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Peripheral Vascular Disease
Peripheral artery disease is most often caused by atherosclerosis. Arterial insufficiency from atherosclerotic blockages in the limbs can impair walking distance and put patients with severe disease at risk of limb loss. Management of the disease centers around early diagnosis, supervised exercise therapy and lifestyle modification, optimizing medical care (with the goal of reducing fatal cardiac and cerebrovascular events), and revascularization. (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - August 30, 2023 Category: Primary Care Authors: Katharine L. McGinigle Source Type: research

Unlocking Cardiovascular Health
In 2011, the Centers for Disease Control and Prevention published the “Ten Great Public Health Achievements—United States, 2001–2010.”1 Cardiovascular disease (CVD) prevention made the list. Indeed, the combination of reductions in major cardiovascular risk factors, such as elevated blood pressure, high cholesterol, and smoking, combined with improvements in t reatments led to a substantial reduction in the prevalence of stroke and coronary heart disease over the past decades. Unfortunately, heart disease and stroke continue to be responsible for more deaths than cancer and lung diseases combined. (Source: Primary ...
Source: Primary Care: Clinics in Office Practice - August 30, 2023 Category: Primary Care Authors: Anthony J. Viera Tags: Preface Source Type: research

Arrhythmias and Sudden Cardiac Death
Ventricular tachyarrhythmias remain a major cause of sudden cardiac arrest (SCA) that leads to sudden cardiac death (SCD). Primary prevention strategies to prevent SCD include promoting a healthy lifestyle, following United States Preventive Service Task Force recommendations related to cardiovascular disease, and controlling comorbid conditions. For a patient experiencing SCA, early cardiopulmonary resuscitation and defibrillation should be performed. Implantable cardioverter defibrillators are more effective at secondary prevention compared with drug therapy but medications such as amiodarone, beta-blockers, and sotalol ...
Source: Primary Care: Clinics in Office Practice - August 29, 2023 Category: Primary Care Authors: Scott Bragg, Brandon Brown, Alexei O. DeCastro Source Type: research

Hypertension Guidelines and Interventions
This article provides a succinct overview of hypertension guidelines, reviews guideline-informed approaches to hypertension screening, diagnosis, and treatment, and concludes with a thoughtful discussion of population-based considerations. (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - August 26, 2023 Category: Primary Care Authors: Janelle Bludorn, Kenyon Railey Source Type: research

Acute Coronary Syndrome
This article reviews the outpatient evaluation and management of chest pain and summarizes the key points of inpatient evaluation and treatment of acute coronary syndrome. (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - August 26, 2023 Category: Primary Care Authors: Raman Nohria, Brian Antono Source Type: research

Thromboembolic Disease
Venous thromboembolism (VTE) encompasses deep vein thrombosis and pulmonary embolism, both of which can present on a spectrum from subtle symptoms to life- and limb-threatening emergencies. Some risk factors for VTE overlap cardiovascular risk factors and statin therapy can somewhat reduce the VTE risk. When presentations are not life-threatening, clinical prediction scores using the Well ’s criteria are best used to determine diagnostic testing. The mainstay of VTE treatment is anticoagulant therapy, although life- and limb-threatening presentations can also require thrombolytic therapy. (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - August 26, 2023 Category: Primary Care Authors: Michael J. Arnold Source Type: research

Myocarditis and Pericarditis
Pericarditis typically presents with classic symptoms of acute sharp, retrosternal, and pleuritic chest pain. It can have several different underlying causes including viral, bacterial, and autoimmune etiologies. The mainstays of pericarditis treatment are nonsteroidal anti-inflammatory drugs and colchicine with glucocorticoids or other immunosuppressive drugs used for refractory cases and relapse. Myocarditis is an inflammatory disease of the cardiac muscle that is caused by a variety of infectious and noninfectious conditions. It mainly affects young adults (median age 30 –45 years), and men more than women. The clini...
Source: Primary Care: Clinics in Office Practice - August 26, 2023 Category: Primary Care Authors: Philip Hunter Spotts, Fan Zhou Source Type: research

Congenital Heart Disease
More people are living with congenital heart disease (CHD) because many children now survive to adulthood with advances in medical and surgical treatments. Patients with CHD have ongoing complex health-care needs in the various life stages of infancy, childhood, adolescence, and adulthood. Primary care providers should collaborate with pediatric specialists to provide ongoing care for people living with CHD and to create smooth transitions of care. (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - August 26, 2023 Category: Primary Care Authors: Andrea Dotson, Tiffany Covas, Brian Halstater, John Ragsdale Source Type: research

Lifestyle Intervention for the Prevention of Cardiovascular Disease
Lifestyle medicine is a cornerstone of cardiovascular disease prevention and early disease intervention. A leading cause of death in developed countries, modifiable risk factors of cardiovascular disease like diet, exercise, substance use, and sleep hygiene have significant impacts on population morbidity and mortality. One should address these amendable risks in all patients, independently, and stress the importance of intervention adherence while avoiding the sacrifice of patient trust. One must also understand a patient ’s psychological well-being can be compromised by organic chronic disease states, and poor psycholo...
Source: Primary Care: Clinics in Office Practice - August 23, 2023 Category: Primary Care Authors: Ksenia Blinnikova, Caroline W. Cohen, Ian D. McKeag Source Type: research

Gut Microbiome and Dietary Considerations
The gut microbiome represents a complex microbial ecosystem that exerts direct and indirect effects on other organ systems and contributes to both health and disease. It is sensitive to various stimuli such as childhood immunity, medications, diet, stressors, and sleep. Modulating the gut microbiome can prevent and even treat certain disease states. Although no definitive guidelines exist to support a healthy microbiome, there are several evidence-based interventions proved to improve gut health and reduce the risk for numerous chronic diseases. (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - August 19, 2023 Category: Primary Care Authors: John Damianos, Parvathi Perumareddi Source Type: research

Gut Microbiome and Dietar Considerations
The gut microbiome represents a complex microbial ecosystem that exerts direct and indirect effects on other organ systems and contributes to both health and disease. It is sensitive to various stimuli such as childhood immunity, medications, diet, stressors, and sleep. Modulating the gut microbiome can prevent and even treat certain disease states. Although no definitive guidelines exist to support a healthy microbiome, there are several evidence-based interventions proved to improve gut health and reduce the risk for numerous chronic diseases. (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - July 28, 2023 Category: Primary Care Authors: John Damianos, Parvathi Perumareddi Source Type: research

Gastroenterology
PRIMARY CARE: CLINICS IN OFFICE PRACTICE (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - July 28, 2023 Category: Primary Care Authors: Parvathi Perumareddi Source Type: research

Copyright
ELSEVIER (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - July 28, 2023 Category: Primary Care Source Type: research

Contributors
JOEL J. HEIDELBAUGH, MD, FAAFP, FACG (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - July 28, 2023 Category: Primary Care Source Type: research

Contents
Joel J. Heidelbaugh (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - July 28, 2023 Category: Primary Care Source Type: research