The effect of pastoral care services on anxiety, depression, hope, religious coping, and religious problem solving styles: a randomized controlled study.

This randomized controlled study measured the effect of chaplain interventions on coronary artery bypass graft (CABG) patients over time. One hundred sixty-six CABG patients, received pre- and post-surgery testing at 1 month and 6 months with four instruments. Five chaplain visits were made to the intervention group, the control group received none.

A pilot study to assess the safety of dobutamine stress echocardiography in the emergency department evaluation of cocaine-associated chest pain.

Study Objective: Chest pain in the setting of cocaine use poses a diagnostic dilemma. Dobutamine stress echocardiography (DSE) is a widely available and sensitive test for evaluating cardiac ischemia. Because of the theoretical concern regarding administration of dobutamine in the setting of cocaine use, we conducted a pilot study to assess the safety of DSE in emergency department patients with cocaine-associated chest pain.

Dobutamine Stress Tele-Echocardiography as a Clinical Service in the Emergency Department to Evaluate Patients With Chest Pain.

Patients presenting with chest pain to the emergency department should be efficiently triaged. During our previous research trial, the use of dobutamine stress tele-echocardiography (DSTE) effectively and safely allowed the diagnosis of patients who could be released from the emergency department. To assess the usefulness of DSTE as a clinical service, the protocols, training, and implementation of our experience are reviewed from > 4 years of testing 734 patients in our emergency department.

Echocardiography in the Emergency Department: From the Perspective of the Emergency Physician and the Cardiologist.

Echocardiography performed in the emergency department must adapt to this new setting for noninvasive diagnostic testing. Emergency physicians require echocardiography to provide rapid diagnosis in life-threatening emergencies. New initiatives are being proposed by emergency physicians in the delivery of this test.

Dobutamine stress tele-echocardiography for evaluation of emergency department patients with chest pain.

Objectives: The practically and accuracy of dobutamine stress tele-echocardiography (DSTE) were assessed in patients presenting to the emergency department with chest pain.

Background: Many patients evaluated for chest pain in the emergency department (ED) are admitted to the hospital needlessly because of the difficulty in differentiating noncardiac chest pain from myocardial ischemia.

Methods: One hundred sixty-three patients with no evidence of myocardial infarction on initial blood studies or the electrocardiogram who were recommended for hospital admission to rule out myocardial infarction or myocardial ischemia were enrolled in this four-phase study.

Emergency echocardiography telemedicine: an efficient method to provide 24-hour consultative echocardiography.

Objectives: This study sought to assess the clinical utility of interpreting emergency echocardiograms after regular working hours through a telemedicine connection to on-call cardiologists.

Background: Physician interpretation of emergency echocardiograms is often delayed during weekends, evenings or night hours. This delay places undue responsibility on less qualified personnel to interpret echocardiograms of vital importance.

The feasibility of dobutamine stress echocardiography in the emergency department with telemedicine interpretation.

Dobutamine stress echocardiography (DSE) was performed on 26 patients admitted for chest pain deemed at low risk for myocardial infarction. Pharmacologic stress in the emergency department on a 24-hour basis was administered by nurses and echocardiographic ultrasonographers with electrocardiograms and echocardiograms being interpreted through telemedicine relay by an off-site cardiologist. Target heart rate was achieved in 84% of patients with an average peak dobutamine dose of 48 microg/kg/min.

Post inferior myocardial infarction ventricular septal rupture.

Mortality from ventricular septal rupture after myocardial infarction (MI) is high. Ventricular septal rupture after inferior MI is particularly associated with a high risk because of difficulty in diagnosis and surgical approach. These three case reports show how diagnosis and correction can be expedited by emergency transportation and color-flow echo-Doppler cardiography.

Transesophageal echocardiography. A technique for intraoperative monitoring.

Cardiac ischemia and myocardial infarction continue to be major causes of perioperative morbidity and mortality, despite aggressive intraoperative monitoring. Intraoperative TEE is evolving as a helpful noninvasive monitor in patients with coronary artery disease and valvular heart disease. Early detection of ischemia and evaluation of valve function with continuous imaging has allowed the use of TEE as a dynamic tool to optimize therapeutic management of cardiac dysfunction that was not always readily available by conventional invasive techniques.