Abstract:
:Patients who have chest pain following the use of cocaine have become more common in emergency departments throughout the United States,with approximately 6% of these patients sustaining an acute MI. The authors have described the rationale for recommending aspirin, benzodiaze-pines, and nitroglycerin as first-line treatments and calcium-channel blockade or phentolamine as possible second-line therapies and have summarized the controversies surrounding the use of fibrinolytic agents. Admission for observation is one reasonable approach to the management of the low-risk cohort. Evaluation for underlying coronary artery disease is reasonable, particularly in patients who have acute MI. Patients who do not have infarction can undergo evaluation for possible coronary artery disease on an outpatient basis. Routine interventions for secondary prophylaxis as well as cocaine rehabilitation should be used in this patient population, because the long-term prognosis seems somewhat dependent upon the ability of the patient to discontinue cocaine use.
journal_name
Cardiol Clinjournal_title
Cardiology clinicsauthors
Hollander JE,Henry TDdoi
10.1016/j.ccl.2005.09.003subject
Has Abstractpub_date
2006-02-01 00:00:00pages
103-14issue
1eissn
0733-8651issn
1558-2264pii
S0733-8651(05)00074-3journal_volume
24pub_type
杂志文章,评审abstract::Coronary thrombosis is now recognized as the most common proximate cause of acute myocardial infarction, and thrombolysis is evolving as an accepted therapeutic approach to patients presenting in the early stages of myocardial infarction. The ascent of thrombolysis in treatment hierarchies reflects multiple factors, i...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:
更新日期:1987-02-01 00:00:00
abstract::There has been heightened interest in the design and role of preparticipation screening for high school and college athletes. An American Heart Association consensus panel, composed of cardiovascular specialists and other physician experts having extensive clinical experience with athletes of all ages as well as a leg...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/s0733-8651(05)70353-2
更新日期:1997-08-01 00:00:00
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::The Fontan operation is a unique approach to create a circulation in series without 2 distinct pumping chambers. Although the approach has enabled many patients to live well into adulthood, the unique physiology results in many complications, cardiac and extracardiac. This review focuses on the pathophysiology of the ...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccl.2015.07.010
更新日期:2015-11-01 00:00:00
abstract::Bacterial infections of the heart in compromised patients are uncommon but may be increasing in relative frequency. They are associated with near-equal frequencies in patients who have pre-existing or simultaneous infections at other sites, patients with neoplasms (usually solid tumors), those who have undergone cardi...
journal_title:Cardiology clinics
pub_type: 杂志文章
doi:
更新日期:1984-11-01 00:00:00
abstract::The advent of immunotherapy, particularly immune checkpoint inhibitors and chimeric antigen receptor T-cell therapy, has ushered in a promising new era of treatment of patients with a variety of malignancies who historically had a poor prognosis. However, these therapies are associated with potentially life-threatenin...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccl.2019.07.008
更新日期:2019-11-01 00:00:00
abstract::As the incidence of valvular disease in the elderly is increasing, understanding of its pathogenesis and natural progression as well as surgical approaches and device technologies are improving. Future studies are needed to develop medical interventions that slow or halt the degenerative valvular processes associated ...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/s0733-8651(05)70061-8
更新日期:1999-02-01 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::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::This article provides a summary of the types of congenital atrioventricular block and the various acquired diseases in which atrioventricular block may occur. Some lesions found in atrioventricular block are illustrated. ...
journal_title:Cardiology clinics
pub_type: 杂志文章
doi:
更新日期:1984-11-01 00:00:00
abstract::Diseases of the thoracic aorta are serious conditions that require close observations. Impressive advances in imaging modalities such as magnetic resonance imaging, computed tomography sacs, and transesophageal echocardiography have aided diagnosis and provided insights into the pathogenesis and natural history of tho...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/s0733-8651(05)70109-0
更新日期:1999-11-01 00:00:00
abstract::Except for the unique eccentricities of individual devices, most dual-chamber paced rhythms, both normal and abnormal, are readily understood and lend themselves to analysis if the programmed parameters are known. Although they may appear intimidating, this need not be the case if the physician is initially willing to...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:
更新日期:1985-11-01 00:00:00
abstract::The cardiologist and internist can make a major contribution to the care of patients with neurologic disease, both in terms of treating patients with symptomatic cardiac involvement and reducing mortality. This article highlights the need to recognize ECG abnormalities that may represent purely neurologic disease as w...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:
更新日期:1995-05-01 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::Right ventricular (RV) failure is an increasingly common clinical problem that may require mechanical support. In contrast to severe left ventricular failure, RV failure is typically more reversible. Therefore, application of shorter-term percutaneous support devices is potentially attractive. Current innovations prom...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccl.2012.03.007
更新日期:2012-05-01 00:00:00
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 o...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccl.2012.09.003
更新日期:2013-02-01 00:00:00
abstract::As the next millennium approaches, excitement and promise characterize the future of dilated cardiomyopathy. Until recently, dilated cardiomyopathy was considered an incurable, uniformly fatal chronic disease. Epidemiologic studies have demonstrated that at least a quarter of patients with recent onset of symptoms wit...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/s0733-8651(05)70047-3
更新日期:1998-11-01 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::The major adaptations of the maternal cardiovascular system that progress throughout gestation may unmask previously unrecognized heart disease and result in significant morbidity and mortality. Most of these changes are almost fully reversed in the weeks and months after delivery. Hemodynamic changes during pregnancy...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccl.2012.05.004
更新日期:2012-08-01 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::There have been significant advances in the diagnosis and treatment of the patient with mitral stenosis over the past two decades. Two-dimensional and Doppler echocardiography have supplanted the cardiac catheterization laboratory in the diagnosis and determination of the hemodynamic severity of the stenotic mitral va...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/s0733-8651(05)70021-7
更新日期:1998-08-01 00:00:00
abstract::Myocardial systolic contractile dysfunction can occur despite preservation of myocardial viability, conditions referred to as myocardial 'stunning' or 'hibernation.' Because simple assessment of wall motion does not adequately distinguish nonviable from viable but noncontracting myocardial regions, clinicians require ...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:
更新日期:1994-05-01 00:00:00
abstract::Under normal baseline conditions the unique anatomy, myocardial ultrastructure, and coronary physiology of the right ventricle (RV) reflect a high-volume low-pressure pump. Early work described the RV as a passive conduit with minimal pumping capability. It is now appreciated that through a mechanism of ventricular in...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccl.2012.03.009
更新日期:2012-05-01 00:00:00
abstract::Percutaneous left atrial appendage (LAA) closure is being increasingly used as a treatment strategy to prevent stroke in patients with atrial fibrillation (AF) who have contraindications to anticoagulants. Several approaches and devices have been developed in the last few years, each with their own unique set of advan...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccl.2014.07.006
更新日期:2014-11-01 00:00:00
abstract::This is an extensive review of thrombolysis in myocardial infarction with discussions of the pathophysiology of occlusion, clinical occlusion and rationale for thrombolysis, thrombolytic agents, results of thrombolysis (incidence of reperfusion, left ventricular function, and mortality), complications of thrombolytic ...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:
更新日期:1988-02-01 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::Evaluation of mitral regurgitation (MR) severity remains complex and challenging. An integrative approach to grading MR is recommended. The use of multiple Doppler methods should be used to help discriminate between grades of severity. Importantly, MR severity should always be considered in the context of clinical dat...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccl.2013.04.002
更新日期:2013-05-01 00:00:00
abstract::The myocardium consists of three compartments: cardiac muscle cells; a nutritive microcirculation; and an extracellular matrix composed largely of fibrillar collagen. The hypertrophic remodeling of the myocardium, which involves each of these compartments, can be adaptive or pathologic. This article reviews the remode...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:
更新日期:1989-02-01 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::The pericardium consists of a visceral mesothelial monolayer (epicardium) that reflects over the great vessels and joins an outer, relatively inelastic fibrous parietal layer of organized collagen and elastin fibers, between which is a potential space that normally contains up to 50 mL of plasma filtrate. Although not...
journal_title:Cardiology clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ccl.2017.07.002
更新日期:2017-11-01 00:00:00