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Cardiovascular Medicine & Surgery NetWork

March 10, 2010
Cardiovascular Medicine and Surgery NetWork Puzzler - March 2010

A 68–year–old man previously diagnosed with a "heart-murmur," but otherwise considered healthy, was transferred to our hospital with a 3–day history of fever, back pain and confusion.

March 09, 2010
NetWork Special Presentations from CHEST 2009
All presentations are in read-only PDF format. Printing is restricted. To download a presentation to your computer, click on the presentation title.
August 05, 2009
Cardiovascular Medicine and Surgery NetWork Online Puzzler - August 2009

A 41-year-old woman at 17 weeks gestation was referred for resting dyspnea. On physical examination, she had a faint diastolic murmur. ECG revealed mitral stenosis with dilated left atrium and a normal ejection fraction. She had two prior documented strokes and is noncompliant with her anticoagulant medication. She is not responding to the current medical management.

May 06, 2009
Cardiovascular Medicine and Surgery NetWork Online Puzzler - May 2009
A 50-year-old man of Indian descent with a past medical history only significant for multiple myeloma was admitted to our hospital for complaints of fatigue, increasing dyspnea, and bilateral lower extremity edema, which had been progressive for the past 2 months. The multiple myeloma had been refractory to treatment with considerable progression since the diagnosis was made 3 years earlier. Over the years, he had been treated with pulse steroids and chemotherapy (CDEP: cyclophosphamide, dexamethasone, etoposide, cisplatin), followed by a peripheral stem cell transplant and then maintenance steroids.  His disease continued to progress with refractory cytpopenias and extensive bone involvement.
December 03, 2008
Cardiovascular Medicine and Surgery NetWork Online Puzzler - December 2008
A 66-year-old woman with hypertension, osteoarthritis, hypertensive heart disease, and chronic persistent atrial fibrillation presents to the ED with 1 week of progressive fatigue, exertional dyspnea, and nausea. For over 1 year, management of her conditions has included a daily regimen of enalapril,10 mg, bid, digoxin, 0.25 mg, chlorthalidone, 25 mg, warfarin, 5 mg, and verapamil (time-released), 240 mg. She takes aspirin as needed for joint discomfort. She was feeling well 1 month ago when seen in the clinic.
November 03, 2008
Cardiovascular Medicine and Surgery NetWork Online Puzzler - November 2008
A 51-year-old man with multiple myeloma was admitted to the ICU with severe sepsis, 2 months after an unrelated allogeneic stem cell transplant. On the day of planned hospital discharge, he developed tachypnea, diaphoresis, and agitation within 15 to 20 min after removal of a right subclavian central venous catheter (CVC) while lying flat in bed. This episode rapidly progressed to obtundation and cardiopulmonary collapse, necessitating emergency intubation. His ECG showed a new right bundle-branch block (RBBB) (Fig 1). Chest CT was negative for pulmonary embolism.
January 01, 2008
Circulating osteoprotegerin levels and long-term prognosis in patients with acute coronary syndromes

 This study tested the hypothesis that serum osteoprotegerin levels on admission are associated with long-term prognosis in patients with acute coronary syndrome.

January 01, 2008
Drug-eluting stents vs coronary-artery bypass grafting in multivessel coronary disease

Given the rapid pace of advancement in the fields of interventional cardiology and cardiac surgery, there are scant data comparing current catheter-based and surgical revascularization techniques.

January 01, 2008
Effect of tilarginine acetate in patients with acute myocardial infarction and cardiogenic shock: the TRIUMPH randomized controlled trial

This study tested the hypothesis that nitric oxide synthase inhibition using NG-monomethyl-L-arginine (L-NMMA) by bolus plus a 5 h moderate dose infusion would reduce 30-day all-cause mortality in patients with cardiogenic shock due to acute myocardial infarction in patients with an open infarct-related artery.

January 01, 2008
Effects of extended-release metoprolol succinate in patients undergoing non-cardiac surgery (POISE trial)
The use of β-blockers in the perioperative setting has remained controversial and a subject of much debate.
January 01, 2008
Impact of Previous Percutaneous Coronary Intervention in Coronary Artery Bypass Grafting Outcome in Diabetic Patients.

In the context of coronary artery disease, diabetes mellitus is a challenging risk factor for both the cardiologists and the cardiac surgeons, alike.

January 01, 2008
Intensive blood glucose control and vascular outcomes in patients with type 2 diabetes
Vascular complications are the most common cause of death and disability among patients with diabetes.