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Handling Heat On Blood Pressure Medication: Your Summer Health Guide
Conclusion Summing it up, individuals taking blood pressure medication must be cautious during the hot weather season. Heat exposure can significantly impact blood pressure and may amplify the effects of medication, leading to potentially harmful health conditions. These risks, however, can be managed with the right precautions such as staying hydrated, dressing appropriately, and planning outdoor activities during cooler times of the day. Importantly, each person’s response to heat and medication varies. Hence, a one-size-fits-all approach isn’t ideal. Your healthcare provider is an invaluable resourc...
Source: The EMT Spot - July 26, 2023 Category: Emergency Medicine Authors: Michael Rotman, MD, FRCPC, PhD Tags: Blood Pressure Source Type: blogs

Blood Pressure Meds vs Blood Thinners: What ’ s The Difference?
Conclusion In conclusion, while blood pressure medicines and blood thinners are both crucial to heart health, their roles and mechanisms of action are notably distinct. Blood pressure medication works primarily on the vascular system, aiding in reducing blood pressure by relaxing blood vessels or altering the heart’s function. On the other hand, blood thinners target the blood itself, working to prevent the formation of potentially dangerous blood clots. Throughout this article, one thing becomes undeniably clear: the importance of regular consultations with your healthcare provider. When it comes to managing m...
Source: The EMT Spot - July 20, 2023 Category: Emergency Medicine Authors: Michael Rotman, MD, FRCPC, PhD Tags: Blood Pressure Source Type: blogs

8 Risk Factors Of Low Blood Pressure
Conclusion In a nutshell, understanding the risk factors associated with low blood pressure is essential for maintaining good health. Individuals with certain risk factors, such as age, medication usage, underlying medical conditions, dehydration, prolonged bed rest, nutritional deficiencies, pregnancy, and inherited factors, should be particularly aware of the potential for low blood pressure. Regular monitoring of blood pressure, communication with healthcare providers, and appropriate management strategies are important for individuals with these risk factors to ensure their well-being. Furthermore, diet pla...
Source: The EMT Spot - June 23, 2023 Category: Emergency Medicine Authors: Michael Rotman, MD, FRCPC, PhD Tags: Blood Pressure Source Type: blogs

Ultrahigh-Resolution Photon-counting CT Useful Prior to Transcatheter Aortic Valve Replacement
Assessment of coronary anatomy prior to Transcatheter Aortic Valve Replacement has great prognostic significance. Invasive coronary angiography is done prior to TAVR though CT coronary angiography has a role in ruling out coronary artery disease in those with low or intermediate pretest probabilities. Accurate interpretation of coronary arteries in those planned for TAVR has challenges because of high occurrence of abnormal heart rhythm, contraindications for beta blockers and nitroglycerine administraton. Still important is the blooming artifacts on CT coronary angiography in those with coronary stents or severe calcific...
Source: Cardiophile MD - June 21, 2023 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs

Nocturnal Hypertension Unveiled: Protect Your Health While You Sleep
Is your blood pressure working the night shift? Let’s decode the mysteries of nocturnal hypertension together – from its symptoms and causes, to diagnosis and effective management. Sleep peacefully with our handy guide! Quick Summary Nocturnal Hypertension refers to high blood pressure that occurs at night, usually when blood pressure should naturally dip due to the circadian rhythm. Risk factors for nocturnal hypertension include conditions such as sleep apnea, diabetes, kidney disease, and lifestyle factors like high salt intake and lack of adequate sleep. Diagnosis and management of nocturna...
Source: The EMT Spot - June 3, 2023 Category: Emergency Medicine Authors: Michael Rotman, MD, FRCPC, PhD Tags: Blood Pressure Source Type: blogs

A man in his 60s with acute chest pain
Sent by anonymous, written by Pendell MeyersA man in his 60s presented with acute chest pain with diaphoresis. He had received aspirin and nitroglycerin by EMS, with some improvement. His vitals were within normal limits. Here is his triage ECG:2045:What do you think?The ECG is subtle, but diagnostic of infero-posterior OMI. The QRS is normal, yet in aVL the normal upright small QRS complex is followed by in appropriately large-volume T wave inversion, which is reciprocal to the T waves in lead III, which are probably hyperacute if compared to available baseline. Corroborating this is the subtle ST depression in V2-V3 whic...
Source: Dr. Smith's ECG Blog - February 6, 2023 Category: Cardiology Authors: Pendell Source Type: blogs

What is the role of Disopyramide in HCM?
Disopyramide is a class Ia antiarrhythmic agent which can be used in hypertrophic obstructive cardiomyopathy when beta blockers alone are ineffective. Disopyramide has a negative inotropic action and is useful in reducing left ventricular outflow tract gradients in hypertrophic obstructive cardiomyopathy and does not increase the risk of sudden cardiac death. Dose reduction is recommended when QTc exceeds 480 ms. It should be avoided in those with glaucoma and men with prostatic symptoms in view of its anticholinergic action. Anticholinergic action is responsible for increase in ventricular rate with atrial fibrillation. ...
Source: Cardiophile MD - November 24, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs

Which type of beta blocker is not ideal for HOCM?
Vasodilating beta blockers are not an ideal choice for the treatment of hypertrophic obstructive cardiomyopathy. Non vasodilating betablockers are recommended for the treatment of hypertrophic obstructive cardiomyopathy (Class I, Level of Evidence B, as per European Society of Cardiology Recommendations 2014). Other class I drug recommendation when beta blockers are not tolerated is verapamil. Disopyramide has a class I recommendation in combination with betablocker or verapamil. Reference 1. Elliott PM, Anastasakis A, Borger MA, Borggrefe M, Cecchi F, Charron P, Hagege AA, Lafont A, Limongelli G, Mahrholdt H, McKenna W...
Source: Cardiophile MD - November 24, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs

Role of beta blockers in hypertrophic obstructive cardiomyopathy (HOCM)
Beta blockers are the mainstay of medical treatment in hypertrophic cardiomyopathy with or without obstruction. They reduce the dynamic left ventricular outflow obstruction, angina, exertional dyspnea and the risk of ventricular arrhythmias [1]. Reduction in left ventricular outflow obstruction is mostly due to the negative inotropic effect of beta blockers [2]. Reduction in heart rate by beta blockers increases diastolic filling time. Sympatholytic effect of beta blockade can also reduce ventricular stiffness. Non-vasodilating beta blockers titrated to maximum tolerated dose is considered for those with symptomatic left ...
Source: Cardiophile MD - November 18, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs

High Blood Pressure and Erectile Dysfunction
Research confirms that high blood pressure and ED are closely linked. But did you know the majority of cases of ED are caused by hypertension? Keep reading to find out more. Experts suggest that “hypertension is sometimes a standalone condition and sometimes it’s associated with other conditions, which also impact erectile dysfunction.” According to the European Society of Cardiology, this likelihood is almost double in men with uncontrolled high blood pressure. Long-term exposure to hypertension and elevated blood pressure damages the arterial wall. This leads to atherosclerosis and the narrowing of art...
Source: The EMT Spot - November 8, 2022 Category: Emergency Medicine Authors: Michael Kutryk Tags: Guides Blood Pressure Source Type: blogs

Heart failure in chronic kidney disease – Cardiology Basics
Heart failure in chronic kidney disease – Cardiology Basics Prevalence of both heart failure and chronic kidney disease (CKD) are increasing as the population is aging globally. Hence heart failure in chronic kidney disease is seen more often. Presence of CKD in heart failure increases morbidity and mortality. Though there is increasing use of effective medications and special devices like cardiac resynchronization therapy in heart failure patients in general, those with CKD have not been benefited well. CKD is defined as abnormalities of kidney structure or function, present for >3 months, with implications for h...
Source: Cardiophile MD - October 21, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs

Single chamber or dual chamber pacemaker? Cardiology Basics
The decision between single chamber and dual chamber pacemaker though important based on cost, device longevity and complication wise, is not that easy to make. I am trying to summarize based on the 2018 American College of Cardiology/American Heart Association/Heart Rhythm Society guidelines on this aspect [1]. In underprivileged regions, given an option, there is always a potential bias towards single chamber devices as they are cheaper, tend to have more battery life, easier to implant and likely to have lesser procedure and lead related issues. In symptomatic sinus node dysfunction, with correlation between symptoms a...
Source: Cardiophile MD - October 10, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs

What is inappropriate sinus tachycardia? Cardiology Basics
Inappropriate sinus tachycardia (IST) is sinus tachycardia inappropriate to the situation. It is defined as sinus rates above 100 beats per minute at rest or average sinus rate above 90 beats per minute over 24 hours without an underlying cause. Important secondary causes of sinus tachycardia like the use of caffeine, alcohol, nicotine, drugs of abuse like cocaine, increased function of thyroid gland, fever, anxiety, pain, and other illnesses which can increase the heart rate have to be excluded before considering IST. IST may be either asymptomatic or sometimes associated with palpitation, shortness of breath, near synco...
Source: Cardiophile MD - October 9, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs

What is Wellens ’ syndrome?
What is Wellens’ syndrome? The original description of Wellens’ syndrome dates back to 1982 in which they identified a subgroup of patients admitted with unstable angina who are at high risk of development of an extensive anterior wall myocardial infarction. These patients with critical stenosis high in the left anterior descending coronary artery, had characteristic ST-T segment changes in the precordial leads on or shortly after admission. They noted this finding in 26 of their 145 patients admitted because of unstable angina. In spite of symptom control with nitroglycerine and beta blockade, 12 of the 16 pat...
Source: Cardiophile MD - September 26, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs

Spontaneous coronary artery dissection (SCAD)
Spontaneous coronary artery dissection (SCAD) is an important, though rare cause of acute coronary syndrome. Management of SCAD is different from that of acute coronary syndrome due to atherosclerosis [1]. High index of suspicion is required for the diagnosis of SCAD in young patients with acute coronary syndrome. Unlike atherosclerotic coronary artery disease, management of SCAD is mostly medical, in stable patients. Revascularization is considered only in high risk patients with left main dissection, ongoing ischemia, severely limited flow, hemodynamic compromise or refractory cardiac arrhythmia [2]. It has been mentio...
Source: Cardiophile MD - September 23, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs