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The prolonged QT interval is both widely seen and associated with the potentially deadly rhythm, Torsades de Pointes (TdP). While it can occur spontaneously in the congenital form, there is a wide array of drugs that have been implicated in the prolongation of the QT interval. Some of these drugs have either been restricted or withdrawn from the market due(More)
Very high takeoff of the left main coronary artery in the absence of another coronary anomaly is a rare finding. The pathologic consequences of this anomaly are unclear, and the literature on this subject does not agree on whether the condition is dangerous. We present our findings in 2 patients who were discovered to have this anomaly upon noninvasive(More)
Three hundred nine patients were followed during their recovery area stay after percutaneous coronary intervention. Recovery area times for patients who received bivalirudin during percutaneous coronary intervention showed an average reduction in total recovery area length of stay of 36 minutes (p <0.0001) compared with patients who received heparin alone.(More)
Complex cardiac congenital anomalies can occasionally be found in adult patients who have no knowledge of their condition. Here we present the case of a 27-year-old man with cocaine-induced acute myocardial infarction in whom an isolated congenitally corrected transposition of the great arteries with dextroversion was discovered incidentally.
We tested whether routine preprocedure fluoroscopy of the femoral head would improve sheath placement or reduce the incidence of groin complications. Patients were randomized to receive either fluoroscopy or "blind" sheath placement using palpation alone. The location of the femoral sheath was established by femoral artery angiography. Sheath placement in(More)
Long QT syndrome (LQTS) is characterized by inherited or acquired prolonged QT interval on the surface electrocardiogram. This can lead to torsade de pointes ventricular tachycardia (TdP VT) and ventricular fibrillation. In the acquired form of the disease, medications from several classes can cause TdP VT or potentiate the electrocardiographic findings.(More)
The accurate diagnosis of anomalous coronary arteries by invasive angiography is limited by the inability to define the anatomic course in relation to surrounding structures. Computed tomographic coronary angiography has recently emerged as a noninvasive method to visualize the coronary arteries. Multislice computed tomography with up to 64 detector arrays,(More)
Sixty-four slice computed tomographic coronary angiography (CTCA) is being used more often in the evaluation of patients with chest pain. The strength of this test is its high specificity and negative predictive value in exclusion of coronary artery disease (CAD). Its use remains controversial because there are theoretical risks of radiation, additional(More)
Sixty-four-slice computed tomographic (CT) coronary angiography is a new technique for the noninvasive visualization of the coronary arteries. It enables noninvasive detection of coronary plaque and determination of severity without instrumentation of the heart. Although not yet commonly used in the emergency department setting, it stands poised to(More)