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Query: UMLS:C0729233 (Thoracic)
 6,478 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Stress echocardiography is widely used to assess several cardiovascular diseases, including ischemic heart disease, valvular heart disease (VHD), heart failure, congenital heart disease, and pulmonary hypertension. In valvular heart disease with asymptomatic severe or symptomatic non-severe status, stress echocardiography plays a central role in the management. As of 2017, the updated American College of Cardiology/American Heart Association and European Society of Cardiology/European Association for Cardio-Thoracic Surgery VHD guidelines recommended stress testing to (1) confirm symptoms and (2) evaluate the hemodynamic response to exercise. In patients with undetermined VHD severity in the presence of low-flow status, it can also be helpful to determine whether the VHD is severe based on flow-dependent changes in response to stress. The clinical indications of stress echocardiography in VHD have expanded with growing evidence for prognosis and being an early marker for interventions. As a result, demand has increased in major cardiology societies for the standardization of stress echocardiography in VHD. Echocardiographic centers should be aware of the clinical potential of stress echocardiography to ensure its optimal application and performance in VHD. This article reviews the clinical application of stress echocardiography, including dobutamine, semisupine bicycle, treadmill, and leg-positive pressure for VHD patient management, and focuses on the current consensus regarding the use of stress echocardiography in VHD. Stress echocardiography is safe and should be encouraged, especially in heart valve clinics, to understand the complex mechanism in asymptomatic patients.
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PMID:Clinical application of stress echocardiography for valvular heart disease. 3128 72

Antiplatelet agents are the mainstay of treatment for patients with acute coronary syndrome (ACS) or stable ischemic heart disease (SIHD). The most commonly used antiplatelet agents are aspirin and clopidogrel. Newer agents such as ticagrelor are becoming more commonplace as new studies have shown more cardiovascular benefits with these group of medications. The duration of use of these agents in setting of stable disease versus ACS is variable. We have tried to delineate the usage and duration of these agents in patients with the history of ACS or SIHD in numerous medical conditions. We have delved into available guidelines from American College of Cardiology/American Heart Association, Society of Thoracic Surgeons, and American College of Gastroenterology for our review article.
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PMID:Management of Antiplatelet Agents in Patients with History of Coronary Artery Disease in Various Medical Conditions. 3146 Dec 31

Recent changes in the demographics of surgical candidates, in terms of age, have increased the number of patients with surgical risk factors. In patients with preoperative cardiac diseases such as myocardial ischemia, arrhythmia, or congestive heart failure, it is important to offer any necessary preoperative medical examinations and treatments because postoperative cardiac failure is more of a concern in patients with already abnormal cardiac physiology, undergoing significant lung resection. Thoracic surgeons should be challenged by another conundrum to accurately select the best candidates for surgical treatment. Usually perioperative management of antithrombotic therapy in patients who need general thoracic operations such as lung cancer surgery after coronary artery stent placement or valve replacement have made recommendations, and heparinization is needed for patients with atrial fibrillation for prevention of thrombo-embolism. It is sometimes used in clinical practice as bridging therapy during the period of discontinuation of antiplatelet therapy for patients with cardiac complications after several cardiac surgery. As points to be aware of regarding surgical operations, minimal invasive surgery probably should be performed if possible.
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PMID:[Management of Patients with Cardiac Failure Undergoing General Thoracic Surgery]. 3313 Jul 79


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