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Condition: Heart Failure
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3 steps for doctors who are grieving
As an advanced heart failure and transplant cardiologist, I witness plenty of tragedy. But I don’t lay awake at night anymore grieving bad outcomes — that is the privilege and purview of loved ones. While family and friends may move through Elizabeth Kubler-Ross’ classic stages of grief, doctors do not have that luxury. To give tragedies a purpose, I take three steps when faced with bad outcomes: Separate fault from fluke, separate the expected from the unforeseen and make peace with what I cannot control.
The first step: Ask yourself, “Was it my fault?” Identifying yourself as the proximate cause is gut-wrenchin...
Source: Kevin, M.D. - Medical Weblog - July 26, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/michelle-m-kittleson" rel="tag" > Michelle M. Kittleson, MD < /a > Tags: Physician Cardiology Hospital-Based Medicine Source Type: blogs
CHAMP-HF: Heart Failure Treatment in US Remains Subpar
@media print { body { margin: 2mm 9mm; } .original-url { display: none; } #article .float.left { float: left !important; } #article .float.right { float: right !important; } #article .float { margin-top: 0 !important; margin-bottom: 0 !important; } }CHAMP-HF: Heart Failure Treatment in US Remains Subparhttps://www.medscape.com/viewarticle/899433?src=rssCHAMP-HF: Heart Failure Treatment in US Remains SubparMajor gaps remain in use and dosing of evidence-based, guideline-recommended medications for heart failure with reduced ejection fraction (HFrEF), according to a new...
Source: Dr Portnay - July 25, 2018 Category: Cardiology Authors: Dr Portnay Source Type: blogs
Artificial Model of Heart Ventricle for Studying Cardiac Diseases, Drugs, Therapies
Custom-built artificial hearts are still something from science fiction, but the engineering knowledge to get there is already being assembled in labs around the world. One important piece of the puzzle has just been reported on by researchers at Har...
Source: Medgadget - July 24, 2018 Category: Medical Devices Authors: Editors Tags: Cardiology Diagnostics Genetics Materials Source Type: blogs
Medtronic ’s HVAD Heart Pump FDA Approved for Less Invasive Implantation
Medtronic’s HVAD System, a left ventricular assist device, can now be implanted via a thoracotomy, a less invasive procedure than a median sternotomy. Moreover, a thoracotomy means that future procedures that may require access through the ch...
Source: Medgadget - July 12, 2018 Category: Medical Devices Authors: Editors Tags: Cardiac Surgery Cardiology Source Type: blogs
MKSAP: 68-year-old man with heart failure
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 68-year-old man is evaluated at a follow-up appointment. He has a 7-year history of heart failure secondary to ischemic cardiomyopathy. Over the past 6 months, he has had three hospitalizations for exacerbations of his heart failure. He currently has exertional dyspnea while getting dressed, and his maximal activity level is limited to riding to the store with his wife but staying in the car. Medical history is significant for disseminated prostate cancer treated with androgen deprivation therapy. Medications ...
Source: Kevin, M.D. - Medical Weblog - July 7, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/mksap" rel="tag" > mksap < /a > Tags: Conditions Cardiology Source Type: blogs
Is the stethoscope a vestigial organ?
In the context of human evolution, a vestigial organ is defined as one that has lost all or most of its original function through evolution. Charles Darwin provided a list of vestigial human organs in “The Descent of Man,” including the muscles of the ear, wisdom teeth, the appendix, the coccyx, body hair and the semilunar fold in the corner of the eye. If you had told me 19 years ago when I graduated from medical school that I would one day compare my stethoscope to a vestigial organ, I would have smiled politely and discounted everything you subsequently said. But back then, beta-blockers were contraindicated...
Source: Kevin, M.D. - Medical Weblog - June 21, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/michelle-m-kittleson" rel="tag" > Michelle M. Kittleson, MD < /a > Tags: Physician Cardiology Source Type: blogs
The EBM Wars: When Evidence has a Price – The ECMO Trials (Part 2)
By ANISH KOKA
The year was 1965, the place was Boston Children’s and a surgery resident named Robert Bartlett took his turn at the bedside of a just born baby unable to breathe. This particular baby couldn’t breathe because of a hole in the diaphragm that had allowed the intestines to travel up into the thoracic cage, and prevent normal development of the lungs. In 1965, Robert Bartlett was engaged in the cutting edge treatment of the time – squeeze a bag that forced oxygenated air into tiny lungs and hope there was enough functioning lung tissue to participate in gas exchange to allow the body...
Source: The Health Care Blog - June 17, 2018 Category: Consumer Health News Authors: anish_koka Tags: Uncategorized Source Type: blogs
Device Delivers Drugs Direct to Heart to Help Recover from Heart Attacks
A team of researchers from the U.S. and Ireland have developed a device that can be used to deliver drugs directly to a damaged region of the heart. The capability has the potential to provide a direct therapeutic option to guide how the heart recove...
Source: Medgadget - June 12, 2018 Category: Medical Devices Authors: Editors Tags: Cardiology Genetics Medicine Source Type: blogs
Biomarker of myocardial fibrosis – Cardiology MCQ – Answer
Which of the following is a biomarker of myocardial fibrosis?
Correct answer: a) Soluble ST2 receptor
Galectin-3 is another biomarker of myocardial fibrosis.
Back to question
Reference
Yancy CW, Jessup M, Bozkurt B, Butler J, Casey DE Jr, Colvin MM, Drazner MH, Filippatos GS, Fonarow GC, Givertz MM, Hollenberg SM, Lindenfeld J, Masoudi FA, McBride PE, Peterson PN, Stevenson LW, Westlake C. 2017 ACC/AHA/HFSA Focused Update of the 2013 ACCF/AHA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Fai...
Source: Cardiophile MD - June 7, 2018 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs
Why is not neprilysin inhibitor used alone? – Discussion
Neprilysin is a neutral endopeptidase involved in the degradation of natriuretic peptides (A, B and C), bradykinin, adrenomedullin and other vasoactive peptides.
Combining neprilysin inhibitor with angiotensin converting enzyme inhibitor showed superior efficacy, but was associated with serious angioedema.
ARNI (Angiotensin receptor blocker neprilysin inhibitor) valsaratn/sacubitril does not inhibit angiotensin converting enzyme inhibitor or aminopeptidase P, was not associated with increased risk of angioedema in the PARADIGM-HF trial [1]. Omapatrilat, a drug which inhibits all the three enzymes involved in degradation o...
Source: Cardiophile MD - June 6, 2018 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: General Cardiology Source Type: blogs
Switching from ACEI to ARNI – Cardiology MCQ – Answer
While switching over from an ACE inhibitor to ARNI, ARNI can be started — hours after ACEI:
Correct answer: c) 36 hours
Combination of ACEI (angiotensin converting enzyme inhibitor) and neprilysin inhibitor can lead to higher rates of angioedema as both can lead to accumulation of bradykinin [1]. Bradykinin is inactivated by angiotensin converting enzyme and neprilysin.
Another drug omapatrilat which is an inhibitor of neprilysin, aminopeptidase P and ACE was tried for hypertension and heart failure. All the three enzymes are involved in inactivation of bradykinin [2]. The development of the drug was discontinued be...
Source: Cardiophile MD - June 6, 2018 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs
Guideline recommended treatment for heart failure with preserved ejection fraction (HFpEF)
Heart failure with preserved ejection fraction (HFpEF) is becoming a well recognized entity, occurring more often in the older age group with diastolic left ventricular dysfunction. But unlike in heart failure with reduced ejection fraction (HFrEF), guideline recommended therapeutic options are limited in HFpEF. At the same time, prognosis is not that better in HFpEF. Some of the guideline recommended therapeutic options in HFpEF are as follows:
Systolic and diastolic blood pressures should be controlled as per clinical practice guidelines.
Diuretics should be used for symptomatic relief when there is evidence of volume ...
Source: Cardiophile MD - June 5, 2018 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: General Cardiology Source Type: blogs
Will you estimate BNP or NT-proBNP while on ARNI?
Will you estimate BNP or NT-proBNP (N-terminal pro-B-type natriuretic peptide) while on ARNI?
BNP (B-type natriuretic peptide) and NT-proBNP are commonly estimated biomarkers for heart failure. They have importance in diagnosis as well as prognosis [1]. Valsartan/sacubitril is an Angiotensin II Receptor Blocker Neprilysin Inhibitor (ARNI), an important new medication in our therapeutic armamentarium for management of heart failure.
But which one will you estimate if the person is on ARNI and why?
Please post your answer as a comment below. Do follow the comments as we expect an active discussion!
Reference
Yancy CW, Jess...
Source: Cardiophile MD - June 5, 2018 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: General Cardiology Source Type: blogs
Higher Blood Pressure Correlates with Higher Healthcare Costs
Risk factors associated with age-related disease and mortality tend to also associate with higher medical costs. Obesity, for example, both shortens life span and increases lifetime medical costs thanks to the impact it has on health. High blood pressure, the condition known as hypertension, is another measure that reliably predicts a higher risk of mortality and poor health in later life. Here researchers run the numbers to show that it also results in higher medical costs, much as expected.
Hypertension isn't too far removed from the root causes of aging. High blood pressure is a direct result of arterial stiffeni...
Source: Fight Aging! - June 1, 2018 Category: Research Authors: Reason Tags: Daily News Source Type: blogs
New Transcatheter Aortic Heart Valve to Treat Regurgitation and Stenosis
JC Medical, based in Burlingame, California, has announced that its J-Valve transfemoral transcatheter aortic valve system has been implanted in the first patient to treat aortic regurgitation. Other transcatheter aortic valves available in the U.S. ...
Source: Medgadget - May 31, 2018 Category: Medical Devices Authors: Editors Tags: Cardiac Surgery Cardiology Radiology Source Type: blogs
