Review of Movahed's sign (D shaped left ventricle seen on gated SPECT) suggestive of right ventricular overload.

Recently, D shaped ventricle seen on gated SPECT imaging (Movahed's sign) has shown to correlate with right ventricular overload similar to the D shape ventricle seen on echocardiography. Right ventricle (RV) imaging during gated SPECT studies is challenging because of the low tracer uptake due to relatively smaller right ventricular myocardial mass and lower coronary flow to the RV. Increased mass or workload causes higher tracer uptake in the RV wall secondary to increase in RV wall thickness and higher coronary flow.

Chronic total occlusions in peripheral vasculature: techniques and devices.

Peripheral artery disease continues to increase in an ever-aging society and consumes a significant part of health resources. Chronic total occlusions account for a significant portion of the lesions encountered by endovascular interventionalists. Unlike the coronary circulation, these occlusions are often long and associated with other features of complexity.

Collagen mechanics: a rationale for radiofrequency energy to treat mitral regurgitaton.

Despite a variety of pharmacological interventions to limit the regurgitant fraction, mitral regurgitation requires surgical intervention for definitive treatment. New nonsurgical techniques are being applied to treat mitral regurgitation. The mitral and tricuspid annuli are areas of dense collagen.

Clopidogrel-induced hepatotoxicity and fever.

A 59-year-old woman developed fever and elevated hepatic enzyme levels within days of starting clopidogrel, which had been prescribed in conjunction with a percutaneous coronary intervention. When she discontinued the clopidogrel, her liver enzyme levels returned to baseline and her fever disappeared. These signs and symptoms returned after rechallenge with clopidogrel.

Patient care transformation: the plan and the reality.

An explosion of new hospital building has created the opportunity for nurse leaders to transform the patient care experience with evidence-based architecture, technology innovations, and new patient care delivery models. The authors share the first-year results of the creation of a hospital of the future in which staff actively participated and addressed the challenges of transforming the patient care experience. Positive results include patient satisfaction at the 99th percentile, successful integration of 63 software applications, and energized nursing staff.