Use of biomarkers to diagnose and manage cardiac amyloidosis

Use of Physiologic Reasoning to Diagnose and Manage Shock States

Shock states are defined by stereotypic changes in well-known physiologic parameters. While these well-known changes provide a convenient entry point into further evaluation of patients in shock or at risk for shock, use of such physiologic evaluation is not commonly seen in clinical medicine. A formal description of physiologic reasoning in the diagnosis of shock states is presented in this pa...

Problems of Cold Agglutinins in Cardiac Surgery: How to Manage Cardiopulmonary Bypass and Myocardial Protection

Cold agglutinins are of unique relevance in cardiac surgerybecause of the use of hypothermic cardiopulmonary bypass (CPB). Cold autoimmune diseases are defined by the presence of abnormal circulating proteins (usually IgM or IgA antibodies) that agglutinate in response to a decrease in body temperature. These disorders include cryoglobulinemia and cold hemagglutinin disease.Immunoglobulin M aut...

Use of Echocardiography to Manage Cardiac Resynchronization Therapy

Current guidelines recommend cardiac resynchronization therapy (CRT) for a subset of patients with systolic heart failure; however, the optimal settings for each patient and the characterization of the patient population most likely to benefit are still areas of active research and debate. New techniques in echocardiography may facilitate adjustment of pacer specifications to augment a positive...

How should we diagnose and manage photosensitivity?

How I diagnose and manage HIT.

Heparin-induced thrombocytopenia (HIT) is a prothrombotic drug reaction caused by platelet-activating IgG antibodies that recognize platelet factor 4 (PF4)/polyanion complexes. Platelet activation assays, such as the serotonin-release assay, are superior to PF4-dependent immunoassays in discerning which heparin-induced antibodies are clinically relevant. When HIT is strongly suspected, standard...