• Title/Summary/Keyword: Cardiologist

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Left Ventricular Hypertrophy and Prelude to Hypertensive Cardiovascular Diseases: from the Pediatric Cardiologist's Point of View (좌심실 비대와 고혈압성 심혈관 합병증: 소아 심장 의사의 관점)

  • Cho, Min-Jung
    • Childhood Kidney Diseases
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    • v.15 no.1
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    • pp.14-21
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    • 2011
  • Although left Left ventricular hypertrophy (LVH) is not only an adaptive response of the heart to increased cardiac workload in hypertension, it surelybut also is the most potent risk factor of overt cardiovascular complications such as coronary heart disease, heart failure, arrhythmia and stroke in the hypertensive population. Also it has become generally accepted that subclinical cardiovascular disease begins in childhood and LVH is the most readily assessed marker for that. As LVH can be seen in children and adolescents with even mild blood pressure elevation with the reported prevalence of 10 to 47%, aggressive antihypertensive treatment is critical in preventing the development of hypertensive heart disease in that those cases.

Congenital heart disease in the newborn requiring early intervention

  • Yun, Sin-Weon
    • Clinical and Experimental Pediatrics
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    • v.54 no.5
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    • pp.183-191
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    • 2011
  • Although antenatal diagnostic technique has considerably improved, precise detection and proper management of the neonate with congenital heart disease (CHD) is always a great concern to pediatricians. Congenital cardiac malformations vary from benign to serious conditions such as complete transposition of the great arteries (TGA), critical pulmonary and aortic valvular stenosis/atresia, hypoplastic left heart syndrome (HLHS), obstructed total anomalous pulmonary venous return (TAPVR), which the baby needs immediate diagnosis and management for survival. Unfortunately, these life threatening heart diseases may not have obvious evidence early after birth, most of the clinical and physical findings are nonspecific and vague, which makes the diagnosis difficult. High index of suspicion and astute acumen are essential to decision making. When patent ductus arteriosus (PDA) is opened Widely, many serious malformations may not be noticed easily in the early life, but would progress as severe acidosis/shock/cyanosis or even death as PDA constricts after few hours to days. Ductus dependent congenital cardiac lesions can be divided into the ductus dependent systemic or pulmonary disease, but physiologically quite different from each other and treatment strategy has to be tailored to the clinical status and cardiac malformations. Inevitably early presentation is often regarded as a medical emergency. Differential diagnosis with inborn error metabolic disorders, neonatal sepsis, persistent pulmonary hypertension of the newborn (PPHN) and other pulmonary conditions are necessary. Urgent identification of the newborn at such high risk requires timely referral to a pediatric cardiologist, and timely intervention is the key in reducing mortality and morbidity. This following review deals with the clinical presentations, investigative modalities and approach to management of congenital cardiac malformations presenting in the early life.

Clinical Experience of Cleft Lip and/or Palate Repair in Complex Congenital Heart Disease (선천성 복잡심장병 환아의 구순 구개열의 치험례)

  • Koh, Kyung Suk;Lee, Sang Hyuk;Eom, Jin Sup
    • Archives of Plastic Surgery
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    • v.32 no.3
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    • pp.385-388
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    • 2005
  • In cleft lip and/or palate patients with the complex congenital heart diseases, surgical repair of the cleft lip and/or palate has been postponed after the open heart surgery because the heart problem of the patient might cause more complications associated with anesthesia and surgery. There has been little report about experiences in the surgical management of these patients and optimal time of surgical intervention. Authors are introducing the experiences of performing corrective surgery of cleft lip and/or palate in the patients with congenital heart diseases before and after the open heart surgery. We managed five patients from May 1992 to March 2004. Two patients were male and the rest were female. One of them had cleft lip alone and others had cleft lip and palate. Two of them underwent delayed cleft lip and/or palate surgery after open heart surgery, and the rest had immediate intervention for cleft lip and/or palate. There was no complication during the operation and postoperative period. There would be no need to delay the corrective surgery of the cleft lip and/or palate after the open heart surgery, if solid medical team approach was available with the pediatric cardiologist and the anesthesiologist.

Emergency Coronary Artery Bypass Following Unsuccessful Percutaneous Transluminal Coronary Angioplasty -A Case Report- (경피적 관상동맥성형술후 응급 관상동맥 우회로 조성술 경험)

  • 안욱수
    • Journal of Chest Surgery
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    • v.21 no.2
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    • pp.373-378
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    • 1988
  • Since the introduction of percutaneous; transluminal coronary angioplasty[PTCA] by Grunt-zig in 1977, this is widely used in some patients with coronary artery disease and is an effective alternative to surgery for many patients. Indications for emergency coronary artery bypass graft[CABG] after PTCA are prolonged chest pain, worsening of coronary artery obstruction, "current of injury" by electrocardiogram, cardiogenic shock, and in a lesser incidence, ventricular fibrillation, coronary artery dissection[without obstruction], heart block, and intractable cardiac arrest. Recently, we have experienced one case of emergency CABG following unsuccessful PTCA. The patient was 54 year-old male and admitted with complaint of angina pectoris. The routine electrocardiogram revealed within normal limit. The treadmill test revealed severe chest pain after 2 min. exercise. Coronary cineangiogram revealed 95% segmental stenosis of the proximal right coronary artery. Our cardiologist was planned PTCA. During PTCA, severe chest pain and ischemic pattern on electrocardiogram were developed. But they were not relieved even by morphine and nitroglycerin till 90 min. So we performed emergency single coronary artery bypass graft from aorta to proximal right coronary artery with great saphenous vein. The patient had an excellent postoperative recovery and was free from anginal attack. He has shown striking improvement in general status[NYHA functional class 1] during 6 months after operation.operation.

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Wearable Approach of ECG Monitoring System for Wireless Tele-Home Care Application

  • Kew, Hsein-Ping;Noh, Yun-Hong;Jeong, Do-Un
    • Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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    • 2009.05a
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    • pp.337-340
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    • 2009
  • Wireless tele-home-care application gives new possibilities for ECG (electrocardiogram) monitoring system with wearable biomedical sensors. Thus, continuously development of high convenient ECG monitoring system for high-risk cardiac patients is essential. This paper describes to monitor a person's ECG using wearable approach. A wearable belt-type ECG electrode with integrated electronics has been developed and has proven long-term robustness and monitoring of all electrical components. The measured ECG signal is transmitted via an ultra low power consumption wireless sensor node. ECG signals carry a lot clinical information for a cardiologist especially the R-peak detection in ECG. R-peak detection generally uses the threshold value which is fixed thus it bring errors due to motion artifacts and signal size changes. Variable threshold method is used to detect the R-peak which is more accurate and efficient. In order to evaluate the performance analysis, R-peak detection using MIT-BIH databases and Long Term Real-Time ECG is performed in this research. This concept able to allow patient to follow up critical patients from their home and early detecting rarely occurrences of cardiac arrhythmia.

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Abnormal Electrocardiogram Signal Detection Based on the BiLSTM Network

  • Asif, Husnain;Choe, Tae-Young
    • International Journal of Contents
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    • v.18 no.2
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    • pp.68-80
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    • 2022
  • The health of the human heart is commonly measured using ECG (Electrocardiography) signals. To identify any anomaly in the human heart, the time-sequence of ECG signals is examined manually by a cardiologist or cardiac electrophysiologist. Lightweight anomaly detection on ECG signals in an embedded system is expected to be popular in the near future, because of the increasing number of heart disease symptoms. Some previous research uses deep learning networks such as LSTM and BiLSTM to detect anomaly signals without any handcrafted feature. Unfortunately, lightweight LSTMs show low precision and heavy LSTMs require heavy computing powers and volumes of labeled dataset for symptom classification. This paper proposes an ECG anomaly detection system based on two level BiLSTM for acceptable precision with lightweight networks, which is lightweight and usable at home. Also, this paper presents a new threshold technique which considers statistics of the current ECG pattern. This paper's proposed model with BiLSTM detects ECG signal anomaly in 0.467 ~ 1.0 F1 score, compared to 0.426 ~ 0.978 F1 score of the similar model with LSTM except one highly noisy dataset.

Epistaxis in dental and maxillofacial practice: a comprehensive review

  • Psillas, George;Dimas, Grigorios Georgios;Papaioannou, Despoina;Savopoulos, Christos;Constantinidis, Jiannis
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.48 no.1
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    • pp.13-20
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    • 2022
  • The lifetime incidence of epistaxis in dental and maxillofacial practice has been reported to be as high as 60% and can be caused by dental implant placement, Le Fort I osteotomy, intranasal supernumerary tooth, odontogenic tumors, blood disorders and maxillofacial trauma. Most epistaxis cases are minor and easily managed with direct compression on the nares for 10 minutes. For more significant or recurrent epistaxis, other techniques might include electrocautery, anterior or posterior nasal packing, or Foley catheter balloon. For patients with refractory epistaxis, cauterization of the sphenopalatine artery under endonasal endoscopy or embolization of the internal maxillary artery should be performed. Epistaxis control is required in patients diagnosed with inherited or acquired bleeding disorders or with drug-induced coagulopathies during dental procedures. In these cases, hemostatic system adjustment and hemostasis achieved by local and adjunctive methods are required. Dentists and maxillofacial surgeons must be aware that the nasal cavity is a potential source of perioperative hemorrhage. Depending on the invasiveness of the dental intervention, preoperative involvement of the hematologist and cardiologist is usually necessary to reverse anticoagulation or to cease anticoagulant therapy.

A cadaveric study of arteriovenous trigone of heart: the triangle of Brocq and Mouchet

  • Swati Bansal;Rajiv Jain;Virendra Budhiraja;Shveta Swami;Rimpi Gupta
    • Anatomy and Cell Biology
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    • v.56 no.2
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    • pp.205-210
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    • 2023
  • Left coronary artery divides into anterior interventricular branch and circumflex branch. As both the arteries run in their corresponding grooves, an arteriovenous trigone is formed between conus arteriosus and left auricle called triangle of Brocq and Mouchet. The triangle base is formed by great cardiac vein. This study aims to describe the frequency of triangle and its type and relationship between various boundaries and content of triangle and to supplement the existing knowledge of clinicians. This observational and descriptive study was conducted on 40 formalin fixed cadaveric hearts in department of anatomy, Kalpana chawla government medical college. The triangle was found in 92.5% of specimen with most common type being closed (51.3%) which is followed by inferiorly open in 35.1%, superiorly open in 8.1% and completely open in 5.4% hearts. Most frequent content of triangle was median artery followed by diagonal branches of anterior interventricular and circumflex branches. The mean area of the triangle was 246.3 mm2. Relationship of vein with two arterial branches was either superficial or deep. The knowledge of different patterns of existence will be required for angiographic procedures. Further the triangle is a potential epicardial access route to left fibrous ring. Thus detailed knowledge of variations will help cardiologist to achieve better outcome in interventional procedures with minimal complications.

A Study on Perceived Discomfort in Patients Following Cardiac Catheterization (심도자 검사 환자의 불편감에 관한 연구)

  • 이은자
    • Journal of Korean Academy of Nursing
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    • v.25 no.1
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    • pp.124-140
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    • 1995
  • Cardiac cathererization has become a routine diagnostic procedure indicated for evaluation of a wide varity of cardiac conditions. Patients are admitted to the coronary care unit after cardiac catheterization. These conscious patients report feeling uncomfortable in the CCU, but no studies have been done on the effects of bed rest, sand bags on the femoral puncture site and restricted mobility for 4 to 12 hours or longer postprocedure. The main objective of this thesis is to provide basic data to nursing on interventions which de-crease the uncomfortableness experienced by patients in the CCU following cardiac catheterization. In this phenomenological study, the various discomforts felt by the patients were collected and classified. The study subjects were a convenience sample of 29 patients who were admitted to the CCU of a general hospital in Inchon following cardiac catheterization. They were conscious, so they were able to communicate without difficulty. The data were collected over an U days period from July 21, to October 14, 1994. The subjects were interviewed using unstructured open questions and the interviews were tape recorded with the patient's permission The data were analyzed using the Van Kaams phenomenological method. Reliability and validity were exammed by two professor of nursing science, one head nurse, one staff nurse and one cardiologist. The results of the study are summarized as follows ; 1. The 129 descriptive statements by the postcardiac catheterization patients of discomfort were organized into 19 themes. 2. The 19 themes were divided into 3 categories ; physical, psychological, and environmental aspects. 3. The problems concerning the physical aspect were the discomfort of restriction of movement, dysuria, medical devices, pain in the puncture site, symptom is related to the procedure of cardiac catheterization, headache and dizziness, leg painand tingling sensation, and chest pain. The problems concerning the psychological aspect were regret resulting from dependency, economic burden, dissatisfaction with medical personnel, dissatisfaction with medical service system, anxiety about the result of the procedure, concern about the prognosis, loneliness, and concern over treatment procedure. The problems concerning the environmental aspect were influence from neighboring patients, noise, and maladaptation to environmental change. The necessity for holistic care which satisfies physical, psychological, and environmental need must be emphasized in order to solve these discomforts.

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The Effect of the Team-based Cardiac Rehabilitation Program on the Health Behavior Performance, Anxiety, and Quality of Life in the Group of Ischemic Heart Disease with PTCA (팀접근 심장재활 교육이 건강행위 이행, 불안과 삶의 질에 미치는 효과)

  • Jo, Hyun-Sook
    • The Korean Journal of Rehabilitation Nursing
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    • v.1 no.1
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    • pp.83-92
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    • 1998
  • This study was designed to determine the outcomes of the team-based cardiac rehabilitation programs for patients with Ischemic Heart Disease(IHD) on their level of health behavior performance, anxiety, and quality of life. A total of 19 in-patients with IHD who have had PTCA treatment at G.Hospital in Inchon were selected as subject to data collection from 1 May 1998 to 30 Oct. 1998. The experimental group, consisting of 11 patients participated in the Hospital's cardiac rehabilitation program was compared with the non-rehabilitation control group of 8 patients. The experimental group has been trained on the cardiac rehabliltation programfor 120-150minute during hospitalization by a team consisted of four specialists, those are cardiologist, head nurse, dietian, and the author. Also individual follow-up training and interview were performed for the members of experimental group at their every visit to the Hospital after discharge. For all subjects, scores on health behavior performance, anxiety, and quality of life were collected two days and 12 weeks after PTCA treatment by questionnaire. The collected data were analyzed with the SPSS. The results of this study were summarized as follows : 1) The experimental group shows significant increase in health behavior performance score compared to the control group(-2.27, p=.022). 2) There was no significant difference between two group's anxiety scores (-.24, p= .803) and quality of life scores(-1.86, p= .061). 3) The correlation between health behavior performance and anxiety ( .07, p= .771), and that between health behavior performance and quality of life( .12, p= .621) respectively were not significant statistically. But the correlation between anxiety and quality of life were significant reversely ( .49, p= .032).

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