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[PMID]:28462757
[Au] Autor:Karpuz D; Giray D; Ozyurt A; Bozlu G; Unal S; Hallioglu O
[Ad] Endereço:1Department of Pediatrics, University of Mersin Faculty of Medicine,Mersin,Turkey.
[Ti] Título:Can whole-blood parameters be used in follow-up of children with rheumatic valvular heart disease?
[So] Source:Cardiol Young;27(4):764-769, 2017 May.
[Is] ISSN:1467-1107
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: The aim of the present study was to investigate the relationships between red blood cell distribution width, platelet distribution width, and mean platelet volume and the presence and severity of valvular involvement in patients with rheumatic heart disease. METHODS: Between April, 2012 and December, 2015, 151 patients who were admitted to the Pediatric Cardiology Unit with diagnosis of rheumatic heart disease and 148 healthy children were included to our study. Transthoracic echocardiography for all children was performed, and the values of red blood cell distribution width, platelet distribution width, and mean platelet volume, besides other blood count parameters, erythrocyte sedimentation rate, and C-reactive protein levels were recorded. RESULTS: Red blood cell distribution width, platelet distribution width, mean platelet volume, and C-reactive protein levels were significantly higher in patients with rheumatic heart disease when compared with healthy controls (p0.05). CONCLUSION: This is the first study in children with rheumatic heart disease that demonstrated significantly increased red blood cell distribution width, platelet distribution width, and mean platelet volume levels, as well as evaluated all three parameters together. Furthermore, red blood cell distribution width values in the chronical period of acute rheumatic fever, due to the positive correlation with the other chronic inflammatory markers, may help make the diagnosis in children.
[Mh] Termos MeSH primário: Proteína C-Reativa/análise
Índices de Eritrócitos
Volume Plaquetário Médio
Cardiopatia Reumática/sangue
[Mh] Termos MeSH secundário: Adolescente
Biomarcadores/sangue
Estudos de Casos e Controles
Criança
Ecocardiografia
Feminino
Seres Humanos
Masculino
Estudos Retrospectivos
Cardiopatia Reumática/diagnóstico por imagem
Índice de Gravidade de Doença
Turquia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Biomarkers); 9007-41-4 (C-Reactive Protein)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170503
[St] Status:MEDLINE
[do] DOI:10.1017/S1047951116001281


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[PMID]:29203757
[Au] Autor:Osovska NY; Datsyuk OI; Kuzminova NV; Shaprynskyi YV; Bevz HV; Pashynskyy YM; Bondarchuk OD; Sergiichuk OV; Karyi YV; Mazur GM
[Ad] Endereço:National Pirogov Memorial Medical University, Vinnytsya, Ukraine.
[Ti] Título:Variant of myocardial infarction course in the patient with left ventricular non-compaction.
[So] Source:Wiad Lek;70(5):998-1004, 2017.
[Is] ISSN:0043-5147
[Cp] País de publicação:Poland
[La] Idioma:eng
[Ab] Resumo:Non-compacted left ventricle in adults is a rare occurrence, though it is diagnosed even more rarely. As a rule in patients with non-compacted left ventricle (LVNC) other pathologic condition is diagnosed, notably hypertrophic or dilated cardiomyopathy. The majority of LVNC cases are diagnosed in early infancy but currently there are asymptomatic cases detected by means of echocardiographic examination. Real prevalence of LVNC is unknown. According to many authors LVNC occurs in 9.2-9.5% of children with diagnosed cardiomyopathies. The majority of such children do not survive till adulthood because of progressive severe heart failure, fatal arrhythmias and thromboembolisms. This value ranges from 0.014 to 0.05% in adult population. The article presents a clinical case illustrating the stages in establishing the diagnosis of non-compacted left ventricle in a young patient with myocardial infarction and congestive heart failure. Common characteristics of non-compacted left ventricle and connective tissue dysplasia syndrome in the patient suggested etiopathogenetic relationship between these two pathologic states. The basic common characteristic feature of both non-compacted left ventricle and connective tissue dysplasia syndrome proved to be multiple abnormal chords of the left ventricle. The patient was supposed to have some coronary circulation abnormality inherited together with non-compacted left ventricle and connective tissue dysplasia syndrome. Adverse prognosis and high mortality in non-compacted left ventricle require its early recognition and differentiated approach to treatment depending on the severity of the disease and using all modern methods of treatment both conservative and surgical.
[Mh] Termos MeSH primário: Miocárdio Ventricular não Compactado Isolado/diagnóstico por imagem
Miocárdio Ventricular não Compactado Isolado/fisiopatologia
[Mh] Termos MeSH secundário: Adulto
Cardiomiopatia Dilatada/patologia
Criança
Ecocardiografia
Ventrículos do Coração/patologia
Seres Humanos
Anamnese
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171206
[St] Status:MEDLINE


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[PMID]:29223273
[Au] Autor:van der Veer T; In 't Veen JCCM; den Dekker WK; Miedema J
[Ad] Endereço:Department of Pulmonology, Franciscus Gasthuis & Vlietland, Erasmus Medical Center, Rotterdam, the Netherlands. Electronic address: t.vanderveer@franciscus.nl.
[Ti] Título:A 79-Year-Old Woman With Dyspnea and Hypoxemia That Worsened in an Upright Position.
[So] Source:Chest;152(6):e139-e142, 2017 12.
[Is] ISSN:1931-3543
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:CASE PRESENTATION: A 79-year-old woman presented to the ED with complaints of gradually worsening exertional dyspnea, dizziness, and chest discomfort. For several weeks she had not been able to perform light household work. The patient's medical history mentioned pulmonary embolism following immobilization (2012), several fractures after trauma, an ischemic cerebral vascular accident (2014), and curative treatment for breast cancer (1995). Her current medication included esomeprazole, clopidogrel, simvastatin, calcium/vitamin D, amitriptyline, and acetaminophen.
[Mh] Termos MeSH primário: Anormalidades Múltiplas
Aneurisma da Aorta Torácica/complicações
Dispneia/etiologia
Forame Oval Patente/complicações
Hipóxia/etiologia
[Mh] Termos MeSH secundário: Idoso
Aneurisma da Aorta Torácica/diagnóstico
Cateterismo Cardíaco
Procedimentos Cirúrgicos Cardíacos/métodos
Diagnóstico Diferencial
Dispneia/diagnóstico
Ecocardiografia
Feminino
Forame Oval Patente/diagnóstico
Forame Oval Patente/cirurgia
Seres Humanos
Hipóxia/diagnóstico
Dispositivo para Oclusão Septal
Síndrome
Tomografia Computadorizada por Raios X
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171211
[St] Status:MEDLINE


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[PMID]:28742031
[Au] Autor:Larsson D; Spuhler JH; Petersson S; Nordenfur T; Colarieti-Tosti M; Hoffman J; Winter R; Larsson M
[Ti] Título:Patient-Specific Left Ventricular Flow Simulations From Transthoracic Echocardiography: Robustness Evaluation and Validation Against Ultrasound Doppler and Magnetic Resonance Imaging.
[So] Source:IEEE Trans Med Imaging;36(11):2261-2275, 2017 Nov.
[Is] ISSN:1558-254X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The combination of medical imaging with computational fluid dynamics (CFD) has enabled the study of 3-D blood flow on a patient-specific level. However, with models based on gated high-resolution data, the study of transient flows, and any model implementation into routine cardiac care, is challenging. This paper presents a novel pathway for patient-specific CFD modelling of the left ventricle (LV), using 4-D transthoracic echocardiography (TTE) as input modality. To evaluate the clinical usability, two sub-studies were performed. First, a robustness evaluation was performed, where repeated models with alternating input variables were generated for six subjects and changes in simulated output quantified. Second, a validation study was carried out, where the pathway accuracy was evaluated against pulsed-wave Doppler (100 subjects), and 2-D through-plane phase-contrast magnetic resonance imaging measurements over seven intraventricular planes (6 subjects). The robustness evaluation indicated a model deviation of <12%, with highest regional and temporal deviations at apical segments and at peak systole, respectively. The validation study showed an error of <11% (velocities <10 cm/s) for all subjects, with no significant regional or temporal differences observed. With the patient-specific pathway shown to provide robust output with high accuracy, and with the pathway dependent only on 4-D TTE, the method has a high potential to be used within future clinical studies on 3-D intraventricular flow patterns. To this, future model developments in the form of e.g., anatomically accurate LV valves may further enhance the clinical value of the simulations.
[Mh] Termos MeSH primário: Ecocardiografia/métodos
Ventrículos do Coração/diagnóstico por imagem
Processamento de Imagem Assistida por Computador/métodos
Modelagem Computacional Específica para o Paciente
Função Ventricular Esquerda/fisiologia
[Mh] Termos MeSH secundário: Adulto
Idoso
Algoritmos
Ecocardiografia Doppler em Cores/métodos
Seres Humanos
Imagem Cinética por Ressonância Magnética/métodos
Meia-Idade
Reprodutibilidade dos Testes
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170726
[St] Status:MEDLINE
[do] DOI:10.1109/TMI.2017.2718218


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[PMID]:27776988
[Au] Autor:Dobarro D; Urban M; Booth K; Wrightson N; Castrodeza J; Jungschleger J; Robinson-Smith N; Woods A; Parry G; Schueler S; MacGowan GA
[Ad] Endereço:Cardiothoracic Directorate, Freeman Hospital, Newcastle upon Tyne Hospitals. NHS Foundation Trust, Newcastle upon Tyne, United Kingdom; Instituto de Ciencias del Corazón (ICICOR), Hospital Clínico Universitario, Valladolid, Spain; Department of Medicine, Universidad de Valladolid, Valladolid, Spain.
[Ti] Título:Impact of aortic valve closure on adverse events and outcomes with the HeartWare ventricular assist device.
[So] Source:J Heart Lung Transplant;36(1):42-49, 2017 Jan.
[Is] ISSN:1557-3117
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: This study examined whether aortic valve opening (AVO) and other echocardiographic parameters influence outcomes in patients on left ventricular (LV) assist device (LVAD) support. Pump thrombosis (PT) and ischemic stroke (IS) are known complications of LVAD, but mechanisms that could influence them are not completely understood. METHODS: This was a retrospective analysis of 147 patients who received a HeartWare Ventricular Assist Device ( HeartWare International) as a bridge to transplant or to candidacy between July 2009 and August 2015, of whom 126 had at least 30 days of follow-up before the first event (30-days-out cohort). Outcomes included survival, PT, IS, and PT+IS (combined thrombotic event; CTE). RESULTS: Median time on support was 518 days. Of the 30-days-out cohort, 29% had a first PT and 19% a first IS. AVO was associated with longer survival on device (1,081 vs 723 days; p = 0.01) in the entire cohort. In the 30-days-out cohort, the aortic valve was more frequently closed in patients with lower ejection fractions on support (14% ± 6% vs 18% ± 9%; p = 0.009), more dilated pre-event echocardiogram (LV end-diastolic diameter, 66 ± 12 mm vs 62 ± 10 mm; p = 0.04), and pre-implant LV end-diastolic diameter (70 ± 10 mm vs 66 ± 9 mm; p = 0.06). CTE-free survival on the device was lower with a closed aortic valve (897 vs 1,314 days; p = 0.003) as was PT-free survival on the device (1,070 vs 1,457 days; p = 0.02). Cox regression analysis showed that AVO was an independent predictor of CTE (p = 0.03) CONCLUSIONS: Thrombotic events are relatively frequent in patients on long-term LVAD support. A closed aortic valve was associated with decreased overall survival, thrombosis-free survival, and poorer LV function on support. These are high-risk patients, so whether they require more intense anti-coagulation or prioritizing for transplantation requires further research.
[Mh] Termos MeSH primário: Valva Aórtica/fisiopatologia
Insuficiência Cardíaca/terapia
Ventrículos do Coração/fisiopatologia
Coração Auxiliar/efeitos adversos
Trombose/epidemiologia
Função Ventricular Esquerda/fisiologia
[Mh] Termos MeSH secundário: Valva Aórtica/diagnóstico por imagem
Diástole
Intervalo Livre de Doença
Ecocardiografia
Feminino
Seguimentos
Insuficiência Cardíaca/mortalidade
Insuficiência Cardíaca/fisiopatologia
Transplante de Coração
Ventrículos do Coração/diagnóstico por imagem
Seres Humanos
Incidência
Masculino
Meia-Idade
Prognóstico
Falha de Prótese
Estudos Retrospectivos
Taxa de Sobrevida/tendências
Trombose/etiologia
Fatores de Tempo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161026
[St] Status:MEDLINE


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[PMID]:29390335
[Au] Autor:Burzo ML; Antonelli M; Pecorini G; Favuzzi AMR; Landolfi R; Flex A
[Ad] Endereço:Institute of Internal Medicine.
[Ti] Título:Fever of unknown origin and splenomegaly: A case report of blood culture negative endocarditis.
[So] Source:Medicine (Baltimore);96(50):e9197, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Fever of unknown origin (FUO) can be determined by different conditions among which infectious diseases represent the main cause. PATIENT CONCERNS: A young woman, with a history of aortic stenosis, was admitted to our unit for a month of intermittent fever associated with a new diastolic heart murmur and splenomegaly. Laboratory tests were negative for infectious screening. The total body computed tomography (CT) scan excluded abscesses, occulted neoplasia, or lymphadenopathy. DIAGNOSES: The transthoracic and transesophageal echocardiogram showed an aortic valve vegetation. Three sets of blood cultures were negative for all microorganisms tested. According to these findings, Bartonella endocarditis was suspected and the serology tests performed were positive. Finally, real-time polymerase chain reaction (RT-PCR) detected Bartonella henselae DNA on tissue valve. INTERVENTIONS: The patient underwent heart valve surgery and a treatment of Ampicillin, Gentamicin, and oral Doxycycline was prescribed for 16 days and, successively, with Doxycycline and Ceftriaxone for 6 weeks. OUTCOMES: After surgery and antibiotic therapy, patient continued to do well. LESSONS: Bartonella species are frequently the cause of negative blood culture endocarditis. Molecular biology techniques are the only useful tool for diagnosis. Valvular replacement is often necessary and antibiotic regimen with Gentamicin and either Ceftriaxone or Doxycycline is suggested as treatment.Echocardiogram and blood cultures must be performed in all cases of FUO. When blood cultures are negative and echocardiographic tools are indicative, early use of Bartonella serology is recommended.
[Mh] Termos MeSH primário: Doença da Arranhadura de Gato/diagnóstico
Endocardite Bacteriana/diagnóstico
[Mh] Termos MeSH secundário: Antibacterianos/uso terapêutico
Doença da Arranhadura de Gato/tratamento farmacológico
Doença da Arranhadura de Gato/cirurgia
Terapia Combinada
Diagnóstico Diferencial
Ecocardiografia
Endocardite Bacteriana/tratamento farmacológico
Endocardite Bacteriana/cirurgia
Feminino
Febre de Causa Desconhecida
Seres Humanos
Meia-Idade
Reação em Cadeia da Polimerase em Tempo Real
Esplenomegalia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Bacterial Agents)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009197


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[PMID]:29390286
[Au] Autor:Kuo CC; Yu WL; Lee CH; Wu NC
[Ad] Endereço:Division of Cardiovascular Surgery, Department of Surgery.
[Ti] Título:Purulent constrictive pericarditis caused by Salmonella enteritidis in a patient with adult-onset Still's disease: A case report.
[So] Source:Medicine (Baltimore);96(50):e8949, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Purulent pericarditis is a rare and usually fatal disease. Immunodeficiency state and preexisting pericardial effusion can predispose patients to infections. However, we are not aware of similar cases in patients with adult-onset Still's disease (AOSD). In addition, it is seldom caused by Salmonella bacteria. PATIENT CONCERNS: We report a 30-year-old woman with dyspnea on exertion and epigastric fullness. She was newly diagnosed with AOSD 4 months previously and medicated with prednisolone. DIAGNOSES: Transthoracic echocardiography (TTE) and computed tomography revealed a thickened pericardium with loculations in the pericardial space, consistent with purulent constrictive pericarditis. Subsequent cultures of blood and pericardial fluid yielded S enteritidis. INTERVENTIONS: She underwent subtotal pericardiectomy through a limited median sternotomy, and antibiotic therapy (ceftriaxone) for 1 month. OUTCOMES: The New York Heart Association functional classification downgraded from class III to class I. There was no recurrence during the 1-year follow-up. LESSONS: This case presents an opportunity to highlight the importance of considering purulent pericarditis in patients previously diagnosed with AOSD. High clinical suspicion, early diagnosis, and prompt management can result in a better outcome in purulent pericarditis.
[Mh] Termos MeSH primário: Pericardite Constritiva/microbiologia
Salmonella enteritidis/isolamento & purificação
Doença de Still de Início Tardio/complicações
Doença de Still de Início Tardio/diagnóstico
[Mh] Termos MeSH secundário: Adulto
Antibacterianos/uso terapêutico
Terapia Combinada
Ecocardiografia
Feminino
Seres Humanos
Pericardite Constritiva/diagnóstico por imagem
Pericardite Constritiva/terapia
Esternotomia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Bacterial Agents)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008949


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[PMID]:28460775
[Au] Autor:Balasingam M; Ebrahim J; Ariffin IA
[Ad] Endereço:Department of Medicine, Kajang Hospital, Selangor, Malaysia. Electronic address: manobm3@gmail.com.
[Ti] Título:Tele-echocardiography - Made for astronauts, now in hospitals.
[So] Source:Indian Heart J;69(2):252-254, 2017 Mar - Apr.
[Is] ISSN:0019-4832
[Cp] País de publicação:India
[La] Idioma:eng
[Ab] Resumo:Telemedicine, ie 'the delivery of healthcare and sharing of medical knowledge using telecommunication systems' has penetrated every field of medicine. As a result, tele-echocardiography, the study of the heart via telemedicine started expanding. Ironically, space became the next frontier for mankind's new innovations and technology pursuit. However, the microgravity environment of space is known to be challenging to astronauts hearts. As such, new tele-echocardiography techniques have evolved. The main aim was to research a system that can be operated by a layperson but still be able to provide high yield diagnostic information in real time to specialists on earth. This spin-off space technology is recognized to have a positive impact, especially in developing countries with vast terrain. It is now utilized in hospitals and other terrestial locations where patients in remote regions can have their hearts analysed and data relayed to specialists in bigger centres for interpretation and further management.
[Mh] Termos MeSH primário: Medicina Aeroespacial/métodos
Astronautas
Doenças Cardiovasculares/diagnóstico
Ecocardiografia/métodos
Hospitais
Telemedicina
[Mh] Termos MeSH secundário: Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170503
[St] Status:MEDLINE


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[PMID]:28460764
[Au] Autor:Pandian J; Kaur D; Yalagudri S; Devidutta S; Sundar G; Chennapragada S; Narasimhan C
[Ad] Endereço:CARE Hospital, Road No.1, Banjara Hills, Hyderabad 500 034, India.
[Ti] Título:Safety and efficacy of epicardial approach to catheter ablation of ventricular tachycardia - An institutional experience.
[So] Source:Indian Heart J;69(2):170-175, 2017 Mar - Apr.
[Is] ISSN:0019-4832
[Cp] País de publicação:India
[La] Idioma:eng
[Ab] Resumo:BACKGROUND AND AIM: Epicardial approach to VT ablation increases the success rate of ablation but is not without complications. We studied the safety and efficacy of epicardial VT ablations performed at our institute. METHODS: All patients who underwent epicardial VT ablation at our institute were studied retrospectively. The outcome of VT ablation was among three groups: ischaemic cardiomyopathy (ICM), non-ischaemic cardiomyopathy (NICM) and granulomatous myocarditis (GM). Safety outcomes assessed included all complications considered to be due to pericardial access or epicardial mapping/ablation. RESULTS: A total of 54 patients (total 119 VTs, mean 2.2 (0.9)) were taken up for ablation procedure through epicardial access. Mean age: 47 (10) years, males: 83%. All patients had drug resistant recurrent VTs. The epicardial procedure was abandoned in three patients due to access issues; percutaneous sub-xiphoid access was employed in 48 and surgical approach in four patients. Complete success was achieved in 59% and partial success in 76%. The outcomes were poor in ICM patients as compared to those with GM and NICM. Overall success rates for all clinical VTs were 89% in GM, 90% in NICM and 67% in ICM. Success rates for epicardial VT ablation were 94%, 85% and 78% respectively for GM, NICM and ICM. Procedure related complications occurred in six patients. CONCLUSION: Epicardial ablation for VT offers good immediate outcomes with acceptable safety profile.
[Mh] Termos MeSH primário: Cateterismo Cardíaco/métodos
Ablação por Cateter/métodos
Sistema de Condução Cardíaco/cirurgia
Pericárdio/cirurgia
Taquicardia Ventricular/cirurgia
[Mh] Termos MeSH secundário: Adulto
Idoso
Ecocardiografia
Técnicas Eletrofisiológicas Cardíacas/métodos
Feminino
Seguimentos
Sistema de Condução Cardíaco/fisiopatologia
Seres Humanos
Masculino
Meia-Idade
Estudos Retrospectivos
Taquicardia Ventricular/diagnóstico
Taquicardia Ventricular/fisiopatologia
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170503
[St] Status:MEDLINE


  10 / 77268 MEDLINE  
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[PMID]:28460759
[Au] Autor:Patel A; Tomar NS; Bharani A
[Ad] Endereço:Department of Medicine, M.G.M. Medical College, Indore, M.P., India.
[Ti] Título:Utility of physical examination and comparison to echocardiography for cardiac diagnosis.
[So] Source:Indian Heart J;69(2):141-145, 2017 Mar - Apr.
[Is] ISSN:0019-4832
[Cp] País de publicação:India
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To find out the accuracy of cardiac auscultation using non-digital stethoscope in physical diagnosis of cardiac diseases. METHODS: We enrolled 104 consecutive patients with abnormal cardiac auscultatory findings attending cardiology clinic and not previously evaluated by echocardiography. One time detailed cardiac physical examination followed by echocardiography within 1 month was undertaken. Agreement between two methods was calculated using mean pair percentage agreement, kappa statistics (κ) and calculation of 95% confidence interval (CI) for kappa statistics. RESULTS: Using kappa statistics, there was almost perfect agreement between cardiac auscultation and echocardiography for the detection of mitral stenosis (κ=0.865; CI 0.76-0.97) and ventricular septal defect (κ=0.872; CI=0.73-1.01). Substantial agreement was noted for aortic stenosis (κ=0.752; CI=0.56-0.94), pulmonary stenosis (κ=0.647; CI=0.33-0.97) and atrial septal defect (κ=0.646; CI=0.32-0.97), while moderate agreement was found for mitral regurgitation (κ=0.470; CI=0.30-0.64), aortic regurgitation (κ=0.456; CI=0.25-0.66) and tricuspid regurgitation (κ=0.575; CI=0.38-0.77). For combined mitral stenosis and mitral regurgitation lesions, almost perfect agreement was found for mitral stenosis (κ=0.842; CI=0.691-0.993) while fair agreement noted for mitral regurgitation (κ=0.255; CI=-0.008 to 0.518). CONCLUSION: Careful clinical auscultation using a stethoscope remains a valuable tool for cardiac diagnosis. Decision on initial diagnosis and management of valvular and congenital heart diseases should be based on clinical examination and integrating such information with echocardiography as required.
[Mh] Termos MeSH primário: Ecocardiografia/utilização
Cardiopatias/diagnóstico
Exame Físico/utilização
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Idoso de 80 Anos ou mais
Criança
Pré-Escolar
Estudos Transversais
Feminino
Auscultação Cardíaca/métodos
Seres Humanos
Masculino
Meia-Idade
Reprodutibilidade dos Testes
Estudos Retrospectivos
Adulto Jovem
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170503
[St] Status:MEDLINE



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