General Practitioners' Decision Making About Primary Prevention Of Cardiovascular Disease In Older Adults: A Qualitative Study, Jesse Jansen, Shannon Mckinn, Carissa Bonner, Les Irwig, Jenny Doust, Paul Glasziou, Katy Bell, Vasi Naganathan, Kirsten Mccaffery
Primary cardiovascular disease (CVD) prevention in older people is challenging as they are a diverse group with varying needs, frequent presence of comorbidities, and are more susceptible to treatment harms. Moreover the potential benefits and harms of preventive medication for older people are uncertain. We explored GPs' decision making about primary CVD prevention in patients aged 75 years and older.
25 GPs participated in semi-structured interviews in New South Wales, Australia. Transcribed audio-recordings were thematically coded and Framework Analysis was used.
Analysis identified factors that are likely to contribute to variation in the management of CVD risk ...
Paranormal Activity: Para-Esophageal/Gastric Hemorrhage In A Patient With A Heartmate Ii Lvad, 2017 St. Vincent's Indianapolis/Heart Center of Indiana, Indianapolis, Indiana
Paranormal Activity: Para-Esophageal/Gastric Hemorrhage In A Patient With A Heartmate Ii Lvad, Anna Stone, Ashwin Ravichandran
The VAD Journal
In this report we present an unusual case of non-traumatic, spontaneous para-esophageal/para-gastric hemorrhage requiring multiple units of red blood cells in a female patient with a continuous flow left ventricular assist device. She presented with dysphagia and atypical chest pain 18 months post implantation, on the recommended anticoagulation regimen for HeartMate II support of ASA 81mg and international normalized ratio goal (INR) of 2-3 and was successfully managed with conservation support, volume resuscitation and multiple transfusions. Non-traumatic causes of acute bleeding, including acquired platelet dysfunction are considered.
Improving Heart Failure Education Prior To Discharge: An Emmi Implementation Project, 2017 University of Arkansas, Fayetteville
Improving Heart Failure Education Prior To Discharge: An Emmi Implementation Project, Elizabeth Mccord
The Eleanor Mann School of Nursing Student Works
Background: Heart failure is one of the leading causes of hospitalizations and increased health care costs in the United States. Many patients are readmitted within 30 days of discharge, resulting in increased costs. Purpose of Capstone Project: The purpose of this capstone project was to improve heart failure education for patients admitted with heart failure to Mercy Medical Center by utilizing Emmi educational videos in order to decrease the risk of hospital readmissions, improve quality of life, and decrease costs. Methods: The project focused on educating nurses about the importance of utilizing the video. It was asked of the nurses ...
Exploring The Effects Of Caring For Congestive Heart Failure Patients On Caregiver Well-Being: A Descriptive Study, 2017 University of Arkansas
Exploring The Effects Of Caring For Congestive Heart Failure Patients On Caregiver Well-Being: A Descriptive Study, Hanna S. Curtis
The Eleanor Mann School of Nursing Undergraduate Honors Theses
Background: As the incidence of heart failure (HF) quickly becomes the leading cause of disability among older adults, the need for non-professional, in-home caregivers increases as well. Many caregivers are family members who receive no compensation for their efforts, but all are an invaluable tool in the fight against a debilitating disease. Patients with caregivers experience an improved quality of life and lower mortality rates than patients with little social support. The caregiver of a patient with HF may be responsible for everyday activities such as housekeeping and shopping, as well as more complex disease-related necessities as managing medication regimens ...
Fatal Flaw - Driveline Fracture As A Rare But Serious Complication Of Mechanical Circulatory Support With Left Ventricular Assist Devices, Yuri Boyechko, Thomas Tribble, Maya Guglin
The VAD Journal
Background: Patients with advanced heart failure have seen decreased mortality and improved quality of life due to mechanical circulatory support with left ventricular assist devices (LVAD). Regardless of such outcomes, many complications still exist and remain a significant cause of morbidity and mortality. Our purpose is to study the prevalence, clinical course, and outcomes specifically of patients with LVAD driveline (DL) fractures.
Methods: This single-center, retrospective review included all patients at our institution who had continuous flow LVADs and experienced DL fracture/injury from January 2012 - December 2015.
Results: Thirteen of 110 LVAD patients (11.8%) had DL fractures (Table ...
St Elevation Myocardial Infarction In A Young Adult: Expect The Unexpected, 2017 Thomas Jefferson University
St Elevation Myocardial Infarction In A Young Adult: Expect The Unexpected, Shashank Jain, Md, Priya Rajagopalan, Md, Mitul Kanzaria, Md, Meir Mazuz, Md
Department of Medicine Posters
- Acute myocardial infarction (MI) in young adults can present a diagnostic and therapeutic challenge
- Kawasaki disease (KD) is a vasculitis of unknown etiology that occurs in infancy and childhood
- Coronary artery aneurysms (CAA) are the most serious complication of untreated KD seen in upto 25% of patients
- Thrombosis of these CAA or coronary stenosis can present as MI in less than 2% of cases which mainly occur in the 1st year of disease onset
- Late presentations in adult life is extremely rare
A Review Of Pain Control In Pediatric Cardiac Bypass Surgery, 2017 George Washington University
A Review Of Pain Control In Pediatric Cardiac Bypass Surgery, Pranathi Ari, Andrew T. Waberski, Nina Deutsch
GW Research Days 2016 - Present
Background: Children undergoing cardiac surgery with cardiopulmonary bypass receive high dose opioids for analgesia and to reduce the neurohormonal stress response. While opioids have excellent pharmacodynamics profiles adverse effects include: respiratory depression, bradycardia, nausea, vomiting, and tolerance. Additionally, opioids with short half-lives like fentanyl require several boluses to be administered during surgery causing fluctuating levels analgesia. Several strategies to advance pain control incorporate regional and neuraxial anesthetic techniques, however anticoagulation preclude its routine use. Alternatively using opioids with longer half-lives for analgesia may improve pain control and reduce adverse effects.
Objective: The objective of this study is to quantify postoperative ...
Secondary Prevention At The Aswan Heart Centre, 2017 George Washington University
Secondary Prevention At The Aswan Heart Centre, Amira Athanasios
GW Research Days 2016 - Present
Cardiovascular disease remains the leading cause of death globally, taking the lives of almost 18 million patients around the world each year. The overwhelming majority of cardiovascular deaths take place in low- to mid-income counties, suggesting that most cardiovascular deaths are preventable. In this study, current literature on secondary prevention of coronary artery disease was analyzed. Specific emphasis was given to preventative measures and successes in low income countries. Based on a literature review, a patient questionnaire to better understand patient adherence to preventative measures was created. This questionnaire focuses on patients receiving dual antiplatelet therapy post acute myocardial infarct ...
Venoarterial Extracorporeal Membrane Oxygenation For Cardiogenic Shock: A Retrospective Analysis Based On The Etiology Of Shock, Andrew Burchett, Thomas Tribble, Richard Charnigo, Susan Smyth, Maya Guglin
The VAD Journal
Background: We performed a retrospective analysis to evaluate the efficacy of VA-ECMO support in cardiogenic shock based on various etiologies.
Methods: We retrospectively analyzed 99 patients supported with VA-ECMO from January 1, 2012 to January 1, 2015. Outcomes included survival to discontinuation of VA-ECMO support and survival to hospital discharge. The etiologies of cardiogenic shock included cardiac arrest (CPR), acute myocardial infarction (AMI), decompensated congestive heart failure (CHF), pulmonary embolism (PE), right ventricular failure (RVF) not secondary to an acute pulmonary embolism, and post-cardiotomy syndrome (PCS). The PCS group was used as a reference group; odds ratios were estimated ...
Does Left Ventricular Assist Device Implantation Affect Driving Patterns In Patients With End-Stage Heart Failure?, 2017 Aurora Cardiovascular Services, Aurora Health Care
Does Left Ventricular Assist Device Implantation Affect Driving Patterns In Patients With End-Stage Heart Failure?, Mamatha Pinninti, Christina Sauld, Vinay Thohan, Omar Cheema, T. Edward Hastings, John Crouch, Frank Downey, Nasir Z. Sulemanjee
The VAD Journal
In 2012, the Canadian Society of Cardiology indicated that patients supported with left ventricular assist device (LVAD) may drive a private vehicle 2 months after implantation, provided they are deemed clinically stable. Objective evidence supporting this recommendation is limited. We sought to compare data regarding driving habits in our patients following LVAD implantation.
A standard questionnaire addressing driving patterns before and after LVAD implantation was sent to all living patients who had received an LVAD between January 2010 and January 2014. Ninety-four of 124 patients responded (average age 58 years, 69.2% men, 77.7% bridge to transplant ...
Reversible Mitral Regurgitation As A Complication Of Impella® 5.0, 2017 University of Kentucky, Department of Internal Medicine
Reversible Mitral Regurgitation As A Complication Of Impella® 5.0, Katrina A. Bidwell, Andrew R. Kolodziej, Maya E. Guglin
The VAD Journal
The Impella® is a ventricular assist device used for temporary left ventricular support and has been approved for use since 2008. In this report we present a case of a patient who experienced mitral regurgitation as a complication shortly after placement of an Impella® as well as a brief literature review. To our knowledge this is the first such case demonstrating resolution of iatrogenic mitral regurgitation with removal of the device as opposed to permanent damage.
Usage Of 3d Models Of Tetralogy Of Fallot For Medical Education: Impact On Learning Congenital Heart Disease., 2017 George Washington University
Usage Of 3d Models Of Tetralogy Of Fallot For Medical Education: Impact On Learning Congenital Heart Disease., Yue-Hin Loke, Ashraf S Harahsheh, Axel Krieger, Laura J Olivieri
Pediatrics Faculty Publications
BACKGROUND: Congenital heart disease (CHD) is the most common human birth defect, and clinicians need to understand the anatomy to effectively care for patients with CHD. However, standard two-dimensional (2D) display methods do not adequately carry the critical spatial information to reflect CHD anatomy. Three-dimensional (3D) models may be useful in improving the understanding of CHD, without requiring a mastery of cardiac imaging. The study aimed to evaluate the impact of 3D models on how pediatric residents understand and learn about tetralogy of Fallot following a teaching session.
METHODS: Pediatric residents rotating through an inpatient Cardiology rotation were recruited. The ...
A Mendelian Randomization Study Of The Effect Of Calcium On Coronary Artery Disease, Myocardial Infarction And Their Risk Factors, Lin Xu, Shi Lin Lin, C. Mary Schooling
Publications and Research
Meta-analyses of randomized controlled trials (RCTs) suggest calcium could have adverse effects on cardiovascular disease, although these findings are controversial. To clarify, we assessed whether people with genetically higher calcium had a higher risk of coronary artery disease (CAD), myocardial infarction (MI) and their risk factors. We used a two-sample Mendelian randomization study. We identified genetic variants (single nucleotide polymorphisms (SNPs)) that independently contributed to serum calcium at genome-wide significance which we applied to large extensively genotyped studies of CAD, MI, diabetes, lipids, glycaemic traits and adiposity to obtain unconfounded estimates, with body mass index (BMI) as a control outcome ...
Messenger Rna And Microrna Transcriptomic Signatures Of Cardiometabolic Risk Factors, 2017 University of Massachusetts Medical School
Messenger Rna And Microrna Transcriptomic Signatures Of Cardiometabolic Risk Factors, David D. Mcmanus, Jian Rong, Tianxiao Huan, Sean Lacey, Kahraman Tanriverdi, Peter J. Munson, Martin G. Larson, Roby Joehanes, Venkatesh Murthy, Ravi Shah, Jane E. Freedman, Daniel Levy
UMass Center for Clinical and Translational Science Supported Publications
BACKGROUND: Cardiometabolic (CM) risk factors are heritable and cluster in individuals. We hypothesized that CM risk factors are associated with multiple shared and unique mRNA and microRNA (miRNA) signatures. We examined associations of mRNA and miRNA levels with 6 CM traits: body mass index, HDL-cholesterol and triglycerides, fasting glucose, and systolic and diastolic blood pressures through cross-sectional analysis of 2812 Framingham Heart Study who had whole blood collection for RNA isolation for mRNA and miRNA expression studies and who consented to genetic research. We excluded participants taking medication for hypertension, dyslipidemia, or diabetes. We measured mRNA (n = 17,318; using ...
Heart Pump Modelling: Design Of Pulsatile Flow Phantoms, 2017 University of Portland
Heart Pump Modelling: Design Of Pulsatile Flow Phantoms, Olivia Coiado, Kevin Jones, Parker Schibel, Nicolas De Almeida
Biomedical Engineering Western Regional Conference
The purpose of this project is to build a model, which mimics physiological conditions of the human cardiovascular system in order to simulate the parameters of the human heart in vivo. For this project, it was developed a flow phantom with vessel mimicking material, as well as blood-mimicking and tissue-mimicking fluid. Phantoms in general are specifically designed objects involving dedicated biomaterials to simulate special realistic circuits of human beings. To develop the flow phantom, low-priced biomaterials for blood mimicking fluid, tissue mimicking, and vessel mimicking material was researched.
Keywords: Cardiovascular system, heart pump, modelling, pulsatile.
Common Clinical Dilemmas In Left Ventricular Assist Device Therapy: A Glimpse Into Current Trends, 2017 The Ohio State University
Common Clinical Dilemmas In Left Ventricular Assist Device Therapy: A Glimpse Into Current Trends, Ahmet Kilic, Michael S. Kiernan, Meredith A. Brisco-Bacik, Sangjin Lee, Behzad Soleimani, Aditya Bansal, Igor Gosev, Peter Eckman, Brian Lima, Brian Bethea, Chetan B. Patel, Jason N. Katz, Jonathan D. Rich, Susan M. Joseph
The VAD Journal
Left ventricular assist device (LVAD) therapy has been thrust into the forefront of surgical treatment for advanced heart failure (HF). Despite advancements in survival and quality of life with these devices, the multi-disciplinary care for these patients remains far from standardized across institutions.
A survey of current practices in LVAD was carried out at the St. Jude Medical User’s meeting representing a variety of caregivers including cardiac surgeons, HF cardiologists, non-HF cardiologists, advanced practice providers and ventricular assist device coordinators, with representation from several continents. Utilizing an audience response system, eleven questions were asked related to the ...
Junctional Ectopic Tachycardia Secondary To Myocarditis Associated With Sudden Cardiac Arrest, 2017 George Washington University
Junctional Ectopic Tachycardia Secondary To Myocarditis Associated With Sudden Cardiac Arrest, Michael E. A. Cunningham, Robin W. Doroshow, Laura Oliveri, Jeffrey P. Moak
Pediatrics Faculty Publications
No abstract provided.
Superior Septal Approach Versus Left Atrial Approach For Mitral Valve Replacement: A Retrospective Cohort Study, Tooba Ansar, Taimur Asif Ali, Saneeha Shahid, Saulat H. Fatimi, Ghulam Murtaza
Department of Surgery
To compare the outcomes of superior septal approach and left atrial approach for mitral valve replacement.
This retrospective cohort study was conducted at the Aga Khan University Hospital, Karachi, and comprised records of patients who had undergone isolated mitral valve replacement from May 2003 to April 2012. Cases were reviewed for the outcomes [primary: loss of normal sinus rhythm; secondary: complications, residual defect and mortality]. Patients with prior history of dysrhythmia, low ejection fraction (<30%), emergency/redo mitral valve replacement and concomitant coronary artery bypass grafting were excluded. SPSS 19 was used for data analysis.
Of the 78 patients, 52(66.67%) were of superior septal approach and 26(33.33%) of left atrial approach. Both groups ...
A Rare Case Of Paradoxical Left Sided Endocarditis Through Patent Foramen Ovale., 2017 Marshall University
A Rare Case Of Paradoxical Left Sided Endocarditis Through Patent Foramen Ovale., George M. Yousef, Paul I. Okhumale, Haytham Aljoudi, Silvestre Cansino
Marshall Journal of Medicine
A 36 -year old woman IV drug abuser admitted with Right-Sided Infective Endocarditis (RSIE) as demonstrated by transthoracic echocardiogram. Patient was admitted 8 weeks later with recurrence of symptoms, moreover signs of systemic embolization were noted. Transthoracic and Transesophageal Echocardiograms revealed tricuspid valve vegetation, severe tricuspid regurgitation, left atrial mass, Patent Foramen Ovale (PFO), severely dilated right atrium and prominent Chiari's network. Systemic embolization included brain and Left iliacus abscesses. Patent Foramen ovale is the proposed mechanism leading to extensive systemic embolization in the present case.
Inferior Stemi Complicated By Retroperitoneal Hemorrhage Due To Ruptured Aaa, 2017 Marshall University
Inferior Stemi Complicated By Retroperitoneal Hemorrhage Due To Ruptured Aaa, Farley B. Neasman Iii, Melissa D. Lester, Nepal C. Chowdhury
Marshall Journal of Medicine
When patients present with life threatening conditions, a rapid cost-benefit analysis prioritizes care and commits treatment to a certain course that, in the case of ST Elevation Myocardial Infarction (STEMI) treated with drug-eluting stents (DES), could be fatal if there is any deviation. Antiplatelet therapy is vital and secondary concerns (i.e. bleeding diatheses) may accept suboptimal outcomes – in rare cases, another life-threatening condition may be unmasked, the treatment for which runs directly counter to the first. We present a case of STEMI with high clot burden treated with multiple DES, complicated by retroperitoneal hemorrhage due to a ruptured abdominal ...