Chest pain one day after a negative stress test
Discussion Points:The patient ’s ECG transmitted to ED providers by EMS showed T waves that are easily confused with the peaked T waves of hyperkalemia. Sometimes hyperacute T waves have this slimmer, taller appearance, and it can be difficult to distinguish them in these cases. The new STE in anterior leads helps to understan d these as hyperacute. Also, other signs of hyperkalemia were absent, as there was no P wave flattening or QRS broadening, bradycardia, new AV blocks or NSIVCD, bizarre QRS morphology, or Brugada patterning. Additionally the clinical context was clearly ACS in this case, and if there were remaining...
Source: Dr. Smith's ECG Blog - October 3, 2022 Category: Cardiology Authors: Pendell Source Type: blogs
Cardiac tumours
Cardiac tumours are most often secondaries from malignancies of breast, lung or malignant melanoma. Primary tumours of the heart are most often benign, of which about half are myxomas. Malignant primary tumours of the heart contribute to about a quarter of the primary cardiac tumours. The commonest primary malignant tumour of the heart would be a sarcoma [1]. Cardiac tumours may present with cardiovascular or constitutional symptoms. Sometimes they are incidentally detected on echocardiography or other imaging modalities.
Left atrial myxoma on echocardiogram
Computed tomography and magnetic resonance imaging can give addi...
Source: Cardiophile MD - August 25, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
Transpulmonary gradient and diastolic pressure gradient
In this study, elevated preoperative transpulmonary gradient was associated with significant increase in mortality at 6 months and 12 months after orthotopic heart transplantation.
Elevated transpulmonary gradient is a risk factor for right heart failure after heart transplantation. Jahanyar J et al queried the UNOS (United Network for Organ Sharing) database from 1987 to 2017 and included adults who had complete transpulmonary gradient data. Those who underwent retransplant were excluded. Their sample consisted of 38,243 patients. It was found that median survival was higher in low transpulmonary gradient group (145 month...
Source: Cardiophile MD - March 1, 2021 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Cardiology Source Type: blogs
If EF% is a most flawed LV functional parameter,.. why we Insist HF to be classified based on it ?
Heart failure has been classified in many ways, with prevailing levels of our knowledge and ignorance. It is based on a variety of factors like rapidity of onset, etiology, chambers involved, hemodynamics, etc.
Forward vs backward failure
Acute vs chronic failure
RV/LV or Biventicular failure
Systolic vs diastolic heart failure
High output vs low out failure
Ischemic vs non-ischemic failure
Reversible vs Refractory HF
None of them have really helped at the bedside though it helped us understand the condition. Now, in the last decade, we have crash-landed on our favorite obsession to classify HF ie based...
Source: Dr.S.Venkatesan MD - September 25, 2020 Category: Cardiology Authors: dr s venkatesan Tags: Uncategorized ase esc acc csi echo cariteria definition of heart failure diastolic heart failure ejection fraction limitation forward vs backward failure hf with normal GLS HFpEF HFrEF rv vs lv failure systolic vs diastolic heart failu Source Type: blogs
Fight Aging! Newsletter, February 11th 2019
We report that the bone marrow stromal cell senescence is driven by p16INK4a expression. The p16INK4a-expressing senescent stromal cells then feedback to promote AML blast survival and proliferation via the SASP.
Importantly, selective elimination of p16INK4a-positive senescent bone marrow stromal cells in vivo improved the survival of mice with leukemia. Next, we find that the leukemia-driven senescent tumor microenvironment is caused by AML induced NOX2-derived superoxide. Finally, using the p16-3MR mouse model we show that by targeting NOX2 we reduced bone marrow stromal cell senescence and consequently reduced A...
Source: Fight Aging! - February 10, 2019 Category: Research Authors: Reason Tags: Newsletters Source Type: blogs
$100 Million Longevity Vision Fund Launches
A new fund to invest in companies working on aging recently launched, the $100 millions Longevity Vision Fund. From what has been said, and what was presented at the Longevity Leaders conference, it sounds very much as though the Longevity Vision Fund principals wish to follow in the footsteps of Juvenescence, with an initial focus on small molecule drug discovery infrastructure. Unlike Juvenescence, it will probably continue to focus on established infrastructure technologies related to age-related disease, such as diagnostics, and fairly safe work with modest benefits, such as stem cell therapies, rather than invest in a...
Source: Fight Aging! - February 7, 2019 Category: Research Authors: Reason Tags: Daily News Source Type: blogs
Heart disease in pregnancy: Risk stratification
It is needless to say that heart disease in pregnancy is a challenge for the obstetrician and the cardiologist. Hemodynamic changes in pregnancy and labour can adversely affect many of the significant cardiac lesions. Increase in blood volume and heart rate are the important factors during pregnancy. In general stenotic lesions and pulmonary hypertension are poorly tolerated, while regurgitant lesions are better tolerated. Specific risks like aortic dissection and rupture are there for coarctation of aorta. Several risk stratification schemes have been developed for assessing the risk of pregnancy with heart disease over ...
Source: Cardiophile MD - May 27, 2018 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: General Cardiology CARPREG II risk scoring CARPREG risk stratification mWHO classification ZAHARA risk score Source Type: blogs
Chest Pain, " Negative " Stress Tests, POCUS, & ECG Equations -- A Case from Salim Rezaie (R.E.B.E.L. EM)
This case is posted by Salim Rezaie (@srrezaie)Chest Pain, “Negative” Stress Tests, POCUS,& ECG EquationsIt has some peer review by me at the end, so we ' reco-posting!!Chest Pain, " Negative " Stress Tests, POCUS,& ECG Equationsby Salim RezaieI was working a busy shift in the ED, like many of us do, and the next patient I was going to see was a 57 year old male with no real medical problems complaining of chest pain. I remember thinking as I walked into the room this guy looks ashen and diaphoretic ….he doesn’t look well. He is a paramedic telling me how he has been having off and on chest pain...
Source: Dr. Smith's ECG Blog - April 30, 2018 Category: Cardiology Authors: Steve Smith Source Type: blogs
The Color of Bioethics
I would like to take you through a thought exercise. More often than not, we are reflecting on more sober, serious topics but I would like to invite you think about a different question today: what is the color of bioethics? To some this may seem like a silly question and maybe it is. However, as we move towards an increased professional presence we need to reflect on our image, including color. We reflect on how we present ourselves in body language, communication, and writing but why not color as well?
In the professional marketing world, a lot of thought is given to color. As professionals, we are sometimes traine...
Source: blog.bioethics.net - March 12, 2018 Category: Medical Ethics Authors: Bioethics Today Tags: Health Care syndicated Source Type: blogs
Integrated Heart/Cancer on a Chip Helps Discover Side Effects of Drugs
At Kyoto University in Japan researchers have created what they call an Integrated Heart/Cancer on a Chip (iHCC) that was designed to help discover side effects of anti-cancer and other medications. The microfluidic system, which is smaller than a common glass slide used with microscopes, consists of healthy myocardial cells populating some chambers and cancerous liver cells living in different chambers, each pair making up a unique line of testing. The chambers are connected to a pump that can control how fluids move through the system, allowing a liquid to circulate round. The idea is to simulate how blood circulates t...
Source: Medgadget - August 28, 2017 Category: Medical Devices Authors: Editors Tags: Diagnostics Genetics Oncology Source Type: blogs
Who gets heart cancer?
Over the last quarter of a century, I’ve written about a lot of different aspects of science and medical research. Cancer features a lot, the Big C is prominent in human misery and more common than many other diseases. Often I’ll use a phrase such as “treating liver, bowel, lung, breast, prostate and other cancers”. One phrase I don’t think I’ve ever written, until today is “heart cancer”.
Heart cancer? Do people even get heart cancer? Almost every other organ from skin to brain from gonads to liver, from head and neck to bone and blood, there’s a cancer. Experts repe...
Source: David Bradley Sciencebase - Songs, Snaps, Science - September 2, 2016 Category: Science Authors: David Bradley Tags: Science Source Type: blogs
Why we may “never-ever” understand the seriousness of NSVT in HOCM ?
Hypertrophic cardiomyopathy (HCM) is the most common primary cardiac muscle disorder.It is one of the extensively studied medical entity in terms of pathology, genetics, electrophysiology and treatment.Though it has dramatic myocardial phenotypic expression , longevity can be near normal except in a minority who are prone for LV dysfunction and SCD due to the indirect electrical instability.These arrhythmia arise due to myocardial disarray , micro vascular disease or fibrosis.
NSVT by definition is runs of VT at a rate of > 100 /mt occurring less than 30 seconds.
How common is NSVT in HCM ?
On Holter study ...
Source: Dr.S.Venkatesan MD - April 3, 2016 Category: Cardiology Authors: dr s venkatesan Tags: hocm hcm how to manage non sustained vt in hcm hoc hypertrophic cardiomyopathy icd for nsvt managment issues in hocm nsvt in hocm sustained vs nonsustained vt in hocm Source Type: blogs
Left atrial myxoma – echocardiogram in parasternal long axis view
Brief Review with Echocardiogram video
Left atrial myxoma in parasternal long axis view
Myxoma is a primary cardiac tumour, which is much less common than the secondary cardiac tumours. Echocardiogram demonstrates left atrial myxoma very well.
Left atrial myxoma in parasternal long axis view – annotated
Left atrial myxoma prolapsing into LV in diastole
Myxoma is seen on echocardiogram in parasternal long axis view as a mass prolapsing into the left ventricle in diastole. The site of attachment of the myxoma is not evident in this view. A four chamber view had shown that it is actually attached to the interatr...
Source: Cardiophile MD - November 16, 2015 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Echocardiogram Library Echocardiography Carney complex Familial myxoma PRKAR1A PRKAR1A mutation Source Type: blogs
ResQCPR System Approved by FDA. First and only CPR adjunct ever approved.
Keith Lurie and his colleagues have spent over 25 years trying to improve outcomes in cardiac arrest. I know him personally. He is very smart and very hard working, and has impeccable integrity. He is more committed to saving lives than anyone I know.I asked Dr. Lurie to tell us about this device he has worked on for so long and which has finally been FDA approved.I do not promote any commercial products on my site, nor have any advertisements. I am promoting this because it saves lives.We have been using the inspiratory threshold device for years in our ED and all over Minnesota, where we have the highe...
Source: Dr. Smith's ECG Blog - March 13, 2015 Category: Cardiology Authors: Steve Smith Source Type: blogs
