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Machine learning to predict risk of MI and CV death
Machine learning has been used to predict the long term risk of myocardial death and cardiac death in a study published in Cardiovascular Research from the European Society of Cardiology. It was a prospective study using clinical parameters, coronary artery calcium scoring and automated epicardial adipose tissue quantification.
The study included 1912 asymptomatic persons from EISNER (Early Identification of Subclinical Atherosclerosis by Noninvasive Imaging Research) trial with long-term follow-up after coronary artery calcium scoring. Epicardial adipose tissue is a metabolically active fat deposit which has been show...
Source: Cardiophile MD - December 21, 2019 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Machine Learning and AI in Cardiology Source Type: blogs
Potential risks of hyperoxemia
Potential risks of hyperoxemia:
Detrimental effects due to vasoconstriction of the vasculature
Generation of reactive oxygen species which could cause:
Toxic myocardial contractile dysfunction
Increased oxidative stress
Reperfusion injury
Myocardial cell death
Earlier it was common practice to give supplemental oxygen for acute coronary syndrome and after percutaneous coronary interventions. This practice has been discontinued after publication of the DETO2X-AMI trial [1] and other similar studies which showed no benefit for supplemental oxygen in those with normal oxygen saturation.
Reference
Hofmann R, James SK, J...
Source: Cardiophile MD - December 20, 2019 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Cardiology Source Type: blogs
Cardiology MCQ – Classic cardiogenic shock – Answer
Cardiology MCQ – Classic cardiogenic shock – Answer
My Cardiology MCQ books on Amazon
“Classic” cardiogenic shock having hypotension with features of hypoperfusion, needing inotropes and mechanical circulatory support comes under Stage — of the 2019 SCAI (Society for Cardiovascular Angiography and Intervention) classification:
Correct answer: 3. Stage C
The Society for Cardiovascular Angiography and Intervention (SCAI) has classified cardiogenic shock into stages from A through E.
Stage A: “At risk” for cardiogenic shock – large myocardial infarction or heart failure, but not yet in sho...
Source: Cardiophile MD - December 18, 2019 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs
SCAI Shock Stages A Through E
The Society for Cardiovascular Angiography and Intervention (SCAI) has classified cardiogenic shock into stages from A through E. This was developed by a multidisciplinary team from cardiology (interventional, advanced heart failure and noninvasive), emergency medicine, critical care and cardiac nursing.
Stage A: “At risk” for cardiogenic shock – large myocardial infarction or heart failure, but not yet in shock, with normal mentation and systolic blood pressure of 100 mm Hg or more.
Stage B: “Beginning” shock – hypotension or tachycardia without features of hypoperfusion (normal mentation). Systo...
Source: Cardiophile MD - December 16, 2019 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Cardiology Source Type: blogs
Monk fruit –More than a healthy sweetener?
Because I wanted a benign and healthy way for followers of the Wheat Belly lifestyle to recreate dishes such as chocolate chip cookies, cheesecake, and pies with none of the health problems of grains or sugars, I helped Wheat-Free Market develop its Virtue Sweetener product.
Yes, you could do without such sweeteners. But I learned long ago when I introduced Wheat Belly concepts to patients in my cardiology practice that having options while entertaining friends, during holidays, and pleasing kids was important for staying on course on this lifestyle. Before I understood how to use such natural sweeteners, patients would ...
Source: Wheat Belly Blog - December 12, 2019 Category: Cardiology Authors: Dr. Davis Tags: Open blood sugar diabetes Dr. Davis Inflammation insulin low-carb monk fruit natural sweeteners undoctored virtue sweetener Weight Loss wheat Wheat Belly Total Health Source Type: blogs
Medications as effective as stents for most with coronary artery disease
This study suggests that for most, managing CAD with medications alone (the conservative approach) is as safe and effective as the more invasive strategy of cardiac catheterization and opening of the blocked artery.
Findings of the ISCHEMIA trial
ISCHEMIA followed over 5,000 patients with significant narrowing in one or more coronary arteries. Half of the patients were randomly selected to receive conservative treatment with optimal medical therapy (OMT) and lifestyle changes to treat risk factors such as high blood pressure and high cholesterol. The other half were given OMT and also sent for cardiac catheterization (thre...
Source: Harvard Health Blog - December 9, 2019 Category: Consumer Health News Authors: Dara K. Lee Lewis, MD Tags: Health Source Type: blogs
The complicated relationship between fish oil and heart health
For nearly two decades, the American Heart Association (AHA) has recommended that people with coronary heart disease (CHD) consume omega-3-fatty acids (the kinds of fatty acids found in fish and fish oil) to prevent another heart attack. This recommendation was based on early randomized, controlled trials, which found that fish oil supplementation was associated with lower rates of stroke, heart attack, and death in people who already had heart disease. On the other hand, the impact of fish oil supplements on preventing a first heart attack or stroke (primary prevention) was never clearly demonstrated.
Recently there have ...
Source: Harvard Health Blog - December 4, 2019 Category: Consumer Health News Authors: Alyson Kelley-Hedgepeth, MD Tags: Drugs and Supplements Health Heart Health Nutrition Source Type: blogs
Could white-coat hypertension harm your heart?
For most people, going to the doctor is usually a bit nerve-racking. But for some, the stress of a medical appointment triggers a temporary rise in blood pressure. If that’s the case for you — and if your blood pressure is normal at home and in other nonmedical settings — you may have what’s known as white-coat hypertension. Now, a large study suggests that people with this condition face a greater threat of heart disease than people whose blood pressure readings are always normal.
According to current guidelines from the American College of Cardiology and the American Heart Association, normal blood pressure is de...
Source: Harvard Health Blog - November 29, 2019 Category: Consumer Health News Authors: Julie Corliss Tags: Health Heart Health Hypertension and Stroke Men's Health Women's Health Source Type: blogs
A man in his 30s with chest pain
Written by Pendell Meyers, submitted by Siva Vittozzi-WongA man in his 30s with history of hypertension, hyperlipidemia, and diabetes presented with chest pain which started 12 hours prior to presentation. The pain was described as pressure, constant for 12 hours, radiating to the jaw, with left arm numbness. Initial vitals were significant for bradycardia at 45 beats per minute.Here is his presenting ECG with active pain:What do you think?Here was the prior EKG on file:The emergency medicine resident (who has received lectures from me on hyperacute T-waves, suble OMI, etc) documented the following interpretation:" Initial...
Source: Dr. Smith's ECG Blog - November 19, 2019 Category: Cardiology Authors: Pendell Source Type: blogs
A man in his 30s with 12 hours of chest pain; is the ECG consistent with 12 hours of occlusion?
Written by Pendell Meyers, submitted by Siva Vittozzi-WongA man in his 30s with history of hypertension, hyperlipidemia, and diabetes presented with chest pain which started 12 hours prior to presentation. The pain was described as pressure, constant for 12 hours, radiating to the jaw, with left arm numbness. Initial vitals were significant for bradycardia at 45 beats per minute.Here is his presenting ECG with active pain:What do you think?Here was the prior EKG on file:The emergency medicine resident (who has received lectures from me on hyperacute T-waves, suble OMI, etc) documented the following interpretation:" Initial...
Source: Dr. Smith's ECG Blog - November 19, 2019 Category: Cardiology Authors: Pendell Source Type: blogs
High-Sensitivity Troponin is not a Myth, and “Myth-busting” is often another Myth to be Busted
Conclusion: Early rule out protocol is effective and safe.We refer interested readers to the following excellent reviews of high-sensitivity troponin implementation:Twerenbold, R. et al.JACC70 (8): 996 –1012.https://doi.org/10.1016/j.jacc.2017.07.718.Yader S. et al. 2016. Am J Med 129 (4): 354 –65.https://doi.org/10.1016/j.amjmed.2015.12.005.Response to the 2nd “Myth-busting” articleInterestingly, on Nov 5, Dr. Spiegel publishedanother “Myths in EM” piece in EM News: “Is hs-cTnT Worth the Downstream Testing?. The piece assesses a new randomized trial of the Roche hs -cTnT (not the Abbott Troponin I,...
Source: Dr. Smith's ECG Blog - November 9, 2019 Category: Cardiology Authors: Steve Smith Source Type: blogs
Lifestyle changes to lower heart disease risk
Nearly half of all premature deaths may be due to unhealthy lifestyle choices, such as insufficient exercise, poor diet, and smoking. These risk factors increase the risk of high blood pressure, diabetes, heart attack, and stroke.
The good news is that lifestyle changes can make a difference. In a study analyzing over 55,000 people, those with favorable lifestyle habits such as not smoking, not being obese, engaging in regular physical activity, and eating a healthy diet lowered their heart disease risk by nearly 50%.
The American College of Cardiology (ACC) and the American Heart Association (AHA) recently published guide...
Source: Harvard Health Blog - November 2, 2019 Category: Consumer Health News Authors: James Yeh, MD, MPH Tags: Alcohol Diabetes Exercise and Fitness Heart Health Hypertension and Stroke Smoking cessation Source Type: blogs
A young peripartum woman with Chest Pain
This is written by Brooks Walsh.https://twitter.com/BrooksWalshA 30 year-old woman was brought to the ED with chest pain.It had started just after nursing her newborn, about an hour prior, and she described it as a severe non-pleuritic “pressure” radiating to the back.She had given birth a week ago, and she had similar chest pain during her labor. She attributed the chest pain to anxiety and stress, saying " I ' m just an anxious person. "A CXR and a CTA for PE were normal.The ECGsAn initial ECG was obtained as the pain was rapidly resolving:Minimal upsloping ST Elevation in III, with a steeply biphasic T wave, and&nbs...
Source: Dr. Smith's ECG Blog - October 23, 2019 Category: Cardiology Authors: Brooks Walsh Source Type: blogs
60-something with 2 days of intermittent epigastric pain. Why does the cardiologist disagree?
Conclusion An invasive strategy based on coronary stenting with adjunctive use of abciximab reduces infarct size in patients with acute STEMI without persistent symptoms presenting 12 to 48 hours after symptom onset.===================================MY Comment by KEN GRAUER, MD (10/20/2019):===================================I find it difficult to believe that the Cardiologist Attending On Call did not allow for the possibility that the OMI in this case was either acute and/or ongoing.MY Question: Was this the opinion of the Attending Cardiologist — or a Resid...
Source: Dr. Smith's ECG Blog - October 19, 2019 Category: Cardiology Authors: Steve Smith Source Type: blogs
Denial and rationalization will not save you from a heart attack
Smoking was cool. And he started smoking at the age of 15. Two packs a day — every day. When he was 32 years old, we had our first-born son. And he decided to quit cold turkey. But the damage was done. Somehow, someway, it would catch up with him in devastating ways. By the […]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 - October 16, 2019 Category: General Medicine Authors: < span itemprop="author" > < a href="https://www.kevinmd.com/blog/post-author/debbie-moore-black" rel="tag" > Debbie Moore-Black, RN < /a > < /span > Tags: Conditions Cardiology Source Type: blogs
