Three normal high sensitivity troponins over 4 hours with a " normal ECG "
Written byWilly FrickA 46 year old man with a history of type 2 diabetes mellitus presented to urgent care with complaint of " chest burning. " The documentation does not describe any additional details of the history. The following ECG was obtained.ECG 1What do you think?The ECG shows sinus bradycardia but is otherwise normal. There is TWI in lead III, but this can be seen in normal ECGs. No labs were obtained. The patient was given a prescription for albuterol and a referral to cardiology.Smith comment:No patient over 25 years of age with unexplained chest burning should be discharged without a troponin rule out, no matt...
Source: Dr. Smith's ECG Blog - January 5, 2024 Category: Cardiology Authors: Willy Frick Source Type: blogs
ACE Inhibitors For High Blood Pressure: Types, Side Effects, Drug Interactions
Conclusion
In conclusion, the rising utilization of blood pressure medications reflects a growing awareness of the importance of managing hypertension for overall health.
ACE inhibitors, among other drug classes, are widely used due to their effectiveness in lowering blood pressure and providing additional benefits for heart and kidney health.
It’s essential to consult your doctor before starting or adjusting ACE inhibitor treatment to ensure personalized care and monitor for potential side effects or drug interactions.
Taking ACE inhibitors as prescribed, following consistent dosing schedules, and attend...
Source: The EMT Spot - July 9, 2023 Category: Emergency Medicine Authors: Michael Rotman, MD, FRCPC, PhD Tags: Blood Pressure Source Type: blogs
The Med List: ACE Inhibitors
Today I’m starting a new series called The Med List. Once or twice a month, I’d like take a closer look at a single class of home medications and explore the medical implications for our patients who take these meds.
The patient’s medications list holds a wealth of information. Prescribed medications tell us about the patient’s medical history. They also give us clues to the patient’s possible current condition and presentation. Some medicines can better explain the clinical picture in front of us and others can be red flags regarding treatment options and the patients likely response.
Let’s kic...
Source: The EMT Spot - November 9, 2022 Category: Emergency Medicine Authors: Steve Whitehead Tags: EMT Source Type: blogs
Fight Aging! Newsletter, October 10th 2022
Fight Aging! publishes news and commentary relevant to the goal of ending all age-related disease, to be achieved by bringing the mechanisms of aging under the control of modern medicine. This weekly newsletter is sent to thousands of interested subscribers. To subscribe or unsubscribe from the newsletter,
please visit:
https://www.fightaging.org/newsletter/
Longevity Industry Consulting Services
Reason, the founder of Fight Aging! and Repair Biotechnologies, offers strategic consulting services to investors, entrepreneurs, and others interested in the longevity industry and its complexities. To find out m...
Source: Fight Aging! - October 9, 2022 Category: Research Authors: Reason Tags: Newsletters Source Type: blogs
Interventions Testing Program Results for Rapamycin and Arcabose in Combination
The Interventions Testing Program (ITP) at the National Institute on Aging (NIA) performs rigorous, expensive assessments of the ability of various (usually pharmaceutical) interventions to slow aging in mice. Conducting a study with rigor in this context means the use of large numbers of mice spread across multiple facilities, with careful control of the environment in order to minimize both known and unknown confounding factors in life span studies. Most of the interventions tested over the past twenty years of the ITP, on the basis of earlier studies suggesting that they may slow aging, in fact fail to extend life in mi...
Source: Fight Aging! - October 6, 2022 Category: Research Authors: Reason Tags: Medicine, Biotech, Research Source Type: blogs
Left ventricular reverse remodeling
In this study, change in LVESV was the single most important predictor of all cause and cardiovascular mortality. Clinical parameters could not predict outcome events in this study.
Similar beneficial effect on left ventricular remodeling was demonstrated long back in the trials with angiotensin converting enzyme inhibitors. SOLVD (Studies of Left Ventricular Dysfunction) study showed that in patients with heart failure and reduced left ventricular ejection fraction, chronic treatment with angiotensin converting enzyme inhibitor enalapril prevented progressive left ventricular dilatation, systolic dysfunction and increase ...
Source: Cardiophile MD - June 11, 2021 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Cardiology Source Type: blogs
Left ventricular remodeling
Left ventricular remodeling occurs in response to left ventricular stress and injury. It is progressive and occurs after large myocardial infarctions and dilated cardiomyopathy. Left ventricular volume increases and the normal elliptical shape becomes globular. Left ventricular remodeling is associated with changes at microscopic level which include myocyte hypertrophy, apoptosis and increased interstitial collagen deposition [1]. Left ventricular remodeling is a central pathophysiological mechanism in advancing heart failure. Reversal of remodeling with treatment is an important goal in the management of heart failure. ...
Source: Cardiophile MD - April 2, 2021 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Cardiology Source Type: blogs
“ Exclusion tests ” for primary aldosteronism
“Exclusion tests” for primary aldosteronism
Oral sodium loading test
Saline infusion test
Captopril challenge test
Fludrocortisone with salt loading test
Though these tests were proposed as ‘confirmatory tests’ for primary aldosteronism, it was found that their negative predictive value was more than the positive predictive value.
Reference
Rossi GP. Primary Aldosteronism: JACC State-of-the-Art Review. J Am Coll Cardiol. 2019 Dec 3;74(22):2799-2811.
Rossi GP, Belfiore A, Bernini G, Desideri G, Fabris B, Ferri C, Giacchetti G, Letizia C, Maccario M, Mallamaci F, Mannelli M, Palumbo G, Rizzoni D, ...
Source: Cardiophile MD - December 12, 2019 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Cardiology Source Type: blogs
Zero tolerance for low blood pressure
Just as we have zero tolerance for hypoglycemia in the Wheat Belly lifestyle, we also have zero tolerance for hypotension, or low blood pressure (BP).
Follow the Wheat Belly lifestyle free of ciabattas, penne pasta, and tortellini, and blood sugars plummet. If you are injecting insulin or taking other diabetes drugs, hypoglycemia is a risk and can be dangerous, resulting in loss of consciousness and injury. We therefore urge everyone to talk to their doctor about discontinuing or reducing insulin and diabetes drugs immediately upon starting the Wheat Belly lifestyle. Unfortunately, the majority of doctors don’t under...
Source: Wheat Belly Blog - May 8, 2018 Category: Cardiology Authors: Dr. Davis Tags: Wheat Belly Lifestyle blood pressure blood sugar BP gluten-free grain-free grains health hypertension hypertensive Source Type: blogs
Notes to myself – 2
Pentobarb coma – BIS should be 10-20 and SR (suppression ratio) should be 70-80
Consider lev albuterol
Should give vaccines after coiling of spleen or before if possible
No calcium channel blockers post MI definitely and post op in general
Toradol inhibits spine healing
Don’t do endoscopes with patients in supine position
don’t ambulate patients with known dvt’s. wait 2-3 days until clots get stuck.
dvt’s even with filter get heparin as much as possible for post phlebitic syndrome and to retard new clot formation
diffuse alveolar hemorrhage – secondary to chemo, goodpasture’s, wege...
Source: Inside Surgery - December 31, 2016 Category: Surgery Authors: Editor Tags: General Source Type: blogs
ACE Inhibition Extends Life in Nematodes
This is an illustrative example of the continued exploration of modest life extension via metabolic manipulation in short-lived animals. A lot of effort is spent on sifting through the existing catalog of known and approved drugs for those that might impact life span, something I consider to be a waste of time and effort from the point of view of producing therapies to extend life in humans. It is an important part of purely scientific efforts to map the interaction of metabolism and aging, however:
To identify drugs that delay age-related degeneration, we used the powerful Caenorhabdtitis elegans model system to screen f...
Source: Fight Aging! - March 3, 2016 Category: Research Authors: Reason Tags: Daily News Source Type: blogs
Rodent Control
A crotchety old fellow from the nursing home gets brought in for trouble breathing. After looking at the swelling in his legs and listening to the crackles in his lungs, it’s pretty obvious that he’s in congestive heart failure.
We started an IV, drew labs, and performed a chest x-ray. Then he got some nitroglycerin, some captopril, and he even got Lasix just to spite all of the #FOAMed wonks.
About 45 minutes later, the patient needs to go to the bathroom. We didn’t want him walking since he didn’t appear to be the steadiest on his feet, so he got a urinal. He grabbed the urinal and the nurse walked out of the roo...
Source: WhiteCoat's Call Room - May 26, 2015 Category: Emergency Medicine Authors: WhiteCoat Tags: Patient Encounters Source Type: blogs
How are drug companies making millions from generic drugs?
It is well accepted among health economics wonks that the lion’s share of pharmaceutical company profits come when these companies hold exclusive rights to their products. Once their blockbuster pills go “generic,” competitors enter the marketplace and profits plummet. Consider captopril, a groundbreaking heart failure medication introduced in the early 80s by Bristol-Myers Squibb under the trade name Capoten. After making a fortune for the company, captopril went generic in 1996. By 2013, you could purchase a captopril pill for the lofty price of … hold your breath … 1.4 cents.
Continue reading ...
Your pati...
Source: Kevin, M.D. - Medical Weblog - April 17, 2015 Category: Journals (General) Authors: Peter Ubel, MD Tags: Meds Medications Primary care Source Type: blogs
Medications After a Heart Attack
From: www.secondscount.orgYour heart attack recovery will include medications. Taking these medications exactly as prescribed is one of the best tools at your disposal for avoiding death in the months following a heart attack. According to an article published in Circulation, the journal of the American Heart Association, heart attack patients who had not filled any of their prescriptions within 120 days of being discharged from the hospital had 80 percent greater odds of death than those who filled all of their prescriptions.Medications you are likely to be prescribed after a heart attack fall int...
Source: Dr Portnay - January 23, 2015 Category: Cardiology Authors: Dr Portnay Source Type: blogs
