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American Family Physician November 15, 2002 Bernard M. Karnath	Preoperative Cardiac Risk Assessment Heart disease is the leading cause of mortality in the United States. An important subset of heart disease is perioperative myocardial infarction, which affects approximately 50,000 persons each year.
American Family Physician April 15, 2004 Mark H. Ebell, M.D., M.S.	Preoperative Evaluation for Noncardiac Surgery The physician should assess the patient's preoperative risk factors and the risks associated with the planned surgery.
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.
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 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 October 15, 2000 Patricia A. Howard & Edward F. Ellerbeck	Optimizing Beta-Blocker Use After Myocardial Infarction Although beta-adrenergic blockers can significantly reduce mortality after a myocardial infarction, these agents are prescribed to only a minority of patients...
American Family Physician August 1, 2004 Wiviott & Braunwald	Unstable Angina and Non-ST-Segment Elevation Myocardial Infarction: Part II. Coronary Revascularization, Hospital Discharge, and Post-Hospital Care In patients hospitalized with UA/NSTEMI, one of the most important decisions is the early strategy of care regarding coronary angiography and revascularization.
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.
American Family Physician July 15, 2000 Valerie Palda	Editorials PRE-OPportunity Knocks: A Different Way to Think About the Preoperative Evaluation...
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...
American Family Physician October 15, 2002 Mahesh Krishnan	Preoperative Care of Patients with Kidney Disease Preoperative attention to common medical problems that occur in patients with impaired renal function can lower some surgical risks.
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 15, 2005 Hanna & Wenger	Secondary Prevention of Coronary Heart Disease in Elderly Patients A review of the scientific evidence for the secondary prevention of coronary heart disease in the elderly.
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 December 1, 2000 William E. Chavey	The Importance of Beta Blockers in the Treatment of Heart Failure Traditionally, beta blockers have been considered to be contraindicated in patients with heart failure. Recently, however, several large randomized, controlled mortality trials have been stopped early because of the effects of beta blockers...
American Family Physician November 15, 2000 Tarik M. Ramahi	Beta Blocker Therapy for Chronic Heart Failure Recent studies have shown that beta blocker therapy improves survival and reduces hospitalizations in patients who have chronic heart failure and left ventricular systolic dysfunction...
American Family Physician February 1, 2005 Dickerson & Gibson	Management of Hypertension in Older Persons Antihypertensive therapy has been shown to reduce morbidity and mortality in older patients with elevated systolic or diastolic blood pressures.
American Family Physician April 1, 2001 Joan Bedinghaus	Coronary Artery Disease Prevention: What's Different for Women? Cardiovascular disease is the leading cause of death in women, as well as an important cause of disability, although many women and their physicians underestimate the risk...
American Family Physician April 1, 2006 Upchurch & Schaub	Abdominal Aortic Aneurysm Most abdominal aortic aneurysms (AAAs) are asymptomatic, not detectable on physical examination, and silent until discovered during radiologic testing for other reasons.
American Family Physician October 15, 2001 Katherine L. Margo	Spironolactone in Left-Sided Heart Failure: How Does It Fit In? The familiar diuretic spironolactone has taken on new life as a treatment for left-sided congestive heart failure. More research is necessary to determine the order and combinations of spironolactone and other medications in slowing the progression of 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
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 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...
American Family Physician January 1, 2007 Lee et al.	Vascular Surgery: An Update Caring for patients with vascular illnesses has become increasingly more complex and has changed dramatically over the past 10 years, with a widening array of diagnostic and treatment options.
American Family Physician October 15, 2006 Sharonne N. Hayes	Preventing Cardiovascular Disease in Women The American Heart Association guidelines for cardiovascular disease prevention in women provide physicians with a clear plan for assessment and treatment of cardiovascular disease risk and personalization of treatment recommendations.
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 October 1, 2002 Konzem et al.	Controlling Hypertension in Patients with Diabetes Hypertension and diabetes mellitus are common diseases in the United States. Patients with diabetes have a much higher rate of hypertension than would be expected in the general population. Regardless of the antihypertensive agent used, a reduction in blood pressure helps to prevent diabetic complications.
American Family Physician March 15, 2005 Lockman et al.	Treatment of Cholesterol Abnormalities The relationship between coronary heart disease and elevated cholesterol levels has been recognized for many years, but now studies show an improvement in patient-oriented outcomes in patients receiving drug therapy.
American Family Physician December 1, 2000 Assad Movahed	Beta Blockers and Congestive Heart Failure Heart failure is a complex condition, and its treatment requires consideration of two separate goals: symptom relief and tertiary prevention...
Nurse Practitioner September 2011 Wells & Kalman	Women & Heart Disease: Symptoms and Treatment Guidelines Coronary heart disease is the leading cause of death for women. Nurse practitioners need to educate women about their risk and follow practice guidelines.
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 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 January 15, 2002 Lori J. Mosca	Optimal Management of Cholesterol Levels and the Prevention of Coronary Heart Disease in Women Elevated levels of low-density lipoprotein cholesterol and triglycerides and low levels of high-density lipoprotein cholesterol are significant risk factors for coronary heart disease. Abundant data show inadequate utilization of lipid-lowering therapy in women...
Nursing Management May 2011 Kirsten Drake	SCIP core measures: Deep impact In August 2005, the SIP project grew to become a multiyear, national quality partnership of organizations called the Surgical Care Improvement Project, or SCIP, with the goal of decreasing surgical complication by 25% by 2010.
American Family Physician December 15, 2003 Ezekowitz et al.	Stroke: Strategies for Primary Prevention Stroke is a leading cause of morbidity and mortality. Every year, approximately 500,000 Americans have a first stroke, and approximately 20 percent die within 30 days. This article summarizes strategies that have been shown to be effective in stroke prevention.
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 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.
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.
American Family Physician October 15, 2003 Gavin et al.	Reducing Cardiovascular Disease Risk in Patients with Type 2 Diabetes By increasing patient awareness of the link between diabetes and heart disease, family physicians can encourage patients to take medications (including aspirin), stop smoking, lower blood pressure, and lower cholesterol and blood glucose levels.
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.
Managed Care June 2001 Walter Alexander	Trials Support Chronic Therapy For High-Risk Cardiovascular Patients HOPE and CURE trials find that significant reductions in major cardiovascular events are associated with ramipril and clopidogrel therapies...
American Family Physician December 1, 2004 Steven A. Dosh	Diagnosis of Heart Failure in Adults The evaluation of symptomatic patients with suspected heart failure is directed at confirming the diagnosis, determining the cause, identifying concomitant illnesses, establishing the severity of heart failure, and guiding therapy.
American Family Physician January 1, 2003 Jennifer B. Marks	Perioperative Management of Diabetes Diabetic patients who require surgery present special challenges in perioperative management. Special attention must be paid to prevention and treatment of metabolic derangements.
American Family Physician April 15, 2006 Virji & Murr	Caring for Patients After Bariatric Surgery Pulmonary emboli, anastomotic leaks, and respiratory failure account for 80% of all deaths 30 days after bariatric surgery; therefore, appropriate prophylaxis for venous thromboembolism and awareness of the symptoms of common complications are important.
American Family Physician June 15, 2002 A. Kesh Hebbar	Management of Common Arrhythmias: Part I. Supraventricular Arrhythmias Family physicians frequently encounter patients with symptoms that could be related to cardiac arrhythmias, most commonly atrial fibrillation or supraventricular tachycardias.
American Family Physician November 15, 2004 Mark H. Ebell	Prognosis for Patients Undergoing Coronary Angioplasty Several clinical decision rules have been developed and validated to estimate the likelihood of short-term, in-hospital complications such as death, myocardial infarction, and urgent coronary artery bypass graft surgery.
Nursing June 2010 Daniel A. Hussar	New drugs 2010, part 2 In this article, you'll learn about 14 recently marketed new drugs.
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.
American Family Physician December 15, 2001 Julia Tucker De Sanctis	Percutaneous Interventions for Lower Extremity Peripheral Vascular Disease Peripheral vascular disease is a common condition with variable morbidity affecting mostly men and women older than 50 years. More than 70 percent of patients diagnosed with the disease remain stable or improve with conservative management...