Abstract：
:Chest pain units are now established centers for assessment of low-risk patients presenting to the emergency department with symptoms suggestive of acute coronary syndrome. Accelerated diagnostic protocols, of which treadmill testing is a key component, have been developed within these units for efficient evaluation of these patients. Studies of the last decade have established the utility of early exercise testing,which has been safe, accurate, and cost-effective in this setting. Specific diagnostic protocols vary, but most require 6 to 12 hours of observation by serial electrocardiography and cardiac injury markers to exclude infarction and high-risk unstable angina before proceeding to exercise testing. However, in the chest pain unit at UC Davis Medical Center,the approach includes "immediate" treadmill testing without a traditional process to rule out myocardial infarction. Extensive experience has validated this approach in a large, heterogeneous population. The optimal strategy for evaluating low-risk patients presenting to the emergency department with chest pain will continue to evolve based on current research and the development of new methods.
journal_name
Cardiol Clinjournal_title
Cardiology clinicsauthors
Amsterdam EA,Kirk JD,Diercks DB,Lewis WR,Turnipseed SDdoi
10.1016/j.ccl.2005.08.016subject
Has Abstractpub_date
2005-11-01 00:00:00pages
503-16, viiissue
4eissn
0733-8651issn
1558-2264pii
S0733-8651(05)00070-6journal_volume
23pub_type
杂志文章,评审abstract：:Cardiac implantable electronic devices (CIEDs) store clinically valuable, time-sensitive information regarding system integrity, arrhythmias, and heart failure parameters. Remote monitoring has impacted clinical practice by reducing scheduled office visits, providing protocols for device recalls and advisories, and fa...
journal_title：Cardiology clinics
pub_type： 杂志文章,评审
doi：10.1016/j.ccl.2014.01.001
更新日期：2014-05-01 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：:Although it is convenient to think of hypertension in its renal, epidemiologic, and vascular eras, a new perspective is rapidly coming to the forefront. As we become more critical in evaluating the performance of our health care systems, it is obvious that the major problems in hypertension do not lie entirely with un...
journal_title：Cardiology clinics
pub_type： 杂志文章,评审
doi：
更新日期：1995-11-01 00:00:00
abstract：:Stress-first approaches to myocardial perfusion imaging provide diagnostically and prognostically accurate perfusion data equivalent to a full rest-stress study, save time in the imaging laboratory, and reduce the radiation exposure to patients and laboratory staff. Converting a nuclear cardiology laboratory from a co...
journal_title：Cardiology clinics
pub_type： 杂志文章,评审
doi：10.1016/j.ccl.2015.06.006
更新日期：2016-02-01 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：:The AbioCor is a revolutionary device. It is the only device of its kind in the clinical world. The role of the AbioCor is to provide permanent replacement of the failing heart for patients who are not transplant candidates. The clinical trial has been successful in the majority (four of seven) of patients implanted t...
journal_title：Cardiology clinics
pub_type： 杂志文章,评审
doi：10.1016/s0733-8651(02)00141-8
更新日期：2003-02-01 00:00:00
abstract：:This article discusses the epidemiology of cardiovascular (CV) events in end-stage and early renal disease, summarizes the profile of classic and nonclassic CV risk factors in renal patients, highlights recent evidence documenting accelerated atherogenesis in renal disease, and provides information on the central arte...
journal_title：Cardiology clinics
pub_type： 杂志文章,评审
doi：10.1016/j.ccl.2005.03.002
更新日期：2005-08-01 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：: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：: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：:Heart-kidney interactions have been increasingly recognized by clinicians and researchers who study and treat heart failure and kidney disease. A classification system has been developed to categorize the different manifestations of cardiac and renal dysfunction. Work has highlighted the significant negative prognosti...
journal_title：Cardiology clinics
pub_type： 杂志文章,评审
doi：10.1016/j.ccl.2010.04.004
更新日期：2010-08-01 00:00:00
abstract：:In cases of suspected acute coronary syndrome (ACS), rapid and accurate diagnosis is essential to establish effective evidence-based medical treatment. Patients' history, clinical examination, 12-lead electrocardiogram, and cardiac biomarkers are cornerstones in initial management. Since high-sensitivity cardiac tropo...
journal_title：Cardiology clinics
pub_type： 杂志文章,评审
doi：10.1016/j.ccl.2020.06.001
更新日期：2020-11-01 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
abstract：:The goal of anticoagulant therapy in unstable angina is to prevent progression of a subocclusive coronary thrombus to complete occlusion of the coronary artery, thereby preventing myocardial infarction and death. Although these have been many advances in therapy with anticoagulants, considerable morbidity and mortalit...
journal_title：Cardiology clinics
pub_type： 杂志文章,评审
doi：10.1016/s0733-8651(05)70078-3
更新日期：1999-05-01 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：:Anger is the affective state most commonly associated with myocardial ischemia and life-threatening arrhythmias. The scope of the problem is sizeable-at least 36,000 (2.4% of 1.5 million) heart attacks are precipitated annually in the United States by anger. The lethal cardiovascular consequences in ischemic heart dis...
journal_title：Cardiology clinics
pub_type： 杂志文章,评审
doi：10.1016/s0733-8651(05)70281-2
更新日期：1996-05-01 00:00:00
abstract：:This article briefly reviews the background and rationale for the development of polymer paving. The process of endoluminal paving is described both in its generic form as well as in three experimental embodiments. Several experimental studies with two forms of paving, solid paving and gel paving, are reviewed. Finall...
journal_title：Cardiology clinics
pub_type： 杂志文章,评审
doi：
更新日期：1994-11-01 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：: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：:Cardiac transplantation is now an accepted therapeutic procedure in the management of patients suffering from end-stage congestive heart failure. The advances in myocardial preservation, long-distance procurement, immunosuppression, improvement in the treatment of infectious diseases, and utilization of endomyocardial...
journal_title：Cardiology clinics
pub_type： 杂志文章,评审
doi：
更新日期：1989-02-01 00:00:00
abstract：:Mechanical circulatory support using left ventricular assist devices (LVAD) has become an accepted mode of therapy for both bridging patients with end-stage heart failure to transplant and as a destination therapy. Right ventricular (RV) dysfunction is common after LVAD insertion and is a significant source of morbidi...
journal_title：Cardiology clinics
pub_type： 杂志文章
doi：10.1016/j.ccl.2011.08.011
更新日期：2011-11-01 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：:Intracoronary ultrasound provides unique information during percutaneous transluminal coronary angioplasty (PTCA), including more accurate measurement of vessel size and plaque burden as well as plaque characteristics such as composition and distribution. As a research tool, it has been useful in determining the mecha...
journal_title：Cardiology clinics
pub_type： 杂志文章,评审
doi：10.1016/s0733-8651(05)70316-7
更新日期：1997-02-01 00:00:00
abstract：:Subaortic stenosis can be a complex disease of multiple anatomic etiologies. At the core is either an elongated and narrow outflow tract as compared to normal or a fully muscle-rimmed VSD used as an intraventricular routing pathway. An array of treatment modalities is needed for an effective management strategy. ...
journal_title：Cardiology clinics
pub_type： 杂志文章,评审
doi：10.1016/s0733-8651(02)00013-9
更新日期：2002-08-01 00:00:00
abstract：:The chronotropic response is the most important means by which cardiac output is increased and oxygen delivery is maintained in response to increased oxygen consumption during exercise or stress. When the chronotropic response is suboptimal or absent, exercise intolerance results. This condition, called chronotropic i...
journal_title：Cardiology clinics
pub_type： 杂志文章,评审
doi：10.1016/s0733-8651(05)70132-6
更新日期：2000-02-01 00:00:00
abstract：:Several studies have indicated that women sustaining a myocardial infarction have a higher unadjusted short-term (i.e., in-hospital or 30-day) mortality than men. The advanced age of women at the time of presentation appears to be the major factor contributing to their worse prognosis relative to men. Controlling for ...
journal_title：Cardiology clinics
pub_type： 杂志文章,评审
doi：10.1016/s0733-8651(05)70383-0
更新日期：1998-02-01 00:00:00
abstract：:In the past, much attention in imaging research was focused on the macroscopic morphology and patency of arteries. Only recently, research and clinical interest have shifted to the microcirculation and its impact on the long-term prognosis in patients with vascular diseases. This focus and newly developed therapeutic ...
journal_title：Cardiology clinics
pub_type： 杂志文章,评审
doi：10.1016/s0733-8651(03)00110-3
更新日期：2003-11-01 00:00:00
abstract：:Clinical trial results support the aggressive use of anticoagulant therapy to prevent systemic embolism in patients with acute myocardial infarction who are at high risk for embolism (e.g., anterior transmural infarction). Other patients at risk for systemic embolism include those with chronic left ventricular aneurys...
journal_title：Cardiology clinics
pub_type： 杂志文章,评审
doi：
更新日期：1994-08-01 00:00:00
abstract：:Despite the decline in rheumatic heart disease worldwide and the use of antibiotic prophylaxis, there is no evidence that the incidence of infective endocarditis is decreasing. In fact, some data suggest it may be increasing. The classical fever of unknown origin presentation represents a minority of infective endocar...
journal_title：Cardiology clinics
pub_type： 杂志文章,评审
doi：10.1016/s0733-8651(03)00023-7
更新日期：2003-05-01 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
