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Condition: Heart Attack
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Should I participate in a cardiac rehabilitation program?
Cardiac rehabilitation (CR), or “cardiac rehab,” is a multifaceted, medically supervised program proven to improve heart health and outcomes in people with certain types of cardiovascular disease. CR revolves around three major components: an individualized exercise and training program, education on topics related to heart health, and stress reduction.
CR is currently recommended for the following diagnoses: angina (chest pain); heart attack with or without angioplasty or bypass surgery; heart failure with reduced ejection fraction (HFrEF); and heart surgery including heart valve procedures or heart or heart/lung tran...
Source: Harvard Health Blog - October 10, 2019 Category: Consumer Health News Authors: Hicham Skali, MD, MSc, FACC Tags: Exercise and Fitness Health Heart Health Source Type: blogs
Study supports benefit of statin use for older adults
In this study, the most common reason that patients or their doctors stopped statins was the development of advanced cancer or other major illness.
In my practice, I have also cared for many patients who have stopped taking statins or who express reluctance to take statins due to side effects. The most common side effect is muscle ache (typically tenderness or soreness of the large muscle groups, such as the biceps and thighs), which affects about 20% of statin takers and reverses when the statin is discontinued. There is also a slightly increased risk of diabetes with long-term statin use and, very rarely, liver problems....
Source: Harvard Health Blog - October 2, 2019 Category: Consumer Health News Authors: Dara K. Lee Lewis, MD Tags: Drugs and Supplements Health Healthy Aging Heart Health Source Type: blogs
A 50-something woman with chest pain, BP 230/120, and LBBB with 7 mm ST Elevation
A 50-something woman with history of CHF of unknown etiology, and of HTN, presented for evaluation of chest pressure.Her BP was 223/125, Sp02 98% on RA. HR 106, RR 18. Here was her ED ECG:There is sinus rhythm with Left Bundle Branch Block (LBBB)There is a large amount of ST Elevation in V2 and V3 (more than 5 mm)Thus, this meets the unweighted Sgarbossa Criteria of 5 mm of discordant ST ElevationBut it does NOT meet the Smith Modified Sgarbossa Criteria, which depend on the ST/S ratio.This ratio is critical because LBBB with very large depolarization voltage (QRS) also has very large repolarization voltage (ST/T).Her...
Source: Dr. Smith's ECG Blog - September 24, 2019 Category: Cardiology Authors: Steve Smith Source Type: blogs
Machine Learning Helps Predict Risk of Heart Failure in Patients with Diabetes
Researchers from Brigham and Women’s Hospital and UT Southwestern Medical center have developed a new machine learning algorithm that predicts the risk of heart failure hospitalization for people suffering from type 2 diabetes. Their work demonstra...
Source: Medgadget - September 19, 2019 Category: Medical Devices Authors: Siavash Parkhideh Tags: Cardiology Informatics Medicine Source Type: blogs
Material to Repair Cardiac Tissue Damaged by Heart Attacks Passes First Clinical Trial
Ventrix, a spin-off company of the University of California San Diego, has developed a special hydrogel that can be injected into the heart to provide a platform for cardiac repair following a heart attack. The technology was just tested in humans fo...
Source: Medgadget - September 17, 2019 Category: Medical Devices Authors: Medgadget Editors Tags: Cardiac Surgery Cardiology Materials Source Type: blogs
Machine Learning to Predict MI – MI3 Index
Machine Learning to Predict MI – MI3 Index
Myocardial Ischemic Injury Index (MI3 Index) is a Machine Learning Algorithm which has been developed and tested to predict the likelihood of developing acute myocardial infarction [1].
It used simple easy to collect variables: age, sex, and paired high-sensitivity cardiac troponin I concentrations. Initial troponin estimation was at presentation and second one between 1-3 hours later.
Their training set had data from 3013 patients and it was tested on data from 7998 patients with suspected myocardial infarction. A technique called gradient boosting was used to compute a va...
Source: Cardiophile MD - September 17, 2019 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Machine Learning and AI in Cardiology Source Type: blogs
MINOCA vs TpNOCA
TpNOCA: Troponin-positive nonobstructive coronary arteries
Apparent myocardial infarction in the absence of obstructive coronary artery disease
MINOCA: Myocardial Infarction With Nonobstructive Coronary Arteries
Term reserved for only those who have evidence of ischemia related myocardial necrosis
MINOCA included only coronary disorders like coronary dissection, plaque disruption, coronary spasm, microvascular dysfunction, coronary thrombus and embolism (recanalized).
TpNOCA includes in addition to MINOCA, myocardial disorders like myocarditis, takotsubo cardiomyopathy and other cardiomyopathies as well as non cardia...
Source: Cardiophile MD - September 10, 2019 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Cardiology Source Type: blogs
Leg pain when you walk? Don ’t ignore it
Walking is often touted as a perfect exercise to improve multiple aspects of health. But what if walking causes leg pain? Many people shrug off leg pain when they walk as a normal part of aging. In some cases, though, it’s the sign of peripheral artery disease (PAD), which can put heart and brain health at risk. While PAD doesn’t usually run in families, it’s more likely to occur as people age, or among people who smoke or have high blood pressure, high cholesterol, or diabetes.
What causes leg pain if you have PAD?
People with PAD have fatty deposits in arteries outside the heart — most often in their legs. Pain o...
Source: Harvard Health Blog - September 6, 2019 Category: Consumer Health News Authors: Kelly Bilodeau Tags: Exercise and Fitness Healthy Aging Heart Health Hypertension and Stroke Pain Management Source Type: blogs
A primary care physician ’s decisions are questioned and second-guessed daily
A 67-year-old woman with a high-stress job had a vigorous disagreement with her neighbors last week. She developed severe substernal chest pain and called 911 fearing a heart attack. She is thin, has never smoked, has normal blood pressure and normal cholesterol. She is not a diabetic and runs on a treadmill for two hours […]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 - September 3, 2019 Category: General Medicine Authors: < span itemprop="author" > < a href="https://www.kevinmd.com/blog/post-author/steven-reznick" rel="tag" > Steven Reznick, MD < /a > < /span > Tags: Physician Cardiology Primary Care Source Type: blogs
Editorial by Meyers and Smith, full text: Prospective, real-world evidence showing the gap between ST elevation myocardial infarction (STEMI) and occlusion MI (OMI)
Read this full text article on the OMI paradigm, from International Journal of Cardiology:Prospective, real-world evidence showing the gap between ST elevation myocardial infarction (STEMI) and occlusion MI (OMI)https://authors.elsevier.com/a/1Zbyec5r~MxXk
Source: Dr. Smith's ECG Blog - August 22, 2019 Category: Cardiology Authors: Steve Smith Source Type: blogs
Podcast: Planning for Death and Why It Matters
In this episode, Gabe talks with PsychCentral.com editor-in-chief Dr. John Grohol about the importance of planning for the end of life. We all know that everybody dies, but at the same time, no one wants to think about their own inevitable death. Do you know how you would like the end of your life to go? What if you needed to make that decision for a loved one? Do you know what they want? Would they want to be resuscitated? Do they want to die at home or in a hospital? Do you even know what kinds of decisions need to be made, or what the options are?
Listen in as Dr. John explains that there is a degree of wisdom ...
Source: World of Psychology - August 15, 2019 Category: Psychiatry & Psychology Authors: The Psych Central Podcast Tags: Aging Death & Dying General LifeHelper The Psych Central Show Source Type: blogs
FAQs in STEMI : Why is the 3 hour gap recommended before pharmaco Invasive strategy?
Background STEMI knowledge check : Evidence-based Ignorance
I think , It was unfortunate, In the management of STEMI , the two popular strategies of myocardial reperfusion was made to fight with each other as if they are perennial enemies for over two decades. Suddenly, someone with a rare coronary insight thought, why fight each other , they can have a friendly hug and work together. That brought the concept of pharmco -Invasive approach or strategy(PIA) backed up by STREAM, FAST-MI, and TRANSFER AMI studies.Yes, it appears to work well and devoid of all the early adverse events of pPCI. (Much to the dismay of ardent fans...
Source: Dr.S.Venkatesan MD - August 14, 2019 Category: Cardiology Authors: dr s venkatesan Tags: acute coronary syndrome Cardiology - Animations Cardiology -Interventional -PCI Cardiology -unresolved questions cath lab tips and tricks Infrequently asked questions in cardiology (iFAQs) open artery hypothesis STEMI STEMI -Managment ST Source Type: blogs
The ECG was correct. The angiogram was not.
In this study, approximately 10% of Transient STEMI had no culprit found:Early or late intervention in patients with transient ST ‐segment elevation acute coronary syndrome: Subgroup analysis of the ELISA‐3 trialOne must use all available data, including the ECG, to determine what happened.Final Diagnosis?If the troponin remained under the 99% reference, then it would be unstable angina. If it rose above that level before falling, it would be acute myocardial injury due to ischemia, which is, by definition, acute MI. If that is a result of plaque rupture, then it is a type I MI. The clinical presentat...
Source: Dr. Smith's ECG Blog - August 12, 2019 Category: Cardiology Authors: Steve Smith Source Type: blogs
Fight Aging! Newsletter, August 12th 2019
We examined 9293 individuals from the Copenhagen General Population Study using nuclear magnetic resonance spectroscopy measurements of total cholesterol, free- and esterified cholesterol, triglycerides, phospholipids, and particle concentration. Fourteen subclasses of decreasing size and their lipid constituents were analysed: six subclasses were very low-density lipoprotein (VLDL), one intermediate-density lipoprotein (IDL), three low-density lipoprotein (LDL), and four subclasses were high-density lipoprotein (HDL). Remnant lipoproteins were VLDL and IDL combined.
Mean nonfasting cholesterol concentration was 72...
Source: Fight Aging! - August 11, 2019 Category: Research Authors: Reason Tags: Newsletters Source Type: blogs
How does acute left main occlusion present on the ECG?
Post by Smith and MeyersSam Ghali (https://twitter.com/EM_RESUS) just asked me (Smith):" Steve, do left main coronary artery *occlusions* (actual ones with transmural ischemia) have ST Depression or ST Elevation in aVR? "Smith and Meyers answer:First, LM occlusion is uncommon in the ED because most of these die before they can get a 12-lead recorded.But if they do present:The very common presentation of diffuse STD with reciprocal STE in aVR is NOT left main occlusion, though it might be due to subtotal LM ACS, but is much more often due to non-ACS conditions, especially demand ischemia. In these ...
Source: Dr. Smith's ECG Blog - August 8, 2019 Category: Cardiology Authors: Steve Smith Source Type: blogs
