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  1. Fulltext The Principles of Hearable Photoplethysmography Analysis and Applications in Physiological Monitoring-A Review
    Azudin K, Gan KB, Jaafar R, Ja'afar MH
    Sensors (Basel), 2023 Jul 18;23(14).
    PMID: 37514778 DOI: 10.3390/s23146484
    Not long ago, hearables paved the way for biosensing, fitness, and healthcare monitoring. Smart earbuds today are not only producing sound but also monitoring vital signs. Reliable determination of cardiovascular and pulmonary system information can explore the use of hearables for physiological monitoring. Recent research shows that photoplethysmography (PPG) signals not only contain details on oxygen saturation level (SPO2) but also carry more physiological information including pulse rate, respiration rate, blood pressure, and arterial-related information. The analysis of the PPG signal from the ear has proven to be reliable and accurate in the research setting. (1) Background: The present integrative review explores the existing literature on an in-ear PPG signal and its application. This review aims to identify the current technology and usage of in-ear PPG and existing evidence on in-ear PPG in physiological monitoring. This review also analyzes in-ear (PPG) measurement configuration and principle, waveform characteristics, processing technology, and feature extraction characteristics. (2) Methods: We performed a comprehensive search to discover relevant in-ear PPG articles published until December 2022. The following electronic databases: Institute of Electrical and Electronics Engineers (IEEE), ScienceDirect, Scopus, Web of Science, and PubMed were utilized to conduct the studies addressing the evidence of in-ear PPG in physiological monitoring. (3) Results: Fourteen studies were identified but nine studies were finalized. Eight studies were on different principles and configurations of hearable PPG, and eight studies were on processing technology and feature extraction and its evidence in in-ear physiological monitoring. We also highlighted the limitations and challenges of using in-ear PPG in physiological monitoring. (4) Conclusions: The available evidence has revealed the future of in-ear PPG in physiological monitoring. We have also analyzed the potential limitation and challenges that in-ear PPG will face in processing the signal.
    Matched MeSH terms: Heart Rate
  2. Fulltext Toward a Roadmap for Best Practices in Pediatric Preventive Cardiology: A Science Advisory From the American Heart Association
    Perak AM, Baker-Smith C, Hayman LL, Khoury M, Peterson AL, Ware AL, et al.
    Circ Cardiovasc Qual Outcomes, 2023 Sep;16(9):e000120.
    PMID: 37548024 DOI: 10.1161/HCQ.0000000000000120
    Cardiovascular disease risk factors are highly prevalent among youth in the United States and Canada. Pediatric preventive cardiology programs have independently developed and proliferated to address cardiovascular risk factors in youth, but there is a general lack of clarity on best practices to optimize and sustain desired outcomes. We conducted surveys of pediatric cardiology division directors and pediatric preventive cardiology clinicians across the United States and Canada to describe the current landscape and perspectives on future directions for the field. We summarize the data and conclude with a call to action for various audiences who seek to improve cardiovascular health in youth, reduce the burden of premature cardiovascular disease, and increase healthy longevity. We call on heart centers, hospitals, payers, and policymakers to invest resources in the important work of pediatric preventive cardiology programs. We urge professional societies to advocate for pediatric preventive cardiology and provide opportunities for training and cross-pollination across programs. We encourage researchers to close evidence gaps. Last, we invite pediatric preventive cardiology clinicians to collaborate and innovate to advance the practice of pediatric preventive cardiology.
    Matched MeSH terms: American Heart Association
  3. Fulltext Improving perception and confidence towards bystander cardiopulmonary resuscitation and public access automated external defibrillator program: how does training program help?
    Liaw SY, Chew KS, Zulkarnain A, Wong SSL, Singmamae N, Kaushal DN, et al.
    Int J Emerg Med, 2020 Mar 17;13(1):13.
    PMID: 32183687 DOI: 10.1186/s12245-020-00271-3
    BACKGROUND: In conjunction with an automated external defibrillator (AED) placement program at various locations within a public university in Malaysia, a series of structured training programs were conducted. The objectives of this study is to (1) evaluate the effectiveness of a structured training program in improving the perception of the importance of AED and cardiopulmonary resuscitation (CPR), (2) evaluate the confidence of the employees in using an AED and performing bystander CPR, (3) identify the fears and concerns of these employees in using AED and performing CPR, and (4) determine the perception of these employees towards the strategy of the AEDs placed at various locations within the university.

    METHODS: In this single-center observational study, a validated questionnaire aimed to assess the university employees' attitude and confidence in handling AED and performing CPR before (pre-test) and immediately after (post-test) the training program was conducted.

    RESULTS: A total of 184 participants participated in this study. Using the Wilcoxon signed-rank test, the training programs appeared to have improved the perception that "using AED is important for unresponsive victims" (z = 4.32, p 

    Matched MeSH terms: Heart Arrest
  4. Fulltext Confirmatory Factor Analysis of the Malay Version of the Confusion, Hubbub and Order Scale (CHAOS-6) among Myocardial Infarction Survivors in a Malaysian Cardiac Healthcare Facility
    Ganasegeran K, Selvaraj K, Rashid A
    Malays J Med Sci, 2017 Aug;24(4):39-46.
    PMID: 28951688 DOI: 10.21315/mjms2017.24.4.5
    BACKGROUND: The six item Confusion, Hubbub and Order Scale (CHAOS-6) has been validated as a reliable tool to measure levels of household disorder. We aimed to investigate the goodness of fit and reliability of a new Malay version of the CHAOS-6.

    METHODS: The original English version of the CHAOS-6 underwent forward-backward translation into the Malay language. The finalised Malay version was administered to 105 myocardial infarction survivors in a Malaysian cardiac health facility. We performed confirmatory factor analyses (CFAs) using structural equation modelling. A path diagram and fit statistics were yielded to determine the Malay version's validity. Composite reliability was tested to determine the scale's reliability.

    RESULTS: All 105 myocardial infarction survivors participated in the study. The CFA yielded a six-item, one-factor model with excellent fit statistics. Composite reliability for the single factor CHAOS-6 was 0.65, confirming that the scale is reliable for Malay speakers.

    CONCLUSION: The Malay version of the CHAOS-6 was reliable and showed the best fit statistics for our study sample. We thus offer a simple, brief, validated, reliable and novel instrument to measure chaos, the Skala Kecelaruan, Keriuhan & Tertib Terubahsuai (CHAOS-6), for the Malaysian population.

    Matched MeSH terms: Heart
  5. Olanzapine Induced Dilated Cardiomyopathy
    Puttegowda B, Theodore J, Basappa R, Nanjappa MC
    Malays J Med Sci, 2016 Mar;23(2):82-4.
    PMID: 27547120
    A 28-year-old male patient with bipolar disorder taking olanzapine and lorazepam for almost 10 years presented with weight gain, diabetes, and anasarca was examined in this study. Evaluation of the patient revealed he was in heart failure. The reason for his heart failure was ambiguous and an investigation into it revealed negative results. Literature search conducted showed a few reported cases of putative olanzapine induced cardiomyopathy. One such relatively rare case is presented here.
    Matched MeSH terms: Heart Failure
  6. Improving detection of obstructive sleep apnoea by overnight oximetry in children using pulse rate parameters
    Sahadan DZ, Davey MJ, Horne RS, Nixon GM
    Sleep Breath, 2015 Dec;19(4):1409-14.
    PMID: 25739713 DOI: 10.1007/s11325-014-1108-4
    PURPOSE: Overnight oximetry is a simple tool for investigation of obstructive sleep apnoea (OSA) in children, but only severe cases will be detected, and children with obstructive events resulting in arousal, but not desaturation, will have a normal (inconclusive) result. We hypothesised that pulse rate rises using pulse rate indices per hour (PRI) and pulse rate standard deviation (PR-SD) automatically calculated from commercially available software would improve oximetry as a diagnostic tool.

    METHODS: Children having home overnight oximetry for suspected OSA were identified over 12 months, and those with a normal result who went on to have polysomnography (PSG) were included. Oximetry, including PR-SD and PRI (rises of 8, 10 and 15 beats/min per hour), was analyzed using commercially available software. PR parameters were compared between those with OSA (obstructive apnoea-hypopnoea index (OAHI) >1 event/h) and those without OSA.

    RESULTS: One hundred sixteen children had normal oximetry, of whom 93 (median age 4.5 years; 55 % M) had PSG. Fifty-seven of 93 (61 %) children had OSA (median OAHI 4.5 events/h, range 1.1-24). PR-SD was not different between the OSA and non-OSA groups (p = 0.87). PRI tended to be higher in those with OSA, but there was considerable overlap between the groups: PRI-8 (mean ± SD 58.5 ± 29.0/h in OSA group vs 48.6 ± 20.2/h in non-OSA group, p = 0.07), PRI-10 (45.1 ± 25.0 vs 36.2 ± 16.7, p = 0.06) and PRI-15 (24.4 ± 14.5 vs 18.9 ± 9.0, p = 0.04). A PRI-15 threshold of >35/h had specificity of 97 % for OSA.

    CONCLUSION: The PRI-15 shows promise as an indicator of OSA in children with normal oximetry.

    Matched MeSH terms: Heart Rate*
  7. Fulltext The effect of wearing sanitary napkins of different thicknesses on physiological and psychological responses in Muslim females
    Mohamed NG, Abidin NZ, Law KS, Abe M, Suzuki M, Muhamed AM, et al.
    J Physiol Anthropol, 2014;33:28.
    PMID: 25189184 DOI: 10.1186/1880-6805-33-28
    Menstruation is associated with significant unpleasantness, and wearing a sanitary napkin (SN) during menses causes discomfort. In addition, many Muslim women use a thick type of SN during menses due to the religious requirement that even disposable SNs be washed before disposal. Therefore, the objective of this study was to measure the physiological and psychological responses to wearing SNs of different thicknesses during menstruation and non-menstruation phases at rest and during physical activity/exercise among Muslim women.
    Matched MeSH terms: Heart Rate/physiology*
  8. Strategy for ventricular septal defect closure after prior gastric pull-through
    Sivalingam S, Krishnasamy S, Yakub MA
    Asian Cardiovasc Thorac Ann, 2015 Jun;23(5):612-4.
    PMID: 24962807 DOI: 10.1177/0218492314540667
    A 9-year-old boy was referred with a perimembranous ventricular septal defect. At birth, he had undergone a right thoracotomy with ligation of a tracheoesophageal fistula, cervical esophagostomy, and feeding gastrostomy. At 2 years of age, he had gastric tube reconstruction with a pull-through retrosternally, anterior to the heart, and an end-to-end esophagogastric anastomosis. Via a right anterolateral thoracotomy through the previous scar, the entire gastric tube was mobilized away from the sternum to facilitate a median sternotomy. With the patient supine, a median sternotomy was performed without difficulty, and the ventricular septal defect was closed under cardiopulmonary bypass.
    Matched MeSH terms: Heart Septal Defects, Ventricular/surgery*
  9. Effect of glyphosate-based herbicide on early life stages of Java medaka (Oryzias javanicus): a potential tropical test fish
    Yusof S, Ismail A, Alias MS
    Mar Pollut Bull, 2014 Aug 30;85(2):494-8.
    PMID: 24731878 DOI: 10.1016/j.marpolbul.2014.03.022
    Glyphosate is globally a widely used herbicide, yet there is little information on their toxicity to marine fishes. Java medaka, a small tropical fish native to coastal areas in several Southeast Asian countries, is viewed as a suitable candidate for toxicity test and thus was used for this study. Java medaka adults were cultured in the laboratory and the fertilized eggs of the F2 generation were exposed to different concentrations of glyphosate-based herbicide (100, 200, 300, 400 and 500 ppm) until they hatched. The survival and hatching rates of the embryos, changes in the heart rate and morphological impairments were recorded. Generally, survival and hatching percentage decreased as glyphosate concentration increased. Absence of pectoral fin(s) and cornea, permanently bent tail, irregular shaped abdomen, and cell disruption in the fin, head and abdomen are among the common teratogenic effects observed. Furthermore, risk factor also increased with the increased in glyphosate concentrations.
    Matched MeSH terms: Heart Rate/drug effects
  10. Pediatric resident resuscitation skills improve after "rapid cycle deliberate practice" training
    Hunt EA, Duval-Arnould JM, Nelson-McMillan KL, Bradshaw JH, Diener-West M, Perretta JS, et al.
    Resuscitation, 2014 Jul;85(7):945-51.
    PMID: 24607871 DOI: 10.1016/j.resuscitation.2014.02.025
    Previous studies reveal pediatric resident resuscitation skills are inadequate, with little improvement during residency. The Accreditation Council for Graduate Medical Education highlights the need for documenting incremental acquisition of skills, i.e., "Milestones". We developed a simulation-based teaching approach "Rapid Cycle Deliberate Practice" (RCDP) focused on rapid acquisition of procedural and teamwork skills (i.e., "first-five minutes" (FFM) resuscitation skills). This novel method utilizes direct feedback and prioritizes opportunities for learners to "try again" over lengthy debriefing.
    Matched MeSH terms: Heart Arrest/therapy*
  11. Automated identification of normal and diabetes heart rate signals using nonlinear measures
    Rajendra Acharya U, Faust O, Adib Kadri N, Suri JS, Yu W
    Comput Biol Med, 2013 Oct;43(10):1523-9.
    PMID: 24034744 DOI: 10.1016/j.compbiomed.2013.05.024
    Diabetes mellitus (DM) affects considerable number of people in the world and the number of cases is increasing every year. Due to a strong link to the genetic basis of the disease, it is extremely difficult to cure. However, it can be controlled to prevent severe consequences, such as organ damage. Therefore, diabetes diagnosis and monitoring of its treatment is very important. In this paper, we have proposed a non-invasive diagnosis support system for DM. The system determines whether or not diabetes is present by determining the cardiac health of a patient using heart rate variability (HRV) analysis. This analysis was based on nine nonlinear features namely: Approximate Entropy (ApEn), largest Lyapunov exponet (LLE), detrended fluctuation analysis (DFA) and recurrence quantification analysis (RQA). Clinically significant measures were used as input to classification algorithms, namely AdaBoost, decision tree (DT), fuzzy Sugeno classifier (FSC), k-nearest neighbor algorithm (k-NN), probabilistic neural network (PNN) and support vector machine (SVM). Ten-fold stratified cross-validation was used to select the best classifier. AdaBoost, with least squares (LS) as weak learner, performed better than the other classifiers, yielding an average accuracy of 90%, sensitivity of 92.5% and specificity of 88.7%.
    Matched MeSH terms: Heart Rate/physiology*
  12. Fulltext Effects of extracts and fractions of Gynura procumbens on rat atrial contraction
    Abrika OS, Yam MF, Asmawi MZ, Sadikun A, Dieng H, Hussain EA
    J Acupunct Meridian Stud, 2013 Aug;6(4):199-207.
    PMID: 23972242 DOI: 10.1016/j.jams.2013.01.020
    There is currently a great deal of research interest in utilizing plant compounds against human diseases, including hypertension. The present study investigated the effects of different extracts and fractions from leaves of Gynura procumbens Merr. on rat atrial contraction in vitro. Isolated left and right atria, mounted in a 20-ml organ bath, were allowed to equilibrate for 15 min before the application of the extracts or fractions. The extracts (petroleum-ether extract (PE) and methanol extract (ME)) and the fractions (chloroform fraction (CHL), ethyl-acetate fraction (EA), n-butanol fraction (NB) and water fraction (WA) of the methanol extract) were tested at three concentrations (0.25, 0.5 and 1.0 mg/ml), with a β-adrenergic agonist (isoprenaline) as a control. All data on contraction responses were log-transformed and analyzed. When exposed to the different extracts, both atria tended to exhibit greater contractive responses with the NB whereas cardiac contractions had a tendency to be reduced with most other extracts. For a given extract, the contraction responses were particularly greater at 0.5 mg/ml for the right atrium and at 1 mg/ml for the left atrium. Further analysis focusing on the NB fraction revealed that positive inotropism was greater in left atria exposed to highly-concentrated F2 and F3 sub-fractions. Taken together, our results suggest that NB extracts and fractions from the G. procumbens-leaf methanol extract have positive inotropic activities and, hence, can be considered as an alternative/traditional medicine against increased blood pressure in humans or can be used in strategies aimed at finding antihypertensive biomolecules from an accessible source.
    Matched MeSH terms: Heart Atria/drug effects*
  13. Fulltext Prevalence and quantification of Listeria monocytogenes in chicken offal at the retail level in Malaysia
    Kuan CH, Goh SG, Loo YY, Chang WS, Lye YL, Puspanadan S, et al.
    Poult Sci, 2013 Jun;92(6):1664-9.
    PMID: 23687164 DOI: 10.3382/ps.2012-02974
    A total of 216 chicken offal samples (chicken liver = 72; chicken heart = 72; chicken gizzard = 72) from wet markets and hypermarkets in Selangor, Malaysia, were examined for the presence and density of Listeria monocytogenes by using a combination of the most probable number and PCR method. The prevalence of L. monocytogenes in 216 chicken offal samples examined was 26.39%, and among the positive samples, the chicken gizzard showed the highest percentage at 33.33% compared with chicken liver (25.00%) and chicken heart (20.83%). The microbial load of L. monocytogenes in chicken offal samples ranged from <3 to 93.0 most probable number per gram. The presence of L. monocytogenes in chicken offal samples may indicate that chicken offal can act as a possible vehicle for the occurrence of foodborne listeriosis. Hence, there is a need to investigate the biosafety level of chicken offal in Malaysia.
    Matched MeSH terms: Heart/microbiology
  14. Fulltext Value of Shock Index in prognosticating the short-term outcome of death for patients presenting with severe sepsis and septic shock in the emergency department
    Yussof SJM, Zakaria MI, Mohamed FL, Bujang MA, Lakshmanan S, Asaari AH
    Med J Malaysia, 2012 Aug;67(4):406-11.
    PMID: 23082451
    INTRODUCTION: The importance of early recognition and treatment of sepsis and its effects on short-term survival outcome have long been recognized. Having reliable indicators and markers that would help prognosticate the survival of these patients is invaluable and would subsequently assist in the course of effective dynamic triaging and goal directed management.
    STUDY OBJECTIVES: To determine the prognosticative value of Shock Index (SI), taken upon arrival to the emergency department and after 2 hours of resuscitation on the shortterm outcome of severe sepsis and septic shock patients.
    METHODOLOGY: This is a retrospective observational study involving 50 patients admitted to the University of Malaya Medical Centre between June 2009 and June 2010 who have been diagnosed with either severe sepsis or septic shock. Patients were identified retrospectively from the details recorded in the registration book of the resuscitation room. 50 patients were selected for this pilot study. The population comprised 19 males (38%) and 31 females (62%). The median (min, max) age was 54.5 (17.0, 84.0) years. The number of severe sepsis and septic shock cases were 31 (62%), and 19 (38%) respectively. There were 17 (34%) cases of pneumonias, 13 (26%) cases of urological sepsis, 8 (16%) cases of gastro intestinal tract related infections and 12 (24%) cases of other infections. There were a total of 23 (46%) survivors and 27 (54%) deaths. The value of the shock index is defined as systolic blood pressure divided by heart rate was calculated. Shock Index on presentation to ED (SI 1) and after 2 hours of resuscitation in the ED (SI 2). The median, minimum and maximum variables were tested using Mann-Whitney U and Chi square analysis. The significant parameters were re-evaluated for sensitivity, specificity and cut-off points. ROC curves and AUC values were generated among these variables to assess prognostic utility for outcome.
    RESULTS: Amongst all 7 variables tested, 2 were tested to be significant (p: < 0.05). From the sensitivity, specificity and ROC analysis, the best predictor for death was (SI 2) with a sensitivity of 80.8%, specificity of 79.2%, AUC value of 0.8894 [CI 95 0.8052, 0.9736] at a cut-off point of > or = 1.0.
    CONCLUSION: (SI 2) may potentially be utilized as a reliable predictor for death in patients presenting with septic shock and severe sepsis in an emergency department. This parameters should be further analyzed in a larger scale prospective study to determine its validity.
    Matched MeSH terms: Heart Rate*
  15. Myocardial ischaemic time and its relation with left ventricular ejection fraction after single valve replacement
    Izham IN, Zamrin DM, Joanna OS, Ramzisham AR, Hairolfaizi H, Ishamuddin IM, et al.
    Clin Ter, 2011;162(6):521-5.
    PMID: 22262321
    The effect of the duration of ischaemic myocardial time to left ventricular ejection fraction (LVEF) after valve replacement surgery has been attributed. This study aims to look at the correlation between myocardial ischaemic time and changes LVEF post valve replacement surgery up to 6 months period.
    Matched MeSH terms: Heart Valve Prosthesis Implantation*
  16. Fulltext Antepartum fetal heart rate feature extraction and classification using empirical mode decomposition and support vector machine
    Krupa N, Ali M, Zahedi E, Ahmed S, Hassan FM
    Biomed Eng Online, 2011;10:6.
    PMID: 21244712 DOI: 10.1186/1475-925X-10-6
    Cardiotocography (CTG) is the most widely used tool for fetal surveillance. The visual analysis of fetal heart rate (FHR) traces largely depends on the expertise and experience of the clinician involved. Several approaches have been proposed for the effective interpretation of FHR. In this paper, a new approach for FHR feature extraction based on empirical mode decomposition (EMD) is proposed, which was used along with support vector machine (SVM) for the classification of FHR recordings as 'normal' or 'at risk'.
    Matched MeSH terms: Heart Rate, Fetal/physiology*
  17. Fulltext Translating knowledge to attitude: a survey on the perception of bystander cardiopulmonary resuscitation among dental students in Universiti Sains Malaysia and school teachers in Kota Bharu, Kelantan
    Chew KS, Yazid MN, Kamarul BA, Rashidi A
    Med J Malaysia, 2009 Sep;64(3):205-9.
    PMID: 20527268
    This voluntary, anonymous questionnaire survey was performed to assess the willingness of Basic Life Support (BLS) participants to perform bystander cardiopulmonary resuscitation (CPR). A total of 55 dental students and 73 school teachers were assessed on their willingness to perform bystander CPR after completion of their BLS training. In general, only 29.0% of the total 128 participants said that they would offer to perform CPR under any cardiac arrest condition and 69.0% said that they would just offer to call the ambulance but they would not offer to perform CPR. When analyzed separately, only 16.4% of school teachers said that they would perform CPR as compared to 45.5% of dental students (p < 0.001). Knowing how to perform CPR does not necessarily translate into willingness to perform CPR.
    Matched MeSH terms: Heart Arrest/therapy*
  18. Newborn seizure detection based on heart rate variability
    Malarvili MB, Mesbah M
    IEEE Trans Biomed Eng, 2009 Nov;56(11):2594-603.
    PMID: 19628449 DOI: 10.1109/TBME.2009.2026908
    In this paper, we investigate the use of heart rate variability (HRV) for automatic newborn seizure detection. The proposed method consists of a sequence of processing steps, namely, obtaining HRV from the ECG, extracting a discriminating HRV feature set, selecting an optimal subset from the full feature set, and, finally, classifying the HRV into seizure/nonseizure using a supervised statistical classifier. Due to the fact that HRV signals are nonstationary, a set of time-frequency features from the newborn HRV is proposed and extracted. In order to achieve efficient HRV-based automatic newborn seizure detection, a two-phase wrapper-based feature selection technique is used to select the feature subset with minimum redundancy and maximum class discriminability. Tested on ECG recordings obtained from eight newborns with identified EEG seizure, the proposed HRV-based neonatal seizure detection algorithm achieved 85.7% sensitivity and 84.6% specificity. These results suggest that the HRV is sensitive to changes in the cardioregulatory system induced by the seizure, and therefore, can be used as a basis for an automatic seizure detection.
    Matched MeSH terms: Heart Rate/physiology*
  19. Cystic tumor of papillary muscle of heart: a rare finding in sudden death
    Murty OP
    Am J Forensic Med Pathol, 2009 Jun;30(2):201-3.
    PMID: 19465820 DOI: 10.1097/PAF.0b013e31819d9af5
    Primary cystic tumors of papillary muscles of the heart are extremely rare. Here, one case of unusual cystic tumor in papillary muscle of the heart in a 37-year-old Myanmar migrant worker has been reported. He came to Malaysia 2 weeks before and one morning was found dead in sleep. Autopsy revealed cystic lesion in the papillary muscle of the mitral valve of heart, which was prolapsing into ventricular cavity. The cyst had white-jelly like sticky mucus material. The cyst was present in papillary muscle with slight invasion in septum area; it was lined by cuboidal-columnar epithelium and contained mucinous contents. There was no evidence of an inflammatory reaction in the cyst and in cardiac muscles. In addition to cystic neoplasm, the deceased also had histoplasmosis of the lungs. The case is presented with macroscopic and microscopic photographs of the cyst and histoplasmosis of the lungs. This case is reported because of its rarity, unique position, and unusual appearance.
    Matched MeSH terms: Heart Septum/pathology
  20. Mediastinal irradiation and its effect on the cardiovascular system
    Tang D, Peng EW, Giri D, Chowdhary M, Sarkar P
    Br J Hosp Med (Lond), 2009 Apr;70(4):222-4.
    PMID: 19357601 DOI: 10.12968/hmed.2009.70.4.41626
    Mediastinal irradiation for various malignancies can cause radiation injury to mediastinal structures, most importantly the cardiovascular system. This article reviews the effect of radiation on cardiovascular structures and the manifestations of various radiation-induced heart diseases.
    Matched MeSH terms: Heart Diseases/etiology*
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