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Condition: Heart Attack
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Total 782 results found since Jan 2013.
hs-CRP as a risk assessment tool for cardiovascular disease
It is often mentioned that almost half of first cardiovascular events occur in individuals with no known risk factors. C-reactive protein (CRP) which is usually considered as an inflammatory marker, has emerged as an important cardiovascular risk marker as well. CRP is equivalent to LDL cholesterol (low density lipoprotein cholesterol) as a risk marker. Being an inflammatory marker, high CRP levels also indicate the possibility of plaque rupture leading to coronary thrombosis and myocardial infarction [1].
The current high sensitivity assays of CRP known in short as hs-CRP can also predict recurrent coronary events in tho...
Source: Cardiophile MD - September 25, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
A 50 year old with chest pain? What is going on? By Emre Aslanger.
Posted by Emre Aslanger, our newest blog Editor. Emre is a distinguished cardiologist in Turkey, and has published widely on the ECG in OMI and other areas.Emre Aslanger Google Scholar ProfileA 50-year-old male with a 20 years ’ history of diabetes mellitus treated with metformin only presents with chest pain that started 20 minutes ago. The pain radiates to left inner arm and is now about to resolve. His admission ECG is given below.What do you think?You can click on it to make it larger, but let ' s make it a bit easier to see here:What do you think?(you can still click on it to make it larger)Although the wa...
Source: Dr. Smith's ECG Blog - September 25, 2022 Category: Cardiology Authors: Emre Aslanger Source Type: blogs
Finerenone, a non-steroidal MRA
Finerenone is a nonsteroidal, selective mineralocorticoid receptor antagonist. Finerenone is thought to have lower risk of hyperkalemia and renal issues compared to other MRAs. It has been shown to reduce albuminuria in patients with chronic kidney disease and type 2 diabetes mellitus. FInerenone in reducing kiDnEy faiLure and dIsease prOgression in Diabetic Kidney Disease (FIDELIO-DKD) study evaluated the renal and cardiovascular outcomes in patients with CKD and type 2 diabetes mellitus. 5734 patients with CKD and type 2 diabetes were randomized to finerenone or placebo. All patients were on renin-angiotensin system blo...
Source: Cardiophile MD - September 24, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
Spontaneous coronary artery dissection (SCAD)
Spontaneous coronary artery dissection (SCAD) is an important, though rare cause of acute coronary syndrome. Management of SCAD is different from that of acute coronary syndrome due to atherosclerosis [1]. High index of suspicion is required for the diagnosis of SCAD in young patients with acute coronary syndrome. Unlike atherosclerotic coronary artery disease, management of SCAD is mostly medical, in stable patients. Revascularization is considered only in high risk patients with left main dissection, ongoing ischemia, severely limited flow, hemodynamic compromise or refractory cardiac arrhythmia [2].
It has been mentio...
Source: Cardiophile MD - September 23, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
5 Scenarios Of How Your Health Data Can Be (Or Was Already) Stolen
I really don’t want to sound like Aunt Karen, suspecting a culprit hiding behind every bush, but chances are your health data was or will be stolen. This is a strong statement and might sound paranoid. But, as the old joke goes: being paranoid doesn’t mean someone is not after you.
Here we will introduce five general scenarios of how unknown third-party actors can access your health data without your knowledge (and consent). We introduce these to paint a clearer picture of how medical data can change hands and help you prepare to avoid it – as much as possible.
You had a genetic test done
You o...
Source: The Medical Futurist - September 15, 2022 Category: Information Technology Authors: Andrea Koncz Tags: TMF Forecast Artificial Intelligence in Medicine Digital Health Research Future of Food Healthcare Policy Security & Privacy Source Type: blogs
A man in his 60s with chest pain and LBBB
Sent by Ali Khan MD, written by Pendell MeyersA man in his 60s with HTN, HLD, known prior LBBB, presented with episodes of chest pain radiating to the left shoulder, with diaphoresis and dyspnea. Episodes started yesterday after starting to exercise, came and went throughout the day, and he decided to present to the ED the next morning after the one of these episodes failed to resolve like the others.Here is his ECG at triage with ongoing pain (prior unavailable):Same image optimized by PM Cardio appWhat do you think?I sent this to Drs. Smith, McLaren, and Grauer all of whom immediately diagnosed LAD occlusion based ...
Source: Dr. Smith's ECG Blog - September 11, 2022 Category: Cardiology Authors: Pendell Source Type: blogs
Vitamin K antagonist superior to DOAC in RHD with AF – INVICTUS study
Vitamin K antagonist superior to DOAC in RHD with AF – INVICTUS study
The INVICTUS program (INVestIgation of rheumatiC AF Treatment Using VKA) was designed as an open label parallel group trial comparing treatment with vitamin K antagonists or rivaroxaban, in rheumatic heart disease with atrial fibrillation [1]. It was an international multicentre randomized study. A registry of 17,000 patients was also planned to document the contemporary clinical course of patients with RHD, including a focused sub-study on pregnant women with RHD within the registry. RHD is considered as a neglected disease affecting 33 million pe...
Source: Cardiophile MD - September 10, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
Weekly Overseas Health IT Links –10th September, 2022.
This article is adapted fromVoices in the Code: A Story About People, Their Values, and the Algorithm They Made,out Sept. 8 from Russell Sage Foundation Press.In May 2021, I got a call I never expected. I was working on abook about A.I. ethics, focused on the algorithm that gives out kidneys to transplant patients in the United States. Darren Stewart —a data scientist from UNOS, the nonprofit that runs the kidney allocation process—was calling to get my take: How many decimal places should they include when calculating each patient’s allocation score? The score is an incredibly important number, given it determines w...
Source: Australian Health Information Technology - September 10, 2022 Category: Information Technology Authors: Dr David G More MB PhD Source Type: blogs
Gerbode ventricular septal defects type I, II and III
Though congenital left ventricle to right atrium connections have been described as early as 1838 at autopsy [1, cited in 2], the description by Frank Gerbode and colleagues was in 1958, in their surgical series [3]. They described three varieties of communications:
Fusion of the septal leaflet of the tricuspid valve to the edges of the ventricular septal defect associated with a perforation of the leaflet. Shunt occurs from left ventricle directly into right atrium.
A defect or cleft of tricuspid valve close to its point of attachment directly overlying the VSD.
A combination of these two lesions.
They also described t...
Source: Cardiophile MD - September 8, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
60 year old with vomiting, diarrhea, and syncope: is this Wellens? Is this type 2 MI?
Written by Jesse McLaren, with edits/comments by Smith and Grauer A 60 year-old patient with diabetes and ESRD presented with 24 hours of vomiting, diarrhea, weakness and then a syncopal episode. Vitals: RR 18, sat 98%, HR 103, BP 124/71 and temp 38.0. Here ’s their ECG: is this Wellens? There ’s borderline sinus tach, normal conduction, normal axis, and low voltages in the limb leads. The anterior leads have loss of R waves, mild convex ST segments and primary T wave inversion. In the context of QS waves, T wave inversion indicates old or subacute infarct, or reperfusion after signif icant infarc...
Source: Dr. Smith's ECG Blog - August 19, 2022 Category: Cardiology Authors: Jesse McLaren Source Type: blogs
The distribution of doctor quality: evidence from cardiologists in England
Institute of Fiscal StudiesThere is widespread and unexplained variation in the outcomes of similar patients across place and providers in all developed health systems. This paper provides new evidence on the role senior doctors play in determining patient outcomes. It exploits within-hospital quasi-random assignment of patients to senior doctors following a heart attack to estimate the e ffectiveness of individual doctors, and to estimate returns to experience for these doctors. PaperMore detail
Source: Health Management Specialist Library - August 9, 2022 Category: UK Health Authors: The King ' s Fund Library Tags: Quality of care and clinical outcomes Source Type: blogs
Understanding IRA localization: An illustration
The 12-lead ECG is the single most important investigation that has withstood the test of time for over 100 years. I think it will never lose its relevance in cardiology. However, the traditional sequence of the 12 lead printout could have been a little more user-friendly, especially in its ability to convey the anatomical orientation. Expecting some Innovation in the ECG reporting format.
This illustration helps us to understand, ECG lead orientation, and coronary arterial territory, IRA localization with reference to the various surfaces of the heart. (Courtesy of visible body-modified ) Always remember the heart is a...
Source: Dr.S.Venkatesan MD - July 21, 2022 Category: Cardiology Authors: dr s venkatesan Tags: Uncategorized IRA localisation ECG Source Type: blogs
Chest pain, RBBB but “STEMI Negative”: Is this a false cath lab activation, or a false cancellation?
A 90 year old with a history of atrial fibrillation presented with two weeks of intermittent retrosternal chest pain lasting minutes. An hour prior to presentation it became constant and more severe, accompanied by nausea and general weakness, and the paramedics brought them to the ED as a code STEMI. Heart rate was in the 50s and other vitals normal. What do you think? There ’s atrial fibrillation, a right bundle branch block, normal axis and normal voltages. RBBB should produce secondary ST depression and T wave inversion in the anterior leads with the RsR’ (as it does in V1). But here in...
Source: Dr. Smith's ECG Blog - July 18, 2022 Category: Cardiology Authors: Jesse McLaren Source Type: blogs
Acute Chest pain with LBBB. What is going on?
This history and ECG were texted to me from a far away ED on a Friday night:" Very elderly make with history of coronary disease on an angiogram 1 year prior presents with 2 hours of chest pain, sternal, pressure, and mild diaphoresis. "What do you think?There is sinus tachycardia with LBBB. There is concordant ST depression (STD) in lead V2, and excessively proportionally discordant STD in all of leads V3-V6. Thus, there is one lead (V2) that meets the Sgarbossa criteria and the Smith modified criteria, and 4 other leads (V3-V6) that meet the alternative Smith modified criteria (proportionally excessively disc...
Source: Dr. Smith's ECG Blog - June 23, 2022 Category: Cardiology Authors: Steve Smith Source Type: blogs
LVH and Anterior ST Elevation: is it OMI and would you activate the cath lab?
Written by Jesse McLaren (@ECGCases), with comments by Smith and Grauer A 50 year old presented with chest pain radiating to the shoulder. They had a history of an LAD stent 10 years ago and alcohol use disorder, with repeated visits for chest pain and two code STEMIs two years ago that found no occlusive disease. What do you think? There ’s normal sinus rhythm, normal intervals, normal axis, and normal R wave progression. There’s LVH with repolarization abnormalities, including discordant ST depression and T wave inversion inferolaterally and discordant ST elevation and tall T wave in V2. Are there...
Source: Dr. Smith's ECG Blog - June 20, 2022 Category: Cardiology Authors: Jesse McLaren Source Type: blogs
