bluuebunny/crossref_metadata_2025_split huggingface dataset:
Neurological Worsening After Subarachnoid Hemorrhage
Authors: Wijdicks Eelco F. M , Rabinstein Alejandro A 
Published: May 2013

Abstract
Patients with a subarachnoid hemorrhage have a proclivity to deteriorate. Common causes include rebleeding, hydrocephalus, and cerebral vasospasm. Prevention of complications—neurologic and medical—is key to reduce morbidity. Diagnostic and therapeutic recommendations are provided.
Cardiovascular Examination
Authors: Shub Clarence 
Published: May 2013

Abstract
The physical examination, including the general appearance of the patient, is an extremely important component of cardiology examinations. Important clues to a cardiac diagnosis can be obtained from inspection of the patient. Blood pressure should always be determined in both arms and in the legs if there is any suspicion of coarctation of the aorta. The patient should be examined in both the supine and the left lateral decubitus position. Abnormal waveforms in the jugular veins reflect abnormal hemodynamics of the right side of the heart. Heart sounds, including clicking, splitting, intensity, and snap, should be evaluated. Murmurs should also be evaluated because they may indicate conditions requiring treatment.
Essential Molecular Biology of Cardiovascular Diseases
Authors: Tom Cindy W. , Simari Robert D. 
Published: May 2013

Abstract
Molecular biologic tools are helpful in the diagnosis of cardiovascular diseases. Polymerase chain reaction is a powerful tool for amplifying minute portions of DNA for analysis. Sensitive PCR tests have been developed for various diseases by extracting DNA from a small blood sample. The identification of genes associated with disease has been the focus of an enormous effort in biomedical science. Genetic diseases can be associated with single-gene or multigene abnormalities. Of the many types of diseases that affect the cardiovascular system, an increasing number have been identified as resulting from single-gene (monogenic) or polygenic mutations. Several of these diseases are reviewed.
Principles of Echocardiography
Authors: Tsang Teresa S. M. 
Published: May 2013

Abstract
This chapter summarizes the central role of echocardiography in both the initial diagnosis and the quantification of the nature and severity of specific cardiovascular diseases. It is important to appreciate the relative strengths, weaknesses, and incremental value of information obtained by different echocardiographic methods. The appropriateness criteria for use of transthoracic echocardiography and TEE were published jointly in 2007 by leading professional organizations in the field. Appropriate, uncertain, and inappropriate indications for the use of echocardiography are reviewed.
Nuclear Imaging
Authors: Askew III J. Wells , Miller Todd D. 
Published: May 2013

Abstract
Nuclear imaging techniques are commonly used to evaluate myocardial perfusion at rest and with stress, to measure left ventricular function and volume, and to determine the presence or absence of myocardial viability. Nuclear cardiology is based on the administration of a radiopharmaceutical consisting of a radionuclide (isotope) with or without a complexing agent (depending on the type of study) in order to image the cardiovascular system. Nuclear imaging is primarily used for measuring left ventricular volume and ejection fraction; assessing myocardial perfusion; assessing left ventricular size, function, and wall motion; and detecting right-to-left shunts. Limitations are also reviewed.
Cardiopulmonary Exercise Testing in Clinical Medicine
Authors: Allison Thomas G. 
Published: May 2013

Abstract
Cardiopulmonary exercise testing is an important tool in a state-of-the-art, comprehensive cardiovascular center. Cardiopulmonary exercise testing is useful for accurate assessment of aerobic capacity, establishment of prognosis in various forms of cardiac disease, verification of symptomatic status (functional class), determination of appropriateness and timing of surgery for patients who have cardiac disease, exercise prescription, evaluation of benefits of various forms of intervention, and establishment of differential diagnosis of dyspnea on exertion. Interpretation of test results and sample cases are also included.
Atrial Fibrillation and Flutter
Authors: Brady Peter A. 
Published: May 2013

Abstract
Atrial fibrillation (AF) is the most common sustained arrhythmia, estimated to affect approximately 6 million Americans. Atrial flutter (AFL) is closely related to AF. Approximately 200,000 cases of AFL are diagnosed each year in the United States, and AFL is the most common indication for catheter ablation. Without treatment, AF is associated with an increased risk of death, thromboembolism, and stroke. In a patient with AF, rate regularization may result from transition to AFL or development of complete heart block. Less commonly, it may result from onset of a junctional or ventricular tachycardia. Primary goals in the management of AF are relief of symptoms and prevention of consequences (thromboembolism and tachycardia-induced cardiomyopathy). Restoring and maintaining normal sinus rhythm is preferred for patients with symptoms, whereas controlling the rate may be appropriate for asymptomatic patients or those who have multiple comorbid conditions. Nonpharmacologic approaches to managing AF and AFL include ablation of the AV node (with permanent pacemaker implantation), left atrial ablation aimed at isolation of the pulmonary and other thoracic veins, and surgical approaches.
Evaluation and Management of Pregnancy-Associated Arrhythmias
Authors: Brady Peter A. 
Published: May 2013

Abstract
The presentation and management of heart rhythm disorders arising during pregnancy and lactation are similar to those in nonpregnant patients. However, patients who present with a heart rhythm disorder during pregnancy deserve special consideration. Accurate rhythm diagnosis and assessment of symptom severity (especially hemodynamic symptoms) are mandatory. Arrhythmias that result in hemodynamic compromise (usually in patients with structural heart disease) are of major concern—not only because of potential harm to the mother but also because of potential harm to the fetus through reduced placental blood flow. Risks of antiarrhythmic drug therapy during pregnancy include risk to the mother and risk to the fetus. Cardioversion is safe during pregnancy and should be an early option in the management of arrhythmia, especially in the presence of hemodynamic compromise.
Cardiac Resynchronization Therapy
Authors: Lin Grace , Hayes David L. 
Published: May 2013

Abstract
Cardiac resynchronization therapy (CRT) is the term applied to reestablishing synchrony between left ventricular free wall and ventricular septal contraction. Approximately one-third of patients with dilated cardiomyopathy also have a conduction delay due to left bundle branch block, resulting in left ventricular dyssynchrony and worsening heart failure. In these patients, CRT may promote left ventricular reverse remodeling and improve symptoms and mortality from heart failure. CRT is achieved through biventricular pacing, with placement of a left ventricular lead in addition to a right ventricular lead. Indications for CRT, implantation techniques, prediction of response, and clinical trials are reviewed in this chapter.
Heart Disease in Athletes
Authors: Hammill Stephen C. 
Published: May 2013

Abstract
The medical community, the public, and athletes all have concerns about identifying persons at risk for sudden cardiac death. Physicians are frequently asked to assess the suitability of an athlete to participate in a particular sport. Typically, compared with nonathletes, athletes have a slower minimal heart rate, a higher percentage of sinus pauses lasting longer than 2 seconds, and more Mobitz I atrioventricular block because of higher vagal tone that occurs with conditioning. Guidelines recommend that athletes be screened initially by obtaining a history and conducting a physical examination. If the history identifies previous near syncope, syncope, palpitations, or a family history of sudden cardiac death, or if the physical examination identifies a serious heart murmur or other cardiac problem, the athlete should have an electrocardiogram, an echocardiogram, and stress testing.
Antiarrhythmic Drugs
Authors: Brady Peter A. 
Published: May 2013

Abstract
In general terms, antiarrhythmic drugs work in 1 of 2 ways: to slow the velocity of the propagating wave front (the action of drugs that predominantly block sodium channels) or to increase the amount of cardiac tissue that is refractory and, therefore, cannot be excited by the propagating wave front (predominantly drugs that block potassium channels). In this way, antiarrhythmic drugs act to alter the myocardial-electrical substrate to decrease the stability of sustained reentrant circuits. In some circumstances, drugs may either slow conduction too much or alter the refractoriness of remote parts of the reentrant circuit that increases, rather than decreases, the stability of the reentrant circuit and, in this way, may be proarrhythmic.
Carcinoid and Drug-Related Heart Disease
Authors: Connolly Heidi M. , Pellikka Patricia A. 
Published: May 2013

Abstract
Progress in the medical and surgical management of patients with metastatic carcinoid tumor has resulted in improved symptoms and survival. However, carcinoid heart disease remains a major cause of morbidity and death. Limited medical treatment options are available for patients with carcinoid valvular disease; for those with severe valvular heart disease, valve replacement has been increasingly used. Clinical and echocardiographic features and management are reviewed in this chapter. Drug-related heart disease, also covered in this chapter, has been linked to some anorexigens, ergot alkaloids, and pergolide.
Prosthetic Heart Valves
Authors: Grogan Martha A. , Miller Fletcher A. 
Published: May 2013

Abstract
Prosthetic valves can only approximate normal human valve hemodynamics, and they carry the risk of unique complications, such as structural failure, thrombosis, hemolysis, and infections. Valve prostheses are classified as mechanical and bioprosthetic valves. Mechanical valves are subdivided into caged-ball, tilting-disk, and bileaflet. Bioprosthetic valves are subdivided into stented heterografts, homografts, and stentless heterografts. The homograft and stentless heterograft valves are designed for implantation in the aortic or pulmonic position. All the other valve types can be implanted in any valve position. Mechanical valves are generally preferred in patients who require long-term anticoagulation for other reasons, such as an existing mechanical prosthesis in another position or atrial fibrillation. Patients unwilling or unable to take warfarin or to comply with long-term monitoring should receive tissue valves. Complications and valve dysfunction are also reviewed.
The Aorta
Authors: Spittell Peter C. 
Published: May 2013

Abstract
The various conditions affecting the aorta, including atheroembolism, abdominal aortic aneurysm, dissection, penetrating ulcer, intramural hematoma, and rupture are reviewed in this chapter. Causes, clinical presentation, evaluation, natural history, and treatment of conditions affecting the aorta are covered as well.
Pathophysiology of Arterial Thrombosis
Authors: McBane Robert D. , Wysokinski Waldemar E. 
Published: May 2013

Abstract
Atherosclerosis is the most common cause of major disability and death in the United States. The most devastating complication of this disease occurs when a platelet-rich thrombus abruptly occludes arterial blood flow, resulting in acute MI, stroke, or sudden cardiac death. This chapter reviews the basic pathophysiology of arterial thrombosis. The pathophysiology of arterial thrombosis involves platelet-rich thrombus formation over a ruptured atherosclerotic plaque. This process can be partitioned into platelet adhesion, coagulation factor activation, and thrombus propagation through platelet accretion.
Treatment and Prevention of Arterial Thrombosis
Authors: McBane Robert D. , Wysokinski Waldemar E. 
Published: May 2013

Abstract
Each year, 1.45 million Americans have a myocardial infarction and 800,000 Americans have a new or recurrent stroke. These events are thrombotic in nature and are therefore potentially treatable and preventable with the appropriate use of antithrombotic agents. Current antithrombotic therapy targets 3 of the 4 stages of thrombus formation: platelet activation, platelet aggregation, and coagulation cascade activation. There are no effective means to prevent the initial stage of platelet adhesion to injured arterial walls. This chapter reviews the mechanism of action, pharmacology, and clinical use of agents for the prevention and treatment of arterial thrombosis.
Venous and Lymphatic Disorders
Authors: Shields Raymond C. 
Published: May 2013

Abstract
Venous and lymphatic diseases, such as venous thromboembolism, heparin-induced thrombocytopenia, antiphospholipid syndrome, lymphedema, edema, and leg ulcers, are frequently encountered in patients who have cardiac or arterial disorders. Understanding the evaluation and management of these problems is an important part of modern cardiovascular practice.
Marfan Syndrome
Authors: Ammash Naser M. , Connolly Heidi M. 
Published: May 2013

Abstract
Marfan syndrome is the most common inherited multisystem disorder of connective tissue. This autosomal dominant condition, first described by Antoine Marfan in 1896, has a reported incidence of 2 to 3 per 10,000 persons, and it has no particular sex, racial, or ethnic predilection. Early identification and appropriate management improve the outcomes among patients with Marfan syndrome, who are prone to life-threatening cardiovascular complications. Genetic characteristics, manifestations, diagnosis, medical and surgical management, and pregnancy in Marfan syndrome are reviewed.
Coronary Artery Disease Epidemiology
Authors: Allison Thomas G. 
Published: May 2013

Abstract
Coronary artery disease develops as a consequence of decreased blood flow to the myocardium due to coronary atherosclerosis. It begins as fatty streaks in the coronaries and other arterial beds early in life. Fatty streaks and some raised lesions have been identified in various autopsy studies in men in their late teens and early 20s and women by their late 20s and early 30s. The development of atherosclerosis appears to follow a complex pathway. Prevalence, incidence, risk factors, and changing trends in coronary artery disease are also reviewed.
Metabolic Syndrome
Authors: Allison Thomas G. 
Published: May 2013

Abstract
Metabolic syndrome is a novel CV risk factor that has generated widespread interest—and controversy—since its inclusion in the Adult Treatment Panel III of the National Cholesterol Education Program. The National Cholesterol Education Program lists 5 characteristics for consideration of metabolic syndrome: large waist circumference, low HDL-C level, high triglyceride level, elevated blood pressure, and impaired fasting glucose level. Controversies surrounding metabolic syndrome, its prevalence, and its relation to other cardiovascular risk factors are reviewed in this chapter.
Pathogenesis of Atherosclerosis
Authors: Blackshear Joseph L. , Kantor Birgit 
Published: May 2013

Abstract
Atherosclerosis is a disease primarily involving pathologic changes in the intima, with reactive changes in the media and adventitia. The prevalence of atherosclerotic lesions is highest in the abdominal aorta, coronary arteries, femoropopliteal arteries, internal carotid arteries, and vertebrobasilar arterial regions. Some arteries, such as the internal mammary artery or the radial artery, are rarely or never affected by atherosclerosis. Major independent risk factors for the development of atherosclerosis include elevated plasma concentrations of total cholesterol and LDL-C, cigarette smoking, hypertension, diabetes mellitus, advancing age, low plasma concentrations of HDL-C, and a family history of premature coronary artery disease. The consensus pathogenetic explanation for the development of atherosclerosis is that cumulative exposure to risk factors over many years results in a cycle or series of episodes of cyclical injury and repair, which culminate in clinical events, including acute coronary thrombotic syndromes, angina, intermittent claudication or acute arterial occlusion, ischemic stroke, and development and rupture of abdominal aortic aneurysm.
Lipid-Lowering Clinical Trials and Medications
Authors: Murphy Joseph G. , Wright R. Scott , Allison Thomas G. 
Published: May 2013

Abstract
This chapter reviews trials that studied the effect of diet and various lipid-lowering medications on reducing the risk of cardiovascular disease. Trials studying the effect of diet on cardiovascular risk were the Lyon Diet Heart Study, the DART trial, the Moradabad Heart Study, and the Step Two Plus Study. Trials studying the effect of statins, nicotinic acid, fibric acid derivatives, bile acid-binding sequestrants, ezetimibe, and other antiatherogenic agents are also reviewed.
Novel Biomarkers of Coronary Artery Disease Risk
Authors: Kullo Iftikhar J. 
Published: May 2013

Abstract
Assessment of cardiovascular risk is necessary to inform preventive and therapeutic interventions. Predictive models based on conventional risk factors have less than desired accuracy in predicting CAD risk in an individual, in part because of the widespread prevalence of these risk factors in the general population. Although most patients who suffer a cardiovascular event will have one or more of the conventional risk factors, so do many adults who do not have CAD. Consequently, there is interest in novel biomarkers that might improve cardiovascular risk stratification. Examples include CRP, fibrinogen, NT-proBNP, Lp (a), LDL particle size and number, Lp-PLA2, and genetic susceptibility variants. This chapter provides a brief update on these ‘novel’ risk markers.
Diabetes Mellitus and Coronary Artery Disease
Authors: Frye Robert L. , Holmes David R. 
Published: May 2013

Abstract
The prevalence of diabetes mellitus has reached epidemic proportions and continues to increase. Type 2 diabetes has been estimated to account for up to 90% to 95% of all diagnosed cases of diabetes. Heart disease is the leading cause of diabetes-related mortality. Almost two-thirds of diabetics die of heart or blood vessel disease, and death rates from heart disease are two to four times higher among diabetic patients than among nondiabetic patients. In addition, diabetes is associated with an increase in the risk of stroke. Cardiologists need to understand that fat cells (adipocytes) are active metabolically and are the source of several cytokines and other substances that not only influence insulin sensitivity and resistance but have profound effects on the cardiovascular system.
Hypertension
Authors: Brady Adrian J. B. , Wright R. Scott , Murphy Joseph G. 
Published: May 2013

Abstract
Hypertension is the clinical condition of sustained high blood pressure. Untreated, hypertension promotes atherosclerotic peripheral arterial vascular disease, carotid and coronary artery disease. Directly, it causes hypertensive left ventricular hypertrophy and heart failure; renal failure and retinal damage. It is the most important risk factor for hemorrhagic stroke and causes hypertensive encephalopathy. The detection and treatment of hypertension is the single most important and cost effective intervention in cardiovascular medicine worldwide, according to the World Health Organization. While detection of hypertension is straightforward, and effective drugs are both inexpensive and readily available, hypertension remains one of the most important chronic conditions seen by all physicians
Cardiac Biomarkers
Authors: Shapiro Brian P. , Babuin Luciano , Jaffe Allan S. 
Published: May 2013

Abstract
The need for a rapid and reliable diagnosis of myocardial infarction is crucial. Initial efforts focused on clinical assessment and electrocardiography, but over time it became clear that they are often nondiagnostic. Therefore, clinicians now rely heavily on cardiac biomarkers. Guidelines call for the routine assessment of cardiac biomarkers for the diagnosis of myocardial infarction. The cardiac biomarkers cardiac troponin and creatine kinase are reviewed in this chapter: cardiac troponin, creatine kinase, as are their use in acute myocardial infarction diagnosis and prognosis.
Right Ventricular Infarction
Authors: Wright R. Scott 
Published: May 2013

Abstract
Isolated right ventricular myocardial infarction is rare, but an estimated 30% of patients with acute inferior myocardial infarction have clinical or echocardiographic evidence of right ventricular dysfunction or infarction. Right ventricular infarction is frequently underdiagnosed and is associated with an increased in-hospital mortality compared with inferior wall myocardial infarction in patients with preserved right ventricular function. Many studies have shown that patients with right ventricular infarction are a unique subgroup with a distinctive clinical presentation, treatment, and prognosis. Resolution of right ventricular dysfunction is common among patients who survive right ventricular infarction.
Cardiogenic Shock
Authors: Murphy Joseph G. 
Published: May 2013

Abstract
Shock is defined as a physiological state of inadequate blood flow to vital organs that leads to a global reduction in tissue perfusion with subsequent widespread cellular dysfunction. Three types of shock are recognized: hypovolemic shock, distributive shock, and cardiogenic shock. The most common causes of cardiogenic shock are acute MI (including extensive left ventricular injury), right ventricular infarction, ruptured papillary muscle, postinfarct septal rupture, ventricular free wall rupture with tamponade, and, uncommonly, severe ventricular stunning in association with the apical balloon (takotsubo) syndrome. Cardiogenic shock is the leading cause of death among hospitalized patients following acute MI. Cardiogenic shock is the focus of this chapter.
Cardiac Emergencies
Authors: Murphy Joseph G. , Boilson Barry A. , Lloyd Margaret A. 
Published: May 2013

Abstract
This chapter outlines the general principles of managing cardiac emergencies in adults. It is deliberately not an exhaustive review. Sudden cardiac arrest is a leading cause of death in developed nations and is frequently associated with ventricular fibrillation. Resuscitation for cardiac arrest is most successful if defibrillation is performed within the first 5 minutes after collapse. This chapter also reviews management of patients presenting with polymorphic ventricular tachycardia, atrial flutter or fibrillation with rapid ventricular response, paroxysmal supraventricular tachycardia, reciprocating tachycardia, multifocal atrial tachycardia, pacemaker-mediated tachycardia, acute coronary syndromes, pulmonary edema, and hypertensive, structural, metabolic, and toxic emergencies.
Coronary Artery Bypass Surgery
Authors: Sundt III Thoralf M. 
Published: May 2013

Abstract
Surgical coronary revascularization is state-of-the-art therapy for cardiac ischemia. Even with scientific and procedural developments that narrow the gap between surgical and percutaneous revascularization strategies, surgical revascularization continues to demonstrate superior durability and greater long-term cost-effectiveness at the expense of greater invasiveness for the patient. Accordingly, cardiologists should understand the surgical perspective on coronary revascularization, particularly the surgeon's view of preoperative assessment and certain aspects of intraoperative decision making and postoperative care.