Abstract:
:A syncope evaluation should start by identifying potentially life-threatening causes, including valvular heart disease, cardiomyopathies, and arrhythmias. Most patients who present with syncope, however, have the more benign vasovagal (reflex) syncope. A busy syncope practice often also sees patients with neurogenic orthostatic hypotension presenting with syncope or severe recurrent presyncope. Recognition of these potential confounders of syncope might be difficult without adequate knowledge of their presentation, and this can adversely affect optimal management. This article reviews the presentation of the vasovagal syncope confounder and the putative pathophysiology of orthostatic hypotension, and suggests options for nonpharmacologic and pharmacologic management.
journal_name
Cardiol Clinjournal_title
Cardiology clinicsauthors
Nwazue VC,Raj SRdoi
10.1016/j.ccl.2012.09.003subject
Has Abstractpub_date
2013-02-01 00:00:00pages
89-100issue
1eissn
0733-8651issn
1558-2264pii
S0733-8651(12)00097-5journal_volume
31pub_type
杂志文章,评审abstract::Abnormal systolic ventricular function and persistent ischemia are sensitive indicators of poor prognosis following myocardial infarction. The use of exercise improves the utility of both radionuclide ventriculography and myocardial perfusion scintigraphy in the identification of postinfarction patients at high risk o...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:
更新日期:1984-08-01 00:00:00
abstract::Venous thromboembolism (VTE) is a potentially fatal condition and includes deep vein thrombosis and pulmonary embolism. The novel oral anticoagulants, which include the direct thrombin and factor Xa inhibitors, have been shown to be safe and effective for the treatment of VTE. Additional interventions include thrombol...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccl.2014.09.007
更新日期:2015-02-01 00:00:00
abstract::The treatment of cardiorenal syndrome is as complex as the various mechanisms underlying its pathophysiology. Randomized controlled data typically focus on the treatment of heart failure with cardiac specific endpoints and a lack of worsening renal function used as a surrogate for efficacy. When heart failure is consi...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccl.2019.04.002
更新日期:2019-08-01 00:00:00
abstract::The evaluation and management of volume status in patients with heart failure is a challenge for most clinicians. In addition, such an evaluation is possible only during a personal clinician-patient interface. The ability to acquire hemodynamic data continuously with the help of implanted devices with remote monitorin...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccl.2011.03.002
更新日期:2011-05-01 00:00:00
abstract::Initial pharmacologic therapy for hypertension is low-dose thiazide diuretics, beta-blockers, and ACE inhibitors. Increasing data have confirmed that ACE inhibitors have specific benefit in patients with diabetes, atherosclerosis, left ventricular dysfunction, and renal insufficiency. CCBs are alternative agents for I...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/s0733-8651(05)70213-7
更新日期:2001-05-01 00:00:00
abstract::Concurrent, independent clinical series at Yale University and the University of Virginia demonstrate an important role for CABG in patients with advanced ischemic cardiomyopathy. It is found that CABG can be performed safely in these patients, both angina and congestive heart failure states improve, ejection fraction...
journal_title:Cardiology clinics
pub_type: 临床试验,杂志文章
doi:
更新日期:1995-02-01 00:00:00
abstract::The indications for clinical electrophysiologic study have continued to evolve since the introduction of this technique in the mid 1960s. They now include evaluation of sinus node dysfunction, AV conduction disturbances, syncope of unknown etiology, supraventricular arrhythmias with and without Wolff-Parkinson-White s...
journal_title:Cardiology clinics
pub_type: 杂志文章
doi:
更新日期:1985-02-01 00:00:00
abstract::In this era of interventional electrophysiology, the accuracy of the electrocardiogram in diagnosis of supraventricular tachycardia could be improved by detailed endocardial mapping and confirmed by results of radiofrequency catheter ablation. This article describes the electrocardiographic characteristics for differe...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/s0733-8651(05)70361-1
更新日期:1997-11-01 00:00:00
abstract::Chronic total coronary occlusions (CTOs) are a frequent finding in patients with coronary disease and remain one of the most challenging target lesion subsets for intervention. CTOs have been reported in approximately one-third of patients undergoing diagnostic coronary angiography. By nature of their complexity, CTO ...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccl.2009.10.003
更新日期:2010-02-01 00:00:00
abstract::Over the last 2 decades human immunodeficiency virus (HIV) infection has become a chronic disease requiring long-term management. Aging, antiretroviral therapy, chronic inflammation, and several other factors contribute to the increased risk of cardiovascular disease in patients infected with HIV. In low-income and mi...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccl.2016.09.003
更新日期:2017-02-01 00:00:00
abstract::Percutaneous transluminal coronary angioplasty was first performed in a human coronary artery in 1977. In this article, we review the possible mechanisms of angioplasty, current indications for angioplasty, and complications of angioplasty including acute closure and restenosis. ...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:
更新日期:1988-08-01 00:00:00
abstract::Ischemic heart disease remains the leading cause of death worldwide. Low-density lipoprotein cholesterol (LDL-C) has proved to have a causal relationship with atherosclerotic cardiovascular disease. Lowering LDL-C improves outcomes, although some patients continue to have residual risk of cardiovascular disease. Cardi...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccl.2017.12.002
更新日期:2018-05-01 00:00:00
abstract::The medical management of patients with CHF and ventricular arrhythmias is one of the most challenging clinical situations frequently encountered by physicians on a daily basis. Reviewed and examined in this article are available data regarding the clinical relevance and prevalence of ventricular arrhythmias, their pr...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:
更新日期:1994-02-01 00:00:00
abstract::Hypertensive crises, which include hypertensive emergencies and urgencies, are frequently encountered in the emergency department, and require immediate attention as they can lead to irreversible end-organ damage. Normal blood pressure (BP) regulation is altered during acute rises in BP, leading to end-organ damage. M...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccl.2012.07.011
更新日期:2012-11-01 00:00:00
abstract::The role of heart catheterization continues to evolve as the sophistication of cardiac MRI and CT improves and the breadth of interventional catheter techniques widens. This analysis is approached from four perspectives: (1) planning of the procedure, including information required, potential pitfalls, and equipment; ...
journal_title:Cardiology clinics
pub_type: 杂志文章
doi:10.1016/j.ccl.2006.08.008
更新日期:2006-11-01 00:00:00
abstract::Cardiac CT is an accurate and reasonable alternative modality for valvular imaging. It is used primarily for the evaluation of coronary artery disease; however, important information regarding valvular anatomy and function can be derived from CT. Calcification is a common CT finding in various valvular abnormalities a...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccl.2009.06.010
更新日期:2009-11-01 00:00:00
abstract::On a variety of fronts, chronic infection has been found to be significantly associated with the development of atherosclerosis and the clinical complications of unstable angina, myocardial infarction, and stroke. For the most part, these relationships are still just associations. Failure to confirm initial reports of...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/s0733-8651(03)00054-7
更新日期:2003-08-01 00:00:00
abstract::The field of defibrillation is one of the most rapidly advancing areas in resuscitation. Defibrillation is also one of the most promising interventions for achieving improved survival from cardiac arrest. The purpose of this article is to provide an overview of the science and clinical applications of defibrillation. ...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/s0733-8651(03)00062-6
更新日期:2002-02-01 00:00:00
abstract::The electrocardiographic diagnosis of myocardial infarction (MI) in the presence of left bundle branch block (LBBB) has long been considered problematic or even almost impossible. Many proposed ECG markers in the old literature have now been discarded. However, the advent of reperfusion therapy has generated greater i...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccl.2006.05.002
更新日期:2006-08-01 00:00:00
abstract::Quantification of regional myocardial blood flow and of its responses to targeted physiologic and pharmacologic interventions, which is now available with positron emitting tracers of blood flow and positron emission tomography (PET), extends the diagnostic potential of standard myocardial perfusion imaging. These non...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccl.2008.12.009
更新日期:2009-05-01 00:00:00
abstract::To whatever extent the improvement in symptoms and survival rendered by treatment with ACE inhibitors is attributable to their effects on the circulation and the kidneys, this benefit can be rescinded by concomitant administration of aspirin. Although some useful prostaglandin-independent actions may persist, shutting...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/s0733-8651(05)70246-0
更新日期:2001-11-01 00:00:00
abstract::Although the long-term durability of stent grafts is still a concern, stent-graft treatment is already the best option in a large number of patients with descending thoracic aortic diseases who are poor candidates for surgical repair, or in an acute setting. With improved capability to recognize proper anatomy and sel...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccl.2010.01.011
更新日期:2010-05-01 00:00:00
abstract::Valvular heart disease (VHD) is generally well tolerated during pregnancy; however, the dramatic changes in hemodynamics that occur during pregnancy can lead to clinical decompensation in high-risk women. Women with VHD considering pregnancy should undergo preconception counseling with a high-risk obstetrician and car...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccl.2020.09.010
更新日期:2021-02-01 00:00:00
abstract::Incident heart failure and the burden of hospitalization may be demonstrating a decline. However, as the population ages, the prevalence of heart failure continues to increase. Mortality among heart failure patients is increasingly due to non-cardiovascular causes. Current evidence-based therapy for heart failure has ...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccl.2016.12.008
更新日期:2017-05-01 00:00:00
abstract::Coronary artery bypass grafting (CAGB) is superior to percutaneous coronary intervention (PCI) in reducing mortality in certain patients and improving the composite end points of angina, recurrent myocardial infarction, and repeat revascularization procedures. However, CABG is associated with a higher perioperative st...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccl.2014.04.011
更新日期:2014-08-01 00:00:00
abstract::Mechanical circulatory assistance is making the transition from an investigational technique to standard clinical practice, especially for post-cardiotomy shock. History, techniques, medications, complications, and results of mechanical assistance are reviewed. Promising trends for the future are presented. ...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:
更新日期:1988-08-01 00:00:00
abstract::Implantable cardioverter-defibrillators (ICDs) improve survival in patients who have left ventricular dysfunction; however, they are associated with numerous problems at implant and during follow-up. The diagnosis and management of these problems is usually straightforward, but more difficult problems may include the ...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccl.2008.03.012
更新日期:2008-08-01 00:00:00
abstract::When considering all the major series comparing the early and late results of mitral valve repair versus prosthetic or bioprosthetic mitral valve replacement, the operative mortality rate is slightly lower for patients undergoing valve reconstruction. Late survival is also superior after valve repair. Although these m...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:
更新日期:1991-05-01 00:00:00
abstract::This article reviews the definition, locations, and pathogenesis of acute myocardial infarction and provides a review of the pathology of acute reperfusion therapy. Various complications and sequelae of acute myocardial infarction are also surveyed. ...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:
更新日期:1988-02-01 00:00:00
abstract::The number of supporters of complete arch replacement in the surgery of acute type A aortic dissection has been steadily increasing as a result of cerebral perfusion techniques that enable the extension of safe circulatory arrest time. However, there is no agreement in the surgical community on an optimal surgical app...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccl.2010.01.007
更新日期:2010-05-01 00:00:00