A Retrospective Validation of the HEAR Score.

Studies have proposed the history, electrocardiogram, age, risk factors (HEAR) score to risk-stratify patients with chest pain in the emergency department. This paper assessed the utility of the HEAR score for ambulatory patients with chest pain. The findings demonstrate patients with low and high HEAR scores can be safely managed in the outpatient setting.

Overcoming the transcatheter aortic valve replacement Achilles heel: coronary re-access.

Transcatheter aortic valve replacement (TAVR) is an alternative to surgical aortic valve replacement (SAVR) for the treatment of symptomatic severe aortic stenosis (AS). Coronary artery disease (CAD) is common in patients with severe AS. As the indications for TAVR extend to lower risk patients with longer life expectancy and as CAD is a progressive condition, coronary angiography will become increasingly common in patients who have had a previous TAVR.

Complete Versus Incomplete Angiography Prior to Percutaneous Coronary Intervention in ST-Elevation Myocardial Infarction.

Objectives: Shorter reperfusion times in ST-elevation myocardial infarction (STEMI) are associated with improved survival. Prehospital strategies have been developed to minimize door-to-balloon (DTB) time, but few strategies within the catheterization laboratory itself have been evaluated. Incomplete angiography (IA) prior to percutaneous coronary intervention (PCI) is undertaken in clinical practice as a means to further reduce DTB time.

Left atrial myxoma causing coronary steal: an atypical cause of angina.

Cardiac myxomas are rare primary cardiac tumors that usually present with dyspnea or manifestations of systemic embolization. Coronary steal is a rare phenomenon of unbalanced blood flow that is seen primarily in patients who have undergone coronary artery bypass grafting and have subclavian artery stenosis. We report the case of a 72-year-old woman who presented with fatigue, weakness, and exertional chest heaviness and had abnormal results on a cardiac stress test.

Aortic root bentall graft disarticulation following repair of type a aortic dissection.

A 47-year-old man presented with chest pain and was found to have an ascending aortic dissection. He underwent aortic arch resection and replacement with a hemishield tube graft with a valve conduit, better known as the Bentall technique. Five months later he presented with shortness of breath.