Air pollution and heart attacks - what is the real risk?
In the UK all cases of myocardial infarction are logged into a national database (the MINAP audit data set). The BMJ has just published an article examining exposure to (traffic related) air pollution and risk of MI suggesting that such exposure brings forward the heart attack an individual was due to have rather than increase the overall risk. BMJ 2011; 343:d5531 doi: 10.1136/bmj.d5531 This seems counterintuitive to me and I am sure I have previously seen research that suggests that exposure to pollutants (and not just those that come from burning petrol or diesel ) increases the risk of MI. What is the experience o...
Source: Doc2Doc BMJ Cardiology - July 10, 2013 Category: Cardiology Authors: sadian Source Type: forums
Cardiology from the Grand Round
(A) Which of the following, affect plasma level of Digoxin :-1/ St John's wort 2/ Gaviscon 3/ Sulfasalazine 4/ Amiodarone (B) 60 year old man comes to see you with shortness of breath. You take a careful and detailed history, perform a clinical examination, and suspect heart failure. He has never had a previous myocardial infarction. His serum natruritic peptide came back very high ( BNP 610 pg/ml ), what should you do next ?1/ Make a routine referral to a cardiologist 2/ Refer urgently, to have transthoracic Doppler 2D echocardiography and specialist assessment within two weeks 3/ Check his ECG, CXR, B...
Source: Doc2Doc BMJ Cardiology - March 23, 2013 Category: Cardiology Authors: alaminium Source Type: forums
Ivabradine and Myocardial Infarction
In patients with anterior myocardial infarction and early left ventricular systolic dysfunction addition of ivabradine to metoprolol, in comparison with uptitration of metoprolol was associated with improvement of systolic and diastolic left ventricular function and decrease of serum NT-pro-ANP by day 25.Does many hospitals guidelines utilize the benefit of this combination to speed patients recovery and minimize long hospital stay ? (Source: Doc2Doc BMJ Cardiology)
Source: Doc2Doc BMJ Cardiology - March 9, 2013 Category: Cardiology Authors: alaminium Source Type: forums
is a heart attack still a heart attack?
NICE have just issued draft guidance on treatment of acute MIhttp://www.nice.org.uk/newsroom/pressreleases/NICEConsultsOnRecommendationsForTreatingPeopleWithAcuteHeartAttack.jspone of the things that struck me is the considerable decline in mortality from around 20% to 5% in 30 years - is this because our pathways are better or is it that the drugs we now use have changed the pattern of disease and infarction we see?sadian (Source: Doc2Doc BMJ Cardiology)
Source: Doc2Doc BMJ Cardiology - February 9, 2013 Category: Cardiology Authors: sadian Source Type: forums
