Despite continued improvement in risk factor recognition and aggressive medical management, heart disease remains the number one killer in the world. Medications for primary or secondary prevention of heart disease can cause unpleasant side effects leading to non-compliance. Novel therapies are needed to serve as a complement to or alternative for current medical management. Acupuncture and more specifically electroacupuncture may serve as a safe and viable option in the cardiology clinic. This review article focuses on both mechanistic and clinical studies evaluating acupuncture's effectiveness with symptomatic heart disease. Although continued research is needed, currently evidence warrants consideration of acupuncture's use with myocardial ischemia, hypertension, arrhythmias, heart failure as well as autonomic dysfunction.
Acupuncture Therapy ; Cardiology ; methods ; Electroacupuncture ; Humans

Magnetic resonance imaging (MRI) is increasingly becoming a standard of care and hence, an unmatched and irreplaceable diagnostic method. However, patients with implantable cardiac devices have not been guaranteed safety when exposed to the MRI environment. For this reason, Medtronic has taken the initiative and developed SureScan™ devices, which are MRI compatible devices for patients that would enable them to undergo MRI scans safely. The current technological developments in magnetic resonance (MR) and their clinical applications are discussed.
Cardiology ; Humans ; Magnetic Resonance Imaging* ; Methods ; Safety Management ; Standard of Care

Pulse examination was probably the earliest attempt to distinguish between health and illnesses. Starting at the pre-Hippocratic era, Chinese medicine practitioners developed techniques for pulse examination and defined pulse images based on their perceptions of pulse waveforms at the radial artery. Pulse images were described using basic variables (frequency, rhythm, wideness, length, deepness, and qualities) developed under philosophical trends such as Taoism and Confucianism. Recent advances in biomedical instrumentation applied to cardiology opened possibilities to research on pulse examination based on ancient Chinese medical theories: the pulse wave analysis. Although strongly influenced by philosophy, some characteristics used to describe a pulse image are interpretable as parameters obtained by pulse waveform analysis such as pulse wave velocity and augmentation index. Those clinical parameters reflect concepts unique to Chinese medicine - such as yinyang - while are based on wave reflection and resonance theories of fluids mechanics. Major limitations for integration of Chinese and Western pulse examination are related to quantitative description of pulse images and pattern differentiation based on pulse examination. Recent evidence suggests that wave reflection and resonance phenomena may bridge Chinese medicine and cardiology to provide a more evidence-based medical practice.
Cardiology ; Humans ; Image Processing, Computer-Assisted ; Medicine, Chinese Traditional ; Pulse ; methods ; Radial Artery ; physiology ; Wavelet Analysis

Cardiology ; methods ; Complementary Therapies ; Coronary Disease ; etiology ; therapy ; Humans ; Medicine, Chinese Traditional ; methods ; Myocardial Infarction ; therapy ; Myocardial Reperfusion ; adverse effects

Adolescent ; Cardiology ; methods ; trends ; Child ; Child, Preschool ; China ; Cost-Benefit Analysis ; methods ; Diagnostic Tests, Routine ; economics ; Female ; Humans ; Male ; Pediatrics ; methods ; trends ; Syncope, Vasovagal ; diagnosis

For the past decade, the diagnosis and treatment of coronary artery disease (CAD) has shifted from the traditional model by evaluating coronary artery stenosis with morphological imaging methods to a novel model by focusing on the detection of ischemia for risk stratification. The myocardial perfusion imaging (MPI) using stress single photon emission computed tomography (SPECT) has become the most commonly used stress imaging technique for the diagnosis and treatment of patients with suspected or known CAD. It has got strong supports, including those of the American College of Cardiology, American Heart Association, American Society of Nuclear Cardiology (ACC/AHA/ASNC) and other numerous clinical guidelines. They all stressed that the SPECT MPI is recommended to be used as the "gate keeper" to coronary angiography in order to prevent unnecessary intervention test and save the cost. However, in China the introduction and application of nuclear cardiology was late and highly unbalanced. This leads to the lack of understanding of nuclear cardiology in some clinicians, and there often is misunderstanding on correct selection of coronary angiography, cardiac CT, CT coronary angiography and others for diagnosis and treatment of CAD which results in a trend of over-application of these traditional techniques. In this article, we will focus on the status of nuclear cardiology, including SPECT, positron emission tomography (PET) MPI in the patients with CAD for the diagnosis of ischemia, risk stratification and management decision-making, and also compare it with the traditional morphological imaging techniques. In addition, we will briefly introduce the recent advances in cardiac hybrid imaging and molecular imaging. The aim of this paper is to popularize the knowledge of nuclear cardiology, and promote the rational application of nuclear cardiology in China.
Animals ; Cardiology ; methods ; trends ; Coronary Artery Disease ; diagnosis ; Humans ; Molecular Imaging ; Myocardial Perfusion Imaging ; Nuclear Medicine ; methods ; trends ; Tomography, Emission-Computed, Single-Photon ; methods

The left ventricular twist was evaluated by 2-dimensional ultrasound speckle-tracking imaging (STI) in 50 patients with hypertension with normal geometric left ventricle (LV) and 45 normal subjects as control group. The mean value of LV rotation was obtained at each plane using STI. LV twist and twist velocity were defined as apical rotation/rotation rate relative to the base respectively. To adjust the intersubject differences in heart rates, the time sequence were normalized. The results showed that peak twist developed near the end of systole. Peak LV twist was significantly higher in patients with hypertension than normal controls (P<0.001). The diastolic untwisting mainly occurred in early diastole ( approximately 38%). Compared with normal controls, untwisting rate (Untw R) in patients with hypertension was significantly reduced (P<0.001), and untwisting half-time (UHT) was significantly delayed (P<0.05). This study demonstrated that STI has a potential ability to evaluate the early change of heart function in patients with hypertension by measuring the twist of LV.
Cardiology/*methods ; Case-Control Studies ; Diastole ; Echocardiography/*methods ; Heart/physiopathology ; Heart Ventricles/*pathology ; Hypertension/*pathology ; Image Processing, Computer-Assisted/methods ; Reproducibility of Results ; Systole

P wave abnormalities are commonly found on ECG. However, they are seldom discussed and may also be neglected during ECG interpretion. In this article, we discuss two common types of P wave abnormalities, 'P mitrale' and 'P pulmonale'. The former was found in a patient with mitral valve stenosis, while the latter was from a patient with pulmonary hypertension. Echocardiography is important in evaluating the causes of P wave abnormalities.
Adult ; Anticoagulants ; therapeutic use ; Atrial Fibrillation ; diagnosis ; Cardiology ; methods ; Electrocardiography ; methods ; Exercise Tolerance ; Female ; Heart Atria ; abnormalities ; Humans ; Hypertension, Pulmonary ; diagnosis ; Male ; Middle Aged

With the increased use of cardiac implantable electronic devices (CIEDs), it is increasingly important to recognise the unique challenges involved in the management of patients with CIEDs who are undergoing surgery. Practice advisories and consensus statements have been issued by the American Society of Anesthesiologists and the Heart Rhythm Society, advocating a multidisciplinary approach. This review discusses and presents a practical approach to perioperative CIED management in the Singapore context.
Algorithms ; Bradycardia ; surgery ; Cardiac Surgical Procedures ; Cardiology ; methods ; Decision Making ; Defibrillators, Implantable ; Hemodynamics ; Humans ; Intraoperative Period ; Pacemaker, Artificial ; Preoperative Period ; Radiography, Thoracic ; methods ; Singapore

Asia, Southeastern ; Cardiology ; methods ; trends ; Cardiovascular Diseases ; diagnosis ; epidemiology ; therapy ; Heart Failure ; therapy ; Humans ; Myocardial Infarction ; therapy ; Percutaneous Coronary Intervention ; Risk Factors ; Singapore ; Stents