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Total 177 results found since Jan 2013.

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

OCT is not “ Obsessive compulsive tomography ”
This is the story of PCI to LAD from the customary bifurcation workshop for the budding experts, which ended up with a compulsive final OCT run-through, triggering a debate on what to do with the side branch. What shall we do next? Just balloon dilate the distal strut Would consider a second stent. Maybe a TAP  depending upon LCX morphology At this stage, I would like to know the FFR or iFR across LCX Jail. Get rid of this OCT, Let me have look at regular CAG. I bet I can make a better decision. Leave it alone if the clinical status & profile is good Leave it alone? Is it not an incomplete Job? Def...
Source: Dr.S.Venkatesan MD - September 8, 2022 Category: Cardiology Authors: dr s venkatesan Tags: Uncategorized coronary Imaging ILUMEN study oct opitical coherence tomography Source Type: blogs

Another deadly and confusing ECG. Are you still one of the many people who will be fooled by this ECG, or do you recognize it instantly?
Submitted and written byDestiny Folk MD, peer reviewed by Meyers, Smith, Grauer, McLarenA man in his early 30s with no significant past medical history was brought to the ED by EMS after being found unresponsive by a friend. EMS arrived and found him awake and alert. He complained of generalized weakness and left lower extremity numbness. He reported that 12 hours prior to arrival he used fentanyl and cocaine. He reported difficulty walking and felt as if his left leg was “asleep.” He denied any chest pain or shortness of breath and stated he felt at his baseline yesterday prior to drug use. On arrival in the ED, he wa...
Source: Dr. Smith's ECG Blog - May 5, 2022 Category: Cardiology Authors: Pendell Source Type: blogs

A 40-something without past history presents with wide complex tachycardia and crushing chest pain
See Ken Grauer ' s important and detailed ECG analysis at the bottom.CaseA 40-something with no PMH presented with palpitations, tachycardia, and crushing chest pain.This was the prehospital ECG.Sustained wide complex tachycardia.  Is it VT or SVT with Aberrancy?Also: there is no concordant ST segments or clearly excessively discordant ST segments, so superimposed Occlusion MI (OMI) is unlikely.There is a regular wide complex tachycardia, without P-waves, and anLBBB configuration andinferior axis.  [LBBB "configuration" is different from LBBB: it means that there is a predominant S-wave in V1 and V2 and...
Source: Dr. Smith's ECG Blog - February 14, 2022 Category: Cardiology Authors: Steve Smith Source Type: blogs

Acute respiratory distress: Correct interpretation of the initial and serial ECG findings, with aggressive management, might have saved his life.
 Written by Pendell Meyers with edits by SmithA man in his 60s called EMS apparently for shortness of breath. EMS found him in distress and hypoxemic requiring 4 L nasal cannula to maintain oxygen saturation greater than 93%.Here is his triage ECG:What do you think?An old ECG was available on file, from 2 years ago:RBBB, otherwise normal.The triage ECG is diagnostic of life threatening hyperkalemia (sodium channel blockade would also produce this pattern, but the patient was not known to be on any sodium blocking medications). There is the very common brugada pattern STEMI mimic seen in V1 and partially in V3 and aVR....
Source: Dr. Smith's ECG Blog - January 16, 2022 Category: Cardiology Authors: Pendell Source Type: blogs

Cardiac failure Info desk : Diuretics never save lives, while Dapagliflozin does it in style !
An Interaction in IMCU How is Mr. K, who was shifted from ward 102 ? Yes sir, It was acute decompensated LV failure, Patient was in impending pulmonary edema. In fact, he developed. He is fine now, How did he come around? He was too sick I thought. “Just pushed 60 mg Frusemide IV, luckily he also had good BP, so with an infusion of NTG, titrated Carvedilol a little bit, he came out nicely. I guess it is Ischemic DCM”. “Good, You have done a nice job” “Don’t make me embarrassed sir. It is such a routine in our ER.  To make him curious, I asked “Which drug do you think that saved hi...
Source: Dr.S.Venkatesan MD - December 17, 2021 Category: Cardiology Authors: dr s venkatesan Tags: cardiac failure Cardiology -guidelines cardiology -Therapeutics cardiology wisdom cardiology-ethics Cardiology-Land mark studies Ethics in Medicine evidence based cardiology acc aha esc guidelines on heart failure bumatanide Cardiac fa Source Type: blogs

Cardiac failure Info desk :Diuretics never save lives, while Dapagliflozin does it in style !
An Interaction in IMCU How is Mr. K, who was shifted from ward 102 ? Yes sir, It was acute decompensated LV failure, Patient was in impending pulmonary edema. In fact, he developed. He is fine now, How did he come around? He was too sick I thought. “Just pushed 60 mg Frusemide IV, luckily he also had good BP, so with an infusion of NTG, titrated Carvedilol a little bit, he came out nicely. I guess it is Ischemic DCM”. “Good, You have done a nice job” “Don’t make me embarrassed sir. It is such a routine in our ER.  To make him curious, I asked “Which drug do you think that s...
Source: Dr.S.Venkatesan MD - December 17, 2021 Category: Cardiology Authors: dr s venkatesan Tags: cardiac failure Cardiology -guidelines cardiology -Therapeutics cardiology wisdom cardiology-ethics Cardiology-Land mark studies Ethics in Medicine evidence based cardiology acc aha esc guidelines on heart failure bumatanide Cardiac fa Source Type: blogs

An Important work in Clinical cardiology : The hidden gem of “ Diamond & Forrester ” !
     If anyone asks to shortlist the best papers that were, ever published in clinical cardiology, I am sure, this one will reach the top ten. It was 1979, the field of cardiology is just waiting to explode. CAD was managed primarily with drugs and occasional CABGs.  Coronary angiograms were an academic luxury. Both thrombolysis and PCI were unknown. Fortunately, Clinical cardiology was still alive and kicking. Dr. George Diamond and  Dr. James Forrester from  Cedars Sinai, New York worked together to bring this masterpiece. How and when to suspect CAD in the general population? For the first time probability was app...
Source: Dr.S.Venkatesan MD - December 1, 2021 Category: Cardiology Authors: dr s venkatesan Tags: Uncategorized Source Type: blogs

A woman in her 60s with syncope and vomiting. Does she need a pacemaker?
 Written by Pendell Meyers with some edits by Steve SmithA woman in her 60s on chemotherapy presented to the Emergency Department for a syncopal episode just prior to arrival. She was walking to the bathroom when she suddenly felt nauseous and passed out. EMS was called by the patient ' s daughter, and en route to the ED she vomited twice. On arrival to the ED, she adamantly denies chest pain but says she ' s " just still not feeling well. " She had no prior known cardiac disease.Triage at 0755:The rhythm is most either atrial fibrillation with complete heart block and resulting junctional escape, or atrial flutter wi...
Source: Dr. Smith's ECG Blog - November 19, 2021 Category: Cardiology Authors: Pendell Source Type: blogs

Intravascular Lithotripsy for Severely Calcified Coronary Arteries
Intravascular lithotripsy uses acoustic pressure waves to modify calcium inside the blood vessels, increasing the compliance of the vessel and facilitates stent deployment [1]. The device takes care of one of the important night mares of an interventionalist, the calcified coronaries! Disrupt CAD III was a prospective multicenter study for the regulatory approval of intravascular coronary lithotripsy [1]. Optical coherence tomography (OCT) was used to assess the mechanism of modification of calcium in a substudy. Primary safety endpoint of Disrupt CAD III was freedom from major adverse cardiovascular events (MACE) of card...
Source: Cardiophile MD - September 15, 2021 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Cardiology Source Type: blogs

How did all those calcium entered my father ’ s coronary artery doctor ?
“It was severe double vessel disease &  turned out to be a complex angioplasty in LAD ”  Why doctor? what happened? It was a hard lesion, there was plenty of calcium deposits. It was not clearly visible in the angiogram. I had to do IVUS. Curiously, the calcium was clustered in all the three planes of the vessel ( intima the media and adventitia) and they projected into the lumen blocking the path. Image collage representation purpose Thank you, doctor,  how did you manage to remove it,? It was a real struggle. I had to break the calcium shell before deploying the stent. (What we refer to as...
Source: Dr.S.Venkatesan MD - September 3, 2021 Category: Cardiology Authors: dr s venkatesan Tags: Cardiology -unresolved questions calcium supplementation coronary calcification intimal medial adventitial calcium ivl wolverine angiosculpt opn balloon orbitel atherectomy osteoporosis plaque calcium rotoablator serum calcium vs coron Source Type: blogs

Wide and weird
Written by Clare Gunn MD, peer reviewed by Smith, Meyers, BraceyA 74-year-old female presented to the ER after a trip and fall (unclear if purely mechanical or due to possible unsteadiness) causing her to cut her leg. Due to chronic anticoagulation for atrial fibrillation, she could not stop the bleeding, so she came the ED.  On arrival she is found to be hypoxemic requiring four liters of oxygen via nasal cannula. While getting her leg wound repaired, the patient was also evaluated for hypoxemia and tachycardia and was found to have this ECG:What do you think?Here was her most recent prior ECG on file for comparison:...
Source: Dr. Smith's ECG Blog - August 27, 2021 Category: Cardiology Authors: Pendell Source Type: blogs

Cracking Calcium in Arteries Using Sound Waves: Interview with Shockwave Medical ’s Scott Shadiow
Shockwave Medical, a medtech company based in California, has developed a technique called intravascular lithotripsy, which involves delivering sonic waves to calcified plaque in an artery in much the same way that sound waves have been used to treat...
Source: Medgadget - August 26, 2021 Category: Medical Devices Authors: Conn Hastings Tags: Cardiac Surgery Cardiology Radiology Vascular Surgery Source Type: blogs

Cardiology MCQs
Ischemic preconditioning is mediated by: ATP-sensitive potassium channel (KATP) Sodium channel Ikr, the rapid component of delayed rectifier potassium current L-type calcium channel Correct answer: 1. ATP-sensitive potassium channel (KATP) Blockers of ATP-sensitive potassium channel (KATP) like glibenclamide can prevent ischemic reconditioning. KATP channel opener nicorandil can mimic ischemic preconditioning and it is known as pharmacological preconditioning. Stimulation of adenosine receptors is known to simulate ischemic preconditioning. [Tomai F, Crea F, Gaspardone A, Versaci F, De Paulis R, Penta de Peppo A, Chiari...
Source: Cardiophile MD - July 2, 2021 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs

GALACTIC-HF Trial: Omecamtiv mecarbil
GALACTIC-HF trial evaluated omecamtiv mecarbil, a cardiac myosin activator in heart failure with reduced ejection fraction [1]. The study had 8256 patients which included inpatients and outpatients with symptomatic heart failure with an ejection fraction of 35% or less. It was a placebo controlled trial of omecamtiv mecarbil in addition to standard heart failure therapy. Primary outcome was a composite of first heart failure event or death from cardiovascular causes. Heart failure event was defined as hospitalization or urgent hospital visit for heart failure. Over a median follow up of 21.8 months, primary outcome event ...
Source: Cardiophile MD - June 8, 2021 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Cardiology Source Type: blogs