Picture Quiz (Questions)

2005 ◽  
Vol 4 (3) ◽  
pp. 105-105
Author(s):  
Hamid Aizaz Chatha ◽  
◽  
Shaun Nakash ◽  
Keyword(s):  
Atrial Fibrillation ◽  
Heart Disease ◽  
Cervical Spine ◽  
Neck Pain ◽  
Ischemic Heart Disease ◽  
Neurological Examination ◽  
Past History ◽  
Ischemic Heart ◽  
History Of

A 75-year- old man was referred to hospital with a 24 hour history of severe neck pain, associated with fever, rigors and mild confusion. The pain radiated into his arms and was exacerbated by neck movements. Eight days prior to admission he had developed loose stools for 3 days. There was no history of trauma, and no other features of meningism. He gave a past history of ischemic heart disease and atrial fibrillation for which he was taking warfarin. Examination revealed a pyrexia of 38.3c. There was tenderness over the cervical spine but no other positive findings. Neurological examination was unremarkable.

scholarly journals Rate of Heart Failure Following Atrial Fibrillation According to Presence of Family History of Dilated Cardiomyopathy or Heart Failure: A Nationwide Study

2021 ◽  
Author(s):  
Magnus N. Ebbesen ◽  
Maria D’Souza ◽  
Charlotte Andersson ◽  
Jawad H. Butt ◽  
Christian Madelaire ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Heart Disease ◽  
Family History ◽  
Ischemic Heart Disease ◽  
Dilated Cardiomyopathy ◽  
Family Member ◽  
Ischemic Heart ◽  
Degree Relative ◽  
History Of

Background It is poorly understood why some patients with atrial fibrillation develop heart failure (HF) and others do not. We examined the rate of developing HF in patients with atrial fibrillation with and without first‐degree family members with HF or dilated cardiomyopathy (DCM). Methods and Results Using Danish nationwide registries, patients born after 1942 diagnosed with atrial fibrillation in the period 2005 to 2015 were identified and followed for up to 5 years. Patients with pre‐existing HF, DCM, and/or ischemic heart disease diagnoses were excluded. Exposure was defined as a first‐degree relative with HF or DCM. The rate of developing the composite end point of HF or death, and the components, was estimated with multivariable Cox proportional hazard regression models. We included 10 605 patients. A total of 17% had a family member with DCM/HF. Having a family member with HF/DCM was associated with an increased 5‐year risk of the composite of HF/death (cumulative incidence, 9.2% [95% CI, 7.8–10.7] versus 5.6% [95% CI, 5.0–6.1]; adjusted hazard ratio [HR] 1.36 [95% CI, 1.13–1.64]). (HF 8.4% [95% CI, 7.0–9.8] versus 4.5% [95% CI, 4.1–5.0]); (adjusted HR, 1.49 [95% CI, 1.22–1.82]). However, familial HF/DCM was not significantly associated with an increased 5‐year risk and rate of death (0.8% [95% CI, 0.4–1.2] versus 1.1% [95% CI, 0.8–1.3]); (adjusted HR, 0.80 [95% CI, 0.46–1.39]). Conclusions In patients with incident atrial fibrillation without prior ischemic heart disease or HF diagnoses, 1 of 6 had a first‐degree relative with HF, and having such a family history of HF/DCM was associated with an 87% increase in 5‐year incidence of HF compared with those without.

Abstract TP36: Predictors and Associated Outcomes of Subarachnoid Hemorrhage Following Endovascular Treatment for Acute Ischemic Stroke

Stroke ◽  
2016 ◽  
Vol 47 (suppl_1) ◽  
Author(s):  
Alexandros L Geordiadis ◽  
Muhammad A Saleem ◽  
Adnan I Qureshi
Keyword(s):  
Heart Disease ◽  
Subarachnoid Hemorrhage ◽  
Ischemic Heart Disease ◽  
Endovascular Treatment ◽  
Univariate Analysis ◽  
Prospective Trial ◽  
Endovascular Intervention ◽  
Ischemic Heart ◽  
History Of ◽  
Stroke Trial

Introduction: The rates of occurrence, predictors, and associated outcomes of subarachnoid hemorrhage (SAH) following endovascular treatment are not well studied. Methods: We retrospectively analyzed data from the Interventional Management of Stroke Trial (IMS III). This prospective trial randomized patients to intravenous (IV) rt-PA alone versus IV rt-PA followed by endovascular intervention. All patients underwent computed tomography (CT) at 24 hours post randomization. The scans were assessed by independent reviewers at a core laboratory for the presence, location, and type of intracranial hemorrhage.The primary outcome assessment was by modified Rankin Scale (mRS) score at 3 months. Results: Thirty four out of 434 (7.8%) patients who received endovascular treatment suffered SAH at 24 hours. There were 19 men (55.9%), and 19 patients were older than 70 years.In univariate analysis only pre-existing ischemic heart disease was identified as a predictor of SAH (p=0.03) while patient age was borderline significant (p=0.055). Three-monthmRS score was available for 24/34 patients with SAH and for 318/400 among the other patients. There was no difference in mortality (12.5% vs. 4.1%, p=0.167) or favorable outcome defined as mRS =<2 (41.7% vs. 53.5%, p=0.366). Conclusions: SAH following endovascular intervention for acute stroke is more common among patients with history of ischemic heart disease. It does not impact on functional outcome or mortality at 3 months.

scholarly journals Clinical and Etiological Profile of Patients with Atrial Fibrillation (AF): Analysis and implications

2017 ◽  
Vol 4 (1) ◽  
pp. 5-12
Author(s):  
Ram Narayan Mandal ◽  
Ajay Kumar Mishra ◽  
Elena Leonidovna Mandal
Keyword(s):  
Atrial Fibrillation ◽  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Dilated Cardiomyopathy ◽  
Rheumatic Heart Disease ◽  
Ischemic Heart ◽  
Systemic Hypertension ◽  
Clinical Hospital ◽  
Medical College ◽  
Rheumatic Heart

Background and Objectives: Atrial fibrillation (AF) is a frequently encountered cardiac arrhythmia which may be either symptomatic or asymptomatic. So, this study was conducted to know clinical presentation and to find out possible clinical and etiological profile of patients with AF.Material and Methods: This cross sectional study was conducted at Osh Regional Integrated Clinical Hospital, Osh Territorial City Clinical Hospital, The Kyrgyz Republic in collaboration with Janaki Medical College Teaching Hospital, Janakpurdham, Nepal. Sixty consecutive patients with AF were taken. Presenting complaints, past history, personal history was recorded. A thorough clinical examination was done, electrocardiogram, chest X-Ray posterio-anterior view, echocardiogram, thyroid function test and relevant test were done and analyzed.Results: Forty percent of the patients complained palpitation. Systemic thrombo-embolism was found in 15% of the patients. Other presenting complaints were cough, chest pain, shortness of breath, dizziness, swelling of the legs, tremors. Eighteen percent of patients presented with features of congestive cardiac failure and 30% of the patients gave history of rheumatic heart disease, 16.6% and 11.6% hypertension and ischemic heart disease respectively. Etiology-wise, rheumatic heart disease was the most common (46.6%) followed by hypertension (21.6%), ischemic heart disease (11.6%), dilated cardiomyopathy (6.6%), hyperthyroidism (5%), pneumonia (5%).Conclusion: Rheumatic heart disease, especially mitral stenosis is the most common cause of AF in this study. Systemic hypertension was next common etiology of AF, followed by ischaemic heart disease, dilated cardiomyopathy, thyroid disease. Heart failure, Systemic thromboembolism, decreased exercise tolerance are a major determinants for development of significant morbidity and mortality.Janaki Medical College Journal of Medical Sciences (2016) Vol. 4 (1): 5-12

Improving Medical Attention Through an Integral Care Model for Patients With Ischemic Heart Disease or Atrial Fibrillation

2019 ◽  
Vol 72 (9) ◽  
pp. 779-781
Author(s):  
Román Freixa-Pamias ◽  
Pedro Blanch Gràcia ◽  
Maria Lluïsa Rodríguez Latre ◽  
Luca Basile ◽  
Pilar Sánchez Chamero ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Ischemic Heart ◽  
Medical Attention ◽  
Care Model

scholarly journals Association between the level of plasma B-type natriuretic peptide and in-hospital mortality in patients with acute exacerbation of COPD without a history of coronary ischemic heart disease: a retrospective study

2021 ◽  
Author(s):  
Jiyun Cui ◽  
Jie Liu ◽  
Jing Wang ◽  
Meng Lv ◽  
Chunyan Xing ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Heart Disease ◽  
Hospital Mortality ◽  
Ischemic Heart Disease ◽  
Natriuretic Peptide ◽  
Invasive Mechanical Ventilation ◽  
Ischemic Heart ◽  
Composite Outcome ◽  
History Of ◽  
Secondary Outcomes

Abstract Background: Previous studies suggested that plasma B-type natriuretic peptide (BNP) level was often elevated in patients with acute exacerbations of chronic obstructive pulmonary disease (AECOPD) and was associated with increased mortality. However, most studies did not consider the fact that conditions such as coronary ischemic heart disease can also increase BNP level. Therefore, we aimed to explore the association between BNP level and in-hospital mortality in patients with AECOPD without a history of coronary ischemic heart disease.Methods: In this retrospective cohort study, patients who were diagnosed with AECOPD using International Statistical Classification of Diseases and Related Health Problems, Nineth Revision (ICD-9 codes) between January 2017 and December 2019. All data were obtained from electronic patient files and medical data intelligence platform of Jinan Central Hospital. BNP level was determined within 24 hours after admission, and the value was log2 transformed. The primary outcome was in-hospital mortality, and the secondary outcome was a composite outcome of in-hospital mortality or invasive mechanical ventilation.Results: A total of 300 patients were included in this study. Univariate cox regression analysis showed that the unadjusted HRs of the primary and secondary outcomes were 1.85 (95% CI, 1.39-2.47) and 1.45 (95% CI, 1.20-1.75), respectively. After adjustment for age, sex, past medical history, smoking status, drinking status, CURB65 (Confusion, Urea > 7mmol/L, Respiratory rate≥30/min, Blood pressure systolic < 90 mmHg or diastolic <60 mmHg and age > 65 years), arterial partial pressure of O2(PaO2), the adjusted HRs of the primary and secondary outcomes were 3.65 (95% CI, 2.54-5.26) and 1.43 (95% CI, 1.14-1.97), respectively. The results of subgroup analysis by age, sex, and lung function were robust. This study was retrospective, so there was no clinical trial registration.Conclusions: The plasma log2BNP level was significantly associated with in-hospital mortality and a composite outcome of in-hospital mortality or invasive mechanical ventilation.

scholarly journals Patterns of Changes in the Psycho-emotional Background in Patients with Stable Coronary Heart Disease, Complicated By Atrial Fibrillation

2019 ◽  
Vol 26 (2) ◽  
Author(s):  
Lesia Serediuk ◽  
Ihor Vakalyuk ◽  
Halyna Kerniakevych
Keyword(s):  
Atrial Fibrillation ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Stress Level ◽  
Ischemic Heart ◽  
Stable Ischemic Heart Disease ◽  
Constant Form ◽  
Stable Coronary Heart Disease ◽  
Echocardiographic Parameters

The objective is to investigate the influence of stress on the clinical and pathogenetic peculiarities of the course of stable coronary heart disease (SIHD) in conjunction with atrial fibrillation (AF). Materials and methods. The analysis of psychodiagnostic tests, labolatory and instrumental research methods in patients with and without AF has been performed. Patients were divided into three groups: group 1 – patients with stable ischemic heart disease (SIHD) with a constant form of AF (15 patients were examined), group 2 – patients with SIHD with paroxysmal form of AF (16 patients were examined), group 3 – patients with SIHD without AF (15 patients were examined). Results. According to the analysis of the data obtained, low level of stress was found in 6 (37.50%) patients with a permanent form of AF, whereas in patients without AF, it was observed in 1 (6.67%) person (p1<0.05) (p1 – the reliability of the differences in indicators relative to patients without AF). Moderate somatic disorder in women with paroxysmal AF was significantly higher than in the group of patients with a constant form of AF (p2<0.05) (p2 – the reliability of the differences in the indicators relative to patients with a constant form of AF). It is confirmed in patients with AF there are signs of the average stress level on the perceived stress level-10 (p2<0.05). Among the social factors that may have an impact on health are the influence of the media, the use of alcohol by relatives, the threat of unemployment for relatives and friends. These indicators were most often found in the group of patients with AF rather than without it (p2<0.05). Changes of ECG and echocardiographic parameters in all groups of patients were revealed. Conclusion. The association of stress with stable ischemic heart disease combined with atrial fibrillation has shown that stress disorders are associated with an increased risk of atrial fibrillation and may worsen their course and predict the risk of developing paroxysm. The dependence between the severity of clinical manifestations, psychodiagnostic tests, laboratory methods, ECG and echocardiographic parameters of the heart on the course of atrial fibrillation is proved.

scholarly journals Peanut Consumption and Risk of Stroke and Ischemic Heart Disease in Japanese Men and Women: The JPHC Study

Stroke ◽  
2021 ◽  
Author(s):  
Satoyo Ikehara ◽  
Hiroyasu Iso ◽  
Yoshihiro Kokubo ◽  
Kazumasa Yamagishi ◽  
Isao Saito ◽  
...  
Keyword(s):  
Public Health ◽  
Cardiovascular Disease ◽  
Heart Disease ◽  
Ischemic Stroke ◽  
Ischemic Heart Disease ◽  
Ischemic Heart ◽  
Japanese Men ◽  
Food Frequency ◽  
Men And Women ◽  
History Of

Background and Purpose: Several prospective cohort studies and a randomized clinical trial have shown the beneficial effects of peanut consumption on cardiovascular disease and its risk factors. We examined the association between peanut consumption and risk of cardiovascular disease in Japanese men and women. Methods: We analyzed data of 74 793 participants aged 45 to 74 years who completed a lifestyle questionnaire including the validated food frequency questionnaire in the Japan Public Health Center–based Prospective Study. They were followed up from 1995 to 2009 for cohort I and from 1998 to 1999 to 2012 for cohort II. Peanut consumption was calculated from the food frequency questionnaire, and the end points were incidence of stroke, ischemic heart disease, and cardiovascular disease (stroke and ischemic heart disease). Results: During a median follow-up of 14.8 years, 3,599 strokes and 849 ischemic heart diseases were reported. Higher peanut consumption was associated with reduced risks of total stroke, ischemic stroke, and cardiovascular disease among men and women. The multivariable hazard ratios (95% CIs) for the highest versus lowest quartiles of peanut consumption after adjustment for age, sex, public health center, smoking, alcohol consumption, perceived stress level, physical activity, vegetable, fruit, fish, soy, sodium and total energy intakes, body mass index, history of hypertension, history of diabetes, and cholesterol-lowering drug were 0.84 (0.77–0.93, P for trend=0.002) for total stroke, 0.80 (0.71–0.90, P for trend=0.002) for ischemic stroke, 0.93 (0.79–1.08, P for trend=0.27) for hemorrhagic stroke, 0.97 (0.80–1.17, P for trend=0.81) for ischemic heart disease and 0.87 (0.80–0.94, P for trend=0.004) for cardiovascular disease, and these associations were similarly observed in both sexes. Conclusions: Higher peanut consumption was associated with reduced risk of stroke, especially ischemic stroke, but not ischemic heart disease in Japanese men and women.

Abstract 325: Readmission among Hospitalized Patients with Non-Valvular Atrial Fibrillation

2012 ◽  
Vol 5 (suppl_1) ◽  
Author(s):  
Karen E Smoyer-Tomic ◽  
Kimberly Siu ◽  
Barbara Johnson ◽  
David R Walker ◽  
Stephen Sander ◽  
...  
Keyword(s):  
Risk Factors ◽  
Atrial Fibrillation ◽  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Cerebrovascular Disease ◽  
Readmission Rate ◽  
Ischemic Heart ◽  
Index Admission ◽  
Readmission Rates ◽  
Diagnosis Codes

Background: An important goal of healthcare reform is reducing the need for hospital readmissions. This study examined readmission rates, reasons for readmissions, and risk factors associated with readmissions in non-valvular atrial fibrillation (NVAF) patients, which may facilitate identification of potential gaps in care. Methods: Patients with AF hospitalizations in any diagnostic position in 2004-2009 were extracted from a large, national commercial and Medicare supplemental administrative claims database. Patients with valvular or transient causes of AF, under the age of 18 years, pregnant, or dead at discharge were excluded from the study. All patients had at least 30 days follow up from the index hospitalization discharge date. Readmission rate within 30 days of discharge date was calculated. Reasons for readmission were reported by ICD-9 diagnosis codes in the primary position. ICD-9 diagnosis codes were grouped into common acute conditions (e.g., ischemic heart disease, cerebrovascular disease) and reported. Logistic regression analyses were conducted to identify risk factors for readmission, controlling for patients’ demographic and clinical characteristics. Results: A total of 6439 patients met the study criteria. The overall 30-day readmission rate was 18.0%. Readmission rates for patients with AF as primary or secondary diagnosis in index admissions were 11.8% and 20.3%, respectively (p<0.001). Readmissions on average occurred 9.7 (SD 9.0) days from index admission discharge, with a mean readmission length of stay (LOS) of 7.4 (SD 8.0) days. The 4 most common grouped diagnoses for readmissions were AF (ICD-9 code 427.31, 10.2% of all readmissions), ischemic heart disease (IHD; 410.xx - 414.xx, 7.2%), heart failure (HF; 428.xx, 7.1%), and cerebrovascular disease (CVD; 430.xx - 438.xx, 6.0%). Longer LOS in the index admission, higher Charlson comorbidity index, and emergency room admission for the index admission all significantly increased the likelihood of having a readmission (p<0.001 in all cases). Patients discharged to home from index admission, patients with AF as primary diagnosis in index admissions, and patients living in the South region were less likely to be readmitted (p<0.01 in all cases). Conclusions: Almost one fifth of patients with NVAF were readmitted within 30 days of discharge. AF, IHD, HF, and CVD were the most common reasons for readmission. Identification of risk factors for readmission may assist healthcare providers in targeting good clinical practice aimed at improving quality of care and reducing the need for readmissions.

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