Harnessing Data to Assess Equity of Care by Race, Ethnicity and Language.

Objective: Determine any disparities in care based on race, ethnicity and language (REaL) by utilizing inpatient (IP) core measures at Texas Health Resources, a large, faith-based, non-profit health care delivery system located in a large, ethnically diverse metropolitan area in Texas. These measures, which were established by the U.S.

Safety and efficacy of minimally invasive atrial septal defect closure.

Background: Atrial septal defects (ASDs) have been surgically closed with low mortality utilizing the conventional sternotomy approach (CSA). The technical ease of ASD closure has triggered interest in minimally invasive closure (MIC) to obviate the morbidity associated with sternotomy. Our study assesses the safety and efficacy of minimally invasive ASD closure.

Failure of Serial Electrocardiograms to Exclude a Large Anterior Myocardial Infarction and the Role of Transesophageal Echocardiogram in Acute Myocardial Infarction.

When patients present with acute onset of chest pain suggestive of myocardial ischemia, immediate clinical decisions regarding thrombolysis, percutaneous transluminal coronary angioplasty, or both are usually based on the history and abnormal electrocardiograms and confirmed by the presence of abnormally elevated cardiac enzymes. However, there are potential limitations of the electrocardiograms and initial cardiac enzymes in the diagnosis and confirmation of acute myocardial infarction. We describe the case of a patient who presented with an acute onset of chest pain and had a normal electrocardiogram and initial cardiac enzymes yet was found by transesophageal echocardiography to have a large myocardial infarction.

Long-Term Value of Stress Echocardiography in the Triage of Patients with Atypical Chest Pain Presenting to the Emergency Department.

The purpose of this study was to assess the use of stress echocardiography in the triage of patients presenting to the emergency department with atypical chest pain. We hypothesized that a negative stress echocardiogram would identify patients with a very low risk for future cardiac events, thus reducing the requirement for unnecessary hospitalizations. Stress testing was performed in 105 patients presenting with atypical chest pain, no prior history of coronary artery disease, a nondiagnostic electrocardiogram (ECG), negative serial creatine phosphokinase level at 0 and 4 hours, and baseline normal echocardiograms.

Ventricular Septal Defect Masquerading as Severe Tricuspid Regurgitation: A Case Report and Literature Review.

Two-dimensional echocardiography (2-D) is a useful technique for noninvasive evaluation cardiac structure, function, and hemodynamics; however, multiple factors may limit the technical adequacy of the 2-D examination. In this article, we present the case of a ventricular septal defect to right atrial shunt, which was misinterpreted as severe tricuspid regurgitation secondary to severe pulmonary hypertension, despite the absence of right ventricular enlargement or hypertrophy. A transesophageal echocardiography (TEE) examination was performed to explain the discrepancy between the 2-D and Doppler findings, the results of which are discussed, along with a review of the literature.