Datasets:

roxyroxygod
/

statpearls

Dataset card Viewer Files Files and versions Community

Dataset Preview

Split (1)

train

The full dataset viewer is not available (click to read why). Only showing a preview of the rows.

The dataset generation failed because of a cast error

Error code:   DatasetGenerationCastError
Exception:    DatasetGenerationCastError
Message:      An error occurred while generating the dataset

All the data files must have the same columns, but at some point there are 2 new columns ({'source', 'index'}) and 4 missing columns ({'title', 'id', 'content', 'contents'}).

This happened while the json dataset builder was generating data using

hf://datasets/roxyroxygod/statpearls/statpearls/index/ncbi/MedCPT-Article-Encoder/metadatas.jsonl (at revision 3a33ed28a822cac56efc098cd43c1dedae743c17)

Please either edit the data files to have matching columns, or separate them into different configurations (see docs at https://hf.co/docs/hub/datasets-manual-configuration#multiple-configurations)
Traceback:    Traceback (most recent call last):
                File "/src/services/worker/.venv/lib/python3.9/site-packages/datasets/builder.py", line 1870, in _prepare_split_single
                  writer.write_table(table)
                File "/src/services/worker/.venv/lib/python3.9/site-packages/datasets/arrow_writer.py", line 622, in write_table
                  pa_table = table_cast(pa_table, self._schema)
                File "/src/services/worker/.venv/lib/python3.9/site-packages/datasets/table.py", line 2292, in table_cast
                  return cast_table_to_schema(table, schema)
                File "/src/services/worker/.venv/lib/python3.9/site-packages/datasets/table.py", line 2240, in cast_table_to_schema
                  raise CastError(
              datasets.table.CastError: Couldn't cast
              index: int64
              source: string
              to
              {'id': Value(dtype='string', id=None), 'title': Value(dtype='string', id=None), 'content': Value(dtype='string', id=None), 'contents': Value(dtype='string', id=None)}
              because column names don't match
              
              During handling of the above exception, another exception occurred:
              
              Traceback (most recent call last):
                File "/src/services/worker/src/worker/job_runners/config/parquet_and_info.py", line 1417, in compute_config_parquet_and_info_response
                  parquet_operations = convert_to_parquet(builder)
                File "/src/services/worker/src/worker/job_runners/config/parquet_and_info.py", line 1049, in convert_to_parquet
                  builder.download_and_prepare(
                File "/src/services/worker/.venv/lib/python3.9/site-packages/datasets/builder.py", line 924, in download_and_prepare
                  self._download_and_prepare(
                File "/src/services/worker/.venv/lib/python3.9/site-packages/datasets/builder.py", line 1000, in _download_and_prepare
                  self._prepare_split(split_generator, **prepare_split_kwargs)
                File "/src/services/worker/.venv/lib/python3.9/site-packages/datasets/builder.py", line 1741, in _prepare_split
                  for job_id, done, content in self._prepare_split_single(
                File "/src/services/worker/.venv/lib/python3.9/site-packages/datasets/builder.py", line 1872, in _prepare_split_single
                  raise DatasetGenerationCastError.from_cast_error(
              datasets.exceptions.DatasetGenerationCastError: An error occurred while generating the dataset
              
              All the data files must have the same columns, but at some point there are 2 new columns ({'source', 'index'}) and 4 missing columns ({'title', 'id', 'content', 'contents'}).
              
              This happened while the json dataset builder was generating data using
              
              hf://datasets/roxyroxygod/statpearls/statpearls/index/ncbi/MedCPT-Article-Encoder/metadatas.jsonl (at revision 3a33ed28a822cac56efc098cd43c1dedae743c17)
              
              Please either edit the data files to have matching columns, or separate them into different configurations (see docs at https://hf.co/docs/hub/datasets-manual-configuration#multiple-configurations)

Need help to make the dataset viewer work? Make sure to review how to configure the dataset viewer, and open a discussion for direct support.

End of preview.

No dataset card yet

Downloads last month: 9

id string	title string	content string	contents string
article-100024_0	Chronic Total Occlusion of the Coronary Artery -- Continuing Education Activity	Chronic total occlusion (CTO) lesions are diagnosed in patients who are undergoing coronary angiography as part of the evaluation of ischemic heart disease, cardiomyopathy, or valvular heart disease. CTO revascularization has not shown benefit in rates of all-cause mortality, myocardial infarction, stroke, and repeat revascularization and is commonly performed to improve a patient's quality of life by reducing their angina symptoms. This activity reviews the evaluation and treatment of chronic total occlusion of the coronary artery and highlights the role of the interprofessional team in evaluating and treating this condition.	Chronic Total Occlusion of the Coronary Artery -- Continuing Education Activity. Chronic total occlusion (CTO) lesions are diagnosed in patients who are undergoing coronary angiography as part of the evaluation of ischemic heart disease, cardiomyopathy, or valvular heart disease. CTO revascularization has not shown benefit in rates of all-cause mortality, myocardial infarction, stroke, and repeat revascularization and is commonly performed to improve a patient's quality of life by reducing their angina symptoms. This activity reviews the evaluation and treatment of chronic total occlusion of the coronary artery and highlights the role of the interprofessional team in evaluating and treating this condition.
article-100024_1	Chronic Total Occlusion of the Coronary Artery -- Continuing Education Activity	Objectives: Describe the histopathology of a chronic total occlusion (CTO) lesion. Review the risk factors for developing chronic total occlusion (CTO) lesions. Outline the typical presentation of a patient with chronic total occlusion (CTO) lesions. Explain the importance of improving care coordination amongst the interprofessional team( primary care physician, cardiologist, and interventionist) to enhance the delivery of care for patients with chronic total occlusion (CTO). Access free multiple choice questions on this topic.	Chronic Total Occlusion of the Coronary Artery -- Continuing Education Activity. Objectives: Describe the histopathology of a chronic total occlusion (CTO) lesion. Review the risk factors for developing chronic total occlusion (CTO) lesions. Outline the typical presentation of a patient with chronic total occlusion (CTO) lesions. Explain the importance of improving care coordination amongst the interprofessional team( primary care physician, cardiologist, and interventionist) to enhance the delivery of care for patients with chronic total occlusion (CTO). Access free multiple choice questions on this topic.
article-100024_2	Chronic Total Occlusion of the Coronary Artery -- Introduction	A coronary chronic total occlusion (CTO) is defined as 100% occlusion of a coronary artery for a duration of greater than or equal to 3 months based on angiographic evidence. The TIMI (thrombolysis in myocardial infarction) flow grading system is a scoring classification from 0-3 referring to the levels of coronary blood flow assessed during coronary angiography. The TIMI flow grading system is as below [1] : TIMI 0 flow (no perfusion-complete occlusion) - the absence of any forward flow beyond a coronary occlusion. TIMI 1 flow (penetration without perfusion) - faint forward flow beyond the occlusion, associated with an incomplete filling of the distal coronary bed. TIMI 2 flow (partial reperfusion) - delayed forward flow with complete filling of the distal coronary bed. TIMI 3 flow (full perfusion) - normal flow, which fills the distal coronary bed.	Chronic Total Occlusion of the Coronary Artery -- Introduction. A coronary chronic total occlusion (CTO) is defined as 100% occlusion of a coronary artery for a duration of greater than or equal to 3 months based on angiographic evidence. The TIMI (thrombolysis in myocardial infarction) flow grading system is a scoring classification from 0-3 referring to the levels of coronary blood flow assessed during coronary angiography. The TIMI flow grading system is as below [1] : TIMI 0 flow (no perfusion-complete occlusion) - the absence of any forward flow beyond a coronary occlusion. TIMI 1 flow (penetration without perfusion) - faint forward flow beyond the occlusion, associated with an incomplete filling of the distal coronary bed. TIMI 2 flow (partial reperfusion) - delayed forward flow with complete filling of the distal coronary bed. TIMI 3 flow (full perfusion) - normal flow, which fills the distal coronary bed.
article-100024_3	Chronic Total Occlusion of the Coronary Artery -- Introduction	A "true" CTO is defined as 100% occlusion of a coronary artery with TIMI 0 flow; whereas a "functional" CTO is defined as severely stenotic, yet, less than a 100% occlusion of the coronary artery with TIMI 1 flow for a duration of greater than or equal to 3 months based on angiographic evidence. [2] Moreover, it is difficult to identify the exact period over which a CTO lesion is present in the absence of serial angiograms. Therefore, it is mostly estimated based on available clinical information related to the timing of the event that caused the occlusion, for example, prior myocardial infarction or sudden change in anginal symptoms with electrocardiogram changes consistent with the location of the occlusion. However, in many patients, the age of the CTO cannot be determined with confidence.	Chronic Total Occlusion of the Coronary Artery -- Introduction. A "true" CTO is defined as 100% occlusion of a coronary artery with TIMI 0 flow; whereas a "functional" CTO is defined as severely stenotic, yet, less than a 100% occlusion of the coronary artery with TIMI 1 flow for a duration of greater than or equal to 3 months based on angiographic evidence. [2] Moreover, it is difficult to identify the exact period over which a CTO lesion is present in the absence of serial angiograms. Therefore, it is mostly estimated based on available clinical information related to the timing of the event that caused the occlusion, for example, prior myocardial infarction or sudden change in anginal symptoms with electrocardiogram changes consistent with the location of the occlusion. However, in many patients, the age of the CTO cannot be determined with confidence.
article-100024_4	Chronic Total Occlusion of the Coronary Artery -- Etiology	Risk factors for CTO lesion in patients are as below [3] : Known coronary artery disease or history of myocardial infarction Excessive tobacco use High LDL cholesterol, low HDL cholesterol Diabetes Sedentary lifestyle Hypertension Family history of premature disease End-stage kidney disease Obesity Postmenopausal women	Chronic Total Occlusion of the Coronary Artery -- Etiology. Risk factors for CTO lesion in patients are as below [3] : Known coronary artery disease or history of myocardial infarction Excessive tobacco use High LDL cholesterol, low HDL cholesterol Diabetes Sedentary lifestyle Hypertension Family history of premature disease End-stage kidney disease Obesity Postmenopausal women
article-100024_5	Chronic Total Occlusion of the Coronary Artery -- Epidemiology	CTO lesions are found in approximately one-quarter to one-third of patients undergoing diagnostic coronary angiography. The true prevalence, however, in the general population is unknown due to a subset of patients with CTO lesions being asymptomatic or minimally symptomatic and never undergoing diagnostic coronary angiography. Patients with a history of coronary artery bypass graft surgery are found to have CTOs of their native vessels more frequently (50% to 55%). In comparison, patients presenting with ST-elevation myocardial infarction (STEMI) are less likely to have a CTO (9% to 11%). [4] [5]	Chronic Total Occlusion of the Coronary Artery -- Epidemiology. CTO lesions are found in approximately one-quarter to one-third of patients undergoing diagnostic coronary angiography. The true prevalence, however, in the general population is unknown due to a subset of patients with CTO lesions being asymptomatic or minimally symptomatic and never undergoing diagnostic coronary angiography. Patients with a history of coronary artery bypass graft surgery are found to have CTOs of their native vessels more frequently (50% to 55%). In comparison, patients presenting with ST-elevation myocardial infarction (STEMI) are less likely to have a CTO (9% to 11%). [4] [5]
article-100024_6	Chronic Total Occlusion of the Coronary Artery -- Epidemiology	Data from the National Heart, Lung, and Blood Institute (1997–1999) Dynamic Registry showed that CTO lesions are most common in the right coronary artery and least common in the left circumflex artery. Older patients are more likely to have at least one CTO lesion with 37% prevalence in patients under the age of 65 years, 40% in patients between the ages of 65 to 79 years, and 41% in those patients who are older than 85 years. [6]	Chronic Total Occlusion of the Coronary Artery -- Epidemiology. Data from the National Heart, Lung, and Blood Institute (1997–1999) Dynamic Registry showed that CTO lesions are most common in the right coronary artery and least common in the left circumflex artery. Older patients are more likely to have at least one CTO lesion with 37% prevalence in patients under the age of 65 years, 40% in patients between the ages of 65 to 79 years, and 41% in those patients who are older than 85 years. [6]
article-100024_7	Chronic Total Occlusion of the Coronary Artery -- Pathophysiology	Pathogenesis of coronary artery disease, which can progress to CTO lesions, has multiple contributing factors, which include upregulation of the immunologic and inflammatory markers (cytokines, leukocytes, high sensitivity C-reactive protein), endothelial dysfunction, and cholesterol accumulation. Most commonly, it starts with the collection of smooth muscle cells within the intima, and this progresses to macrophages accumulating in the intima leading to pathologic intimal thickening and progression of lesions. [7] [8]	Chronic Total Occlusion of the Coronary Artery -- Pathophysiology. Pathogenesis of coronary artery disease, which can progress to CTO lesions, has multiple contributing factors, which include upregulation of the immunologic and inflammatory markers (cytokines, leukocytes, high sensitivity C-reactive protein), endothelial dysfunction, and cholesterol accumulation. Most commonly, it starts with the collection of smooth muscle cells within the intima, and this progresses to macrophages accumulating in the intima leading to pathologic intimal thickening and progression of lesions. [7] [8]
article-100024_8	Chronic Total Occlusion of the Coronary Artery -- Histopathology	Histopathological attributes of a CTO lesion commonly consist of calcium, lipids (both intracellular and extracellular), smooth muscle cells, an extracellular matrix, and neovascularization. Occlusions typically have a dense concentration of collagen-rich fibrous tissue at the proximal and distal ends contributing to a columnar lesion of calcified, resistant fibrous tissue surrounding a softer core of organized thrombus and lipids. Lesion classification is as soft, hard, or a mixture of both. Soft plaques are more frequent in occlusions less than 12 months of age and consist of cholesterol-laden cells and foam cells. Hard plaques are more prevalent in occlusions that are older than 12 months of age and are characterized by dense fibrous tissue with fibrocalcific regions without neovascular channels. [9]	Chronic Total Occlusion of the Coronary Artery -- Histopathology. Histopathological attributes of a CTO lesion commonly consist of calcium, lipids (both intracellular and extracellular), smooth muscle cells, an extracellular matrix, and neovascularization. Occlusions typically have a dense concentration of collagen-rich fibrous tissue at the proximal and distal ends contributing to a columnar lesion of calcified, resistant fibrous tissue surrounding a softer core of organized thrombus and lipids. Lesion classification is as soft, hard, or a mixture of both. Soft plaques are more frequent in occlusions less than 12 months of age and consist of cholesterol-laden cells and foam cells. Hard plaques are more prevalent in occlusions that are older than 12 months of age and are characterized by dense fibrous tissue with fibrocalcific regions without neovascular channels. [9]
article-100024_9	Chronic Total Occlusion of the Coronary Artery -- History and Physical	CTO lesions are diagnosed in patients who are undergoing coronary angiography as part of the evaluation of ischemic heart disease, cardiomyopathy, or valvular heart disease. Patients with ischemic heart disease generally present with typical chest pain symptoms (stable or unstable angina), atypical chest pain, NSTEMI, or STEMI. In contrast, patients with different types of cardiomyopathies or valvular heart disease may present with a variety of symptoms, including decompensated congestive heart failure. Therefore, during history taking in patients suspected of having ischemic heart disease, it is essential to have them describe and subjectively quantify their symptoms.	Chronic Total Occlusion of the Coronary Artery -- History and Physical. CTO lesions are diagnosed in patients who are undergoing coronary angiography as part of the evaluation of ischemic heart disease, cardiomyopathy, or valvular heart disease. Patients with ischemic heart disease generally present with typical chest pain symptoms (stable or unstable angina), atypical chest pain, NSTEMI, or STEMI. In contrast, patients with different types of cardiomyopathies or valvular heart disease may present with a variety of symptoms, including decompensated congestive heart failure. Therefore, during history taking in patients suspected of having ischemic heart disease, it is essential to have them describe and subjectively quantify their symptoms.
article-100024_10	Chronic Total Occlusion of the Coronary Artery -- History and Physical	The history should also include risk factors for cardiovascular disease (diabetes, tobacco abuse, hypertension, hyperlipidemia) and non-cardiac causes of the patient's symptoms, including pulmonary embolism, aortic dissection, pneumothorax, esophageal rupture or perforating peptic ulcer. Physical examination in these patients should include complete auscultation of the heart and lung sounds together with assessment for heart failure signs including jugular venous distention, Kussmaul sign, hepatojugular reflex, ascites, and peripheral edema.	Chronic Total Occlusion of the Coronary Artery -- History and Physical. The history should also include risk factors for cardiovascular disease (diabetes, tobacco abuse, hypertension, hyperlipidemia) and non-cardiac causes of the patient's symptoms, including pulmonary embolism, aortic dissection, pneumothorax, esophageal rupture or perforating peptic ulcer. Physical examination in these patients should include complete auscultation of the heart and lung sounds together with assessment for heart failure signs including jugular venous distention, Kussmaul sign, hepatojugular reflex, ascites, and peripheral edema.
article-100024_11	Chronic Total Occlusion of the Coronary Artery -- Evaluation	A significant component of an assessment for a patient who presents with signs and symptoms of ischemic heart disease is history and physical exam. These should include vital signs (respiratory rate, blood pressure, temperature, and heart rate), review of the patient's medication list, and an electrocardiogram. During their evaluation, the patient should have an assessment for any underlying or comorbid valvular heart disease or heart failure.	Chronic Total Occlusion of the Coronary Artery -- Evaluation. A significant component of an assessment for a patient who presents with signs and symptoms of ischemic heart disease is history and physical exam. These should include vital signs (respiratory rate, blood pressure, temperature, and heart rate), review of the patient's medication list, and an electrocardiogram. During their evaluation, the patient should have an assessment for any underlying or comorbid valvular heart disease or heart failure.
article-100024_12	Chronic Total Occlusion of the Coronary Artery -- Evaluation	A healthcare provider should consider thyroid function testing, pulmonary function testing, routine blood work, including cardiac enzymes, chest X-ray, and echocardiography as part of their initial evaluation. If the initial assessment and evaluation are performed on an urgent basis, intravenous access should be obtained and, if no contraindication exists, the patient should be administered aspirin (162 to 325 mg) and nitrates. If available, patients should be placed on a cardiac monitor and should be assessed with pulse oximetry for the need for supplemental oxygen.	Chronic Total Occlusion of the Coronary Artery -- Evaluation. A healthcare provider should consider thyroid function testing, pulmonary function testing, routine blood work, including cardiac enzymes, chest X-ray, and echocardiography as part of their initial evaluation. If the initial assessment and evaluation are performed on an urgent basis, intravenous access should be obtained and, if no contraindication exists, the patient should be administered aspirin (162 to 325 mg) and nitrates. If available, patients should be placed on a cardiac monitor and should be assessed with pulse oximetry for the need for supplemental oxygen.
article-100024_13	Chronic Total Occlusion of the Coronary Artery -- Treatment / Management	CTO revascularization has not shown to benefit rates of all-cause mortality, myocardial infarction, stroke, or repeat revascularization; however, it has shown to significantly improve patients' quality of life and reduce symptoms of angina. [10] [11] [12] Nuclear medicine stress test or myocardial viability studies are also used in conjunction with symptoms to objectively demonstrate areas of ischemia or viability supplied by the CTO vessel. Based on current guidelines, patients with single-vessel CTO lesions should undergo coronary artery bypass surgery if they have left main artery disease, proximal LAD disease which supplies a viable anterior wall, or three-vessel disease in a patient with insulin-dependent diabetes, severe left ventricular dysfunction, or chronic kidney disease. [13]	Chronic Total Occlusion of the Coronary Artery -- Treatment / Management. CTO revascularization has not shown to benefit rates of all-cause mortality, myocardial infarction, stroke, or repeat revascularization; however, it has shown to significantly improve patients' quality of life and reduce symptoms of angina. [10] [11] [12] Nuclear medicine stress test or myocardial viability studies are also used in conjunction with symptoms to objectively demonstrate areas of ischemia or viability supplied by the CTO vessel. Based on current guidelines, patients with single-vessel CTO lesions should undergo coronary artery bypass surgery if they have left main artery disease, proximal LAD disease which supplies a viable anterior wall, or three-vessel disease in a patient with insulin-dependent diabetes, severe left ventricular dysfunction, or chronic kidney disease. [13]
article-100024_14	Chronic Total Occlusion of the Coronary Artery -- Treatment / Management	In patients who meet the indication for a CTO PCI, informed consent is necessary before the procedure after an extensive discussion about the risks and benefits of CTO PCI for the patient. Due to the challenging nature of the CTO lesions, a successful outcome for PCI in these lesions is when the procedure obtains TIMI-3 flow, and there is less than 50% of residual stenosis in the vessel.	Chronic Total Occlusion of the Coronary Artery -- Treatment / Management. In patients who meet the indication for a CTO PCI, informed consent is necessary before the procedure after an extensive discussion about the risks and benefits of CTO PCI for the patient. Due to the challenging nature of the CTO lesions, a successful outcome for PCI in these lesions is when the procedure obtains TIMI-3 flow, and there is less than 50% of residual stenosis in the vessel.
article-100024_15	Chronic Total Occlusion of the Coronary Artery -- Treatment / Management	Multiple scoring systems are available to operators to predict technical success in CTO lesions. One of the most commonly used scoring systems is the J-CTO score, developed using the Chronic Total Occlusion Registry in Japan. A J-CTO score is used to predict the probability of crossing the CTO lesion within 30 minutes, and is inclusive of five independent factors; blunt stump appearance of the proximal cap of the occlusion, occlusion length greater than or equal to 20 mm, calcification detected within the CTO segment, the presence of a greater than 45-degree bend within the CTO segment, and prior failed PCI attempt of the CTO lesion. Each of these independent factors carries 1 point in the J-CTO score; zero is considered easy, a score of one is deemed to be intermediate, two rates as difficult, and greater than or equal to three is considered very difficult, with the probability of crossing within 30 minutes found to be 88%, 67%, 42%, and 10% respectively. [14]	Chronic Total Occlusion of the Coronary Artery -- Treatment / Management. Multiple scoring systems are available to operators to predict technical success in CTO lesions. One of the most commonly used scoring systems is the J-CTO score, developed using the Chronic Total Occlusion Registry in Japan. A J-CTO score is used to predict the probability of crossing the CTO lesion within 30 minutes, and is inclusive of five independent factors; blunt stump appearance of the proximal cap of the occlusion, occlusion length greater than or equal to 20 mm, calcification detected within the CTO segment, the presence of a greater than 45-degree bend within the CTO segment, and prior failed PCI attempt of the CTO lesion. Each of these independent factors carries 1 point in the J-CTO score; zero is considered easy, a score of one is deemed to be intermediate, two rates as difficult, and greater than or equal to three is considered very difficult, with the probability of crossing within 30 minutes found to be 88%, 67%, 42%, and 10% respectively. [14]
article-100024_16	Chronic Total Occlusion of the Coronary Artery -- Treatment / Management	Another commonly used score to predict the technical success of CTO PCI is the Prospective Global Registry for the Study of Chronic Total Occlusion Intervention (PROGRESS-CTO) score. This predictor uses four independent factors to assess the CTO lesion, which includes CTO lesion proximal cap ambiguity, moderate/severe tortuosity of the CTO vessel, Circumflex artery CTO, and the absence of interventional collaterals. Each of these factors carries one point and correlates with technical success. A PROGRESS-CTO score of 0 is associated with 91% technical success, a score of 1 correlates with 74%, a score of 2 is 57% percent, and a score of ≥3 is less than 4.3%. [15]	Chronic Total Occlusion of the Coronary Artery -- Treatment / Management. Another commonly used score to predict the technical success of CTO PCI is the Prospective Global Registry for the Study of Chronic Total Occlusion Intervention (PROGRESS-CTO) score. This predictor uses four independent factors to assess the CTO lesion, which includes CTO lesion proximal cap ambiguity, moderate/severe tortuosity of the CTO vessel, Circumflex artery CTO, and the absence of interventional collaterals. Each of these factors carries one point and correlates with technical success. A PROGRESS-CTO score of 0 is associated with 91% technical success, a score of 1 correlates with 74%, a score of 2 is 57% percent, and a score of ≥3 is less than 4.3%. [15]
article-100024_17	Chronic Total Occlusion of the Coronary Artery -- Differential Diagnosis	STEMI NSTEMI Pulmonary embolism Aortic dissection Pneumothorax Esophageal rupture Perforating peptic ulcer disease	Chronic Total Occlusion of the Coronary Artery -- Differential Diagnosis. STEMI NSTEMI Pulmonary embolism Aortic dissection Pneumothorax Esophageal rupture Perforating peptic ulcer disease
article-100024_18	Chronic Total Occlusion of the Coronary Artery -- Prognosis	In addition to causing symptoms, CTOs have correlations with a worse overall prognosis, with higher rates of death and non-fatal adverse cardiovascular events in several populations. Patients with CTOs tend to be older and have more comorbidities and more significant impairment of left ventricular function. Furthermore, patients with non-revascularized CTOs have higher mortality and a higher risk of major adverse cardiovascular events in comparison to patients with multivessel coronary artery disease who are completely revascularized. [16] [17]	Chronic Total Occlusion of the Coronary Artery -- Prognosis. In addition to causing symptoms, CTOs have correlations with a worse overall prognosis, with higher rates of death and non-fatal adverse cardiovascular events in several populations. Patients with CTOs tend to be older and have more comorbidities and more significant impairment of left ventricular function. Furthermore, patients with non-revascularized CTOs have higher mortality and a higher risk of major adverse cardiovascular events in comparison to patients with multivessel coronary artery disease who are completely revascularized. [16] [17]
article-100024_19	Chronic Total Occlusion of the Coronary Artery -- Complications	Percutaneous coronary intervention (PCI) of a CTO lesion on average requires more fluoroscopy time, higher contrast volume, and carries a lower success rate compared to non-CTO PCI’s. CTO PCIs also have a higher complication rate than non-CTO PCIs with major complications, including myocardial infarction, stroke, vessel perforation, and death. However, vascular access site complications during CTO PCI occur at a similar frequency as routine PCI; these include poorly controlled bleeding, hematoma, acute thrombosis, distal embolization, retroperitoneal hemorrhage, dissection of the access artery, arteriovenous fistula, and pseudoaneurysm. Other potentially serious complications include ventricular tachyarrhythmias, bradycardia, allergic reactions, atheroembolism, and contrast nephropathy. [18] [19] [20] [21] [22] [23]	Chronic Total Occlusion of the Coronary Artery -- Complications. Percutaneous coronary intervention (PCI) of a CTO lesion on average requires more fluoroscopy time, higher contrast volume, and carries a lower success rate compared to non-CTO PCI’s. CTO PCIs also have a higher complication rate than non-CTO PCIs with major complications, including myocardial infarction, stroke, vessel perforation, and death. However, vascular access site complications during CTO PCI occur at a similar frequency as routine PCI; these include poorly controlled bleeding, hematoma, acute thrombosis, distal embolization, retroperitoneal hemorrhage, dissection of the access artery, arteriovenous fistula, and pseudoaneurysm. Other potentially serious complications include ventricular tachyarrhythmias, bradycardia, allergic reactions, atheroembolism, and contrast nephropathy. [18] [19] [20] [21] [22] [23]
article-100024_20	Chronic Total Occlusion of the Coronary Artery -- Complications	Data analysis of the National Cardiovascular Data Registry-Cath PCI Registry in the United States showed higher in-hospital major adverse cardiovascular event frequency (1.6 versus 0.8 percent; p<0.001) which included mortality (0.4 % versus 0.3%; p<0.001), stroke (0.1% versus 0.1 %; p = 0.045), tamponade (0.3% versus 0.1%; p<0.001), MI (2.7% versus 1.9 %; p<0.001), and urgent CABG surgery (0.8% versus 0.4%; p<0.001) in 22,365 patients who underwent CTO PCI compared with 572,145 patients who underwent non-CTO PCI. CTO PCIs also had lower procedural success rate (59% vs. 96%, p < 0.001) in this registry. [24]	Chronic Total Occlusion of the Coronary Artery -- Complications. Data analysis of the National Cardiovascular Data Registry-Cath PCI Registry in the United States showed higher in-hospital major adverse cardiovascular event frequency (1.6 versus 0.8 percent; p<0.001) which included mortality (0.4 % versus 0.3%; p<0.001), stroke (0.1% versus 0.1 %; p = 0.045), tamponade (0.3% versus 0.1%; p<0.001), MI (2.7% versus 1.9 %; p<0.001), and urgent CABG surgery (0.8% versus 0.4%; p<0.001) in 22,365 patients who underwent CTO PCI compared with 572,145 patients who underwent non-CTO PCI. CTO PCIs also had lower procedural success rate (59% vs. 96%, p < 0.001) in this registry. [24]
article-100024_21	Chronic Total Occlusion of the Coronary Artery -- Complications	Another multicenter registry (OPEN-CTO) from 12 CTO-PCI centers of 1,000 consecutive patients undergoing CTO PCI evaluated success rates, complication rates, and health status benefits at one month. CTO PCIs showed a success rate of 86%, with an in-hospital mortality of 0.9%, 1-month mortality of 1.3%. 4.8% of the patients had coronary perforations requiring treatment. Additionally, major adverse cardiovascular events were 7%, myocardial infarction 2.6%, acute kidney injury 0.7%, and stroke 0%. [12]	Chronic Total Occlusion of the Coronary Artery -- Complications. Another multicenter registry (OPEN-CTO) from 12 CTO-PCI centers of 1,000 consecutive patients undergoing CTO PCI evaluated success rates, complication rates, and health status benefits at one month. CTO PCIs showed a success rate of 86%, with an in-hospital mortality of 0.9%, 1-month mortality of 1.3%. 4.8% of the patients had coronary perforations requiring treatment. Additionally, major adverse cardiovascular events were 7%, myocardial infarction 2.6%, acute kidney injury 0.7%, and stroke 0%. [12]
article-100024_22	Chronic Total Occlusion of the Coronary Artery -- Deterrence and Patient Education	Patient education should include resources such as videos and pamphlets. Teaching should focus on risk factor reduction and lifestyle modification such as smoking cessation, blood pressure management based on guidelines, screening for new-onset diabetes, and exercise as tolerated.	Chronic Total Occlusion of the Coronary Artery -- Deterrence and Patient Education. Patient education should include resources such as videos and pamphlets. Teaching should focus on risk factor reduction and lifestyle modification such as smoking cessation, blood pressure management based on guidelines, screening for new-onset diabetes, and exercise as tolerated.
article-100024_23	Chronic Total Occlusion of the Coronary Artery -- Enhancing Healthcare Team Outcomes	Educating patients at risk for coronary artery disease and making a closed-loop communication between them and their cardiologist for primary and secondary prevention can further improve the management of patients at risk of these CTO lesions. Collaboration with shared decision making (between primary care physician, cardiologist, and interventionist) and communication are vital elements for good outcomes in patients with coronary artery disease and CTO lesions.	Chronic Total Occlusion of the Coronary Artery -- Enhancing Healthcare Team Outcomes. Educating patients at risk for coronary artery disease and making a closed-loop communication between them and their cardiologist for primary and secondary prevention can further improve the management of patients at risk of these CTO lesions. Collaboration with shared decision making (between primary care physician, cardiologist, and interventionist) and communication are vital elements for good outcomes in patients with coronary artery disease and CTO lesions.
article-100024_24	Chronic Total Occlusion of the Coronary Artery -- Enhancing Healthcare Team Outcomes	The interprofessional team care provided to the patient must use an integrated care pathway combined with an evidence-based approach to evaluating CTO lesions. The earlier angiographic and demographic predictors of failure to revascularize are identified in CTO lesions; the better is the prognosis and outcome.	Chronic Total Occlusion of the Coronary Artery -- Enhancing Healthcare Team Outcomes. The interprofessional team care provided to the patient must use an integrated care pathway combined with an evidence-based approach to evaluating CTO lesions. The earlier angiographic and demographic predictors of failure to revascularize are identified in CTO lesions; the better is the prognosis and outcome.
article-100024_25	Chronic Total Occlusion of the Coronary Artery -- Review Questions	Access free multiple choice questions on this topic. Comment on this article.	Chronic Total Occlusion of the Coronary Artery -- Review Questions. Access free multiple choice questions on this topic. Comment on this article.
article-100131_0	Cardiopulmonary Arrest in Adults -- Continuing Education Activity	Cardiopulmonary arrest is the cessation of adequate heart function and respiration and results in death without reversal. Often this condition is found in patients with coronary artery disease. This activity reviews the management and prevention of cardiopulmonary arrest and highlights the role of the interprofessional team in treating patients with this condition.	Cardiopulmonary Arrest in Adults -- Continuing Education Activity. Cardiopulmonary arrest is the cessation of adequate heart function and respiration and results in death without reversal. Often this condition is found in patients with coronary artery disease. This activity reviews the management and prevention of cardiopulmonary arrest and highlights the role of the interprofessional team in treating patients with this condition.
article-100131_1	Cardiopulmonary Arrest in Adults -- Continuing Education Activity	Objectives: Outline the typical presentation of a patient who suffers from cardiopulmonary arrest. Summarize the epidemiology of cardiac arrest in the U.S. Summarize the causes of cardiopulmonary arrest. Access free multiple choice questions on this topic.	Cardiopulmonary Arrest in Adults -- Continuing Education Activity. Objectives: Outline the typical presentation of a patient who suffers from cardiopulmonary arrest. Summarize the epidemiology of cardiac arrest in the U.S. Summarize the causes of cardiopulmonary arrest. Access free multiple choice questions on this topic.
article-100131_2	Cardiopulmonary Arrest in Adults -- Introduction	Cardiopulmonary arrest (CPA) is the cessation of effective ventilation and circulation. It is also known as cardiac arrest or circulatory arrest. In adults, it is most likely to be caused by a primary cardiac event. The most common electrical mechanism which is responsible for 50 to 80% of cardiopulmonary arrest is ventricular fibrillation (VF). While, 20^% to 30% which represents the less common causes of dysrhythmias involve Pulseless electrical activity (PEA), and asystole. Pulseless sustained ventricular tachycardia (VT) is a less common mechanism. This condition could progress to sudden death if it not treated promptly. Nevertheless, a cardiopulmonary arrest (CPA) could be reversed by cardiopulmonary resuscitation and/or cardioversion or defibrillation, or cardiac pacing. [1]	Cardiopulmonary Arrest in Adults -- Introduction. Cardiopulmonary arrest (CPA) is the cessation of effective ventilation and circulation. It is also known as cardiac arrest or circulatory arrest. In adults, it is most likely to be caused by a primary cardiac event. The most common electrical mechanism which is responsible for 50 to 80% of cardiopulmonary arrest is ventricular fibrillation (VF). While, 20^% to 30% which represents the less common causes of dysrhythmias involve Pulseless electrical activity (PEA), and asystole. Pulseless sustained ventricular tachycardia (VT) is a less common mechanism. This condition could progress to sudden death if it not treated promptly. Nevertheless, a cardiopulmonary arrest (CPA) could be reversed by cardiopulmonary resuscitation and/or cardioversion or defibrillation, or cardiac pacing. [1]
article-100131_3	Cardiopulmonary Arrest in Adults -- Introduction	The American Heart Association's AHA periodically releases updates and recommendations for adult basic life support (BLS) and the quality of cardiopulmonary resuscitation (CPR) on adults. Despite the causes, early induction of cardiopulmonary resuscitation (CPR) along with cardiac monitoring will determine which pulseless arrest pathway one has to follow. Evidence suggests that more than 400000 people die of cardiopulmonary arrest in the U.S every year. [2] They may or may not have been diagnosed with cardiopulmonary disease.	Cardiopulmonary Arrest in Adults -- Introduction. The American Heart Association's AHA periodically releases updates and recommendations for adult basic life support (BLS) and the quality of cardiopulmonary resuscitation (CPR) on adults. Despite the causes, early induction of cardiopulmonary resuscitation (CPR) along with cardiac monitoring will determine which pulseless arrest pathway one has to follow. Evidence suggests that more than 400000 people die of cardiopulmonary arrest in the U.S every year. [2] They may or may not have been diagnosed with cardiopulmonary disease.
article-100131_4	Cardiopulmonary Arrest in Adults -- Etiology	There are various causes for cardiopulmonary arrest in adults which varies by age and population. However, patients diagnosed with cardiac disease are more susceptible to having a cardiac arrest. Furthermore, it can be classified into different categories, which include cardiac, respiratory, and traumatic causes. But 75% of cardiac arrest incidents are believed to be due to coronary artery diseases. [2]	Cardiopulmonary Arrest in Adults -- Etiology. There are various causes for cardiopulmonary arrest in adults which varies by age and population. However, patients diagnosed with cardiac disease are more susceptible to having a cardiac arrest. Furthermore, it can be classified into different categories, which include cardiac, respiratory, and traumatic causes. But 75% of cardiac arrest incidents are believed to be due to coronary artery diseases. [2]
article-100131_5	Cardiopulmonary Arrest in Adults -- Etiology -- Coronary Artery Disease	Coronary artery abnormalities: Anomalous coronary artery anatomy. Acute lesions (platelet aggregation, plaque fissuring, acute thrombosis). Chronic atherosclerosis. coronary artery spasm Myocardial Infarction: Acute Healed	Cardiopulmonary Arrest in Adults -- Etiology -- Coronary Artery Disease. Coronary artery abnormalities: Anomalous coronary artery anatomy. Acute lesions (platelet aggregation, plaque fissuring, acute thrombosis). Chronic atherosclerosis. coronary artery spasm Myocardial Infarction: Acute Healed
article-100131_6	Cardiopulmonary Arrest in Adults -- Etiology -- Myocardial Hypertrophy	Secondary Hypertrophic cardiomyopathy Nonobstructive Obstructive	Cardiopulmonary Arrest in Adults -- Etiology -- Myocardial Hypertrophy. Secondary Hypertrophic cardiomyopathy Nonobstructive Obstructive
article-100131_7	Cardiopulmonary Arrest in Adults -- Etiology -- Infiltrative and Inflammatory Disorders	Infiltrative diseases Noninfectious inflammatory diseases Myocarditis	Cardiopulmonary Arrest in Adults -- Etiology -- Infiltrative and Inflammatory Disorders. Infiltrative diseases Noninfectious inflammatory diseases Myocarditis
article-100131_8	Cardiopulmonary Arrest in Adults -- Etiology -- Inherited Disorders	Early repolarization syndrome. Brugada syndrome Short QT syndrome. Long QT syndrome. Catecholaminergic polymorphic ventricular tachycardia	Cardiopulmonary Arrest in Adults -- Etiology -- Inherited Disorders. Early repolarization syndrome. Brugada syndrome Short QT syndrome. Long QT syndrome. Catecholaminergic polymorphic ventricular tachycardia
article-100131_9	Cardiopulmonary Arrest in Adults -- Etiology -- Heart Failure	Ejection fraction less than 35% [3]	Cardiopulmonary Arrest in Adults -- Etiology -- Heart Failure. Ejection fraction less than 35% [3]
article-100131_10	Cardiopulmonary Arrest in Adults -- Etiology -- Congenital disease	Tetralogy of Fallot	Cardiopulmonary Arrest in Adults -- Etiology -- Congenital disease. Tetralogy of Fallot
article-100131_11	Cardiopulmonary Arrest in Adults -- Etiology -- Respiratory Causes	Airway obstruction: Bronchospasm due to (pulmonary edema, pulmonary hemorrhage, and pneumonia) Severe asthma or Chronic Obstructive Pulmonary Disease (COPD). Pulmonary Embolism Respiratory Muscle Weakness: due to spinal cord injury.	Cardiopulmonary Arrest in Adults -- Etiology -- Respiratory Causes. Airway obstruction: Bronchospasm due to (pulmonary edema, pulmonary hemorrhage, and pneumonia) Severe asthma or Chronic Obstructive Pulmonary Disease (COPD). Pulmonary Embolism Respiratory Muscle Weakness: due to spinal cord injury.
article-100131_12	Cardiopulmonary Arrest in Adults -- Etiology -- Traumatic Causes	Overall, the prevalence of cardiac causes is around 50% to 60%. Whilst, the second most common cause that is respiratory insufficiency is around 15% to 40%. [4]	Cardiopulmonary Arrest in Adults -- Etiology -- Traumatic Causes. Overall, the prevalence of cardiac causes is around 50% to 60%. Whilst, the second most common cause that is respiratory insufficiency is around 15% to 40%. [4]
article-100131_13	Cardiopulmonary Arrest in Adults -- Epidemiology	Cardiac arrest is divided into out-hospital cardiac arrest (OHCA) and in-hospital cardiac arrest (IHCA). However, the incidence of cardiopulmonary arrest worldwide is not well described. In the U.S, more than 290,000 IHCA occur in adults annually, whilst 326,000 cases of OHCA among adults occur yearly. Half of these are unwitnessed. [4] [5]	Cardiopulmonary Arrest in Adults -- Epidemiology. Cardiac arrest is divided into out-hospital cardiac arrest (OHCA) and in-hospital cardiac arrest (IHCA). However, the incidence of cardiopulmonary arrest worldwide is not well described. In the U.S, more than 290,000 IHCA occur in adults annually, whilst 326,000 cases of OHCA among adults occur yearly. Half of these are unwitnessed. [4] [5]