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American Family Physician March 1, 2006 Satpathy et al.	Diagnosis and Management of Diastolic Dysfunction and Heart Failure With early diagnosis and proper management the prognosis of diastolic dysfunction is more favorable than that of systolic dysfunction. Distinguishing diastolic from systolic heart failure is essential because the optimal therapy for one may aggravate the other.
American Family Physician June 1, 2004 Gutierrez & Blanchard	Diastolic Heart Failure: Challenges of Diagnosis and Treatment The outcomes of ongoing clinical trials may provide much-needed information about diastolic heart failure to move from intuitive treatment to therapy based on evidence that matters: decreased morbidity and mortality and improved quality of life.
American Family Physician April 15, 2005 Karnani, Reisfield & Wilson	Evaluation of Chronic Dyspnea Chronic dyspnea is defined as dyspnea lasting more than one month. Information is presented on diagnosis, assessment and treatment for chronic dyspnea.
American Family Physician May 1, 2001 Trenton D. Nauser & Steven W. Stites	Diagnosis and Treatment of Pulmonary Hypertension Regardless of the etiology, unrelieved pulmonary hypertension can lead to right-sided heart failure. Signs and symptoms of pulmonary hypertension are often subtle and nonspecific...
American Family Physician November 15, 2005 William E. Cayley	Diagnosing the Cause of Chest Pain Distinguishing between serious and benign causes of chest pain is imperative, and diagnostic and prognostic questions are important in making this determination.
American Family Physician December 1, 2006 Dout, Lehman & Glasziou	The Role of BNP Testing in Heart Failure With the increasing availability of assays for the measurement of brain natriuretic peptide (BNP), a cardiac hormone, blood tests may have a role in detecting, monitoring, and perhaps preventing chronic heart failure.
Nursing December 2009 Vincent M. Vacca	On the Alert for Pulmonary Arterial Hypertension Progressive and ultimately fatal, pulmonary arterial hypertension is a disease of the pulmonary arterial vasculature with no known cause.
American Family Physician November 15, 2006 Fletcher, Mills & Taylor	Update on Exercise Stress Testing Exercise stress testing is an important diagnostic tool for the evaluation of suspected or known cardiac disease.
American Family Physician September 1, 2001 William E. Chavey	Guideline for the Management of Heart Failure Caused by Systolic Dysfunction Part I: Guideline development, etiology and diagnosis...
American Family Physician July 1, 2005 Achar, Kundu & Norcross	Diagnosis of Acute Coronary Syndrome Differentiating acute coronary syndrome from noncardiac chest pain is the primary diagnostic challenge. The initial assessment requires a focused history (including risk factor analysis), a physical examination, an ECG and, frequently, serum cardiac marker determinations.
American Journal of Nursing May 2009 Kristen J. Overbaugh	Acute Coronary Syndrome Coronary artery disease, in which atherosclerotic plaque builds up inside the coronary arteries and restricts the flow of blood (and therefore the delivery of oxygen) to the heart, continues to be the number-one killer of Americans.
American Family Physician June 1, 2001 Benjamin Shipton & Haney Wahba	Valvular Heart Disease: Review and Update People with valvular heart disease are living longer, with less morbidity, than ever before. Advances in surgical techniques and a better understanding of timing for surgical intervention account for increased rates of survival...
American Family Physician November 1, 2003 Zoorob & Campbell	Acute Dyspnea in the Office Shortness of breath, or dyspnea, is a common problem in the outpatient primary care setting. Establishing a diagnosis can be challenging because dyspnea appears in multiple diagnostic categories. Underlying disorders range from the relatively simple to the more serious.
Nurse Practitioner June 2010 Kevin Hagan	LVADs Help Mend a Broken Heart Left ventricular assist devices are used to treat patients with end-stage heart failure to improve survival and quality of life.
Nursing March 2009 Kate J. Morse	Focusing on the Surgical Patient with Cardiac Problems Learn about the latest guidelines for assessing cardiac risk and protecting his heart during noncardiac surgery.
Nurse Practitioner November 2011 Tracy Brazziel et al.	Stopping the Wave of PAD Early detection and diagnosis of atherosclerotic disease is imperative. Here, learn the risk factors, screening and diagnosis for this disease.
American Family Physician November 15, 2001 Melvin D. Cheitlin	Surgery for Chronic Aortic Regurgitation: When Should It Be Considered? This article discusses the pathophysiologic basis of the signs and symptoms of aortic regurgitation, with the purpose of providing practical recommendations to help physicians determine when surgical intervention is necessary
Nurse Practitioner March 2011 Lauren Wierwille	Pediatric Heart Murmurs: Evaluation and management in primary care This review includes an overview of cardiac assessment, distinguishing features of innocent and pathologic murmurs, differential diagnosis of murmurs, and current referral recommendations.
American Family Physician February 15, 2005 Allan V. Abbott	Diagnostic Approach to Palpitations An increased or abnormal awareness of the heartbeat, palpitations are a common symptom in patients presenting to family physicians. Palpitations can be symptomatic of life-threatening cardiac arrhythmias.
American Family Physician July 15, 2000 Mitchell S. King	Preoperative Evaluation The purpose of a preoperative evaluation is not to "clear" patients for elective surgery, but rather to evaluate and, if necessary, implement measures to prepare higher risk patients for surgery...
American Family Physician July 15, 2000 Showkat A. Haji	Update on Digoxin Therapy in Congestive Heart Failure Congestive heart failure is a progressive disease with significant morbidity and mortality. Despite advances in the prevention and treatment of cardiovascular diseases, the incidence and prevalence of congestive heart failure have increased in recent years...
Nursing May 2010 Debra Castner	Understanding the stages of chronic kidney disease This article will help you to recognize CKD and understand its stages so you can help your patient to modify risk factors, prevent further kidney damage, and manage complications. First, consider the scope of the problem.
American Family Physician October 1, 2005 Bidwell & Pachner	Hemoptysis: Diagnosis and Management Hemoptysis is the spitting of blood that originated in the lungs or bronchial tubes. The patient's history should help determine the amount of blood and differentiate between hemoptysis, pseudohemoptysis, and hematemesis.
American Family Physician April 15, 2006 Eric L. Anderson	Arrhythmogenic Right Ventricular Dysplasia Arrhythmogenic right ventricular dysplasia (ARVD) is a disorder in which normal myocardium is replaced by fibrofatty tissue. This disorder usually involves the right ventricle, but the left ventricle and septum also may be affected.
Nurse Practitioner May 2011 Chris Garvey	Best Practices in Chronic Obstructive Pulmonary Disease Chronic obstructive pulmonary disease is a common, preventable, treatable, and often progressive disorder characterized by airflow limitation that is not fully reversible.
American Family Physician November 1, 2002 Goyle & Walling	Diagnosing Pericarditis Pericarditis is inflammation of the pericardial sac surrounding the heart and the origins of the great vessels. The condition is most often caused by a viral infection and generally resolves in a few weeks with no sequelae.
American Family Physician April 1, 2004 Nina Solenski	Transient Ischemic Attacks: Part I. Diagnosis and Evaluation Transient ischemic attack (TIA) is no longer considered a benign event but, rather, a critical harbinger of impending stroke.
American Family Physician January 1, 2003 Edward Onusko	Diagnosing Secondary Hypertension Secondary hypertension is elevated blood pressure that results from an underlying, identifiable, often correctable cause. Only about 5 to 10 percent of hypertension cases are thought to result from secondary causes. The ABCDE mnemonic can be used to help determine a secondary cause of hypertension.
Nursing March 2011 Ali & Gray-Vickrey	Limiting the Damage From Acute Kidney Injury This article will discuss your role in early detection and management of AKI with an emphasis on care for older adults.
Nursing November 2011 Lawson & Pruitt	Issues in Obesity, Part 2: Obesity Weighs Heavily on Lung Function A look at the impact of obesity on asthma, chronic obstructive pulmonary disease (COPD), and sleep apnea.
American Family Physician August 1, 2004 Wiviott & Braunwald	Unstable Angina and Non-ST-Segment Elevation Myocardial Infarction: Part I. Initial Evaluation and Management, and Hospital Care Because of the scope of the problem, it is important for family physicians to understand the diagnosis, risk assessment, and treatment of this syndrome.
Nursing June 2012 Streets & Vickers	Is this patient with heart failure a candidate for ultrafiltration? Similar to dialysis, ultrafiltration is a type of renal replacement therapy that may be indicated for patients with heart failure who have significant volume overload despite outpatient diuretic therapy.
American Family Physician September 15, 2000 Anne D. Walling, M.D.	Family Practice International Notes from international family physicians' journals: Traumatic Coronary Artery Damage... Morton's Neuroma... Diagnosing Acute Dyspnea...
American Journal of Nursing March 2012 Corbridge et al.	An Evidence-Based Approach to COPD: Part 1 This article, the first in a two-part series on COPD, outlines current guidelines and other evidence-based recommendations on diagnosing and managing stable COPD in the outpatient setting.
Nursing April 2010 Powers & Burchell	Sepsis alert: Avoiding the shock Early recognition of sepsis and early goal-directed therapy can sometimes halt the progression of sepsis to severe sepsis and septic shock. Rapid response and aggressive care can improve patient outcomes in a critical situation.
Nursing March 2010 Peg Gray-Vickrey	Gathering pearls of knowledge for assessing older adults If you attended nursing school more than 10 years ago, you may have received limited education about gerontological nursing. But as baby boomers age, this is becoming an increasingly important area of nursing practice.
Nursing September 2010 Margaret M. Bolton	Sounding the alarm about metabolic syndrome Any health problem that affects a third of American adults is sure to impact your nursing practice. Metabolic syndrome, a growing and commonly silent condition, poses a significant public health crisis.
American Family Physician October 1, 2006 Freeman & Shulman	Kawasaki Disease: Summary of the American Heart Association Guidelines Kawasaki disease is an acute vasculitis of childhood that predominantly affects the coronary arteries. The etiology of Kawasaki disease remains unknown, although an infectious agent is strongly suspected based on clinical and epidemiologic features.
Nursing July 2011 Susan Simmons	Recognizing and Managing Rheumatoid Arthritis Here's what rheumatoid arthritis is, how it's diagnosed and treated, and what you can do to help patients manage the disease.
American Family Physician May 1, 2006 Luma & Spiotta	Hypertension in Children and Adolescents The prevalence and rate of diagnosis of hypertension in children and adolescents appear to be increasing. Most childhood hypertension, particularly in preadolescents, is secondary to an underlying disorder.
American Family Physician December 1, 2004 McConaghy & Smith	Outpatient Treatment of Systolic Heart Failure Optimal outpatient treatment of systolic heart failure has three goals that should be pursued simultaneously: (1) control of risk factors for the development and progression of heart failure, (2) treatment of heart failure, and (3) education of patients.
American Family Physician April 15, 2005 Gabriel Gregoratos	Indications and Recommendations for Pacemaker Therapy The indications for pacemaker therapy have expanded in the past 45 years and now include the treatment of bradyarrhythmias and the electrical therapy of tachyarrhythmias, certain types of syncope, and advanced heart failure.
American Family Physician June 15, 2002 A. Kesh Hebbar	Management of Common Arrhythmias: Part II. Ventricular Arrhythmias and Arrhythmias in Special Populations Patients with established heart disease and premature ventricular complexes have a higher likelihood of developing ventricular tachycardia or fibrillation.
American Family Physician September 15, 2001	Guideline for the Management of Heart Failure Caused by Systolic Dysfunction: Part II. Treatment Treatment recommendations for patients with left ventricular systolic dysfunction...
Nursing April 2011 Smith & Tasota	Smoking Out the Dangers of COPD An overview of the guidelines for preventing, diagnosing, and treating COPD.
American Family Physician April 15, 2001 Robert E. Hoyt & Lester Shawn	Reducing Readmissions for Congestive Heart Failure Hospital admission for congestive heart failure is extremely common and quite expensive, although it is frequently preventable...
Nurse Practitioner September 2009 Laura LaRue	Sarcoidosis: A Granular View The NP integrates detailed history, physical exam, and diagnostic testing into determining the treatment plan for sarcoidosis.
American Family Physician August 1, 2002 Daphne P. Bicket	Using ACE Inhibitors Appropriately Although angiotensin-converting enzyme (ACE) inhibitors have documented clinical benefits in a variety of clinical situations, the disparity between the evidence from clinical trials and bedside medicine is well documented.
Nurse Practitioner February 2012 Wood & Gordon	Preventing CVD in women: The NP's role This article focuses on the new American Heart Association guidelines for preventing cardiovascular disease in women and the nurse practitioner's role in implementing them.
American Family Physician March 1, 2007 Flood & Fleisher	Preparation of the Cardiac Patient for Noncardiac Surgery Perioperative myocardial infarction (MI) is a major cause of morbidity and mortality in patients who have noncardiac surgery.