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F J Pashkow

Publications and source records attributed to F J Pashkow.

41 records · Page 3Linked to original sources
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Rehabilitation strategies for the complex cardiac patient.

Carefully designed, monitored rehabilitation regimens can benefit patients with significant cardiac disease, such as life-threatening arrhythmias or congestive heart failure, or who have concurrent systemic disease such as diabetes. Patients with heart failure can tolerate minimal workloads but, with conditioning, they can increase their duration of exercise. Heart transplant recipients, who are usually severely deconditioned at the time of surgery, are good candidates for a comprehensive rehabilitation program; some have progressed to competition-level athletic achievements. Rehabilitation is safe for patients with arrhythmias, given appropriate monitoring, and can contribute to enhanced quality of life. Objective measures are needed to distinguish between symptomatic and functional improvement.

Electrocardiography↗
PubMedDate not supplied

Diagnostic evaluation of the patient with coronary artery disease.

BACKGROUND: Evaluation of patients with possible coronary artery disease is a challenge to clinicians who face conflicting pressures in the current practice environment. Sensitivity, accuracy, cost, and access have become considerations in the appropriate selection of diagnostic studies. OBJECTIVE: To review and compare the strengths and shortcomings of commonly employed noninvasive techniques for diagnosing coronary artery disease. DISCUSSION: The patient's history is still key in establishing a diagnosis. Exercise electrocardiography (ECG) is not as sensitive or specific as exercise echocardiography or radionuclide studies, but it is relatively inexpensive and accessible. Further, new criteria for interpreting the results of exercise ECG may improve its diagnostic accuracy. The predictive value of any test increases in populations where the prevalence of disease is higher, as in patients with known risk factors for coronary artery disease. Patients who cannot exercise or who have concomitant conditions that obscure the results of exercise ECG are candidates for other diagnostic techniques. CONCLUSION: Rational diagnostic plans for evaluating patients who may have coronary disease can be developed on the basis of existing information and reported experience.

Coronary Disease↗
PubMedDate not supplied

Cardiac rehabilitation: not just exercise anymore.

SUMMARY: The treatment of older and sicker patients and decreasing length of stays are forcing a rethinking of approaches to cardiac rehabilitation. As a result, cardiac rehabilitation programs are becoming more flexible, emphasizing life-style changes and psychosocial support to meet patient needs. KEY POINTS: Today's rehabilitation patients are likely to be older and to stay in the hospital fewer days than patients in the past, and they may have congestive heart failure or be candidates for cardiac transplantation. Newer therapies, such as angioplasty, result in some patients being diagnosed, treated, and discharged quickly. These patients often do not stay in the hospital long enough to undergo the first phase of cardiac rehabilitation. With the decreasing length of stays for most cardiac events, it is not reasonable to expect that inpatient rehabilitation will produce tangible improvement in physical capacity or significant retention of information and instructions. Rehabilitation programs need to be changed accordingly. Low-risk patients undergoing angioplasty may still need cardiac rehabilitation to decrease the risk of restenosis and to reduce cardiac risk factors. Programs that include aggressive risk-factor modification may produce regression in stenosis of coronary arteries, but compliance is difficult to elicit and maintain.

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