Study Finds Limited Benefits of Stent Use for Millions With Heart Disease

Is a stent always the answer for people with chest pain? Maybe not. But they do need to do some work, new research finds, including sticking to medication and changing behaviors. www.nbcnews.com Study Finds Limited Benefits of Stent Use for Millions With Heart Disease Stents and coronary artery bypass surgery are no more effective than intensive drug treatment and better health habits in preventing millions of Americans from heart attacks and death, a large study found. www.wsj.com Thoughts? @VA Hopeful Dr @IMreshopeful @DocVapor @jdh71 @ThoracicGuy and everyone else
Source: Student Doctor Network - Category: Universities & Medical Training Authors: Tags: Topics in Healthcare Source Type: forums

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DiscussionCoronary artery bypass surgery is invasive and can cause death, which is why its use must be thoroughly studied to determine if it yields a large enough long-term benefit for the thousands of patients receiving it every year.Systematic review registrationPROSPERO ID 131924
Source: Systematic Reviews - Category: International Medicine & Public Health Source Type: research
CONCLUSIONS: Compared with systemic analgesia, epidural analgesia may reduce the risk of myocardial infarction, respiratory depression, and atrial fibrillation/atrial flutter, as well as the duration of tracheal intubation and pain, in adults undergoing cardiac surgery. There may be little or no difference in mortality, pneumonia, and epidural haematoma, and effects on cerebrovascular accident are uncertain. Evidence is insufficient to show the effects of epidural analgesia compared with peripheral nerve blocks, intrapleural analgesia, or wound infiltration. PMID: 30821845 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - Category: General Medicine Authors: Tags: Cochrane Database Syst Rev Source Type: research
A previously healthy, well-appearing 42-year-old female living in a modern, high-rise apartment in downtown Los Angeles calls 9-1-1 at 5:30 am complaining of worsening of a burning, epigastric pain she had been experiencing for the last three days. She reports associated nausea and non-bloody, non-bilious vomiting, and that she couldn’t manage to get comfortable in bed until she finally decided to call for help at daybreak. During her 9-1-1 call, she reports “pain, like heartburn, that just woke me up again and I had to throw up, … and then I was sweating so much.” Using the Los Angeles Tiered Disp...
Source: JEMS Special Topics - Category: Emergency Medicine Authors: Tags: Exclusive Articles Cardiac & Resuscitation Source Type: news
This study from Herzog et al (from our own Hennepin County Medical Center) included patients from a national registry and compared 3049 patients on dialysis admitted and eventually found to have acute MI compared with 534,395 patients not on dialysis admitted with an eventual diagnosis of acute MI. Of these groups, only 22% of dialysis patients had an admission diagnosis consistent with acute MI while 43.8% of nondialysis patients had the correct admission diagnosis of acute MI.  Dialysis patients had double the rate of cardiac arrest (11% vs 5%), were less likely to receive reperfusion therapy when eligible (47% vs. ...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs
This case is posted by Salim Rezaie (@srrezaie)Chest Pain, “Negative” Stress Tests, POCUS,&ECG EquationsIt has some peer review by me at the end, so we'reco-posting!!Chest Pain, " Negative " Stress Tests, POCUS,&ECG Equationsby Salim RezaieI was working a busy shift in the ED, like many of us do, and the next patient I was going to see was a 57 year old male with no real medical problems complaining of chest pain.  I remember thinking as I walked into the room this guy looks ashen and diaphoretic ….he doesn’t look well.  He is a paramedic telling me how he has been havin...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs
Conclusion: The complex wound from sternotomy dehiscences presents itself as a challenge to surgical teams. Treatment should include debridement of necrotic tissue and preferably coverage with well-vascularized tissue. We propose that the unilateral pectoralis major muscle flap is an interesting and low morbidity option for the reconstruction of sternal wound dehiscences, with proper sternum stability and satisfactory functional and aesthetic outcomes.
Source: Revista Brasileira de Cirurgia Cardiovascular - Category: Cardiovascular & Thoracic Surgery Source Type: research
Time limit: 0 Quiz-summary 0 of 20 questions completed Questions: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 Information This test series requires login for attempting. You can login easily with your Facebook account (Use the CONNECT WITH icon on the upper part of right sidebar displaying t...
Source: Cardiophile MD - Category: Cardiology Authors: Tags: General Cardiology Source Type: blogs
Abstract Background: The prevalence of coronary artery disease (CAD) in valvular patients is similar to that of the general population, with the usual association with traditional risk factors. Nevertheless, the search for obstructive CAD is more aggressive in the preoperative period of patients with valvular heart disease, resulting in the indication of invasive coronary angiography (ICA) to almost all adult patients, because it is believed that coronary artery bypass surgery should be associated with valve replacement. Objectives: To evaluate the prevalence of obstructive CAD and factors associated with it in adult candi...
Source: Arquivos Brasileiros de Cardiologia - Category: Cardiology Source Type: research
By Paul CarrThank you to Dr. Naheed Dosani and the excellent team at William Osler Health Centre for inspiring this post.What three words describe the essence of palliative care for you? When I asked my friends, family, and colleagues, the most common answers are: pain management, personal and spiritual support, and end of life planning. Those are all key components. But what quickly became apparent to me during my palliative care elective is that excellent palliative care providers embrace the role of enabling patients and families to make well-informed choices.I have taken a long and untraditional route to arrive in the ...
Source: Pallimed: A Hospice and Palliative Medicine Blog - Category: Palliative Care Tags: choice communication goals palliative paul carr Source Type: blogs
Publication date: Available online 10 April 2017 Source:Journal of Cardiology Cases Author(s): Yukako Ogoyama, Nobuhiko Ogata, Shinichi Toriumi, Kazuomi Kario A 72-year-old Japanese man was admitted to our hospital for effort chest pain and bilateral claudication. He was diagnosed as having severe ischemic heart disease and chronic bilateral aorto-iliac occlusions (Leriche syndrome) by a diagnostic angiography. Manifest collaterals via bilateral internal thoracic arteries (ITA) supplied sufficient blood flow for his lower limbs. We planned a two-stage operation for both the severe coronary artery disease and peripheral ar...
Source: Journal of Cardiology Cases - Category: Cardiology Source Type: research
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