Odynophagia after Cardiac Catheterization: A Rare Complication in the Presence of Aberrant Subclavian Artery.

Background: Vascular complications from transradial cardiac catheterization are uncommon. Mediastinal hematoma is a rare complication with life-threatening potential. We present a case of a patient who underwent cardiac catheterization and subsequently experienced odynophagia from injury to an aberrant subclavian artery that led to a mediastinal hematoma.

Urban vs Suburban: Is the Door-to-Balloon Time Affected by Geographic, Socioeconomic, or Racial Differences? A Tale of Two Campuses.

Background: In 2004, the ACC/AHA released guidelines in the treatment of ST-segment elevation myocardial infarction (STEMI) within a time window from the time a patient physically enters the hospital to the time of percutaneous coronary intervention (PCI). This time window is defined as the door-to-balloon time (DTB) and is recommended to be under 90 minutes to improve patient mortality. To add another layer of complexity, patients with varying socioeconomic status and racial differences experience large disparities in health.

Wedged Sensor in Distress? Lessons Learned from Troubleshooting Dampened Transmitted PA Waveforms of CardioMEMS Device.

. Cardiovascular disease is a leading cause of morbidity and mortality with heart failure constituting a large portion of this spectrum. Heart failure patients have 90-day readmission rates of nearly 41% associated with a high expense.

Appropriate Use of Transesophageal Echocardiogram for Infective Endocarditis: A Single Center Experience.

Background: Transesophageal echocardiogram (TEE) is a valuable tool in healthcare today with its ease of use, ability to visualize important structures not seen on transthoracic echocardiogram (TTE), and the relatively lower cost of TEE, high yield, and no significant radiation exposure. The American Society of Echocardiography (ASE) has developed an appropriate use criteria for use of TTE and TEE, which outline various scenarios where a TEE is indicated as an initial diagnostic testing modality and when it is useful as an adjunctive test in hopes of decreasing inappropriate use. Using these criteria as a guide, we devised a quality assessment study to investigate how well TEEs performed at our institution fit the appropriate use criteria specifically for the diagnostic workup of infective endocarditis.

Atrial-Esophageal Fistula After Catheter Ablation: Diagnosing and Managing a Rare Complication of a Common Procedure.

BACKGROUND Atrial fibrillation is considered the most common cardiac arrhythmias in the United States with rate and rhythm control strategies traditionally used for management. If patients are intolerant to class I or class III anti-arrhythmic medications, catheter ablation may be used as a rhythm control strategy. As catheter ablation becomes more commonplace, so too do the procedure-related complications, which include tamponade, total arterio-venous fistula, pulmonary vein stenosis, and atrial-esophageal fistula.

Timeout for Contrast: Using Physician Behavior Modification to Reduce Contrast in the Catheterization Laboratory.

Background: As the number of procedures using contrast media continues to rise, the ensuing complications place an ever increasing burden on the healthcare system. Contrast-induced nephropathy (CIN) is a common postprocedural complication after cardiac catheterization.

Objectives: The purpose of our study was to evaluate the impact of physician behavioral modification on reducing the amount of contrast used during the procedure.

CardioMEMS in a Busy Cardiology Practice: Less than Optimal Implementation of a Valuable Tool to Reduce Heart Failure Readmissions.

Introduction: Congestive heart failure is a leading cause of cardiovascular morbidity and mortality that results in a significant financial burden on healthcare expenditure. Though various strategies have been employed to reduce hospital readmissions, one valuable tool that remains greatly underutilized is the CardioMEMS (), a remote pulmonary artery pressure-monitoring system, which has been shown to help reduce heart failure rehospitalizations in the CHAMPION (CardioMEMS Heart Sensor Allows Monitoring of Pressure to Improve Outcomes in NYHA Class III Heart Failure Patients) trial.

Methods: ICD-9/ICD-10 codes for chronic heart failure were used to identify patients who presented with congestive heart failure.

Inverted Yoga and Near Syncope: An Unusual Diagnosis of Right Ventricular Myxoma.

Primary cardiac tumors are extremely rare and are difficult to diagnose. Although usually benign in nature, myxomas require surgical resection due to their increased risk of embolic and cardiac complications, with the timing of resection dependent on the presentation and size of the tumor. However, if diagnosed early, patients with primary benign cardiac tumors have excellent prognosis following surgery.

Real-world use of PCSK9 inhibitors: A single-center experience.

Objective: Hyperlipidemia is an important risk factor for atherosclerotic cardiovascular disease. Many patients are intolerant to or have limited benefit from statins. Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors have been approved for treating hyperlipidemia in these patients.

Impact of CardioMEMS device placement on lifestyle modifications: a "pseudo-placebo" effect beyond the expected?

Introduction Congestive heart failure is a leading cause of cardiovascular mortality and morbidity in the United States and places a significant economic burden on the health care system. The CHAMPION trial showed significant reductions in heart failure hospitalizations and length of stay as well as improvements in quality of life among patients who underwent implantation of the CardioMEMS device (CardioMEMS Inc., Atlanta, GA, USA).

Single prolonged stress effects on sensitization to cocaine and cocaine self-administration in rats.

Posttraumatic stress disorder (PTSD) is often comorbid with substance use disorders (SUD). Single prolonged stress (SPS) is a well-validated rat model of PTSD that provides a framework to investigate drug-induced behaviors as a preclinical model of the comorbidity. We hypothesized that cocaine sensitization and self-administration would be increased following exposure to SPS.

Managing a Rivaroxaban Bleed: Understanding the Difficulties in Acute Reversal of the New Oral Anticoagulants through a Case Report.

With the arrival of a new generation of oral anticoagulants significant burdens associated with warfarin's use on both the patient and the healthcare system have been alleviated. Nevertheless, a shortfall exists in regard to an agent or protocol for reversal of these new anticoagulants in the setting of an acute bleed. Our case of a patient presenting to the hospital with a vaginal bleed while on rivaroxaban highlights the difficulty in management without a clear protocol or agent for reversal of anticoagulation.