Atrial Fibrillation

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SEATTLE -- Appropriately trained nurses can supervise stress echocardiograms with no more risk than in physician-supervised tests, a review of 15,404 nurse-monitored tests suggests.

SALT LAKE CITY-- Amputations of frostbite-damaged fingers and toes can be prevented in some patients with the use of thrombolytic therapy within 24 hours of exposure, researchers here found.

ROTTERDAM, The Netherlands -- Before heart disease even develops among patients with heart disease, the effects on life expectancy have already begun, found researchers here.

NEWCASTLE UPON TYNE, England, June 5 -- An interim analysis of the 4,447-patient RECORD trial did not confirman increased risk of myocardial infarction or cardiac death in patients taking rosiglitazone (Avandia) for treatment of type 2 diabetes, although the data suggest an increased risk of heart failure. So reported the New England Journal of Medicine online today, one day before a Congressional hearing on the safety of rosiglitazone.

ABSTRACT: Atypical clinical presentations in the quality, intensity, and radiation of pain are common in patients with acute coronary syndromes. Women with an acute myocardial infarction (AMI) are more likely to have atypical symptoms, such as dyspnea, than men. A history of acute anxiety or a psychiatric diagnosis does not preclude the possibility of an acute coronary event in a patient with chest pain. The clinical response to a GI cocktail, sublingual nitroglycerin, or chest wall palpation does not reliably identify the source of pain. Over-reliance on tests with poor sensitivity, such as the ECG, or on the initial set of cardiac biomarkers will miss many patients with MI. Serial troponin levels obtained at 3- to 6-hour intervals are recommended to evaluate the extent of myocardial damage. Coronary angiography that detects mild non-obstructive disease does not exclude the possibility of sudden plaque rupture and acute coronary occlusion.

abstract: Inflammatory bowel disease (IBD) can have a variety of extraintestinal manifestations, including pulmonary disease. Bronchial involvement is the most common, but other manifestations include upper airway disease; parenchymal involvement, such as bronchiolitis obliterans with organizing pneumonia (BOOP) and interstitial lung disease; and serositis, including pleural effusions and pericarditis. Patients with BOOP may present with fever, dyspnea, cough, and pleuritic chest pain. Chest radiographs show bilateral patchy airspace opacities or a diffuse process; CT scans often demonstrate the opacities to be pleural-based. Corticosteroids appear to be effective in the management of certain pulmonary manifestations of IBD, such as BOOP and pulmonary infiltrates with eosinophilia. (J Respir Dis. 2007;28(6):227-234)

WINSTON-SALEM, N.C. -- A simple exercise test measuring the ratio of oxygen consumption to carbon dioxide production can predict mortality risks in systolic heart failure, said researchers here.

PHILADELPHIA -- The most obvious clinical feature of obstructive sleep apnea may be weariness of mind, but this breathing disorder also slowly and silently wears down the heart, according to researchers.

LYNCHBURG, Va. -- Televalgelism pioneer Jerry Falwell, the founder of Moral Majority and a stalwart of the Christian right wing of the GOP, died today after collapsing in his office here. Falwell was 73 and had suffered in recent years from congestive heart failure and pneumonia.