HDL Level, Age, and Smoking are the Largest Determinants of Mortality Risk in Old People
An interesting epidemiological study here stratifies the contributions of various metrics to mortality in later life, age 70 and older. The authors find that the largest effects arise from HDL level, chronological age, and smoking. The largest single cause of death in our species is atherosclerosis, a progressive malfunction in clearance of cholesterol from blood vessel walls that leads to fatty plaques, narrowed arteries, stroke, and heart attack. HDL particles carry excess cholesterol from blood vessel walls back to the liver for excretion, and - thus over a lifetime - the more HDL in circulation one has, the greater the...
Source: Fight Aging! - October 17, 2022 Category: Research Authors: Reason Tags: Daily News Source Type: blogs
How does stress cause heart disease? Cardiology Basics
Stress and heart disease have various aspects. Stress can lead to increase in risk factors for cardiovascular disease as well as precipitate symptoms in a hitherto silent cardiovascular disease. There is also a condition known as stress cardiomyopathy or broken heart syndrome, typically precipitated by an acute stressful event like loss of spouse in an elderly female.
Most older persons have build-up of atherosclerotic plaques in the coronary arteries. When there is a sudden severe stress, heart rate and blood pressure can shoot up due to sympathetic overactivity. There is also the release of stress hormones like adrenali...
Source: Cardiophile MD - October 16, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
How can exercise prevent cardiovascular disease? Cardiology Basics
Dr. Paul Dudley White, the famous physician who has taught many a luminary in the field of cardiology once wrote that heart disease before eighty is our fault and not God’s will or nature’s will.
This means that he recognized long back, the role of life-style modification in preventing heart disease. Exercise in a regular pattern is one of the important life style modifications which everyone can adopt to prevent or delay cardiovascular disease. Exercise helps in various ways for prevention of cardiovascular disease. In those with established cardiovascular disease, graded exercise programs can promote the formation o...
Source: Cardiophile MD - October 15, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
What is thrombolytic therapy for myocardial infarction? Cardiology Basics
Thrombolytic therapy used to be an important mode of early treatment of acute myocardial infarction. Though it has been largely superseded by primary angioplasty, thrombolytic therapy may still be useful in certain situations. It is still an important form of treatment in resource limited locations.
Myocardial infarction is usually due to sudden occlusion of a coronary artery by thrombus formation on a pre-existing partial obstruction by an atherosclerotic plaque. Plaque rupture with local thrombus formation is the usual mechanism. Dissolving the thrombus soon after the occurrence of a myocardial infarction can salv...
Source: Cardiophile MD - October 14, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
What is a perimembranous VSD? Cardiology Basics
Perimembranous VSD is the commonest type of ventricular septal defect. When there is a ventricular septal defect, blood shunts from the left ventricle to the right ventricle as the pressure in the left ventricle is higher. This leads to increased pulmonary blood flow. VSD usually occurs as a congenital defect, though it can rarely occur in the adult after a myocardial infarction due to rupture of the ventricular septum. If the VSD is large, high pulmonary blood flow increases the amount of blood returning to the left atrium and left ventricle through the pulmonary veins. This volume overloading of the left ventricle can l...
Source: Cardiophile MD - October 14, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
Is first degree heart block dangerous? Cardiology Basics
PR interval is measured from the onset of P wave to the onset of QRS complex. It includes the P wave and the PR segment. Normal PR interval is from 120 to 200 ms. If it is prolonged, it is called as first degree atrioventricular (AV) block.
PR interval is the time taken for activation of the atria and conduction of the impulses down to the ventricles and initiate activation of the ventricles. This includes the physiological delay in conduction at the AV node. The delay allows complete emptying of the atria before the ventricles start contracting. The atrial help to ventricular filling acts like an atrial booster at the en...
Source: Cardiophile MD - October 14, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
What is myocardial stunning and hibernation? Cardiology Basics
Just as you can get stunned for some time if hit on the head, part of the myocardium can also stop functioning following transient coronary obstruction. This usually occurs following a myocardial infarction after which the occluded coronary artery gets opened up spontaneously or by thrombolytic therapy or primary angioplasty.
After a variable period of time, the stunned myocardium usually recovers full function. During the period of stunning, if a large part of myocardium is involved, the person may have features of heart failure due to decreased left ventricular systolic function. Myocardial stunning is the reason for he...
Source: Cardiophile MD - October 13, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
What are the types of myocardial infarction? Cardiology Basics
World Heart Federation along with major European and North American Heart Societies have brought forth the universal definition of myocardial infarction. It has been revised the fourth time in 2018. In the latest revision myocardial infarction has been classified into 5 types, of which type 4 has three subtypes as well.
Type 1 is the type of myocardial infarction which all of us are familiar with. It occurs due to sudden occlusion of a coronary artery. This leads to chest pain and ECG changes. Myocardial damage can be noted on echocardiography as well as other imaging modalities like cardiac magnetic resonance imaging (CM...
Source: Cardiophile MD - October 13, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
Chest pain in children – Cardiology Basics
Chest pain in children – Cardiology Basics
Even though chest pain in children is a common symptom, unlike in adults it is seldom due to heart disease. Most often the cause of chest pain in children is not a major life threatening disease. Still chest pain can cause restriction of activities, absence from school and cause of anxiety to children and their parents.
A good history and physical examination can give a lot of information to exclude any potentially serious condition causing chest pain, though it is rare. Costochondritis is a common cause of chest pain in adolescent and preadolescent girls. It can b...
Source: Cardiophile MD - October 13, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
Chest pain and anterior ST depression. What ’s the cause(s)?
Written by Jesse McLaren, with edits from Smith and GrauerA 60 year old with no past medical history presented with two hours of chest pain radiating to the left arm, with normal vitals. What do you think? I sent this to Dr. Meyers without any other information, and he responded, “do you have a prior to make sure that it is all just because of the delta wave? Would be careful to make sure it’s not inferoposterior OMI superimposed on baseline WPW.” In other words, when there are ST/T wave changes thefirst question is whether there ’s abnormal depolarization, because this will be followed by abnormal ...
Source: Dr. Smith's ECG Blog - October 13, 2022 Category: Cardiology Authors: Jesse McLaren Source Type: blogs
What is myocardial viability assessment? Cardiology Basics
Myocardial viability means regions of myocardium which can recover its function if the blood supply is normalized. Viable myocardium will improve after restoring blood supply while non-viable myocardium will not.
So myocardial viability assessment is important in deciding whether the person will benefit from revascularization procedures like coronary angioplasty and coronary bypass surgery.
There are two types of viable myocardium, stunned myocardium and hibernating myocardium. Stunned myocardium needs only time to recover while hibernating myocardium needs restoration of blood supply. Stunned myocardium is transient dela...
Source: Cardiophile MD - October 12, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
How to interpret an echo report? Cardiology Basics
Echocardiogram, often called just echo in short is ultrasound imaging of the heart. Though the actual types of details mentioned in echo report may vary between institutions and even persons reporting it, in general there are several common aspects. Reports of children with congenital heart disease will have a different pattern. This discussion is mainly on an echo report from a general cardiology setup.
In addition to details of identification and date of procedure, indication for the study and the quality of images are usually mentioned in the beginning of the report. Quality of images may be poor in those with emphysem...
Source: Cardiophile MD - October 12, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
Important blood tests in relation to the heart – Cardiology Basics
Important blood tests in relation to the heart – Cardiology Basics
Here are some important blood tests in relation to the heart. Normal ranges of some of these tests may vary between labs.
Cholesterol is a type of fat found in the blood and has a role in the development of atherosclerosis in the coronary arteries as well as other arteries. Desirable value of total cholesterol in blood is less than 200 milligrams per decilitre.
Triglycerides is another type of fat found in the blood. Desirable value is less than 150 milligrams per decilitre. Very high levels of triglycerides carry a risk of pancreatitis. Calorie restr...
Source: Cardiophile MD - October 11, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
What is a myocardial bridge? Cardiology Basics
Normally the coronary arteries are located outside the myocardium. Occasionally a segment of the coronary artery passes through the myocardium. This causes a narrowing of that region in systole and is known as myocardial bridging. Myocardial bridging can be recognized as narrowing of a region of the coronary artery in systole which normalizes in diastole.
Usually myocardial bridges do not cause myocardial ischemia as normally the blood flow into the myocardium occur mostly during diastole. Still myocardial bridges can rarely cause myocardial ischemia and cause chest pain. Rarely this may need recurrent hospital admi...
Source: Cardiophile MD - October 10, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
A man in his 30s with cardiac arrest and STE on the post-ROSC ECG
Conclusions: outpatients with witnessed cardiac arrest and primary PEA carry a high probability of Massive Pulmonary Embolism________________Case Continued:" Initial ROSC EKG showed what appeared to be in atrial fibrillation with inferior ST elevations, depressions in aVL, concerning for STEMI. "He had multiple cardiac arrests with ROSC regained each time. " Endotracheal tube re-intubation was confirmed multiple times, bilateral breath sounds, yet O2 saturation remained in the 50s and 60s. I was able to visualize the ETT on initial intubation pass through the cords however given his continued hypoxemia, I felt it...
Source: Dr. Smith's ECG Blog - October 10, 2022 Category: Cardiology Authors: Pendell Source Type: blogs
