Cardiology

Fractionated lipoproteins – pro

Evidence for this analysis is not strong. There are no randomized studies that demonstrate that this test is beneficial in assigning therapy. Epidemiologic literature has demonstrated an inverse relationship between levels of high-density lipoprotein (HDL) and cardiovascular risk, indicating that HDL may have a protective role against cardiovascular disease. HDL particles exhibit considerable heterogeneity, and it has been proposed that various subclasses

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Electrical Bioimpedance – pro

Cardiac output  can be used to evaluate global cardiac function. Changes in cardiac output may be used to identify a change in the hemodynamic status of a patient or to evaluate the success of a treatment and to monitoor  critically ill patients over time or perioperatively. Currently, the most widely accepted methods for the determination of cardiac output are Fick oximetry, thermodilution catheterization (TDC), and indicator dilution using dye

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Apheresis for hypercholestrolemia – pro

In the United States, LDL apheresis is approved for homozygous familial hypercholestrolemia (FH) patients with an LDL cholesterol level ≥ 500 mg/dL. For patients with heterozygous FH, LDL apheresis may be offered if their LDL is ≥ 300 mg/dL, or ≥ 200 mg/dL with known coronary artery disease, despite maximum medical treatment.  The available LDL apheresis methods differ with respect to acute relative reductions of LDL cholesterol; mean values

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Admission for coronary syndrome – pro

Millman considers a one day admission appropriate for acute coronary syndrome. This is an umbrella term used to cover any group of clinical symptoms compatible with acute myocardial ischemia.  Patients with unstable angina, ECG changes, or both should be admitted to a telemetry bed. A certain subset of patients with stable angina may be treated as outpatients with antianginal agents, but close follow-up is necessary. Patients with chronic stable

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Chest Pain: Admission versus Discharge and outpatient treatment of pulmonary embolus – pro

Chest pain accounts for approximately 6 million annual visits to emergency departments (ED) in the United States (US), making chest pain the second most common complaint.  ED evaluation focuses on distinguishing and admission of life-threatening causes of chest pain; others can be worked up on the outpatient basis. The published guidelines of the American College of Emergency Physicians, the American Heart Association, and the American College of

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Cardiac rehab after aortic dissection – pro

The scientific literature documents that some of the benefits of participation in a cardiac rehabilitation program after myocardial infarction include decreased symptoms of angina pectoris, dyspnea, and fatigue, and improvement in exercise tolerance, blood lipid levels, and psychosocial well-being, as well as a reduction in weight, cigarette smoking and stress.  The efficacy of modification of risk factors in reducing the progression of coronary

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Cardiac CT – pro

Over the past decade, electron beam computed tomography (CT) and multidetector CT have increasingly been used to identify and measure coronary artery calcification. Calcification levels can be related to the extent and severity of underlying atherosclerosis and can potentially improve cardiovascular risk prediction. However, broad use of these methods for screening is controversial. The American Heart Association (AHA) has released guidelines for

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Lipoprotein-associated phospholipase A2 – pro

Lipoprotein-associated phospholipase A2 (Lp-PLA2) is an enzyme that is produced by inflammatory cells, co-travels with circulating low-density lipoprotein (LDL), and hydrolyzes oxidized phospholipids in LDL. Its biological role has been controversial with initial reports purporting atheroprotective effects of Lp-PLA2 thought to be a consequence of degrading platelet-activating factor and removing polar phospholipids in modified LDL. Recent studies,

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