Heart failure (HF) is prevalent among patients with aortic stenosis and presents a poor prognosis. In order to better portray outcomes for HF patients undergoing transcatheter aortic valve replacement (TAVR), we evaluated clinical outcomes in patients with systolic vs diastolic heart failure who underwent TAVR in a large nationwide database. We searched the National Inpatient Sample (NIS) for hospitalized adult patients who underwent TAVR with coexisting history of systolic (SHF) or diastolic heart failure (DHF) as a secondary diagnosis using the ICD-10 codes.
View Article and Find Full Text PDFObjectives: The goal of this study was to determine if emergency physicians (EPs) can correctly perform a bedside diastology examination (DE) and correctly grade the level of diastolic function with minimal additional training in echocardiography beyond what is learned in residency. We hypothesize that EPs will be accurate at detecting and grading diastolic dysfunction (DD) when compared to a criterion standard interpretation by a cardiologist.
Methods: We conducted a prospective, observational study on a convenience sample of adult patients who presented to an urban emergency department with a chief concern of dyspnea.
A 50-year-old lady presented with epigastralgia, electrocardiogram (ECG) showed T-wave inversions and the echocardiogram low ejection fraction (EF) with apical ballooning. An esophagogastroduodenoscopy (EGD) revealed gastritis. She recovered with proton pump inhibitors treatment.
View Article and Find Full Text PDFBackground: The prevalence of prosthesis-patient mismatch (PPM) and its impact on survival after aortic valve replacement have not been clearly defined. Historically, the presence of PPM was identified from postoperative echocardiograms or preoperative manufacturer-provided charts, resulting in wide discrepancies. The 2009 American Society of Echocardiography (ASE) guidelines proposed an algorithmic approach to calculate PPM.
View Article and Find Full Text PDFThe evaluation of valvular and nonvalvular structures is of central importance in the diagnosis, management, and treatment of infective endocarditis (IE). The incidence of IE has remained constant due to changing substrate, with notably higher prevalence observed in the elderly. Mortality and morbidity continue to remain high, despite advances in medical and surgical treatment.
View Article and Find Full Text PDFObjectives: To determine the utility of multislice computed tomography (MSCT) technology to evaluate coronary stent luminal diameter.
Background: Stent metal induced "blooming" artifact makes quantitative coronary angiography by MSCT difficult. There is a paucity of data on the efficacy of using 64 and 16 detector MSCT in evaluating coronary stents.