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Young athletes with an inherited arrhythmia syndrome, such as long QT syndrome (LQTS) or hypertrophic cardiomyopathy (HCM), may undergo implantation of an implantable cardioverter defibrillator (ICD) if they are believed to be at high risk of sudden death. American College of Cardiology (ACC) guidelines have typically recommended that such individuals should be prohibited from vigorous sports. Yet for many young athletes, prohibition of participation in any competitive sport may be a life-altering event, followed by poor grades or depression.
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Elevated troponin levels after non-cardiac surgery have been shown to predict postoperative myocardial infarction (MI) and death. Thus, these investigators from the Netherlands instituted a postoperative troponin monitoring program at one hospital to test the hypothesis that troponin elevations in the first 3 days after surgery would predict 30-day mortality after non-cardiac surgery.
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Atrial septal defects (ASD) can lead to exercise intolerance, pulmonary hypertension, right heart failure, and reduced life expectancy if they are not repaired. Surgical closure for ASD transformed the care of these patients and resulted in similar life expectancy to subjects without ASD. In recent years, transcatheter ASD closure has largely replaced surgery, but long-term data comparing the two techniques are limited.
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The relationship between patients' prognosis and age in decisions regarding implantable cardioverter-defibrillator (ICD) therapy in the primary prevention of sudden death in heart failure patients is poorly understood and not addressed in randomized device trials. Thus, Dewland and colleagues created a survey that was sent to 3000 randomly selected primary care physicians and general cardiologists nationwide.
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Heart failure (HF) is associated with a high mortality rate, debilitating symptoms, impaired quality of life, and major financial costs.
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Dabigatran etexilate, a direct thrombin inhibitor, is one of a new class of oral anticoagulants that was recently demonstrated in a Phase 3 trial to be effective for the prevention of stroke or systemic embolism (SSE) in patients with atrial fibrillation (AF).
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Given the high prevalence of MVP in the general population, a true association with SCA risk has been controversial.
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Evidence-based updates in primary care medicine By Louis Kuritzky, MD
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Overnight observation in the hospital after PCI remains the standard of care in the United States. However, because of the low complication rates, there has been a move toward same-day discharge in some countries.
