From Coronary Care Units to Cardiac Intensive Care Units: Recommendations for Organizational, Staffing, and Educational Transformation.

Medical care in Canadian cardiac units has changed considerably over the past 3 decades in response to an increasingly complex and diverse patient population admitted with acute cardiac pathology. To maintain the highest level of care for these patients, there is a pressing need to evolve traditional coronary care units into contemporary cardiac intensive care units. In this article we aim to highlight the current variations in Canadian units, develop approaches to overcome logistical and infrastructural obstacles, and propose staffing and training recommendations that would allow for the establishment of contemporary cardiac intensive care units.

Impact of preoperative left ventricular ejection fraction on postoperative left ventricular remodeling after mitral valve repair for degenerative disease.

Background And Aim Of The Study: Mitral valve repair has been associated with better preservation of left ventricular (LV) function, especially in the setting of degenerative regurgitation. The goal of this study was to evaluate the impact of mitral valve repair on postoperative LV ejection fraction (LVEF) and LV remodeling as determined by LV end-systolic and diastolic diameters.

Methods: A prospective echocardiographic and clinical evaluation of 91 patients undergoing mitral valve repair for degenerative regurgitation between 1993 and 1998 was performed.

Report of a patient with syndrome X due to excessive adenosine effect: myocardial migraine without myocardial ischemia.

A 53-year-old female presented with disabling chest pain. The pain had most of the characteristics of ischemic pain; however, the results of the initial clinical investigation were consistent with the diagnosis of syndrome X. That is, her treadmill exercise test was positive but her coronary angiogram was normal.

Exercise echocardiography versus 201Tl single-photon emission computed tomography in evaluation of coronary artery disease. Analysis of 292 patients.

Background: Exercise echocardiography (digital cine-loop technique) and 201Tl single-photon emission computed tomography (SPECT) were performed simultaneously in 292 patients being evaluated for coronary artery disease.

Methods And Results: Pretreadmill and posttreadmill echocardiographic images of diagnostic quality were obtained in 289 patients, and the left ventricle was divided into anterior, inferior, and lateral regions. Any wall motion or perfusion abnormality observed within each region was classified as totally reversible, fixed, or partially reversible.

Regression of left ventricular hypertrophy in hypertension with indapamide.

In hypertensive patients, the development of left ventricular hypertrophy seems to increase the risk of cardiovascular death. Although some antihypertensive agents have been associated with regression in left ventricular hypertrophy, diuretics, the most widely used ones, have not. Indapamide is a new, nonthiazide diuretic and vasodilator.