Enhancing the diagnostic efficacy of right-to-left shunt using robot-assisted transcranial Doppler: a quality improvement project.

Background: Stroke is the leading cause of adult disability worldwide, with approximately 30% of strokes remaining cryptogenic. One potential important etiology is a patent foramen ovale (PFO), which may contribute to stroke through paradoxical thromboembolism or thromboembolus formation. Recent advancements in robot-assisted transcranial Doppler (raTCD) have shown increased sensitivity in detecting right-to-left shunt (RLS) compared to transthoracic echocardiography (TTE), particularly in detecting the large shunts which are associated with higher stroke risk.

Impact of change in serum sodium concentration on mortality in patients hospitalized with heart failure and hyponatremia.

Background: Hyponatremia is a common electrolyte abnormality among patients hospitalized with heart failure and it is a marker for increased short-term and long-term mortality. However, little is known about the time course of hyponatremia and whether changes in serum sodium levels affect clinical outcomes.

Methods And Results: Patients (n=322) hospitalized with decompensated heart failure and serum sodium <135 mmol/L were evaluated.