Abstract:
BACKGROUND:A number of innovative approaches have been investigated for their value in the early detection of acute ischemia or infarction in patients presenting to the emergency department (ED) with chest pain suggestive of a cardiac origin. Prior investigations have demonstrated the utility of adding right precordial and posterior chest leads to the standard 12-lead electrocardiogram (ECG) for identifying right ventricular and posterior wall infarctions in the ED. HYPOTHESIS:To assess the utility of additional ECG leads in low-risk patients presenting to the ED with symptoms suggestive of acute coronary syndromes who are managed in a chest pain evaluation unit (CPEU). METHODS:We studied low-risk patients who presented to the ED with chest pain compatible with myocardial ischemia. Low-risk patients were identified by a normal 12-lead ECG, no arrhythmias or hemodynamic instability, and one negative serum cardiac troponin I. Patients were admitted to the CPEU where a 16-lead ECG was recorded by the addition of 2 right-sided precordial leads (V4R, V5R) and 2 posterior leads (V8, V9) to the standard 12-lead ECG. RESULTS:The 16-lead ECG system was applied to 316 consecutive patients. The study group was a middle-aged population with equal numbers of men and women and an average of 2 cardiac risk factors per patient. The 16-lead ECG demonstrated evidence of myocardial injury in only 1 patient and no evidence of ischemia in any of the 316 patients. CONCLUSION:In patients presenting to the ED with chest pain and evidence of low clinical risk by our criteria, the addition of both right-sided precordial and posterior chest leads to the standard 12-lead ECG did not provide additional information for risk stratification.
journal_name
Cardiologyjournal_title
Cardiologyauthors
Ganim RP,Lewis WR,Diercks DB,Kirk D,Sabapathy R,Baker L,Amsterdam EAdoi
10.1159/000077912subject
Has Abstractpub_date
2004-01-01 00:00:00pages
100-3issue
2eissn
0008-6312issn
1421-9751pii
77912journal_volume
102pub_type
杂志文章相关文献
CARDIOLOGY文献大全abstract::Several lines of evidence have shown that viral infections are capable of causing coronary spasm and precipitating or mimicking clinical myocardial infarction. Here we report the case of a 41-year-old woman with recurrent angina who was admitted to our hospital because of ventricular tachycardia. Laboratory examinatio...
journal_title:Cardiology
pub_type: 杂志文章
doi:10.1159/000006987
更新日期:1999-01-01 00:00:00
abstract::In an attempt to determine factors that are related to atrial natriuretic factor (ANF) release in normal subjects, 10 male volunteers were studied at rest supine, sitting and during treadmill exercise. Echocardiography was used to measure atrial volumes, and a Swan-Ganz catheter was used to measure right atrial pressu...
journal_title:Cardiology
pub_type: 杂志文章
doi:10.1159/000174635
更新日期:1990-01-01 00:00:00
abstract:BACKGROUND:Diabetes mellitus (DM) is a well-recognized risk factor for heart failure (HF). We hypothesized that HF also increases the risk for DM. OBJECTIVE:We explored the hypothesis that HF is a risk factor for DM. METHODS:The Cardiovascular Health Study was a prospective cohort study of cardiovascular risk in ambu...
journal_title:Cardiology
pub_type: 杂志文章
doi:10.1159/000363282
更新日期:2014-01-01 00:00:00
abstract:OBJECTIVE:To test the hypothesis that pioglitazone, a peroxisome proliferator-activated receptor-gamma agonist, will improve endothelial function in non-diabetic subjects with coronary artery disease, we conducted a prospective study to evaluate the effect of this medication on the brachial artery vasomotor function an...
journal_title:Cardiology
pub_type: 临床试验,杂志文章
doi:10.1159/000096601
更新日期:2007-01-01 00:00:00
abstract::Aortic dissection is accompanied by fever in about one third of the patients. However, fever of unknown origin as the predominant manifestation of aortic dissection seems to be extremely rare. A review of the English literature revealed only 3 patients characterized by fever as the principal sign of aortic dissection....
journal_title:Cardiology
pub_type: 杂志文章
doi:10.1159/000174770
更新日期:1991-01-01 00:00:00
abstract::In 6 patients with healthy hearts (controls), 17 with coronary artery disease (CAD) and 6 with left ventricular hypertrophy due to aortic valvular disease, aortic pressure, coronary sinus blood flow (CSF) and lactate extraction were determined before and after the sudden onset of a paced ventricular tachycardia of 170...
journal_title:Cardiology
pub_type: 杂志文章
doi:10.1159/000173524
更新日期:1982-01-01 00:00:00
abstract:BACKGROUND:A significant number of heart failure (HF) patients with reduced left ventricular ejection fraction (LVEF) experience ventricular function recovery during follow-up. We studied the variables associated with LVEF recovery in patients treated with sacubitril/valsartan (SV) in clinical practice. METHODS:We ana...
journal_title:Cardiology
pub_type: 杂志文章,多中心研究
doi:10.1159/000505148
更新日期:2020-01-01 00:00:00
abstract::Muscle fiber disarray (MFD) has been described as the histologic feature of hypertrophic cardiomyopathy (HC), but it was also found in normal and other abnormal conditions. Its distribution related to the topography of the myocardium has not been described. In this paper, the incidence of MFD in hearts free from HC, t...
journal_title:Cardiology
pub_type: 杂志文章
doi:10.1159/000173850
更新日期:1985-01-01 00:00:00
abstract:OBJECTIVES:Myocardial perfusion imaging (MPI) with positron emission tomography (PET) has advantages over single-photon emission computerized tomography, particularly for women. This investigation was undertaken to define the prognosis of a normal stress PET MPI study in women. METHODS:The cohort comprised 457 women e...
journal_title:Cardiology
pub_type: 杂志文章
doi:10.1159/000323841
更新日期:2010-01-01 00:00:00
abstract::The severe teratogenic side effects of thalidomide led to its well-publicized withdrawal in the 1970s, but as it is cautiously being reintroduced into clinical use, new adverse effects are being described. A 65-year-old male with multiple myeloma received chemotherapy which included cyclophosphamide, thalidomide and d...
journal_title:Cardiology
pub_type: 杂志文章
doi:10.1159/000348367
更新日期:2013-01-01 00:00:00
abstract::Various aspects of carbohydrate and lipid metabolism were studied in two groups of patients with mild hypertension before and after 6 months' treatment with either lisinopril (n = 10) or hydrochlorothiazide (n = 10). A significant reduction of arterial blood pressure was seen after both treatment regimens. Circulating...
journal_title:Cardiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1159/000175965
更新日期:1993-01-01 00:00:00
abstract:BACKGROUND:The pathogenesis of chronic thromboembolic pulmonary hypertension (CTEPH) is largely unknown. Proteomics offers an approach to overview the molecular activities and signal transduction pathways involved in specific disease processes. OBJECTIVES:In this study, the expression of proteins in endarterectomized ...
journal_title:Cardiology
pub_type: 新闻
doi:10.1159/000502831
更新日期:2020-01-01 00:00:00
abstract::We describe the 2- and 5-year prognoses following coronary artery bypass grafting (CABG) in relation to smoking habits among consecutive patients being operated on in western Sweden during a 3-year period. Among the 2,121 patients, 10.2% admitted smoking at coronary angiography as compared with 7.5% 2 years after CABG...
journal_title:Cardiology
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1159/000177397
更新日期:1997-11-01 00:00:00
abstract::Normal subjects and cardiac chagasic patients without previous history of congestive failure or actual evidences of cardiac decompensation were exercised on a treadmill or a bicycle ergometer. Patients with less than the expected increase in heart rate during exercise were found to exhibit also an abnormal heart rate ...
journal_title:Cardiology
pub_type: 杂志文章
doi:10.1159/000169713
更新日期:1975-01-01 00:00:00
abstract::In a patient with transient WPW syndrome the electrocardiographic pattern of preexcitation could repeatedly be induced by carotid sinus massage during isoprenaline infusion. Adrenergic and cholinergic discharge may favor the conduction of the impulse over an accessory nonfunctional A-V bundle. ...
journal_title:Cardiology
pub_type: 杂志文章
doi:10.1159/000169756
更新日期:1976-01-01 00:00:00
abstract::Since recent studies demonstrated an impaired outcome after percutaneous coronary interventions (PCI) in patients with chronic renal failure but did not address the aetiology of renal failure, we now analysed the outcome of patients with diabetic nephropathy in 721 consecutive patients undergoing PCI. Diabetic nephrop...
journal_title:Cardiology
pub_type: 杂志文章
doi:10.1159/000086050
更新日期:2005-01-01 00:00:00
abstract::Heart failure is a huge healthcare issue not only for clinicians but for healthcare managers also, with increasing pressure to demonstrate the cost-effectiveness of therapies especially for common chronic conditions. The cost-effectiveness of heart failure treatments relate to their effects on the progression of the d...
journal_title:Cardiology
pub_type: 杂志文章,评审
doi:10.1159/000177166
更新日期:1996-01-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to examine the feasibility of M-mode tissue Doppler imaging for localizing the accessory pathway in patients with Wolff-Parkinson-White (WPW) syndrome. METHODS:Two-dimensional guided tissue Doppler M-mode was recorded at the mitral and tricuspid annular levels in 13 WPW patients...
journal_title:Cardiology
pub_type: 杂志文章
doi:10.1159/000006970
更新日期:1999-01-01 00:00:00
abstract:OBJECTIVES:The present study aimed to evaluate the hypertension status of community residents, analyze environmental and epigenetic factors, and propose prevention measures for hypertension. METHODS:In our study, different methylation levels were distinguished utilizing melting temperature (Tm) values in both the case...
journal_title:Cardiology
pub_type: 杂志文章
doi:10.1159/000458520
更新日期:2017-01-01 00:00:00
abstract::The natriuretic effects of furosemide and the long-acting loop diuretic torasemide have been compared in patients with chronic renal failure with and without nephrotic syndrome. In patients with chronic renal failure without nephrotic syndrome, furosemide and torasemide exerted similar natriuretic activity. In patient...
journal_title:Cardiology
pub_type: 杂志文章
doi:10.1159/000176469
更新日期:1994-01-01 00:00:00
abstract:OBJECTIVES:To explore the relation between the baseline aortic valve gradient (AVG) as a continuous variable and clinical outcomes following transcatheter aortic valve implantation (TAVI) in general and specifically in patients with high-gradient aortic stenosis (AS). METHODS:We reviewed 317 consecutive patients who u...
journal_title:Cardiology
pub_type: 杂志文章
doi:10.1159/000444007
更新日期:2016-01-01 00:00:00
abstract:BACKGROUND/AIMS:Mitral regurgitation (MR) is frequently observed in patients with acute myocardial infarction (AMI), and is known to convey an adverse prognosis. We sought to clarify the relationship between MR and left ventricular (LV) remodeling, in association with serum C-reactive protein (CRP) elevation. METHODS/...
journal_title:Cardiology
pub_type: 杂志文章
doi:10.1159/000099057
更新日期:2007-01-01 00:00:00
abstract::Glycoprotein IIb/IIIa inhibitors are used as an adjunct to antiplatelet therapy in percutaneous coronary intervention to reduce postprocedural enzyme elevations. Previous studies have shown a risk for thrombocytopenia that is associated with these agents. We sought to evaluate the incidence and outcomes of glycoprotei...
journal_title:Cardiology
pub_type: 杂志文章
doi:10.1159/000081008
更新日期:2004-01-01 00:00:00
abstract::To study the effect of coronary angioplasty (PTCA) on left ventricular (LV) diastolic filling, mitral Doppler flow tracings of 15 patients with isolated stenosis of the left anterior descending coronary artery (LAD) and normal systolic LV function were recorded before PTCA as well as 24 h and 3 months after successful...
journal_title:Cardiology
pub_type: 杂志文章
doi:10.1159/000175007
更新日期:1992-01-01 00:00:00
abstract::Renin is a key component of the renin-angiotensin system (RAS), which plays an important role in the maintenance of blood pressure and electrolyte-volume homeostasis. RAS also plays a role in cardiovascular (CV) disease as a result of effects on inflammation and oxidative stress. There is growing evidence that plasma ...
journal_title:Cardiology
pub_type: 杂志文章,评审
doi:10.1159/000348365
更新日期:2013-01-01 00:00:00
abstract:OBJECTIVE:To explore the role of platelet-derived growth factor-B (PDGF-B)/platelet-derived growth factor receptor-β (PDGFR-β) signaling in chronic atrial fibrillation (AF). METHODS:Thirty-nine AF patients and 33 patients with sinus rhythm (SR) were enrolled. Twenty canines were randomized into 5 groups: control, sham...
journal_title:Cardiology
pub_type: 杂志文章
doi:10.1159/000442940
更新日期:2016-01-01 00:00:00
abstract::An anonymous patient perception comprehension and satisfaction questionnaire was sent to 438 patients 1-3 months after they had participated in a clinical cardiovascular trial to examine the level of patient comprehension as perceived by the patient. We compared perceived comprehension in acute (acute myocardial infar...
journal_title:Cardiology
pub_type: 临床试验,杂志文章
doi:10.1159/000069729
更新日期:2003-01-01 00:00:00
abstract::Mass screening for heart disease in children can be accomplished by automatic analysis of phonocardiograms (PCG) obtained from five routine auscultation points. An ECG signal serves as reference. PCG signals exceeding 20% of the amplitude of the first heart sound S1 in the diastolic interval and 40% of S1 in the systo...
journal_title:Cardiology
pub_type: 杂志文章
doi:10.1159/000169876
更新日期:1978-01-01 00:00:00
abstract::A double-chambered right ventricle (DCRV) is an uncommon congenital anomaly: the right ventricle (RV) is divided into two chambers due to the presence of an abnormally located muscular band or anomalous muscle hypertrophy in the subinfundibular part of RV outflow tract, with a variable degree of obstruction. Generally...
journal_title:Cardiology
pub_type: 杂志文章,评审
doi:10.1159/000444743
更新日期:2016-01-01 00:00:00
abstract::Lower extremity atherosclerosis results in significant morbidity in women, particularly in women following the menopause. Up to 25% of women aged 55 to 74 years are affected by this disease. When noninvasive testing is used to determine the prevalence of lower extremity atherosclerosis, and men in this age group are e...
journal_title:Cardiology
pub_type: 杂志文章,评审
doi:10.1159/000176899
更新日期:1995-01-01 00:00:00