Every second counts: giant ECG abnormality after every second beat
Clinical introduction The patient had recently been diagnosed with heart failure and dilated cardiomyopathy (left ventricular ejection fraction: 20%). Medication included furosemide, spironolactone, bisoprolol, perindopril, indapamide. The patient was found with a cardiac arrest. After successful basic life support and stabilized circulation, the following ECG was recorded (see figure 1). Question What is the possible explanation for these ECG features? Giant TU waves due to proarrhythmic effect of propafenone (Class 1/c antiarrhythmic drug) the patient was given as paroxysmal atrial fibrillation rhythm control. Hypokalaem...
Source: Emergency Medicine Journal - July 24, 2023 Category: Emergency Medicine Authors: Tomcsanyi, J., Aranyi, P. Tags: EMJ Image Challenge Source Type: research
On Hoofs and Zebras – Struma Ovarii
A 75-year-old mother of ten suffering from a urinary tract infection developed macrohematuria and therefore an abdominal ultrasound was performed, followed by a CT scan when an unexpected large pelvic mass was discovered. Past history included hypertension, paroxysmal atrial fibrillation, and remote history of minor stroke (on candesartan, dabigatran, bisoprolol); bilateral chronic lymphedema; and hysterectomy due to prolapse at the age of 40. Imaging revealed nephrolithiasis and a prominent left adnexal mass suspected as ovarian cancer. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - July 20, 2023 Category: General Medicine Authors: Ami Schattner, Ina Dubin, Livnat Uliel, Daniela Dick-Necula Tags: Clinical Communication to the Editor Source Type: research
An Update on Impacts of Epigallocatechin Gallate Co-administration in Modulating Pharmacokinetics of Statins, Calcium Channel Blockers, and Beta-blockers
Planta Med DOI: 10.1055/a-2111-7319Brewed green tea, green tea extract, and its primary active compound, epigallocatechin gallate, may interact with drugs and alter the drugʼs therapeutic effectiveness, ultimately leading to
therapeutic failure or drug overdose. Several isolated reports have claimed that epigallocatechin gallate is the main active ingredient that causes these effects. While a few studies aimed
to uncover evidence of epigallocatechin gallate-drug interactions, no study has thoroughly and collectively reviewed them. Epigallocatechin gallate is a potential cardioprotective agent used
by many p...
Source: Planta Medica - July 14, 2023 Category: Drugs & Pharmacology Authors: Siew-Keah, Lee Jie, Tan Hong Ang-Lim, Chua Bin, Liew Kai Yik-Ling, Chew Tags: Reviews Source Type: research
Case report: Impact of hyperthyroidism on psychotic symptoms in schizophrenia comorbid with Graves ’ disease
ConclusionThis case highlights the importance of monitoring thyroid function in patients with schizophrenia, particularly those with comorbid Graves’ disease. The correlation between psychiatric symptoms and thyroid hormone levels was demonstrated on an individual level over time, with symptoms worsening as thyroid hormone levels increased. Additionally, our case suggests that abnormally high thyroid hormone levels may trigger visual hallucinations in individuals with schizophrenia. Further studies are needed to elucidate the underlying mechanisms and potential treatment implications of this association. (Source: Frontiers in Psychiatry)
Source: Frontiers in Psychiatry - July 10, 2023 Category: Psychiatry Source Type: research
Change in Echocardiographic Parameters in Patients Receiving a Quadruple Ultra-Low-Dose Anti-Hypertensive Combination for Treatment of Hypertension
This group has previously demonstrated greater blood pressure (BP)-lowering effects using a quadruple ultra-low-dose combination of anti-hypertensives (irbesartan 37.5 mg, amlodipine 1.25 mg, indapamide 0.625 mg, bisoprolol 2.5 mg) ( “quadpill”) compared with standard monotherapy (irbesartan 150 mg). It sought to compare changes in echocardiographic parameters between the two groups after 12 months of treatment. (Source: Heart, Lung and Circulation)
Source: Heart, Lung and Circulation - July 1, 2023 Category: Cardiology Authors: P. Emerson, M. Schlaich, A. Rajwani, C. Chow, G. Hillis, L. Thomas Source Type: research
Influence of Weight and Body Size on the Pharmacokinetics of Heart Failure Pharmacotherapy: A Systematic Review
CONCLUSION: Considering the significant impact of WT on most HF drugs in this review, it may be important to further investigate it in the context of personalized therapy, particularly in patients presenting extreme WTs.PMID:37338205 | DOI:10.1177/10600280231179484 (Source: The Annals of Pharmacotherapy)
Source: The Annals of Pharmacotherapy - June 20, 2023 Category: Drugs & Pharmacology Authors: Jessica Hindi Myriam Fr échette-Le Bel Jean Lucien Rouleau Simon de Denus Source Type: research
Influence of Weight and Body Size on the Pharmacokinetics of Heart Failure Pharmacotherapy: A Systematic Review
CONCLUSION: Considering the significant impact of WT on most HF drugs in this review, it may be important to further investigate it in the context of personalized therapy, particularly in patients presenting extreme WTs.PMID:37338205 | DOI:10.1177/10600280231179484 (Source: The Annals of Pharmacotherapy)
Source: The Annals of Pharmacotherapy - June 20, 2023 Category: Drugs & Pharmacology Authors: Jessica Hindi Myriam Fr échette-Le Bel Jean Lucien Rouleau Simon de Denus Source Type: research
Efficacy and safety of bisoprolol 5 mg plus amlodipine 5 mg in patients with hypertension uncontrolled on monotherapy with 5 mg of amlodipine, a phase III multicenter, randomized, double-blind, placebo-controlled clinical trial - the AMCOR study
Conclusions: Addition of bisoprolol to patients uncontrolled with amlodipine monotherapy significantly improves blood pressure control. We can expect additional 7.2/3.95 mmHg SBP/DBP lowering effect by adding bisoprolol 5 mg to amlodipine 5 mg.PMID:37300442 | DOI:10.1080/03007995.2023.2223915 (Source: Current Medical Research and Opinion)
Source: Current Medical Research and Opinion - June 10, 2023 Category: Research Authors: Piotr J ędrusik Grzegorz Placha Zbigniew Gaciong for AMCOR trial investigators Source Type: research
Beta-blockade improves right ventricular diastolic function in exercising pulmonary arterial hypertension
Right ventricular (RV) function is a main determinant of outcome in pulmonary arterial hypertension (PAH) [1]. Increased neuro-humoral activation associated with decreased survival in PAH may worsen RV adaptation to increased afterload [2, 3]. There is rationale therefore for the use of β-blockers in PAH, especially given their beneficial effect on RV function in experimental PAH models [4, 5]. Small clinical studies in PAH using bisoprolol and carvedilol have demonstrated acceptable patient tolerance, however no change in exercise capacity was seen and, concerningly, resting cardiac output (CO) decreased despite unch...
Source: European Respiratory Journal - May 18, 2023 Category: Respiratory Medicine Authors: Samaranayake, C. B., Kempny, A., Naeije, R., Gatzoulis, M., Price, L. C., Dimopoulos, K., Zhao, L., Wort, S. J., McCabe, C. Tags: Pulmonary vascular disease Research Letters Source Type: research
