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Total 378 results found since Jan 2013.

A Hole In the Heart, Part I
By ANISH KOKA, MD Strokes are the third leading cause of death in the United States. 800,000 people suffer a stroke every year, and the consequences are frequently devastating. Lives are not just lost, but changed forever – speech permanently silenced, arms and legs turned into useless appendages. The brain is very expensive real estate and it is little surprise that a clot the size of a pinhead lodged in a blood vessel feeding the brain is all that is needed to wreak a devastation most fear worse than death. Most of the time the source of the debris that results in a stroke can be readily identified, but at least one-th...
Source: The Health Care Blog - September 6, 2016 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Source Type: blogs

40-something with severe CP. True + vs. False + high lateral MI. ST depression does not localize.
This was sent by Jason Winter of the Facebook PageClinical Electrocardiology This post presents one new case, then reviews some interesting aspects of high lateral MI and of ST Depression in " inferior " leads. Down below are 3 more cases and a discussion of how to differentiate false positive isolated STE in aVL from True positive.CaseA 47 year old male called 911 for severe chest pain. He was clammy and looked unwell. He had a previous MI with cardiac arrest 2 years prior. This is his prehospital ECG:There is very subtle ST elevation in I and aVL, with very subtle ST depression in III and aVF.Is ...
Source: Dr. Smith's ECG Blog - September 3, 2016 Category: Cardiology Authors: Steve Smith Source Type: blogs

Named signs in myocardial bridging
Myocardial bridging is usually seen in left anterior descending coronary artery, with a segment of the artery passing beneath a myocardial bridge. It produces narrowing of the coronary artery in systole, which is relieved in diastole. Hence most often it does not compromise the coronary blood flow, which is mostly in diastole. “Milking effect” is noted on coronary angiography indicating the systolic compression and diastolic relief of compression “Step down-step up” phenomenon can be seen both on coronary angiography still pictures and coronary CT angiography, due to the effect of myocardial bridge...
Source: Cardiophile MD - August 15, 2016 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Angiography and Interventions Cardiology Source Type: blogs

A 12 year old with Wide Complex Tachycardia
A previously healthy 12 year old presented to the ED with a "fast heart rate" that had started about 1.5 hours prior to presentation.  She was reportedly a healthy child and active in several sports. She had a fairly active day and had been swimming off of a boat when her symptoms started. Her mother thought that she was just anxious, so took her home and had her try some deep breathing exercises. When this didn't help she presented to the ED and had this ECG recorded: Here is a higher resolution image, but missing V4-V6:There is regular monomorphic tachycardia with RR interval of about 0.285 ...
Source: Dr. Smith's ECG Blog - July 19, 2016 Category: Cardiology Authors: Steve Smith Source Type: blogs

McKesson Sells IT Division...To Dump Earlier Mistake???
You've all heard by now that healthcare giant McKesson will spin off its IT division. Here's the bullet from Fortune:Healthcare services provider McKesson said it would combine most of its information technology business with Change Healthcare Holdings to form a new company with combined pro forma annual revenue of $3.4 billion.Change Healthcare, a provider of software and analytics, network solutions, and technology-enabled services, will contribute all of its businesses to the new company, with the exception of its pharmacy switch and prescription routing business.Tennessee-based Change Healthcare is majority owned by Bl...
Source: Dalai's PACS Blog - July 1, 2016 Category: Radiology Source Type: blogs

The Perfect Father’s Day Gift: A Prostate Screening
Men’s Health Month: Focus on Prostate Screening By Dr. Jon Elion, MD, FACC and Founder/President of ChartWise Medical Systems. This post first appeared in ChartWise2.0 on Jun 16, 2016 in honor of Men’s Health Month. June is Men’s Health Month, when we focus on prevention, detection, and treatment of disease in men and boys. As a cardiologist, it is tempting for me to use this platform to talk about heart disease. Instead I have decided to push myself beyond that, connecting to my cardiology roots while shooting for some extra bonus points by mentioning coding and Clinical Documentation Improvement. I...
Source: Disruptive Women in Health Care - June 17, 2016 Category: Consumer Health News Authors: dw at disruptivewomen.net Tags: Men's Health Uncategorized Source Type: blogs

The Perfect Father ’s Day Gift: A Prostate Screening
Men’s Health Month: Focus on Prostate Screening By Dr. Jon Elion, MD, FACC and Founder/President of ChartWise Medical Systems. This post first appeared in ChartWise2.0 on Jun 16, 2016 in honor of Men’s Health Month. June is Men’s Health Month, when we focus on prevention, detection, and treatment of disease in men and boys. As a cardiologist, it is tempting for me to use this platform to talk about heart disease. Instead I have decided to push myself beyond that, connecting to my cardiology roots while shooting for some extra bonus points by mentioning coding and Clinical Documentation Improvement. I...
Source: Disruptive Women in Health Care - June 17, 2016 Category: Consumer Health News Authors: dw at disruptivewomen.net Tags: Men's Health Uncategorized Source Type: blogs

How Patient Groups Have Begun To Influence The Value And Coverage Debate
In 2015, two issues related to medicine could be relied on to generate headlines: drug pricing and the proliferation of new value frameworks that claimed to define the value and even the price of drugs in seemingly easy-to-understand ways. In none of the high-profile skirmishes on pricing or frameworks was the voice or perspective of patients and patient groups very much in evidence. But that is beginning to change, in an evolution of a broader shift in the role that patients are playing in the research and development (R&D) enterprise. A New Culture of Engagement Patients and patient organizations are becoming ever mo...
Source: Health Affairs Blog - June 10, 2016 Category: Health Management Authors: Margaret Anderson and Kristin Schneeman Tags: Costs and Spending Health Professionals Organization and Delivery Quality clinical research patient use of evidence venture philanthropy Source Type: blogs

An American Cardiologist in Paris
Next week more than 12,000 cardiologists will stream into the Palais des Congrès in Paris to make presentations and learn about stents, angioplasty, fractional flow reserve, intravascular ultrasound, dual antiplatelet therapy, etc. It’s the annual EuroPCR meeting, “the world-leading course in interventional cardiovascular medicine.” Just be careful in the shower and don’t answer the phone. Especially if you’re traveling with your wife!
Source: Burts Stent Blog : The Voice in the Ear - May 11, 2016 Category: Medical Equipment Source Type: blogs

12 Percent of People Will Be Diagnosed With This Life-Threatening Heart Disease
The post below first appeared on HuffPost Healthy Living on April 20. Jen Hyde, a 30-year-old poet and artist living in Brooklyn, has a congenital heart defect. By the age of 25, Hyde had two open-heart surgeries, including a heart valve replacement. “I know that heart disease is the number one killer of women in America,” Hyde said. “I’m currently in great shape, but part of staying this way means building a strong relationship with my cardiologist so that the care I receive is preventative, not reactive.” Hyde is not alone in suffering from heart health issues — in the U.S., cardiovascular disease is the No...
Source: Disruptive Women in Health Care - April 25, 2016 Category: Consumer Health News Authors: dw at disruptivewomen.net Tags: Chronic Conditions Source Type: blogs

A Perfect Resuscitation Saves a Patient with Refractory Ventricular Fibrillation
This was contributed by Dr. Johanna Moore, one of my Hennepin Colleagues who researches CPR, along with Keith Lurie and Demetris Yannopoulos.  She translated her research knowledge into a spectacular resuscitation.Case A 54 year old male presented via ambulance to the Emergency Department (ED) in cardiac arrest. He was found down outside a clinic, where bystander CPR was initiated by clinic staff. The amount of down time was unclear but thought to be minimal as this was a high traffic pedestrian area. He received an estimated 5 minutes of manual CPR, then, after medic arrival, 20 minutes of LUCAS CPR, including u...
Source: Dr. Smith's ECG Blog - April 16, 2016 Category: Cardiology Authors: Steve Smith Source Type: blogs

Research and Reviews in the Fastlane 128
This study looks at the accuracy of Emergency Physicians (EPs) in using POCUS to diagnose RV dysfunction. The small group of highly trained EPs were able to reliably identify RV issues with a (+) LR = 90 and a (-) LR of 0. While this looks great, it’s important to note the high level of training and the small number of patients (26) with RV dysfunction. More work needs to be done on how this applies to the typical EP. Recommended by: Anand Swaminathan Airway Mosier JM et al. The Physiologically Difficult Airway. W J Emerg Med 2016. PMID: 26759664 This article reviews patient features portending a physiologicall...
Source: Life in the Fast Lane - March 29, 2016 Category: Emergency Medicine Authors: Jeremy Fried Tags: Airway Cardiology Education Emergency Medicine R&R in the FASTLANE Respiratory critical care EBM literature recommendations research and reviews Source Type: blogs

DM / DNB Cardiology Entrance Mock Test 13
In this study, cangrelor was discontinued 1-6 hours prior to surgery, while aspirin was continued throughout the perioperative period. Bridging with cangrelor did not increase major bleeds prior to surgery, though minor bleeds, mostly ecchymosis at venipuncture site, was higher. P2Y12 assay documented sufficient platelet inhibition corresponding to levels required for anti thrombotic effect [1]. Cangrelor is awaiting approval and more large scale trials regarding the use of bridging are needed. Reference 1. Angiolillo DJ et al; BRIDGE Investigators. Bridging antiplatelet therapy with cangrelor in patients undergoing ...
Source: Cardiophile MD - February 7, 2016 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs

DM / DNB Cardiology Entrance Mock Test 12
Please wait while the activity loads. If this activity does not load, try refreshing your browser. Also, this page requires javascript. Please visit using a browser with javascript enabled. If loading fails, click here to try again Click on the 'Start' button to begin the mock test. After answering all questions, click on the 'Get Results' button to display your score and the explanations. There is no time limit for this mock test. Start Congratulations - you have completed DM / DNB Cardiology Entrance Mock Test 12. You scored %%SCORE%% out of %%TOTAL%%. Your performance has been rat...
Source: Cardiophile MD - February 4, 2016 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ DM / DNB Cardiology Entrance Featured Source Type: blogs

Looking for a wall motion abnormality can lead you astray
A Middle-aged male presented with chest pain of 3 hours duration. He has a history of hyperlipidemia only.  There is pressure to mid-chest, radiating to the right arm, associated with diaphoresis.   He never had this before.  It was not related to eating.  There was no cough or fever, nor trauma.  There was no recent surgery, and no h/o thromboembolism. Exam and BP were normal.Here is the first ECG:  0526There is ST elevation in V1-V4, with concave ST segments.  Is it ischemic, or is it early repol?It does not meet STEMI "criteria," but we know they are insensitiveFirst, look for any reci...
Source: Dr. Smith's ECG Blog - January 29, 2016 Category: Cardiology Authors: Steve Smith Source Type: blogs