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Recommendations on Cardiac Imaging Radiation

Recommendations on Cardiac Imaging Radiation

The development of cardiac imaging technologies has revolutionized cardiovascular medicine by allowing for routine, non-invasive assessments of myocardial perfusion and anatomy. “Despite these advances, little evidence exists regarding the impact of radiation exposure on cardiac patients,” says Andrew J. Einstein, MD, PhD. In November 2012, a symposium sponsored by the NIH/National Heart, Lung, and Blood Institute and the National Cancer Institute was conducted to address these knowledge gaps. Dr. Einstein and other symposium participants identified key components of a framework to target critical radiation safety issues for patients, laboratories, and patients with known or suspected cardiovascular disease. Key Recommendations Several important recommendations resulted from the symposium and were published in the Journal of the American College of Cardiology. The overriding theme is to use shared decision making between providers and patients when disclosing the use of ionizing radiation. According to the recommendations, use of ionizing radiation during an imaging procedure should be disclosed to all patients by the ordering provider at the time of ordering and reinforced by the performing provider team. The recommendations also provide measures to ensure the safety and effectiveness of these imaging procedures. “A cardiac imaging procedure with an effective radiation dose of 3 mSv or less is associated with a low risk of adverse events from radiation exposure,” says Dr. Einstein. “This doesn’t require a detailed discussion from ordering physicians or written consent from patients. However, if the effective radiation dose exceeds 20 mSv, ordering physicians should have a discussion with patients about their specific radiation exposure risks and any projected cancer risks or get written informed consent from patients.” Justification for using cardiac...
HFSA 2014

HFSA 2014

New research is being presented at HFSA 2014, the 18th Annual Scientific Meeting of the Heart Failure Society of America, from September 14 to 17 in Las Vegas.   Meeting Highlights Iron & Inflammation in Pulmonary Hypertension DSE Screening Accurately Predicted post-Transplant Adverse Events Arrhythmias Common After LVAD Implantation; Did Not increase Mortality Risk Shared End-of-Life Decisions in Patients With ICDs Improving Care With Heart Failure Patient Perspectives Worsening Renal Function in Acute Heart Failure Left Ventricular End-Diastolic Pressure, STEMI, & PCI   News From HFSA 2014 Withdrawal of HF Meds Can Be Safe After Cardiotoxic Cancer Chemotherapy Pump Up: Ablation Reverses Poor LV Function in Atrial Fib MIBG Imaging Aids Risk Assessment for Congestive HF Patients Elevated CVP After LVAD Implantation Increased GI Bleeding Risk Trials Bolster Hopes New K-Binding Agents Will Prevent, Treat HF-Related Hyperkalemia William T. Abraham, MD, Discusses PARACHUTE III Results (Video) Super Bowl Sunday Shares in the Holiday HF Hazard As Used, Spironolactone Doesn’t Cut 30-Day HF Readmissions Poor Sleep, Poor HF Outcomes: Routinely Test Sleep Quality?   More From HFSA 2014 Registration Advance Program Program-at-a-Glance HFSA 2014 Meeting App CME Information Clinical Trial Row Exhibit Hall Meeting Abstracts Hyde Park Session Late-Breaking Clinical Trials Ground Transportation Hotel & Lodging Information...
Alcohol Abuse Among Physicians: Taking Control

Alcohol Abuse Among Physicians: Taking Control

Physicians, like many adults in the general public, enjoy drinking an alcoholic beverage in a socially-appropriate context when they are not taking call. But what happens when casual drinking becomes a problem? Nine out of 10 doctors recognize when they’ve reached their alcohol limit and stop drinking. However, an estimated 10% of doctors allow alcohol to adversely affect their overall well-being, health, and medical practices (1). The National Institute of Health (NIH) suggests a man—younger than 65 years of age—not have more than 14 drinks a week, and a woman—who is not pregnant or attempting to become pregnant—not exceed more than seven drinks per week (2). If you or a colleague drink more than that, an unhealthy drinking habit may be emerging. Rigorously honest self-evaluation or peer-reporting is the next necessary step to avoid developing more serious issues of alcoholism. Reporting Harmful Behaviors Benefits the Medical Community The American Medical Association (AMA) Code of Ethics, considered the most widely accepted ethics guide for physicians, requires all doctors to promote personal health and wellness and to promptly inform relevant authorities of an impaired or incompetent colleague (3). Yet, one in three (36%) physicians surveyed in a recent national poll said they’ve had firsthand knowledge of a physician struggling with drug and/or alcohol misuse and yet did nothing. Some of the reasons these surveyed doctors gave for ignoring harmful behaviors included: “someone else would take care of the problem,” “nothing would happen as a result of the report,” “fear of retribution,” and feelings of being ill-prepared to deal with an unstable colleague (4). If we are to continue safeguarding patients’ care...
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