Innovations in non-invasive cardiovascular diagnostics

The interplay of nursing, pharmacy, health records, and emergency care in cardiology

https://doi.org/10.53730/ijhs.v2nS1.15055

Authors

  • Mohammad Abdullah Almanna KSA, National Guard Health Affairs
  • Dhiyaa Manawer Alanazi KSA, National Guard Health Affairs
  • Badour Subhi Alaujan KSA, National Guard Health Affairs
  • Bander Ahmad Zamzami KSA, National Guard Health Affairs
  • Nouf Hamed Alanazi KSA, National Guard Health Affairs
  • Reem Sultan Alshaibani KSA, National Guard Health Affairs
  • Salwa Rashed Alowaidan KSA, National Guard Health Affairs
  • Albandary Falah Alharbi KSA, National Guard Health Affairs
  • Khaled Abdul Rahman Suleiman Al-Rashudi KSA, National Guard Health Affairs

Keywords:

Cardiovascular Disease, Person-Centered Care, Multimorbidity, Healthcare Systems, Evidence-Based Practice, Chronic Illness Management

Abstract

Background _ Cardiovascular disease remains the leading cause of mortality and disability in the United States and globally. Despite technological advancements that have improved life expectancy and quality of life, the prevalence of cardiovascular diseases continues to rise, often associated with aging populations experiencing multiple chronic conditions. Current clinical guidelines often neglect the complexity of multimorbidity and the intricacies of healthcare systems, making their practical implementation challenging. Moreover, care plans frequently fail to consider individual preferences, cultures, and lifestyles that shape a person's social and environmental context, hindering acceptance and effectiveness, particularly among high-risk populations. Aim of Work – The objective of this scientific statement is to provide a comprehensive overview of person-centered care delivery models for specific cardiovascular disorders, emphasizing the features and documented outcomes of these approaches. Methods – A scoping study was conducted using a systematic search of databases including Ovid MEDLINE, Embase.com, Web of Science, CINAHL Complete, Cochrane Central Register of Controlled Trials via Ovid, and ClinicalTrials.gov, covering the period from 2010 to 2017. Various research designs were included that specifically assessed care delivery methods for targeted cardiovascular diseases. 

Downloads

Download data is not yet available.

References

Benjamin EJ, Blaha MJ, Chiuve SE, Cushman M, Das SR, Deo R, De Ferranti SD, Floyd J, Fornage M, Gillespie C, Isasi CR. Heart disease and stroke statistics—2017 update: a report from the American Heart Association. circulation. 2017 Mar 7;135(10):e146-603. DOI: https://doi.org/10.1161/CIR.0000000000000491

Roth GA, Johnson C, Abajobir A, Abd-Allah F, Abera SF, Abyu G, Ahmed M, Aksut B, Alam T, Alam K, Alla F. Global, regional, and national burden of cardiovascular diseases for 10 causes, 1990 to 2015. Journal of the American college of cardiology. 2017 Jul 4;70(1):1-25.

Fonarow GC, Stevenson LW, Walden JA, Livingston NA, Steimle AE, Hamilton MA, Moriguchi J, Tillisch JH, Woo MA. Impact of a comprehensive heart failure management program on hospital readmission and functional status of patients with advanced heart failure. Journal of the American College of Cardiology. 1997 Jul;30(3):725-32. DOI: https://doi.org/10.1016/S0735-1097(97)00208-8

Ekman, I, Swedberg, K, Taft, C, Lindseth, A, Norberg, A, Brink, E, Carlsson, J, Dahlin-Ivanoff, S, Johansson, IL, Kjellgren, K, et al. Person-centered care: ready for prime time. Eur J Cardiovasc Nurs. 2011;10:248–251. doi: 10.1016/j.ejcnurse.2011.06.008 DOI: https://doi.org/10.1016/j.ejcnurse.2011.06.008

Writing Group Members, Roger VL, Go AS, Lloyd-Jones DM, Benjamin EJ, Berry JD, Borden WB, Bravata DM, Dai S, Ford ES, Fox CS. Heart disease and stroke statistics—2012 update: a report from the American Heart Association. Circulation. 2012 Jan 3;125(1):e2-20. DOI: https://doi.org/10.1161/CIR.0b013e31823ac046

Dickens C. Exploring Self-care Among Low Socioeconomic Status Heart Failure Patients: A Mixed Methods Study (Doctoral dissertation, University of Illinois at Chicago). 2017.

Briar-Lawson K, Lawson HA. Families as experts and partners in the development, implementation, and evaluation of family-centered policies and practices. InFamily-centered policies and practices: International implications 2001 Dec 31 (pp. 185-212). Columbia University Press. DOI: https://doi.org/10.7312/bria12106-008

Oestmann ER. Program evaluation of the Mutual Expectation Method of Motivation (MEMOM) as measured by net profit and nursing turnover change from 2000 to 2004 in community nonprofit hospitals. Capella University; 2006.

Kessler, C, Tsipis, NE, Seaberg, D, Walker, GN, Andolsek, K. Transitions of care in an era of healthcare transformation. J Healthc Manag. 2016;61:230–241. DOI: https://doi.org/10.1097/00115514-201605000-00011

Vidrine JI, Shete S, Cao Y, Greisinger A, Harmonson P, Sharp B, Miles L, Zbikowski SM, Wetter DW. Ask-Advise-Connect: a new approach to smoking treatment delivery in health care settings. JAMA Internal Medicine. 2013 Mar 25;173(6):458-64. DOI: https://doi.org/10.1001/jamainternmed.2013.3751

Coulter, A, Oldham, J. Person-centred care: what is it and how do we get there? Future Hosp J. 2016;3:114–116. doi: 10.7861/futurehosp.3-2-114 DOI: https://doi.org/10.7861/futurehosp.3-2-114

Flegal KM, Ogden CL, Wei R, Kuczmarski RL, Johnson CL. Prevalence of overweight in US children: comparison of US growth charts from the Centers for Disease Control and Prevention with other reference values for body mass index. The American journal of clinical nutrition. 2001 Jun 1;73(6):1086-93. DOI: https://doi.org/10.1093/ajcn/73.6.1086

Krumholz, HM, Currie, PM, Riegel, B, Phillips, CO, Peterson, ED, Smith, R, Yancy, CW, Faxon, DP; on behalf of the American Heart Association Disease Management Taxonomy Writing Group. A taxonomy for disease management: a scientific statement from the American Heart Association Disease Management Taxonomy Writing Group. Circulation. 2006;114:1432–1445. doi: 10.1161/CIRCULATIONAHA.106.177322 DOI: https://doi.org/10.1161/CIRCULATIONAHA.106.177322

Pina, IL, Cohen, PD, Larson, DB, Marion, LN, Sills, MR, Solberg, LI, Zerzan, J. A framework for describing health care delivery organizations and systems. Am J Public Health. 2015;105:670–679. doi: 10.2105/AJPH.2014.301926 DOI: https://doi.org/10.2105/AJPH.2014.301926

Gaffney A, McCormick D. The Affordable Care Act: implications for health-care equity. The Lancet. 2017 Apr 8;389(10077):1442-52. DOI: https://doi.org/10.1016/S0140-6736(17)30786-9

McClellan, M, McKethan, AN, Lewis, JL, Roski, J, Fisher, ES. A national strategy to put accountable care into practice. Health Aff (Millwood). 2010;29:982–990. doi: 10.1377/hlthaff.2010.0194 DOI: https://doi.org/10.1377/hlthaff.2010.0194

McCormack B. A conceptual framework for person‐centred practice with older people. International journal of nursing practice. 2003 Jun;9(3):202-9. DOI: https://doi.org/10.1046/j.1440-172X.2003.00423.x

Eamer GJ. Systematic reviews of surgical comprehensive geriatric assessment and assessment of drivers of cost in elderly emergency surgery patients. 2017.

Ekman, I, Busse, R, van Ginneken, E, Van Hoof, C, van Ittersum, L, Klink, A, Kremer, JA, Miraldo, M, Olauson, A, De Raedt, W, et al. Health-care improvements in a financially constrained environment. Lancet. 2016;387:646–647. doi: 10.1016/S0140-6736(16)00285-3 DOI: https://doi.org/10.1016/S0140-6736(16)00285-3

Ekman, I, Busse, R, Van Hoof, C, Klink, A, Kremer, JA, Miraldo, M, Olauson, A, Rosen-Zvi, M, Smith, P, Swedberg, K, et al. WE CARE Consortium: strategy plan and R&D roadmap. 2015.

Butler J, Binney Z, Kalogeropoulos A, Owen M, Clevenger C, Gunter D, Georgiopoulou V, Quest T. Advance directives among hospitalized patients with heart failure. JACC: Heart Failure. 2015 Feb;3(2):112-21. DOI: https://doi.org/10.1016/j.jchf.2014.07.016

Dunlay SM, Redfield MM, Weston SA, Therneau TM, Hall Long K, Shah ND, Roger VL. Hospitalizations after heart failure diagnosis: a community perspective. Journal of the American College of Cardiology. 2009 Oct 27;54(18):1695-702. DOI: https://doi.org/10.1016/j.jacc.2009.08.019

Babineau J. Product review: Covidence (systematic review software). Journal of the Canadian Health Libraries Association/Journal de l'Association des bibliothèques de la santé du Canada. 2014 Aug 1;35(2):68-71. DOI: https://doi.org/10.5596/c14-016

Jaffe, MG, Lee, GA, Young, JD, Sidney, S, Go, AS. Improved blood pressure control associated with a large-scale hypertension program. JAMA. 2013;310:699–705. doi: 10.1001/jama.2013.108769 DOI: https://doi.org/10.1001/jama.2013.108769

Comin-Colet, J, Verdu-Rotellar, JM, Vela, E, Cleries, M, Bustins, M, Mendoza, L, Badosa, N, Cladellas, M, Ferre, S, Bruguera, J, et al; Working Group of the Integrated Program for Heart Failure Management of the Barcelona Litoral Mar Integrated Health Care Area, Spain. Efficacy of an integrated hospital-primary care program for heart failure: a population-based analysis of 56,742 patients. Rev Esp Cardiol (Engl Ed). 2014;67:283–293. doi: 10.1016/j.rec.2013.12.005 DOI: https://doi.org/10.1016/j.rec.2013.12.005

Liss, DT, Fishman, PA, Rutter, CM, Grembowski, D, Ross, TR, Reid, RJ. Specialty use among patients with treated hypertension in a patient-centered medical home. J Gen Intern Med. 2014;29:732–740. doi: 10.1007/s11606-014-2776-2 DOI: https://doi.org/10.1007/s11606-014-2776-2

Veazie MA, Galloway JM, Matson-Koffman D, Labarthe DR, Brownstein JN, Emr M, Bolton E, Freund Jr E, Fulwood R, Guyton-Krishnan J, Hong Y. Taking the initiative: implementing the American Heart Association guide for improving cardiovascular health at the community level: healthy people 2010 heart disease and stroke partnership community guideline implementation and best practices workgroup. Circulation. 2005 Oct 18;112(16):2538-54. DOI: https://doi.org/10.1161/CIRCULATIONAHA.105.169179

McAlister, FA, Youngson, E, Kaul, P, Ezekowitz, JA. Early follow-up after a heart failure exacerbation: the importance of continuity. Circ Heart Fail. 2016;9:e003194: doi: 10.1161/CIRCHEARTFAILURE.116.003194 DOI: https://doi.org/10.1161/CIRCHEARTFAILURE.116.003194

Cooper, J, Zimmerman, W. The effect of a faith community nurse network and public health collaboration on hypertension prevention and control. Public Health Nurs. 2017;34:444–453. doi: 10.1111/phn.12325 DOI: https://doi.org/10.1111/phn.12325

Brown DL, Conley KM, Sánchez BN, Resnicow K, Cowdery JE, Sais E, Murphy J, Skolarus LE, Lisabeth LD, Morgenstern LB. A multicomponent behavioral intervention to reduce stroke risk factor behaviors: the Stroke Health and Risk Education cluster-randomized controlled trial. Stroke. 2015 Oct;46(10):2861-7. DOI: https://doi.org/10.1161/STROKEAHA.115.010678

Bradley EH, Curry L, Horwitz LI, Sipsma H, Wang Y, Walsh MN, Goldmann D, White N, Piña IL, Krumholz HM. Hospital strategies associated with 30-day readmission rates for patients with heart failure. Circulation: Cardiovascular Quality and Outcomes. 2013 Jul;6(4):444-50. DOI: https://doi.org/10.1161/CIRCOUTCOMES.111.000101

Kearns PJ, Wang CC, Morris WJ, Low DG, Deacon AS, Chan SY, Jensen WA. Hospital care by hospital-based and clinic-based faculty: a prospective, controlled trial. Archives of Internal Medicine. 2001 Jan 22;161(2):235-41. DOI: https://doi.org/10.1001/archinte.161.2.235

Oti SO, van de Vijver SJ, Kyobutungi C, Gomez GB, Agyemang C, Moll van Charante EP, Brewster LM, Hendriks ME, Schultsz C, Ettarh R, Ezeh A. A community-based intervention for primary prevention of cardiovascular diseases in the slums of Nairobi: the SCALE UP study protocol for a prospective quasi-experimental community-based trial. Trials. 2013 Dec;14:1-1. DOI: https://doi.org/10.1186/1745-6215-14-409

Victor RG, Ravenell JE, Freeman A, Leonard D, Bhat DG, Shafiq M, Knowles P, Storm JS, Adhikari E, Bibbins-Domingo K, Coxson PG. Effectiveness of a barber-based intervention for improving hypertension control in black men: the BARBER-1 study: a cluster randomized trial. Archives of internal medicine. 2011 Feb 28;171(4):342-50. DOI: https://doi.org/10.1001/archinternmed.2010.390

Jafar TH, Jehan I, de Silva HA, Naheed A, Gandhi M, Assam P, Finkelstein EA, Quigley HL, Bilger M, Khan AH, Clemens JD. Multicomponent intervention versus usual care for management of hypertension in rural Bangladesh, Pakistan and Sri Lanka: study protocol for a cluster randomized controlled trial. Trials. 2017 Dec;18:1-2. DOI: https://doi.org/10.1186/s13063-017-2018-0

Xavier D, Gupta R, Kamath D, Sigamani A, Devereaux PJ, George N, Joshi R, Pogue J, Pais P, Yusuf S. Community health worker-based intervention for adherence to drugs and lifestyle change after acute coronary syndrome: a multicentre, open, randomised controlled trial. The lancet Diabetes & endocrinology. 2016 Mar 1;4(3):244-53. DOI: https://doi.org/10.1016/S2213-8587(15)00480-5

Kim J, Lee HS, Nam CM, Heo JH. Effects of statin intensity and adherence on the long-term prognosis after acute ischemic stroke. Stroke. 2017 Oct;48(10):2723-30. DOI: https://doi.org/10.1161/STROKEAHA.117.018140

Hsu S, Ton VK, Dominique Ashen M, Martin SS, Gluckman TJ, Kohli P, Sisson SD, Blumenthal RS, Blaha MJ. A clinician's guide to the ABCs of cardiovascular disease prevention: the Johns Hopkins Ciccarone Center for the Prevention of Heart Disease and American College of Cardiology Cardiosource Approach to the Million Hearts Initiative. Clinical Cardiology. 2013 Jul;36(7):383-93. DOI: https://doi.org/10.1002/clc.22137

Markle-Reid, M, Orridge, C, Weir, R, Browne, G, Gafni, A, Lewis, M, Walsh, M, Levy, C, Daub, S, Brien, H, et al. Interprofessional stroke rehabilitation for stroke survivors using home care. Can J Neurol Sci. 2011;38:317–334. doi: 10.1017/s0317167100011537 DOI: https://doi.org/10.1017/S0317167100011537

Oerkild, B, Frederiksen, M, Hansen, JF, Simonsen, L, Skovgaard, LT, Prescott, E. Home-based cardiac rehabilitation is as effective as centre-based cardiac rehabilitation among elderly with coronary heart disease: results from a randomised clinical trial. Age Ageing. 2011;40:78–85. doi: 10.1093/ageing/afq122 DOI: https://doi.org/10.1093/ageing/afq122

Smith, KM, McKelvie, RS, Thorpe, KE, Arthur, HM. Six-year follow-up of a randomised controlled trial examining hospital versus home-based exercise training after coronary artery bypass graft surgery. Heart. 2011;97:1169–1174. doi: 10.1136/hrt.2010.202036 DOI: https://doi.org/10.1136/hrt.2010.202036

Kono, Y, Yamada, S, Yamaguchi, J, Hagiwara, Y, Iritani, N, Ishida, S, Araki, A, Hasegawa, Y, Sakakibara, H, Koike, Y. Secondary prevention of new vascular events with lifestyle intervention in patients with noncardioembolic mild ischemic stroke: a single-center randomized controlled trial. Cerebrovasc Dis. 2013;36:88–97. doi: 10.1159/000352052 DOI: https://doi.org/10.1159/000352052

Ihle-Hansen, H, Thommessen, B, Fagerland, MW, Oksengard, AR, Wyller, TB, Engedal, K, Fure, B. Effect on anxiety and depression of a multifactorial risk factor intervention program after stroke and TIA: a randomized controlled trial. Aging Ment Health. 2014;18:540–546. doi: 10.1080/13607863.2013.824406 DOI: https://doi.org/10.1080/13607863.2013.824406

Varnfield, M, Karunanithi, M, Lee, CK, Honeyman, E, Arnold, D, Ding, H, Smith, C, Walters, DL. Smartphone-based home care model improved use of cardiac rehabilitation in postmyocardial infarction patients: results from a randomised controlled trial. Heart. 2014;100:1770–1779. doi: 10.1136/heartjnl-2014-305783 DOI: https://doi.org/10.1136/heartjnl-2014-305783

Bodechtel, U, Barlinn, K, Helbig, U, Arnold, K, Siepmann, T, Pallesen, LP, Puetz, V, Reichmann, H, Schmitt, J, Kepplinger, J. The Stroke East Saxony pilot project for organized post-stroke care: a case-control study. Brain Behav. 2016;6:e00455. doi: 10.1002/brb3.455 DOI: https://doi.org/10.1002/brb3.455

Bertelsen, JB, Refsgaard, J, Kanstrup, H, Johnsen, SP, Qvist, I, Christensen, B, Christensen, KL. Cardiac rehabilitation after acute coronary syndrome comparing adherence and risk factor modification in a community-based shared care model versus hospital-based care in a randomised controlled trial with 12 months of follow-up. Eur J Cardiovasc Nurs. 2017;16:334–343. doi: 10.1177/1474515116666781 DOI: https://doi.org/10.1177/1474515116666781

Tang, LH, Kikkenborg Berg, S, Christensen, J, Lawaetz, J, Doherty, P, Taylor, RS, Langberg, H, Zwisler, AD. Patients’ preference for exercise setting and its influence on the health benefits gained from exercise-based cardiac rehabilitation. Int J Cardiol. 2017;232:33–39. doi: 10.1016/j.ijcard.2017.01.126 DOI: https://doi.org/10.1016/j.ijcard.2017.01.126

Szalewska D, Zieliński P, Tomaszewski J, Kusiak-Kaczmarek M, Łepska L, Gierat-Haponiuk K, Niedoszytko P. Effects of outpatient followed by home-based telemonitored cardiac rehabilitation in patients with coronary artery disease. Polish Heart Journal (Kardiologia Polska). 2015;73(11):1101-7. DOI: https://doi.org/10.5603/KP.a2015.0095

Pogosova NV, Sokolova OY, Salbieva AO, Yufereva YM, Ausheva AK, Eganyan RA. Hallmarks of preventive counseling in coronary heart disease patients with abdominal obesity. Kardiologiia. 2017 Apr 1;57(S4):47-52.

Ranta, A, Dovey, S, Weatherall, M, O’Dea, D, Gommans, J, Tilyard, M. Cluster randomized controlled trial of TIA electronic decision support in primary care. Neurology. 2015;84:1545–1551. doi: 10.1212/WNL.0000000000001472 DOI: https://doi.org/10.1212/WNL.0000000000001472

Ingram, SJ, McKee, G, Quirke, MB, Kelly, N, Moloney, A. Discharge of non-acute coronary syndrome chest pain patients from emergency care to an advanced nurse practitioner-led chest pain clinic: a cross-sectional study of referral source and final diagnosis. J Cardiovasc Nurs. 2017;32:E1–E8. doi: 10.1097/JCN.0000000000000374 DOI: https://doi.org/10.1097/JCN.0000000000000374

O’Brien, EC, Xian, Y, Xu, H, Wu, J, Saver, JL, Smith, EE, Schwamm, LH, Peterson, ED, Reeves, MJ, Bhatt, DL, et al. Hospital variation in home-time after acute ischemic stroke: insights from the PROSPER study (Patient-Centered Research Into Outcomes Stroke Patients Prefer and Effectiveness Research). Stroke. 2016;47:2627–2633. doi: 10.1161/STROKEAHA.116.013563 DOI: https://doi.org/10.1161/STROKEAHA.116.013563

Hornnes N, Larsen K, Boysen G. Little change of modifiable risk factors 1 year after stroke: a pilot study. International journal of stroke. 2010 Jun;5(3):157-62. DOI: https://doi.org/10.1111/j.1747-4949.2010.00424.x

Naritomi H, Moriwaki H, Metoki N, Nishimura H, Higashi Y, Yamamoto Y, Yuasa H, Oe H, Tanaka K, Saito K, Terayama Y. Effects of edaravone on muscle atrophy and locomotor function in patients with ischemic stroke: a randomized controlled pilot study. Drugs in R & D. 2010 Sep;10:155-63. DOI: https://doi.org/10.2165/11586550-000000000-00000

Kronish IM, Goldfinger JZ, Negron R, Fei K, Tuhrim S, Arniella G, Horowitz CR. Effect of peer education on stroke prevention: the prevent recurrence of all inner-city strokes through education randomized controlled trial. Stroke. 2014 Nov;45(11):3330-6. DOI: https://doi.org/10.1161/STROKEAHA.114.006623

Albert, NM, Fonarow, GC, Yancy, CW, Curtis, AB, Stough, WG, Gheorghiade, M, Heywood, JT, McBride, M, Mehra, MR, O’Connor, CM, et al. Outpatient cardiology practices with advanced practice nurses and physician assistants provide similar delivery of recommended therapies (findings from IMPROVE HF). Am J Cardiol. 2010;105:1773–1779. DOI: https://doi.org/10.1016/j.amjcard.2010.01.360

Virani, SS, Maddox, TM, Chan, PS, Tang, F, Akeroyd, JM, Risch, SA, Oetgen, WJ, Deswal, A, Bozkurt, B, Ballantyne, CM, et al. Provider type and quality of outpatient cardiovascular disease care: insights from the NCDR PINNACLE registry. J Am Coll Cardiol. 2015;66:1803–1812. DOI: https://doi.org/10.1016/j.jacc.2015.08.017

Maciejewski, ML, Wansink, D, Lindquist, JH, Parker, JC, Farley, JF. Value-based insurance design program in North Carolina increased medication adherence but was not cost neutral. Health Aff (Millwood). 2014;33:300–308. DOI: https://doi.org/10.1377/hlthaff.2013.0260

Wasserman, J, Perry, J, Dowlatshahi, D, Stotts, G, Stiell, I, Sutherland, J, Symington, C, Sharma, M. Stratified, urgent care for transient ischemic attack results in low stroke rates. Stroke. 2010;41:2601–2605. doi: 10.1161/STROKEAHA.110.586842 DOI: https://doi.org/10.1161/STROKEAHA.110.586842

Olivot, JM, Wolford, C, Castle, J, Mlynash, M, Schwartz, NE, Lansberg, MG, Kemp, S, Albers, GW. Two aces: transient ischemic attack work-up as outpatient assessment of clinical evaluation and safety. Stroke. 2011;42:1839–1843. doi: 10.1161/STROKEAHA.110.608380 DOI: https://doi.org/10.1161/STROKEAHA.110.608380

Furze, G, Cox, H, Morton, V, Chuang, LH, Lewin, RJ, Nelson, P, Carty, R, Norris, H, Patel, N, Elton, P. Randomized controlled trial of a lay-facilitated angina management programme. J Adv Nurs. 2012;68:2267–2279. doi: 10.1111/j.1365-2648.2011.05920.x DOI: https://doi.org/10.1111/j.1365-2648.2011.05920.x

Robson, G. A nurse-led rapid access chest pain clinic post NICE guidance: analysis of audit results. Br J Cardiac Nurs. 2012;7:236–241. doi: 10.12968/bjca.2012.7.5.236 DOI: https://doi.org/10.12968/bjca.2012.7.5.236

Sanders, LM, Srikanth, VK, Jolley, DJ, Sundararajan, V, Psihogios, H, Wong, K, Ramsay, D, Phan, TG. Monash transient ischemic attack triaging treatment: safety of a transient ischemic attack mechanism-based outpatient model of care. Stroke. 2012;43:2936–2941. doi: 10.1161/STROKEAHA.112.664060 DOI: https://doi.org/10.1161/STROKEAHA.112.664060

Published

15-01-2018

How to Cite

Almanna, M. A., Alanazi, D. M., Alaujan, B. S., Zamzami, B. A., Alanazi, N. H., Alshaibani, R. S., Alowaidan, S. R., Alharbi, A. F., & Al-Rashudi, K. A. R. S. (2018). Innovations in non-invasive cardiovascular diagnostics: The interplay of nursing, pharmacy, health records, and emergency care in cardiology. International Journal of Health Sciences, 2(S1), 112–128. https://doi.org/10.53730/ijhs.v2nS1.15055

Issue

Section

Peer Review Articles

Most read articles by the same author(s)

<< < 1 2