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Total 782 results found since Jan 2013.

Left ventricular remodeling
Left ventricular remodeling occurs in response to left ventricular stress and injury. It is progressive and occurs after large myocardial infarctions and dilated cardiomyopathy. Left ventricular volume increases and the normal elliptical shape becomes globular. Left ventricular remodeling is associated with changes at microscopic level which include myocyte hypertrophy, apoptosis and increased interstitial collagen deposition [1]. Left ventricular remodeling is a central pathophysiological mechanism in advancing heart failure. Reversal of remodeling with treatment is an important goal in the management of heart failure. ...
Source: Cardiophile MD - April 2, 2021 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Cardiology Source Type: blogs

Correlative Adventures with COVID
By ANISH KOKA “The patient in room 1 should be a quick one, its an addon, they just need a prescription for ivermectin” I’m a bit puzzled by this sentence from my assistant doing his best to help me through a very busy day in the clinic that I’m already behind in. I walk into the room, a script pad stuffed into my hand as I enter the room, to meet a very nice couple.  The wife sits patiently with hands crossed on the exam table.  “So, you’re here for Ivermectin?”, I ask. Why yes, a trip to Texas is planned.. COVID is in the air, the internet, and some important people who have ‘inside ...
Source: The Health Care Blog - March 5, 2021 Category: Consumer Health News Authors: Christina Liu Tags: COVID-19 Health Policy Anish Koka COVID vaccine COVID-19 vaccine Ivermectin Source Type: blogs

When there is less than 1 mm of ST depression, can you make the diagnosis of posterior OMI?
DiscussionApproximately 10% of OMIs will involve the posterior wall, most of which also have concomitant involvement of the lateral and/or inferior walls (though usually not meeting STEMI criteria). Isolated posterior OMI, however, manifests as STD without associated STE since the subepicardial myocardial ischemia that would normally generate STE on overlying leads is occurring in the opposing or negative vector compared to the recording ECG leads. The majority of isolated posterior OMIs will be due to occlusion of the LCX, RCA, or a variety of their posterior branches.The 4th Universal Definition of Myocardial Infarc...
Source: Dr. Smith's ECG Blog - February 27, 2021 Category: Cardiology Authors: Pendell Source Type: blogs

The Paradigm Shift That Wasn ’ t: The ISCHEMIA Trial
By ANISH KOKA A recent email that arrived in my in-box a few weeks ago from an academic hailed the latest “paradigm shift” in cardiology as it relates to the management of stable angina.  (Stable angina refers to chronic,non-accelerating chest pain with a moderate level of exertion).  The points made in the email were as follows (the order of the points made are preserved): The financial burden of stress testing was significant ( 11 billion dollars per annum in the USA!)For stable CAD, medical treatment is critical.  We now have better medical treatments than all prior trials including ischemia. th...
Source: The Health Care Blog - February 26, 2021 Category: Consumer Health News Authors: Christina Liu Tags: Medical Practice Physicians Anish Koka cardiology ISCHEMIA trial Source Type: blogs

Intraoral Stimulation for Obstructive Sleep Apnea: Interview with Akhil Tripathi, CEO of Signifier Medical
Signifier Medical Technologies, a company with headquarters in London, UK and Massachusetts, has created a new treatment for obstructive sleep apnea, and it is the first to be used during waking hours. Unlike conventional sleep apnea devices,...
Source: Medgadget - February 24, 2021 Category: Medical Devices Authors: Conn Hastings Tags: Cardiology Exclusive Medicine Neurology Source Type: blogs

Who says doctors don ’t care?
Yes Virginia, there are still some doctors who truly care for their patients. On December 13, 1993, my husband Bill was playing golf.  Early in his round, he suffered a massive heart attack.  Bill was 56 years old.  Thanks to the staff and emergency room staff’s quick action, Bill was stabilized by the ER physician.   That same afternoon, […]Find jobs at  Careers by KevinMD.com.  Search thousands of physician, PA, NP, and CRNA jobs now.  Learn more.
Source: Kevin, M.D. - Medical Weblog - February 20, 2021 Category: General Medicine Authors: < span itemprop="author" > < a href="https://www.kevinmd.com/blog/post-author/cindy-thompson" rel="tag" > Cindy Thompson < /a > < /span > Tags: Patient Cardiology Patients Source Type: blogs

A man in his early 40s with chest pain: STD in V1-V4, but posterior lead are negative
This study by Shah et al. shows that the STD of subendocardial ischemia (in contrast to posterior OMI) is maximal in V5 and V6.Shah A, Wagner GS, Green CL, et al. Electrocardiographic differentiation of the ST-segment depression of acute myocardial injury due to the left circumflex artery occlusion from that of myocardial ischemia of nonocclusive etiologies. Am J Cardiol [Internet] 1997;80(4):512 –3. Available from: https://europepmc.org/article/med/9285669However, STD in V1-V4 can occasionally be due to subendocardial ischemia.  If posterior leads also show ST depression, then subendocardial ischemia is probable!!&...
Source: Dr. Smith's ECG Blog - February 14, 2021 Category: Cardiology Authors: Pendell Source Type: blogs

Why didn ’ t you try ECMO for my dad , doctor ? I feel really guilty !
It is just past midnight: This is a gloomy conversation between a patient’s son and a cardiologist in the silent waiting room, just outside the dim-lit ICU of a popular 4-star hospital in Chennai. “I am sorry to say, Mr. B., your father didn’t make it. Has succumbed to the heart attack. We have been trying to resuscitate him for the past one hour. We have done everything. We have managed to open up IRA, and 2 more critical blocks still it couldn’t help. It was a massive one. Sorry again. “Doctor, I feel very bad. What went wrong, I want to know. Doc, did you try ECMO ?,” the ...
Source: Dr.S.Venkatesan MD - February 1, 2021 Category: Cardiology Authors: dr s venkatesan Tags: Cardiology -Technology ecmo IABP impella tandem heart ecmo Source Type: blogs

ECG with Aslanger ' s Pattern. CT Pulmonary Angiogram Reveals LAD Ischemia (Septal Transmural). But this is not Contradictory.
A 52 y.o. male presented with persistent central chest pressure, without radiation, SOB or diaphoresis, which began at rest approximately one hour prior to arrival.  He had never had pain like this before.  He felt slightly nauseous earlier but no vomiting.  He is denying any back pain or abdominal pain.  An ECG was recorded during pain:What do you think?This shows significant ST depression in I, II, and V4-V6, with reciprocal ST Elevation in aVR.  This suggests diffuse subendocardial ischemia.  However, along with that subendocardial ischemia, there is also STE in lead III with...
Source: Dr. Smith's ECG Blog - January 4, 2021 Category: Cardiology Authors: Steve Smith Source Type: blogs

Chest pain after motor vehicle collision with an abnormal ECG - blunt cardiac injury? OMI? normal variant?
Discussion:Significant cardiac trauma occurs in approximately 10% of patients with severe blunt chest trauma. Isolated coronary artery dissection from blunt trauma is a very rare event. Traumatic dissections are most often seen in the LAD, followed by the RCA and LCX. It is thought that this is due to the relative anterior position of the LAD. The ECG is a report from the myocytes of their condition. They do not know the etiology of acute complete ischemia. No matter if its typical ACS, traumatic dissection causing acute occlusion, or spasm, it is the same result to the myocytes, and the same findings can be present o...
Source: Dr. Smith's ECG Blog - December 30, 2020 Category: Cardiology Authors: Pendell Source Type: blogs

ECMO – Extracorporeal membrane oxygenation
ECMO – extracorporeal membrane oxygenation ECMO – Extracorporeal membrane oxygenation – has been in use for the past four decades to support persons who are unlikely to survive with mechanical ventilation. ECMO is used in both adult and pediatric practice, though in the initial years, use of ECMO was restricted to pediatric intensive care. The enthusiasm for use of ECMO in adults have been triggered by the beneficial effect noted during the last H1N1 influenza pandemic [1]. In contrast from cardiopulmonary bypass which is used for a short period during cardiac surgery, ECMO is used to support for a ...
Source: Cardiophile MD - December 26, 2020 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Cardiac Surgery Source Type: blogs

Do pro-inflammatory diets harm our health? And can anti-inflammatory diets help?
This study also showed that pro-inflammatory diets were associated with a poor cholesterol profile. This finding was also seen in other another study, also published in JACC, which found that pro-inflammatory foods had a harmful effect on cholesterol levels while some anti-inflammatory foods had favorable effects. What foods are pro-inflammatory and anti-inflammatory? Foods with a higher pro-inflammatory potential are red meat, processed meat, and organ meat; refined carbohydrates such as white bread, white rice, and many desserts; and sweetened beverages including colas and sports drinks. Foods that have a higher anti-inf...
Source: Harvard Health Blog - December 23, 2020 Category: Consumer Health News Authors: Katherine D. McManus, MS, RD, LDN Tags: Food as medicine Healthy Eating Source Type: blogs

ST Depression Maximal in V1-V4 and Angio shows 3 Vessel Disease. Is it posterior? Which is the culprit?
A 70-something woman had acute chest pain.The ECG was texted to me with the words: " Acute chest pain. Could this be posterior MI? What do you make of the ST depression in V4-V6? "What do you think?My response: " The ST depression is maximal in V1-V4.  This is most consistent with a posterior MI.  If it sounds clinically like acute MI then this is good for activating the cath lab. "Her response: " Yeah, I did activate.  But the cardiology fellow told me he was sure it would not be a posterior MI because of diffuse ST depression.  He suggested that we should have consulted cardiology rather than activati...
Source: Dr. Smith's ECG Blog - December 23, 2020 Category: Cardiology Authors: Steve Smith Source Type: blogs

Extreme widespread ST depression, with ST Elevation in aVR. What do you think?
ConclusionsSTE-aVR with multilead ST depression was associated with acutely thrombotic coronary occlusion in only 10% of patients. Routine STEMI activation in STE-aVR for emergent revascularization is not warranted, although urgent, rather than emergent, catheterization appears to be important.
Source: Dr. Smith's ECG Blog - December 16, 2020 Category: Cardiology Authors: Steve Smith Source Type: blogs

A 45 year old smoker presents with palpitations, is discharged, and is found dead 2 days later
A 45 year old smoker presented with palpitations.  He had no other medical problems.  There was no syncope.  He was on no medications.Unfortunately, no other information is available, but that is enough to provide an learning point.Here is the EKG:Do you see anything worrisome?There are PVCs, and these might be the cause of the palpitations (whether they are indeed the source of the palpitations could easily be ascertained by asking the patient if the palpitations are still present during the ECG).  However, there are wide QS-waves (0.8 ms) in III and aVF, and they have afragmented QRS (extra spike...
Source: Dr. Smith's ECG Blog - December 14, 2020 Category: Cardiology Authors: Steve Smith Source Type: blogs