Cardiac Memory T waves; Learning bite
Persistent deep T wave inversions are seen after return of normal depolarization in leads where the T waves were normal before pacing. These changes are generally recognized to occur in association with artificial pacemakers but may occur with other entities with intrinsic ventricular ectopic focus of depolarization, such as intermittent left bundle branch block. Although consideration of ischemia should be given priority, awareness of the benign nature of cardiac memory may allow some patients to avoid unnecessary work-up and admission. Sometimes the diagnosis cannot be confirmed definitively in the Emergency Department (...
Source: Doc2Doc BMJ Cardiology - June 27, 2016 Category: Cardiology Authors: alaminium Source Type: forums
As a whole, what is your mostly prescribed anti-hypertensive drug?
Dear Alll: Hypertension is according to the World Health Organization the number 1 risk factor for death. And every now and then new guidelines from the USA, Europe, Australia, etc.....are issued for hypertension treatment. Good to have your thoughts - and your votes - on this. All Best, Joey. @jmariofoliveira (Source: Doc2Doc BMJ Cardiology)
Source: Doc2Doc BMJ Cardiology - June 27, 2016 Category: Cardiology Authors: Joey Rio Source Type: forums
Lumps, bumps and sarcomas.
A 50 year old man is referred to his local district general hospital. He has an eight month history of a 10 cm left sided chest wall swelling which is painful and increasing in size. What is the preferred management option for this man? (Source: Doc2Doc BMJ Cardiology)
Source: Doc2Doc BMJ Cardiology - May 6, 2016 Category: Cardiology Authors: alaminium Source Type: forums
43 year old man C/O palpitation, Electrocardiogram shown below, the treating physician reduced the dose of his medication after the ECG result What does the ECG show, what medication the patient was taking ? (Source: Doc2Doc BMJ Cardiology)
Source: Doc2Doc BMJ Cardiology - April 30, 2016 Category: Cardiology Authors: alaminium Source Type: forums
Bridging the gap: cta and ivus of the heart
CTA or IVUS – which is better? CTA (computed tomography angiography) is currently the gold standard for evaluating myocardial bridging, because it‘s highly accurate. However, recent research has shown that CTA is not all-seeing and all-knowing. IVUS (intravascular ultrasound) may be the better choice. The study included 64 patients with symptoms of ischemia who underwent both CTA and IVUS. CTA earned its gold star, but surprisingly missed the majority of septal branches and soft plaques that could potentially cause serious complications. Interesting? Read more just clicking on ...
Source: Doc2Doc BMJ Cardiology - April 28, 2016 Category: Cardiology Authors: irene357 Source Type: forums
Should we trust INR testing?
We read with interest the recent BMJ editorial “Rivaroxaban:Can we trust the evidence”.1 which questions the conclusions from the ROCKET AF clinical trial on Rivaroxaban 2. Cohen raises questions about the accuracy of the INRs used for monitoring patients in the warfarin control arm and suggests that they may have compromised the validity of the published conclusions. The ROCKET investigators have defended their conclusions after re assessing the data in light of these concerns 3. The device used for INR testing in the warfarin control arm was not identified in the original publication but subsequen...
Source: Doc2Doc BMJ Cardiology - April 7, 2016 Category: Cardiology Authors: alaminium Source Type: forums
What is the diagnosis? (Source: Doc2Doc BMJ Cardiology)
Source: Doc2Doc BMJ Cardiology - April 2, 2016 Category: Cardiology Authors: MoeTomy Source Type: forums
24 year old patient complains of fatigue, muscle weakness and confusion, examination showed sluggish reflexes and decreased muscle tone, ECG shown below What is the diagnosis ? (Source: Doc2Doc BMJ Cardiology)
Source: Doc2Doc BMJ Cardiology - March 22, 2016 Category: Cardiology Authors: alaminium Source Type: forums
Do you Recommend Insulin Pump For Type 2 Diabetes
Many debates and ongoing researches have not yet come to a conclusion to weigh between the advantages and disadvantages for Insulin Pump specially for diabetes type 2, however many diabetic patients are rushing to aquire the device, irrespective of the main serious side effects such as infection and DKA I think we need more researches to finalize the usefulness of Insulin Pump , and proper health education for diabetic patients on this subject (Source: Doc2Doc BMJ Cardiology)
Source: Doc2Doc BMJ Cardiology - March 10, 2016 Category: Cardiology Authors: alaminium Source Type: forums
MRCP part 2 question
44 year old man complians of, cough, shortness of breathing; painful joints and stiffness of the hands, for one year duration, no past history of hospitalisation or medical condition Examination of the hands reavealed painful tender joints and swelling of metacarpophalangeal joints of both hands and reduced flextion and extension of the fingers, chest examination showed bilateral wheezing and dullness mainly on the bases, 6 month before he was working as a coalminer abroad CXR revealed bilateral scattered nodules varying in size What is the most likely Diagnosis ? What investiga...
Source: Doc2Doc BMJ Cardiology - March 8, 2016 Category: Cardiology Authors: alaminium Source Type: forums
Hidden dangers for the slim
I have grown old - unavoidable. i have not grown fat over the years - avoidable. What interests me is how I am being put at relative risk as well as inconvenience by the latter. 2 examples in health care. 1) For x-rays the standard exposure means an overdiagnosis of bone thinning. This led to bone densitometry - with the verdict that bones better than average for age. 2) For some drugs the dose is administered depending on the eGFR but this test seems very poorly understood and bodyweight is a crucial part of it. The problem is that the lab value is based on a weight I have never achieved even at my heaviest and my...
Source: Doc2Doc BMJ Cardiology - February 25, 2016 Category: Cardiology Authors: sken Source Type: forums
To discharge or not
In a patient with known prior CAD s/p stent, recent improved/ negative nuclear stress test 1 week prior for similar symptoms-presented with some 'atypical' chest pain(on sub-optimal anti-anginal therapy), no EKG changes, ctrop neg X2-chest pain free in ER. Should a patient like this be admitted for diagnostic cath/some other tests or be discharged on optimal medical therapy?To add to the dilemma-this happens on a Friday afternoon(if further work-up needed, pt will have to stay over weekend, with additional LOS/expense/inconvenience etc). (Source: Doc2Doc BMJ Cardiology)
Source: Doc2Doc BMJ Cardiology - February 12, 2016 Category: Cardiology Authors: Heartfelt Source Type: forums
Is one of the primary problems of the NHS a lack of Hospital beds?
I think that it becomes more and more apparent that there are not enough NHS Hospital beds. I think most of the A and E problems would be made better if there were more Hospital beds. Many hospital beds have been lost though hospital closures and amalgamations. There has been great emphasis on community care and early discharge. But there are patients who cannot be managed in the community and need admission. There is a huge pressure not to admit patients and also pressure to discharge patients early. Success in Hospital now seems to be discharging patients from Hospital rather than caring for them and wh...
Source: Doc2Doc BMJ Cardiology - January 17, 2016 Category: Cardiology Authors: PatLush Source Type: forums
Good news or bad news?
For now I think the news that 35% of UK doctors were born elsewhere is good news. This applies to very many of our senior folk - particularly from India - and many with a wealth of Uk qualifications as well. I see this as a recruitment of excellence. But I suspect we are in period of transition and in future the influx will be from Europe. It would be interesting to see the equivalent figures from the USA. If this 35% still applies in 20 years time I would be more concerned (except I won't be around).. Is there really going to be an exodus of UK graduates : I seriously doubt it despite mutterings. Perhaps our projected n...
Source: Doc2Doc BMJ Cardiology - January 2, 2016 Category: Cardiology Authors: sken Source Type: forums
happy new year
happy new year (Source: Doc2Doc BMJ Cardiology)
Source: Doc2Doc BMJ Cardiology - January 2, 2016 Category: Cardiology Authors: irsida Source Type: forums