Cardiology
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Slow, Steady, and Synchronized Wins the Race
In patients with atrial fibrillation and heart failure, definitive rate control via atrioventricular junction ablation and biventricular pacing resulted in a significant reduction in all-cause mortality vs. pharmacologic rate control.
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Resistance Erodes Standard Treatment for Pneumonia
These data suggest community-acquired pneumonia CAP therapy may no longer be relevant for many patients with CAP, and the required use of the current CAP bundle with limited antibacterial therapy choices should be re-assessed.
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Overdiagnosis of Chronic Kidney Disease in the Elderly
Older patients experience a physiological decline in estimated glomerular filtration rate. However, if the same levels are used to define chronic kidney disease for all adults, older patients not at a higher risk for kidney failure might still be classified with the disease.
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Left-Sided Breast Cancer Radiation Therapy and Coronary Artery Disease
A study of breast cancer survivors revealed left breast radiation therapy doubles the subsequent risk of coronary heart disease vs. right-sided radiation.
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Long-Term Post-TAVR Survival and Permanent Pacemaker Implantation
An analysis of a real-world database revealed 14% of patients undergoing routine transfemoral transcatheter aortic valve replacement required permanent pacemaker implantation within 30 days of the valve procedure. There was no difference in long-term survival between patients who did and did not undergo pacemaker implant.
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Importance of Age in the Application of Coronary Artery Calcium Detection
Using coronary CT strategy as a diagnostic first line in patients with symptoms suggestive of coronary artery obstruction revealed relying on the coronary calcium score alone is inadequate for younger patients with a higher frequency of non-calcified obstructions.
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Coronary CT Angiography in the General Population
Coronary artery CT angiography in asymptomatic, middle-aged subjects without known coronary artery disease showed coronary atherosclerosis is common but mostly mild and appears in women after a 10-year delay.
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Intensive Monitoring for Asymptomatic Atrial Fibrillation Did Not Prevent Strokes
Screening with an implantable loop recorder resulted in dramatically higher rates of atrial fibrillation detection and ensuing anticoagulation, but without a significant decrease in risk of stroke or systemic embolism by six years of follow-up.
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Cardiology, Stroke Malpractice Cases Involve ED Providers’ Communication Gaps
Cutting corners with poor communication can lead to devastating patient outcomes.
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Legal Exposure Regarding Recurrent Low-Risk Chest Pain
The most important actions an emergency physician can take are to gather a thorough medical history and correctly interpret the ECG.