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Important blood tests in relation to the heart – Cardiology Basics
Important blood tests in relation to the heart – Cardiology Basics
Here are some important blood tests in relation to the heart. Normal ranges of some of these tests may vary between labs.
Cholesterol is a type of fat found in the blood and has a role in the development of atherosclerosis in the coronary arteries as well as other arteries. Desirable value of total cholesterol in blood is less than 200 milligrams per decilitre.
Triglycerides is another type of fat found in the blood. Desirable value is less than 150 milligrams per decilitre. Very high levels of triglycerides carry a risk of pancreatitis. Calorie restr...
Source: Cardiophile MD - October 11, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
Ultrasound lung comets or B lines in pulmonary edema – Cardiology Basics
Ultrasound lung comets or B lines in pulmonary edema – Cardiology Basics
Usually air in the lungs does not permit transmission of ultrasound and that is the reason for poor echo window in those with chronic obstructive airways disease. But when the lung is waterlogged in pulmonary edema, certain broad lines extending from the transducer location to the end of the imaging field appear on lung ultrasound. These have been called as B lines or ultrasound lung comets. They move with the lung movement in respiration. B lines are easy to detect with any ultrasound device including pocket devices and conventional echocardiog...
Source: Cardiophile MD - October 11, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
What is pulmonary edema? Cardiology Basics
Pulmonary edema is collection of fluid within the lung alveoli.
The most important cause of pulmonary edema is heart failure, specifically, left ventricular failure. Pulmonary edema can also occur when there is fluid overload in the body as in renal failure.
Other causes of pulmonary edema are mitral stenosis, pulmonary venous obstruction and increased permeability of the pulmonary capillaries. Increased permeability of the pulmonary capillaries occurs in noncardiogenic pulmonary edema – e.g. adult respiratory distress syndrome or ARDS.
Sudden breathlessness is the most important symptom of pulmonary edema as the lungs ...
Source: Cardiophile MD - October 8, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
What is a silent myocardial infarction? Cardiology Basics
Silent myocardial infarction is one in which the person does not know that myocardial infarction has occurred. This can be because chest pain was not felt or was only mild. It can also be missed if the person was under sedation or under general anaesthesia when it occurred. In earlier community studies like the Framingham Heart Study, in which ECG was recorded every two years, it was shown that up to one fourth of the previous myocardial infarctions detected on ECG were silent.
Silent myocardial infarctions are more likely in those with diabetes mellitus. Long standing diabetes affects the nerves of the heart so that...
Source: Cardiophile MD - October 6, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
How is thyroid linked to heart disease? Cardiology Basics
Disorders of thyroid gland can cause heart disease in multiple ways. Heart disease can occur with both hypothyroidism and hyperthyroidism. In hyperthyroidism, heart rate increases and there is a hyperdynamic circulatory state which can lead to high output cardiac failure. Unlike in the usual congestive heart failure in which the extremities are cold due to vasoconstriction, in heart failure due to hyperthyroidism, the extremities are warm. Instead of a low volume pulse in usual heart failure, thyrotoxic heart failure has a high volume pulse.
Another important cardiac problem in hyperthyroidism is atrial fibrillation with ...
Source: Cardiophile MD - October 5, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
Interatrial septal device therapy in HFpEF
Interatrial septal device therapy in HFpEF
Effective therapeutic modalities for heart failure with preserved ejection fraction (HFpEF) are lesser than those available for heart failure with reduced ejection fraction (HFrEF). All the same, prevalence, morbidity and mortality for HFpEF are not lower than that of HFrEF. Ongoing search for therapeutic options has led to the development of interatrial septal devices to decompress the left atrium, which are still in investigational phase [1].
A unidirectional left-to-right interatrial shunting device was initially tested in patients with HFrEF as a safety and proof-of-principle...
Source: Cardiophile MD - October 3, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
Coffee good for heart health – Large study
Coffee good for heart health – Large study
Usually physicians, including me, ask patients with cardiovascular disease to avoid coffee, especially for those with cardiac arrhythmia [1]. Now, here is a study which says that taking 2-3 cups of decaffeinated, ground or instant coffee a day is associated with significant reductions in incident cardiovascular disease and mortality. Even more, ground and instant coffee, but not decaffeinated coffee was associated with reduced arrhythmia [2].
In fact, coffee consumption at 3-4 cups per day has been described as probably not harmful and perhaps even moderately beneficial in t...
Source: Cardiophile MD - September 30, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
Are all of these ST-T findings due to LVH?
CONCLUSION: Contrast a final time the appearance of ST-T waves consistent with LV " strain " in the anterior and lateral chest leads of ECG #2 — with the lack of such changes in the chest leads of ECG #1 (in which ST-T wave changes were attenuated by the opposing effect of the ongoing acute infero-postero OMI).
Source: Dr. Smith's ECG Blog - September 30, 2022 Category: Cardiology Authors: Steve Smith Source Type: blogs
Atrial functional mitral regurgitation
Atrial functional mitral regurgitation occurs secondary to left atrial disease, without left ventricular dilatation and intrinsic mitral valve disease. Atrial functional MR typically occurs in the setting of long-standing atrial fibrillation. It is associated with increased mortality risk and hospitalization for heart failure [1]. Reported prevalence of atrial functional MR in patients with AF vary between 3 to 15%. These patients have worse clinical outcome [2].
Dilatation of the mitral annulus, atriogenic tethering of mitral leaflets and insufficient mitral leaflet remodeling are thought to be important pathogenic mecha...
Source: Cardiophile MD - September 28, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
Phosphodiesterase-9 inhibitors for the treatment of heart failure?
Phosphodiesterase-9 (PDE9) has the highest binding affinity among phosphodiesterases with cyclic guanosine monophosphate [1]. Cardioprotective effects of natriuretic peptides released in response to ventricular stretch in heart failure are mediated by the second messenger cyclic guanosine monophosphate (cGMP) [2]. Intracellular levels of cGMP and cAMP are governed by the activity of cyclic nucleotide phosphodiesterases. 11 phosphodiesterases with varying tissue selectivity and substrate affinity for cGMP and cAMP have been identified (PDE1 to PDE11) so far.
Increased mortality with high doses of PDE3 inhibitors milrinone,...
Source: Cardiophile MD - September 28, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
Periodontal disease linked to heart failure – New study report
Periodontal disease linked to heart failure – New study report
Periodontal disease is known to be associated with coronary artery disease as well as poses a risk for bacteremia and subsequent risks [1]. A recent report looked at 6707 participants of the ARIC (Atherosclerosis Risk In Communities) study who had full-mouth periodontal examination at visit 4 between 1996-1998 and longitudinal follow up for incident heart failure. Data on incident heart failure was checked from visit 4 to 2018. In addition data on incident heart failure with preserved ejection fraction (HFpEF) and heart failure with reduced ejection fract...
Source: Cardiophile MD - September 25, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
Intravenous acetazolamide for acute decompensated heart failure – ADVOR Study
Intravenous acetazolamide for acute decompensated heart failure – ADVOR Study
Acetazolamide in Decompensated Heart Failure With Volume OveRload (ADVOR) study assessed whether intravenous acetazolamide can improve the efficacy of loop diuretics in acute decompensated heart failure with volume overload. Acetazolamide is a carbonic anhydrase inhibitor that reduces proximal tubular sodium reabsorption. It was a multicenter, double blind randomized, placebo controlled trial. Edema, pleural effusion and ascites were the important features of volume overload [1].
Ascites was confirmed by abdominal ultrasound and pleural eff...
Source: Cardiophile MD - September 24, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology 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
DIAMOND trial: Patiromer for management of hyperkalemia in HFrEF
Patiromer is a nonabsorbed potassium binder used in the treatment of hyperkalemia. Earlier it was tested in patients with chronic kidney disease who were receiving inhibitors of the renin-angiotensin-aldosterone system (RAAS). It was found that patiromer treatment was associated with a decrease in serum potassium levels compared to placebo and a reduction in the recurrence of hyperkalemia [1].
DIAMOND trial was designed to evaluate patiromer for the management of hyperkalemia in patients receiving RAAS inhibitors for heart failure with reduced ejection fraction (HFrEF) [2]. 1195 patients with RAAS inhibitor related ...
Source: Cardiophile MD - September 24, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
Cardiomyopathy in muscular dystrophies
Important muscular dystrophies due to mutations in structural cytoskeletal dystrophin gene are known as dystrophinopathies. They include Duchenne muscular dystrophy, Becker muscular dystrophy and X-linked dilated cardiomyopathy. Primary presentation of most dystrophinopathies is skeletal muscle weakness. Duchenne muscular dystrophy is caused by mutations leading to absence of functional dystrophin. Becker muscular dystrophy is due to mutations resulting in reduced amounts of shortened dystrophin protein.
Cardiac muscle being a striated muscle, is affected in many types of muscular dystrophies. Cardiomyopathy would contrib...
Source: Cardiophile MD - August 30, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
