Pre-procedural estimate of individualized bleeding risk impacts physicians' utilization of bivalirudin during percutaneous coronary intervention.

Objectives: This study sought to assess whether incorporation of routine bleeding risk estimates affected the utilization of bivalirudin during percutaneous coronary intervention (PCI).

Background: Bivalirudin use during PCI has been shown to reduce bleeding complications. However, a risk-treatment paradox exists, in which patients at highest risk for bleeding are least likely to receive bivalirudin.

Temporal obesity trends in patients undergoing transthoracic echocardiography 2002-2006.

In a recent data brief, the National Center for Health Statistics reported that obesity prevalence has plateaued in recent years, with no increase in obesity from 2003 to 2006. We have subjectively observed a marked increase in clinically severe obesity over this same period in patients presenting to our echocardiographic laboratory. The aim of this study was to determine temporal trends in obesity prevalence in patients presenting for transthoracic echocardiographic studies.

Transoesophageal echocardiographic diagnosis of pulmonary arteriovenous malformation in a patient with ischaemic stroke.

We report a case of an ischaemic stroke secondary to an isolated pulmonary arteriovenous malformation. In this case, transoesophageal echocardiogram played a pivotal role in shunt identification, exclusion of atrial septal defect, and definitive diagnosis and localization of the pulmonary arteriovenous malformations. Pulmonary arteriovenous malformations should be excluded in all patients with cryptogenic stroke.

Acute severe functional mitral regurgitation secondary to cocaine-mediated anterior myocardial infarction.

We report a case of acute severe functional mitral regurgitation in a patient with cocaine-related anterior myocardial infarction. Transesophageal echocardiography played a pivotal role in excluding a mechanical complication, and determining the presence, severity, and mechanism of this life-threatening complication.