) may be safely followed without further intervention or treatment. (aafp.org)
Syncope8
  • A clinical history of syncope or presyncope is common although milder presentations with fatigue or dyspnoea, reduced exercise capacity, or cognitive impairment are also possible. (escardio.org)
  • Syncope is classified as neurally mediated, cardiac, and orthostatic hypotension. (aafp.org)
  • Neurally mediated syncope is the most common type and has a benign course, whereas cardiac syncope is associated with increased morbidity and mortality. (aafp.org)
  • Low-risk patients with a single episode of syncope can often be reassured with no further investigation. (aafp.org)
  • In cases of unexplained syncope, provocative testing and prolonged electrocardiographic monitoring strategies can be diagnostic. (aafp.org)
  • Cardiac syncope may require cardiac device placement or ablation. (aafp.org)
  • Although syncope is associated with serious risks, short-term mortality is low (i.e., 0.7% at 10 days and 1.6% at 30 days). (aafp.org)
  • LQTS is usually diagnosed after a person has a cardiac event (eg, syncope, cardiac arrest). (medscape.com)
Patient's5
  • Several studies have been designed to help the clinician determine a patient's CAD risk level. (medscape.com)
  • Those who are found to be at high risk would therefore benefit from the placement of a defibrillator device which can stop an arrhythmia and save the patient's life. (wikipedia.org)
  • However, subanalyses of the SYNTAX trial and results from different studies have implied that the purely anatomy-based risk stratification of the SxS score made it prone to misclassification of patient's true risk, particularly for all-cause mortality and cardiac death in patients with stable CAD or ACS treated by PCI [ 7 , 8 ]. (hindawi.com)
  • In addition, all-cause mortality information was obtained from the Social Security Death Index, when available - along with medical records of a patient's death, using the institutional death index. (maxwellnutrition.com)
  • The risks to life or limb that could result from a delay in surgery are often greater than the risks of not assessing and subsequently optimizing a patient's preoperative cardiac status. (ccs.ca)
Coronary events1
  • The aim of the present study was to assess the predictive performance of SxSII in patients presenting with ACS undergoing PCI and to compare it to the previously validated SxS and the commonly used Global Registry of Acute Coronary Events (GRACE) risk score [ 13 ]. (hindawi.com)
Events8
  • For these reasons, CT may be suitable for certain intermediate-risk patients with stable chest pain who are referred for ICU because they have a clinical constellation suggesting a high risk of cardiovascular events, abnormal or inconclusive results on functional testing, or persistent symptoms despite medical treatment. (allenpress.com)
  • As all underwriters "should" know, coronary heart disease (CHD) is the leading cause of mortality globally, and patients who have chronic forms of CHD experience substantial morbidity, including high rates of recurrent cardiac events and eventual onset of heart failure. (allenpress.com)
  • Nevertheless, prevention of cardiac events is likely to have the largest impact on decreasing the burden of atherosclerosis. (medscape.com)
  • Coronary calcification, coronary disease risk factors, C-reactive protein, and atherosclerotic cardiovascular disease events: The St Francis Heart Study. (ajbm.net)
  • A history of cardiac events is the most typical clinical presentation in patients with LQTS. (medscape.com)
  • Antiadrenergic therapeutic measures (eg, use of beta-blockers, left cervicothoracic stellectomy) and device therapy (eg, use of pacemakers, implantable cardioverter-defibrillators) aim to decrease the risk and lethality of cardiac events. (medscape.com)
  • Risk stratification and early preventive measures can reduce major cardiovascular events given the long latent asymptomatic period. (bvsalud.org)
  • hs-CRP can be ordered for patients with some established risk factors of coronary heart disease to determine strategy for prevention of cardiovascular events and for follow-up of patients with acute coronary syndromes. (medscape.com)
Incidence3
  • Naser M, Schilling P, Szalai H, Visintainer P, Pack Q. Incidence and Patterns of Falls in Cardiac Rehabilitation. (umassmed.edu)
  • These findings supported the description of five different liver status-linked phenotypes with increasing risk of T2DM: Metabolically healthy patients (1,5% of T2DM incidence), MAFLD (4,4% of T2DM incidence), MAFLD and MetS (10,6% of T2DM incidence), PreDM (11,1% of T2DM incidence) and MAFLD and PreDM (28,2% of T2DM incidence). (unav.edu)
  • These phenotypes provided independent capacity of prediction of T2DM incidence after adjustment for age, sex, tobacco and alcohol consumption, obesity and number of SMet features with a c-Harrell=0.84.Conclusions: MAFLD interplay with MetS and PreDM might help to discriminate patient risk of T2DM in the clinical setting through metabolic remodelling-based phenotypes. (unav.edu)
Treadmill exercise4
  • Many clinicians who see athletes often prefer a CPX to standard treadmill exercise testing (TMET). (acc.org)
  • Stress echo and nuclear stress testing have slightly better accuracy than treadmill exercise stress testing in identifying coronary artery disease, but have never been shown to improve patient oriented outcomes after a negative workup in the ED. (tomwademd.net)
  • Aims - This is a retrospective study on 404 patients with chest pain suggestive for angina and with no history of ischaemic heart disease, which have performed a treadmill exercise stress testing and than after and a selective coronary angiography, from October 2008 to January 2013. (romanianjournalcardiology.ro)
  • Patients were enrolled between March 2001 and June 2004 and underwent baseline MTWA testing by treadmill exercise (Heartwave system, Cambridge Heart, Inc., Bedford, Massachusetts). (uscjournal.com)
Atherosclerotic1
  • Pharmacotherapeutic strategies that affect the risk factor profile, such as the administration of statins for low-density lipoprotein (LDL) reduction or the administration of agents that alter atherosclerotic plaque, are of paramount importance. (medscape.com)
Atherosclerosis5
  • [ 1 ] The prevention and treatment of atherosclerosis requires control of the known modifiable risk factors for this disease. (medscape.com)
  • In addition, addressing risk factors with lifestyle changes is an integral part of atherosclerosis prevention. (medscape.com)
  • Diabetes mellitus is a major cause of death and disability worldwide and is a strong risk factor for stroke and independently predicts coronary atherosclerosis. (ajbm.net)
  • When compared with the TID-negative control cohort, TID-positive patients had no significant differences in the presence and extent of atherosclerosis, the degree of coronary artery stenosis, or the calcium score at cardiac CT. (snmjournals.org)
  • Imaging tests can detect subclinical coronary atherosclerosis and aid initiation of targeted preventative efforts based on patient risk. (bvsalud.org)
Cardiovascular risk8
  • If no cause is found, a primary degenerative lesion of the conducting system may be the cause and cardiovascular risk factor modification is important. (escardio.org)
  • However, other cardiovascular abnormalities such as anomalies of coronary vessels, arrhythmogenic dysplasia of right ventricle (ADRV), mitral valve prolapse, myocarditis, coronary vessel bridge, Marfan Syndrome, bicuspid aortic valve, pulmonary thrombo-embolism and channelopathies also significantly contribute to cardiovascular risk in athletes. (escardio.org)
  • Large studies with long-term follow-up confirmed the utility of CACS as a predictor of cardiovascular risk in populations. (bmj.com)
  • Very low or zero CACS is reassuring and clinically valuable, but age and other prevalent risk factors are major drivers of CACS, 1 such that most middle-aged or older patients in higher cardiovascular risk groups have elevated CACS. (bmj.com)
  • The projective of this study is to analyze whether depression may influence the control of diabetes individuals at high cardiovascular risk. (ajbm.net)
  • PubMed MEDLINE was systematically searched for prospective population-based cohort studies published between on January 1, 2001 and January 1, 2013, of 4628 diabetes patients with high cardiovascular risk factor profiles. (ajbm.net)
  • Together with these results the excess risk of cardiovascular risk associated with diabetes is significantly higher in depressant patients and need for further work to clarify the behavioral mechanisms that are involved. (ajbm.net)
  • Impact of providing genetics-based future cardiovascular risk on LDL-C in patients with familial hypercholesterolemia. (cdc.gov)
Diagnostic3
  • Level B recommendation: "Do not routinely use further diagnostic testing prior to discharge in low risk patients in whom acute MI has been ruled out to reduce 30-day MACE. (tomwademd.net)
  • Laboratory testing and neuroimaging have a low diagnostic yield and should be ordered only if clinically indicated. (aafp.org)
  • An increased corrected QT (QTc) interval in response to standing up ("response to standing" test), which is associated with increased sympathetic tone, can provide more diagnostic information in patients with LQTS. (medscape.com)
Symptoms2
  • They were also asked how far they could walk before being stopped by symptoms, and then tested on their ability to estimate distance. (bmj.com)
  • ACS is suspected when a person presents with symptoms, particularly chest pain, and especially when they also have known risk factors like high blood pressure, being overweight or a family history. (biomerieuxindia.in)
Increased risk of sudden cardi1
  • Most modern references to TWA refer to microvolt T wave alternans (MTWA), a non-invasive heart test that can identify patients who are at increased risk of sudden cardiac death. (wikipedia.org)
Prognosis1
  • 3 To address these challenges, cardiopulmonary exercise testing (CPET) has emerged as a potential tool for risk stratification and clinical decision making in assessing current haemodynamic status, prognosis and planning interventions. (bmj.com)
Chest8
  • Objective To assess current practice in the risk stratification of patients presenting with acute chest pain to emergency departments (EDs) in England who do not develop a rise in cardiac markers. (bmj.com)
  • Cardiovascular Testing and Clinical Outcomes in Emergency Department Patients With Chest Pain. (journalfeed.org)
  • Sixty years later, cardiac stress testing has been pretty much the standard for screening low risk chest pain patients for coronary disease after a visit to the ED. It makes intuitive sense. (tomwademd.net)
  • In this Journal Jam podcast we do a deep dive into the hugely complex literature of cardiac stress testing and see whether or not stress testing portends any benefit for patients who we assess in the ED for chest pain. (tomwademd.net)
  • The problem is - if stress testing doesn't benefit our patients and isn't a good screening test for preventing MIs, then what do we do with our low risk chest pain patients we see in the ED? (tomwademd.net)
  • They are poor at identifying coronary artery disease and stress test studies in low risk chest pain patients suffer from inclusion bias. (tomwademd.net)
  • Complaints of pain in the chest with associated pain radiating down the left arm may be signs of A. Cardiac crisis. (babelouedstory.com)
  • Objective In 2010, the National Institute for Health and Care Excellence (NICE) in the UK published Clinical Guideline 95 (CG95) advocating risk stratification of patients using 'CADScore' to guide appropriate cardiac investigations for chest pain of recent onset. (bmj.com)
Chronic6
  • The MMA method uses routine, symptom-limited exercise stress testing or ambulatory ECG monitoring and standard electrodes and requires that chronic medications be retained. (wikipedia.org)
  • Chronic limitation of exercise aerobic response is a central clinical feature of this syndrome, occurring because of decreased cardiac reserve and altered peripheral responses, 1 and is an important determinant of survival. (bmj.com)
  • Therefore, in order to account for the variability of clinical parameters affecting long-term outcomes and hence better classification of patients' risk, the SYNTAX score II (SxSII) was developed by complementing SxS with 7 prognostic variables including age, creatinine clearance, left ventricular ejection fraction (LVEF), presence of unprotected left main coronary artery (ULMCA) disease, peripheral vascular disease (PVD), female gender, and chronic obstructive pulmonary disease (COPD) [ 9 ]. (hindawi.com)
  • As early and effective antiretroviral therapy has become more widespread, HIV has transitioned from a progressive, fatal disease to a chronic, manageable disease marked by elevated risk of chronic comorbid diseases, including cardiovascular diseases (CVDs). (natap.org)
  • These elevated risks generally persist after demographic and clinical risk factors are accounted for and may be partly attributed to chronic inflammation and immune dysregulation. (natap.org)
  • This guideline is intended to improve communication between clinicians and patients about the risks and benefits of opioid therapy for chronic pain, improve the safety and effectiveness of pain treatment, and reduce the risks associated with long-term opioid therapy, including opioid use disorder, overdose, and death. (cdc.gov)
Morbidity and morta1
  • therefore, low-risk patients can be spared further testing, whereas intermediate- and high-risk patients should undergo preoperative investigations and treatment to reduce overall cardiac perioperative morbidity and mortality. (medscape.com)
Reducing cardiac output1
  • Both epidural and spinal anesthetics cause arteriodilation and venodilation by blocking sympathetic outflow, decreasing preload, and, ultimately, reducing cardiac output. (medscape.com)
Detection2
Mortality and cardiac1
Noncardiac surgery2
  • A substantial number of all deaths among patients undergoing noncardiac surgery are caused by cardiovascular complications. (medscape.com)
  • [ 3 , 4 , 5 ] As data regarding the risks (and also safety) of noncardiac surgery in patients with PH continue to accumulate, it is imperative for anesthesiologists to be well versed in the disease and its sequelae. (medscape.com)
Cardiopulmonary exercise1
  • Cardiopulmonary exercise (CPX) testing is useful in differentiating athlete's heart from HCM. (acc.org)
Cardiology2
Sensitivity2
Adaptations3
  • As a result, physiologic adaptations related to training such as increased myocardial thickness may occur. (acc.org)
  • It is apparent that a variety of adaptations/alterations in cardiac structure and function occur as excessive uncontrol diabetes, even in the absence of comorbidities. (ajbm.net)
  • The adequate delivery of cardiac imaging services requires expertise in both imaging methodology - with specific adaptations to imaging of the heart - as well as intricate knowledge of heart disease. (researchgate.net)
Conclusions2
  • The conclusions included, "findings (that) emphasize the importance of aerobic fitness in overall health, including the magnitude of benefit of increased CRF in relation to traditional clinical risk factors and the incremental survival advantage of extremely high fitness. (maxwellnutrition.com)
  • CONCLUSIONS -The results of stress echo are independent predictors of death in diabetic patients with known or suspected CAD. (diabetesjournals.org)
Atrial2
Stroke4
  • The cardiovascular effects of general anesthesia include changes in the arterial and central venous pressures, cardiac output, and varying heart rhythms, which occur by the following mechanisms: decreased systemic vascular resistance, decreased myocardial contractility, decreased stroke volume, and increased myocardial irritability. (medscape.com)
  • By the same token, CRF has also been associated with a higher quality of healthy life - owning to reductions in the risk to coronary artery disease, high blood pressure, diabetes, stroke, and cancer. (maxwellnutrition.com)
  • [14] [15] Coronary artery disease and stroke account for 80% of CVD deaths in males and 75% of CVD deaths in females. (wikipedia.org)
  • For this common and most important risk respectively), were recruited from 65 study, patients were analysed according factor for stroke and intracerebral hospitals. (who.int)
Findings3
  • Findings from the World Health Organization's Monitor Trends in Cardiovascular Diseases (MONICA) project involving 21 countries showed a 4% fall in CAD death rates. (medscape.com)
  • High-risk patients with cardiovascular or structural heart disease, history concerning for arrhythmia, abnormal electrocardiographic findings, or severe comorbidities should be admitted to the hospital for further evaluation. (aafp.org)
  • The summary of the findings and GRADE Evidence Profile for the 3 clinical risk scores are available on ccs.ca. (ccs.ca)
Clinical risk1
  • 27% of responding departments routinely used objective clinical risk scoring as part of their risk stratification. (bmj.com)
Assess4
  • The Chi-square test was used to assess differences in the trends of macronutrient intake among T2DM patients. (bvsalud.org)
  • To assess the incremental prognostic value of SYNTAX score II (SxSII) as compared to anatomical SYNTAX Score (SxS) and GRACE risk score in patients with acute coronary syndromes who underwent percutaneous coronary intervention. (hindawi.com)
  • As a result, researchers from the Cleveland Clinic Foundation, Cleveland, Ohio, chose to assess, "the association between aerobic fitness and all-cause mortality among the largest reported cohort, to our knowledge, of adult patients undergoing ETT (exercise treadmill testing) at a tertiary care center," in a retrospective study. (maxwellnutrition.com)
  • Several comparable clinical decision rules can be used to assess the short-term risk of death and the need for hospital admission. (aafp.org)
Ischemic2
  • Sudden cardiac death (SCD) is the leading cause of mortality in patients with ischemic heart disease and left ventricular dysfunction. (uscjournal.com)
  • 8-10 Earlier studies have suggested that MTWA may be a useful, non-invasive method for discriminating between patients with ischemic cardiomyopathy who are at low and high risk for SCD. (uscjournal.com)
Electrocardiogram3
  • The TWA test uses an electrocardiogram (ECG) measurement of the heart's electrical conduction using electrodes attached to one's torso. (wikipedia.org)
  • A low-risk patient may only require a clinical evaluation and a stress test or electrocardiogram, while a high-risk patient may proceed directly from clinical evaluation to cardiac catheterization. (acc.org)
  • However, resting ST segment changes may be false positive responses for epicardial coronary disease ( 5 ), and false positive ST segment changes and poor exercise capacity may reduce the utility of standard exercise electrocardiogram testing. (diabetesjournals.org)