Management Of Cardiac Disorders Research Articles

Blended learning approach for teaching cardiac disorders on nursing students’ learning outcomes

Background: Modern Education has been transformed into an instant and self-driven online learning. Blended learning is a way to get the best of both traditional classroom and online learning. Aim: The aim of the study was to find out the effectiveness of Blended learning on Nursing Students’ learning outcomes regarding management of Cardiac Disorders. Methods: A True Experimental study with post-test only control group design was carried out among a Cluster random sample of 271 nursing students studying in Punjab and Haryana. The tools used for data collection were: Structured Knowledge Questionnaire for assessment of knowledge, OSCE for assessment of skills and Case Scenario based questionnaire for the assessment of clinical decision making. The students in Blended Learning group were taught regarding cardiac disorders by Blended learning including web environment as well as contact classes by the Researcher whereas the students in the Conventional Learning group received Conventional method of teaching. It was a double-blinded study. Results: SPSS 21.0 was used for data analysis. There were statistically significant differences between groups in skills and clinical decision-making but not in knowledge. Conclusion: Blended Learning is an effective method to improve learning outcomes of nursing students regarding management of cardiac disorders.

Implantable cardiac devices in geriatric patients: a primer for primary and geriatric physicians.

In the next 20 years, the percentage of people older than 65 years of age in the United States is expected to double. Heart disease is the leading cause of mortality in developed nations, including the United States. Due to the increased incidence of cardiac disease in elderly patients, the need for special treatment considerations, including cardiac devices, may be necessary to reduce morbidity and mortality in this patient population. The purpose of this review is to provide a primer of the common cardiac devices used in the management of cardiac disorders in the geriatric patient population. In order to do this, we have performed a literature review for articles related to cardiac devices published between 2000 and 2020, in addition to reviewing guidelines and recommendations from relevant professional societies. We provide readers with an overview of several cardiac devices including implantable loop recorders, pacemakers, cardiac resynchronization therapy, automated implantable cardiac defibrillators, watchman devices, and ventricular assist devices. Indications, contraindications, clinical trial data, and general considerations in the geriatric population were included. Due to the aging population and increased incidence of cardiac disease, clinicians should be aware of the indications and contraindications of cardiac device therapy in the management of various cardiac conditions that afflict the geriatric population.

Practical Aspects in Genetic Testing for Cardiomyopathies and Channelopathies.

Genetic testing has an increasingly important role in the diagnosis and management of cardiac disorders, where it confirms the diagnosis, aids prognostication and risk stratification and guides treatment. A genetic diagnosis in the proband also enables clarification of the risk for family members by cascade testing. Genetics in cardiac disorders is complex where epigenetic and environmental factors might come into interplay. Incomplete penetrance and variable expressivity is also common. Genetic results in cardiac conditions are mostly probabilistic and should be interpreted with all available clinical information. With this complexity in cardiac genetics, testing is only indicated in patients with a strong suspicion of an inheritable cardiac disorder after a full clinical evaluation. In this review we discuss the genetics underlying the major cardiomyopathies and channelopathies, and the practical aspects of diagnosing these conditions in the laboratory.

Two-dimensional echocardiographic right ventricle measurements adjusted to body mass index and surface area in a normal population

To determine reference echocardiographic values in a normal population and assess their correlation with body mass index (BMI) and body surface area. An expert cardiologist performed two-dimensional echocardiography with triplicate right ventricle (RV) size measurements in 80 subjects with normal heart condition. Results were correlated with anthropometric data. Base-to-apex length in four-chamber view (RVD3) and above-pulmonic valve in short-axis view in males, as well as mid-RV diameter in standard four-chamber view (RVD), basal RV diameter, and mid RV diameter in RV-focused four-chamber view in females, were significantly correlated with BMI. All RV variables were significantly correlated with BMI in 20-30-year-old subjects. All RV variables except RVD3 and above-aortic valve in short-axis view (proximal) were significantly correlated with BMI in 35-55-year-old subjects. All RV parameters were significantly correlated with body surface area, except for RVD and in 20-35-year-old subjects. RV echocardiographic values must be adjusted to anthropometric characteristics for proper diagnosis and management of cardiac disorders. © 2016 Wiley Periodicals, Inc. J Clin Ultrasound 45:204-210, 2017.

CARDIAC DISORDER IN HEMODIALYSIS: BENEFITS OF CHINESE HERBS

Background:A major cause of mortality in hemodialysis patients is cardiac disease. Most complementary and alternative therapies, including Chinese herbal medicine, have been useful in the treatment of cardiac disorders.Materials and Methods:A 46 year old Asian woman with chronic renal failure was admitted to the clinic for hemodialysis. In the course of the fifth session of standard dialysis, she developed shock followed by a ventricular tachycardia which rapidly degenerated into cardiac arrest, from which she was resuscitated through cardio-pulmonary resuscitation. The following therapeutic strategies were applied: low discharge oxygen inhalation; stricter water and salt restriction; dialysate temperature set at 36.0 °C; rhEPO 3000u, per week, low molecular weight iron dextran, 200mg/day, intravenously for five days; the patient received Chinese herbal concoction orally.Results:The patient obtained efficient standard dialysis without any cardiac syndrome.Conclusion:Chinese herbs are useful in the management of cardiac disorders in hemodialysis. Chinese herbs may provide more benefits by adjusting dialysis strategies.

118: Assessment of respiratory variation on inferior vena cava by three-dimensional echocardiography

Accuracy of measurement of inferior vena cava (IVC) respiratory variations has clinical implications in the management of cardiac disorders because it affects the estimation of right-atrial (RA) pressure. We assumed that 3D can added more valuable information in IVC assessment. To develop a methodology of 3D exploration of VCI and evaluate it in comparison with 2D. 20 patients with good echo-visualisation underwent 2D and 3D (Philips IE 33). In 2D, the IVC maximal (2DDmax) and minimal (2DDmin) diameters was measured according to the ASE guidelines. In 3D, VCI was displayed according to its longitudinal axis, from the junction with the RA. Cross-section of the VCI was realized immediately after the hepatic vein junction. The large (D1) and small (D2) diameters and the surface (S) of this cross-section were measured when the VCI has the maximal size during normal respiration (maximal VCI dimensions). After deep inspiration, the same measures were done (minimal VCI dimensions). The IVC collapsibility index was calculate in 2D and 3D. 2DDmax and 2DDmin was 21.3+3.1 mm and 11.4+1.7 mm. 3D shows that VCI in cross section has an oval geometric shape. D1max and D1min was 27.6+1.9 mm and 22.3+1.5 mm. D2max and D2min was 15.6+1.2 mm and 11.1+1.1 m. S max and min was 3.2+0.6cm 2 and 2.0+0.4cm 2 . 2DD is less than D1 (p<0.001). Because VCI moves during respiration (outside of the initial 2D section), the physician can not conclude about the real diameter decrease and as a consequence 2D overestimated its respiratory variations. 3D allows true measurements by using the planes permanently adjusted in the space to anatomical landmarks. Because reflecting both long and short diameters, the surface of the cross-section of the VCI must be the more informative measurement. This study developed a 3D methodology of reliable assessment of the VCI. We propose for evaluation of respiratory variation of IVC an index of collapsibility of the surface of its cross-section.

Radiopharmaceuticals in cardiology

Myocardial perfusion studies are among the most often performed investigations in Nuclear Medicine. However, the development of radiopharmaceuticals for cardiology is an emerging discipline and several other radiotracers have been proven to be useful. Although the myocardial perfusion studies have a well established role in the management of cardiac disorders, still a number of radiopharmaceuticals are under development for a variety of specific cardiac indications and their eventual clinical role remains to be seen. The paper provides a short overview of currently used radiopharmaceuticals and potential molecular imaging radiotracers applicable in cardiology.

Index of Suspicion

Index of Suspicion

Determination of cardiac output by first passage radiocardiography: Theoretical considerations and phantom studies

Non-invasive determination of cardiac output by aid of precordial first passage radiocardiography may prove a useful tool in the management of cardiac disorders. The basic concepts of a method together with theoretical assumptions necessary for the clinical application of the method are described. The principle of the technique was tested in a cardiac phantom model with adjustable stroke volume and heart rate, in which background problems were avoided. First passage radiocardiography gave highly accurate cardiac output determinations compared with the 'true' phantom values, r = 0.998 (p less than 0.001).