Health

How does heart failure treatment differ between internists and cardiologists?_4.jpg

How does heart failure treatment differ between internists and cardiologists?

Patients with congestive heart failure are not exclusively under the care of cardiologists. Indeed, the vast majority are managed by noncardiologists. Two surveys by the Italian Associazione Nazionale Medici Cardiologi Ospedalieri (ANMCO [National Association of Hospital Cardiologists]) compared characteristics, treatment, and outcome in heart failure patients admitted to Italian cardiology and internal medicine wards. TEMISTOCLE […] Read more

Established and Novel Clinical Applications of Diastolic Function ...

What parameters are readily available for assessing ventricular diastolic dysfunction?

Natriuretic peptides are hormones produced within the heart and released into the circulation in response to stretch. Both atrial natriuretic peptide (ANP) and brain-type natriuretic peptide (BNP) relate to left ventricular filling pressure. High levels of both, and of the inactive fragment, N-terminal proANP, are associated with poor long-term prognosis in congestive heart failure and […] Read more

Echocardiography - Wikipedia

What are the most useful echocardiographic parameters for monitoring heart failure?

The ejection fraction (EF) in heart disease with high-dose dobutamine suggests associated coronary heart disease, and may help when selecting cases for coronary arteriography. The association of LV hypertrophy, hypokinesia, and sometimes significant dilatation is compatible with hypertensive heart disease or end-stage hypertrophic cardiomyopathy. Hypertensive heart disease is clearly suspected when heart failure is associated […] Read more

Are depression and heart failure related, and is there a treatment target?_2.jpg

Are depression and heart failure related, and is there a treatment target?

Several studies have shown that patients with chronic heart failure suffer mod-erate-to-severe depression or anxiety, similarly to those with other chronic diseases. However, the relationship between the two sets of variables cardiology and psychology (mental health and health-related quality of life) has rarely been explored in depth. In particular, only a few cardiology variables have […] Read more

Do the increased cardiac levels of nitric oxide in heart failure correlate with clinical severity?_7.jpg

Do the increased cardiac levels of nitric oxide in heart failure correlate with clinical severity?

The vascular endothelium participates in the regulation of regional blood flow by modulating the release of endothelium-dependent relaxing factor, of which nitric oxide (NO) is a major component. Plasma levels of nitrate, the stable end-product of NO, are significantly increased in patients with chronic heart failure; however, the site of NO production is not completely […] Read more

How can cardiologists and primary care physicians be encouraged to practice evidence-based management in heart failure?_21.jpg

How can cardiologists and primary care physicians be encouraged to practice evidence-based management in heart failure?

I vidence-based medicine is a cultural and methodological approach to clinical Hbbh practice that bases decisions on cumulative clinical expertise and an intimate knowledge of the individual patient’s global situation, and that then feeds those decisions back into a database for the advancement of clinical research. As such, it is the art of medicine raised […] Read more

Lithium_8.jpg

Lithium

Lithium exerts minimal cardiotoxicity at therapeutic doses in most patients and can be used safely in cardiac disease if it is initiated at a low dose, increased gradually, and monitored carefully. Clinically significant cardiovascular side effects are very rare and include sinus node dysfunction and increased ventricular irritability. The major toxic effect is neural (confusion, […] Read more

What are the indications for cardiological referral, hospitalization, and discharge in heart failure?_3.jpg

What are the indications for cardiological referral, hospitalization, and discharge in heart failure?

Indications for cardiological referral The causes of heart failure, with particular respect to destabilizing factors, can be determined from a standard workup in the outpatient clinic, day hospital, or during hospitalization. Echocardiography, ergometry, 24-hour Holter monitoring, and specific therapeutic options such as revascularization and valvuloplasty all require specialist referral (Table I). Mild or moderate heart […] Read more