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No Scientific Proof That Multivitamins Promote Heart Health
https://www.medscape.com/viewarticle/899130No Scientific Proof That Multivitamins Promote Heart HealthTaking multivitamin/mineral (MVM) supplements does not prevent myocardial infarction, stroke, or death from a cardiovascular cause, according to a comprehensive meta-analytic review of relevant research." The take-home message is simple: there is no scientific evidence that MVM supplements promote cardiovascular health. We hope that our paper helps to settle the controversy on MVM use for CVD prevention, " lead author Joonseok Kim, MD, University of Alabama at Birmingham, toldtheheart.org | Medscape Cardiology.The study wa...
Source: Dr Portnay - July 25, 2018 Category: Cardiology Authors: Dr Portnay Source Type: blogs

How dangerous are NSAIDs in patients with AF?
One of the most commonly asked questions in the office is the treatment of arthritis pain. This comes up because of the concern over taking NSAIDs (non steroidal anti-inflammatory drugs) in patients who are on anticoagulants (such as warfarin, or dabigatran, rivaroxaban, apixaban). My views on this matter have changed. But first, I want to mention a study published in JACC that addressed the issue of NSAID use in pts with AF who take an anticoagulant. This was a sub-analysis of the RELY trial, which pitted dabigatran vs warfarin. Remember, in the original RELY trial, the 150mg dose of dabigatran did better than warfarin at...
Source: Dr John M - July 13, 2018 Category: Cardiology Authors: Dr John 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

Alcohol and heart health
I’m not a regular drinker, nor a teetotaler. But like many people, I enjoy the occasional glass of wine with dinner, and nothing tastes better than an ice-cold beer on a sweaty summer day. Besides, some alcohol is a toast to my long-term heart health. At least that’s what the science says, right? Not really. When it comes to alcohol and heart health, the existing research is quite conflicting — some studies say alcohol improves heart health, while others imply the opposite. Alcohol and heart health: What’s the real story? The problem with most alcohol-related research is that it consists almost entirely of observ...
Source: Harvard Health Blog - July 6, 2018 Category: Consumer Health News Authors: Matthew Solan Tags: Alcohol Health Heart Health Source Type: blogs

Watch what happens when " pericarditis " and morphine cloud your judgment
Submitted and written by Alex Bracey with edits by Pendell Meyers and Steve SmithCaseA 50ish year old man with a history of CAD w/ prior LAD MI s/p LAD stenting presented to the ED with chest pain “similar to his prior MI, but worse.” The pain initially started the daypriorto presentation. The pain roused him from sleep but subsided without intervention. Around 19 hours later, he experienced the same pain, which prompted his presentation to the ED. By this time, three hours had passed from the onset of the pain but it was no longer present. Here is his initial ECG:00:04What do you think? - Sinus rhythm at ~70 bpmSTE in...
Source: Dr. Smith's ECG Blog - July 3, 2018 Category: Cardiology Authors: Pendell Source Type: blogs

The Evidence Crisis: Causal Inference – Don ’ t be a chicken (Part 3)
By ANISH KOKA Part 1 Part 2 Physicians have been making up numbers longer than people have been guessing weights at carnivals.  How much does this statin lower the chances of a heart attack? How long do I have to live if I don’t get the aortic valve surgery? In clinics across the land confident answers emerge from doctors in white coats.  Most of the answers are guesses based on whatever evidence about the matter exists applied to the patient sitting in the room.  The trouble is that the evidence base used to be the provenance of experts and anecdotes that have in the past concluded leeches were good for pneumonia...
Source: The Health Care Blog - June 29, 2018 Category: Consumer Health News Authors: anish_koka Tags: Uncategorized Source Type: blogs

Cardiology Podcast Every Friday
My editors at Medscape warned me years ago that many people, especially younger ones, read a lot less. This saddened me because I’ve spent a great deal of time learning to write. One of America’s most accomplished writers, Malcolm Gladwell, began his podcast because he worried about not reaching younger people. Each week, I spend a great deal of time putting together thoughts on the top 4-5 cardiology stories of the week. Most of the ‘stories’ are studies, but not always. I have been doing this podcast for a couple of years now, but haven’t promoted it because I was not sure it would stick. ...
Source: Dr John M - June 25, 2018 Category: Cardiology Authors: Dr John Source Type: blogs

Intervention in aortic stenosis – Cardiology MCQ – Answer
Intervention is indicated in symptomatic severe high gradient aortic stenosis with: Correct answer: d) Mean gradient 40 mm Hg or more OR peak velocity 4 m/s or more Severe aortic stenosis can also exist with a low mean gradient below 40 mm Hg. In such cases, usually there is associated left ventricular dysfunction so that left ventricle is unable to produce sufficient force to generate the high gradient. Before intervention is contemplated in such cases, left ventricular contractile reserve should be documented as improvement in stroke volume with dobutamine infusion. Pseudo severe aortic stenosis can also be there when t...
Source: Cardiophile MD - June 18, 2018 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs

Finding Truth: How Much Do We Need Experts?
I am planning a column on the role of experts in translating medical evidence. Evidence is important because it’s how doctors know they are helping not harming people. It’s hardly news that the new (digital) democracy of information has changed the rules of influence in Medicine. In the days of old, academic doctors generated, analyzed and translated evidence. We called these people key opinion leaders (KOLs). To become a KOL, you stayed in academics, published lots of studies, and crucially, you were not too critical of prevailing views. If you did that, you could get invited to speak at meetings, write editor...
Source: Dr John M - June 10, 2018 Category: Cardiology Authors: Dr John Source Type: blogs

Fighting Hubris in Medicine
By ANISH KOKA The weekend started with a tweet about an elderly man with atrial fibrillation.  Atrial fibrillation is an arrhythmia of the heart that predisposes those who suffer with it to strokes.  The strokes are a  result of clots being thrown from the heart into the brain.  The typical treatment for this condition in those deemed high enough risk is to thin the blood to help prevent these clots from forming, and thus reducing the risk of stroke. 101 year old with a history of a stroke stops his Pradaxa. Only other history hypertension. https://t.co/Ai5z519rcX — Anish Koka (@anish_koka) June 3, 2018 The pro...
Source: The Health Care Blog - June 7, 2018 Category: Consumer Health News Authors: anish_koka Tags: Uncategorized Source Type: blogs

A Tale of 2 FDAs
By ANISH KOKA Frances Oldham Kelsey by all accounts was not mean to have a consequential life.  She was born in Canada in 1914, at a time women were meant to be seen and not heard.  Nonetheless, an affinity for science eventually lead to a masters in pharmacology from the prestigious McGill University.  Her first real break came after she was accepted for PhD level work in the pharmacology lab of a professor at the University of Chicago.  An esteemed professor was starting a pharmacology lab and needed assistants, and the man from Canada seemed to have a perfect resume to fit.  That’s right, I said man.  France...
Source: The Health Care Blog - June 4, 2018 Category: Consumer Health News Authors: anish_koka Tags: Uncategorized Source Type: blogs