Vasodilators For High Blood Pressure: Types, Side Effects, Drug Interactions
Conclusion In summary, vasodilators play a pivotal role in managing cardiovascular conditions, including hypertension, which is rapidly becoming a global health concern. By expanding the body’s blood vessels, these unique medications can improve blood flow and decrease the pressure exerted by the heart, thereby providing relief to numerous patients worldwide. Their applications are diverse, extending beyond hypertension to conditions like angina, heart failure, and even erectile dysfunction. However, these medications should be taken carefully and always under the supervision of a doctor due to the potent...
Source: The EMT Spot - July 27, 2023 Category: Emergency Medicine Authors: Michael Rotman, MD, FRCPC, PhD Tags: Blood Pressure Source Type: blogs

Calcium-Channel Blockers For High Blood Pressure: Types, Side Effects, Drug Interactions
Conclusion In a nutshell, calcium-channel blockers are a valuable tool in the medical arsenal for treating a range of cardiovascular conditions. By inhibiting calcium’s entry into the heart and blood vessel cells, these drugs induce blood vessel dilation and relaxation, reducing blood pressure. Their unique properties and effectiveness make them especially suitable for groups like older adults and people of African descent, and those with conditions like angina, certain arrhythmias, and Raynaud’s disease. Even with the possibility of side effects and drug interactions, calcium-channel blockers are g...
Source: The EMT Spot - July 24, 2023 Category: Emergency Medicine Authors: Michael Rotman, MD, FRCPC, PhD Tags: Blood Pressure Source Type: blogs

A 30-something woman with intermittent CP, a HEART score of 2 and a Negative CT Coronary Angiogram on the same day
This was sent by a colleague.A 34 yo woman with a history of HTN, h/o SVT s/p ablation 2006, and 5 months post-partum presented with intermittent central chest pain and SOB.  She had one episode of pain the previous night and two additional episodes early on morning the morning she presented.  Deep breaths are painful and symptoms come and go.  She had one BP that was measured at 160/120, uncertain when and what the BP was at other moments.  Home meds were labetalol and nifedipine.  There are T-wave inversions in precordial leads.  The patient is pain free, so it is qu...
Source: Dr. Smith's ECG Blog - May 10, 2023 Category: Cardiology Authors: Steve Smith Source Type: blogs

Which chemotherapeutic agent is well known to cause coronary vasospasm?
5-fluorouracil is well known to cause coronary vasospasm. 5-fluorouracil and its orally active prodrug capecitabine are fluoropyrimidines, belonging to the class of antimetabolites used for treatment of malignancies of breast, head and neck tumours and gastrointestinal tumours. Mechanisms for coronary vasospasm Endothelial cell damage with cytolysis and denudation Increased endothelin-1 bioactivity leading to vasoconstriction When high dose infusions are given, coronary vasospasm with angina, arrhythmia or even sudden death can occur in up to 5% of patients. Vascular toxicity occurs generally within 72 hours of the...
Source: Cardiophile MD - November 13, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs

What is high altitude pulmonary edema (HAPE)? Cardiology Basics
High altitude pulmonary edema is pulmonary edema which occurs on rapid ascent to high altitudes. It is a potentially life threatening condition and is a severe form of mountain sickness. Severe breathlessness with fall of oxygen level in the blood occurs in this condition. Cyanosis may be noted. The best way to prevent it is to ascend gradually, taking a few days to climb to 3000 meters. After that climb only very slowly, only about 300 to 500 meters a day. The risk is more if your usual residence is near sea level so that you are not acclimatized to high altitude at all. Previous episode increases your risk of a recurren...
Source: Cardiophile MD - October 19, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs

The Art of Prescribing (Or Not)
By HANS DUVEFELT I have learned a few things about prescribing medications during my 42 years as a physician. Some are old lessons, and some are more recent. I thought I’d share some random examples. First: I don’t like to have to use medications, but when they seem necessary, I choose, present and prescribe them with great care. CHOOSING MEDICATIONS Medications are like people. They have personalities. With so many choices for any given diagnosis or symptom, I consider their mechanism of action, possible beneficial additional effects and their risk of unwanted side effects when selecting which one to presc...
Source: The Health Care Blog - February 1, 2021 Category: Consumer Health News Authors: Christina Liu Tags: Medical Practice Patients Physicians Primary Care Hans Duvefelt Source Type: blogs

Adult Human Heart Tissue Grown Using Biowire II Platform
TARA Biosystems, a firm based in New York City, and GlaxoSmithKline have managed to grow adult cardiac tissue inside the Biowire II platform developed by TARA, and have used this live tissue as a test bed for cardiac drug research. Previously, growing cardiac tissue from human induced pluripotent stem cells that can be used in laboratory experiments has resulted in fetal-like cell phenotypes. Heart diseases, though, typically affect adult patients and the drugs that treat them will have different effects in adult and fetal cells. The TARA and GaxoSmithKline team used the Biowire II platform to grow 3D engineered card...
Source: Medgadget - August 14, 2019 Category: Medical Devices Authors: Medgadget Editors Tags: Cardiac Surgery Cardiology Medicine Source Type: blogs

Chemotherapeutic agent causing coronary vasospasm – Cardiology MCQ – Answer
Chemotherapeutic agent causing coronary vasospasm – Cardiology MCQ – Answer Chemotherapeutic agent well known to cause coronary vasospasm:Correct answer: c) 5-fluorouracil 5-fluorouracil and its orally active prodrug capecitabine are fluoropyrimidines, belonging to the class of antimetabolites used for treatment of malignancies of breast, head and neck tumours and gastrointestinal tumours. Mechanisms for coronary vasospasm Endothelial cell damage with cytolysis and denudation Increased endothelin-1 bioactivity leading to vasoconstriction When high dose infusions are given, coronary vasospasm with angina, arrh...
Source: Cardiophile MD - February 22, 2019 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs

Ectopic ( tubal) pregnancy after IVF
While not getting pregnant after an IVF cycle can be heartbreaking, getting pregnant and then losing it can be much worse. This happens either when the patient miscarries; or when she has an ectopic pregnancy.While there is quite a lot of information about miscarriages after IVF, an ectopic pregnancy after IVF is something which most patients are completely unprepared for. It's not common, and happens in about 1-2 % of IVF cycles, but when it occurs, it can be devastating.The HCG test is positive, which means you are pregnant, and when the HCG levels rise, patients are understandably excited. However, the HCG level does no...
Source: Dr.Malpani's Blog - August 6, 2016 Category: Reproduction Medicine Tags: ectopic ivf IVF pregnancy tubal pregnancy Source Type: blogs

Beta-Blockers for Cocaine and other Stimulant Toxicity
Dogma: “a belief or set of beliefs that is accepted by the members of a group without being questioned or doubted; a point of view or tenet put forth as authoritative without adequate grounds.” Years ago I treated a university student who presented to the emergency department (ED) after drinking several cans of a popular caffeinated energy drink to “pull an all-nighter” during final exam week. He was tremulous, agitated, and pale, with sinus tachycardia ranging from 140 to 160 bpm and normal blood pressure (BP). The house officer (registrar) working with me that night proposed treating him with a benzodiazepine, bu...
Source: Life in the Fast Lane - July 4, 2016 Category: Emergency Medicine Authors: John Richards Tags: Toxicology and Toxinology alpha stimulation amphetamines Beta Blockers cocaine dogma John Richards Stimulant Toxicity Stimulants Source Type: blogs

Research and Reviews in the Fastlane 092
This study, on the other hand, was a well done, RDCT comparing tamsulosin to nifedipine to placebo in 1136 patients and showed no statistically significant difference for the primary outcome (need for further intervention at 4 weeks). Subgroup analysis showed a slight benefit for lower tract stones and the issue of utility in larger stones (> 5 mm) remains unanswered. However, with the move to reduce CT use in renal colic, we won’t know stone location or size on many patients making this drug far less useful in the real world. Recommended by Anand Swaminathan Read More: The Adventure of the Impassible Stone (EM...
Source: Life in the Fast Lane - July 23, 2015 Category: Emergency Medicine Authors: Jeremy Fried Tags: Airway Emergency Medicine Intensive Care R&R in the FASTLANE Renal Resuscitation Trauma Urology critical care EBM Education recommendations research and reviews Source Type: blogs

MKSAP: 55-year-old man with nonischemic cardiomyopathy
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 55-year-old man is evaluated during a routine examination. He has a 2-year history of nonischemic cardiomyopathy. (Echocardiogram 2 years ago demonstrated a left ventricular ejection fraction of 35%.) He is feeling well and reports no shortness of breath; he walks 2 miles daily without symptoms. Medical history is remarkable for hypertension. Medications are lisinopril, carvedilol, and chlorthalidone. On physical examination, blood pressure is 150/90 mm Hg and pulse rate is 50/min. No jugular venous distention...
Source: Kevin, M.D. - Medical Weblog - November 15, 2014 Category: Journals (General) Authors: Tags: Conditions Heart Source Type: blogs

Pulmonary Hypertension
Pathophysiology 1) increased arterial pressure in lungs 2) primary or idiopathic form occurs in absence of known precipitating causes 3) secondary form caused by – mitral stenosis, pulmonary venous occlusive disease, extreme obesity (Pickwickian syndrome), chronic hypoxemia, recurrent pulmonary embolism, kyphosis, infiltrative lung disease, chronic bronchitis, long periods at high altitude Signs and Symptoms 1) insidious onset of dyspnea idiopathic form 2) right heart failure with venous distention of neck 3) peripheral cyanosis late in disease 4) palpable right ventricular heave (owing to cor pulmonale) 5) fatigue ...
Source: Inside Surgery - January 23, 2013 Category: Surgeons Authors: Editor Tags: Pulmonology arterial pressure cyanosis dyspnea high altitude lungs obesity right heart failure Source Type: blogs