Let us add “ mitral regurgitation ” in the “ Complication basket ” of hypertensive heart disease
Hypertension is a prevalent condition in the general population, as is mitral regurgitation (MR). For most of us, HT traditionally conveys a “singular meaning” that is, high pressure within blood vessels. We often forget that the origin of blood pressure begins right inside the heart, i.e, the left ventricle, which is guarded by two valves – the aortic and mitral. (Though we are aware, LVH is the classical response to HT),
Obviously, there will be signiifcant consequences to the structural integrity of these valves when LV pressure is raised beyond the tolerable limit of endocardial layers that line th...
Source: Dr.S.Venkatesan MD - November 5, 2023 Category: Cardiology Authors: dr s venkatesan Tags: Uncategorized effect of sht on mr functional MR hyppertension and mitral regurgitation secondary mr tips on mr amanagement valvular heart disease vasodilators in mr Source Type: blogs
Please Include “ mitral regurgitation ” in the “ Complication basket ” of hypertensive heart disease
Hypertension is a prevalent condition in the general population, as is mitral regurgitation (MR). For most of us, HT traditionally conveys a “singular meaning” that is, high pressure within blood vessels. We often forget that the origin of blood pressure begins right inside the heart, i.e, the left ventricle, which is guarded by two valves – the aortic and mitral. (Though we are aware, LVH is the classical response to HT),
Obviously, there will be signiifcant consequences to the structural integrity of these valves when LV pressure is raised beyond the tolerable limit of endocardial layers that line th...
Source: Dr.S.Venkatesan MD - November 5, 2023 Category: Cardiology Authors: dr s venkatesan Tags: Uncategorized effect of sht on mr functional MR hyppertension and mitral regurgitation secondary mr tips on mr amanagement valvular heart disease vasodilators in mr Source Type: blogs
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
20-something with huge verapamil overdose and cardiogenic shock
A 20-something presented after a huge verapamil overdose in cardiogenic shock. He had been seen at an outside institution and been given 6 g calcium gluconate, KCl, and a norepinephrine drip.The initial K was 3.0 mEq/L and ionized calcium was 5.5 mg/dL (sorry, Europeans, for the weird units)Here was the initial ED ECG:There is a junctional rhythm with retrograde P-waves (see the dip in the T-wave in lead II across the bottom; you can follow that up to all the other leads and see the retrograde P wave). There is also Left Bundle Branch Block (LBBB). There is huge proportionally excessively discord...
Source: Dr. Smith's ECG Blog - May 26, 2023 Category: Cardiology Authors: Steve Smith Source Type: blogs
Defining Hypertension : Why we remain in “ Status confusious ” despite 50 years of clinical trials ?
Next to the atmospheric pressure, the most curious pressure to understand is stored within human blood. Yes, it is the “blood pressure”, fondly referred to as BP by both physicians and patients. (When worried men & women visit us and say, that they are suffering from BP, please make it a point to clarify, BP is a sign of existence of life, rather than a dreaded pathology )
Why should blood have pressure?
BP is lateral pressure exerted by flowing blood on the vessel wall (or is it the propelling pressure head ? It is to be noted, cuff pressure doesn’t measure this !) BP is generated by the heart in...
Source: Dr.S.Venkatesan MD - May 8, 2021 Category: Cardiology Authors: dr s venkatesan Tags: Hypertension 2013 STEMI AHA ACC Guidelines blood pressure lowering treatment trialist collaboration hypertension and dyslipidemia Hypertension current guidelines jnc 6 7 8 hypertesnion Lancet BP LTT trial LDL vs diastolic BP vs fasting blood Source Type: blogs
CORAL study on renal artery stenting
In the Cardiovascular Outcomes in Renal Atherosclerotic Lesions (CORAL) study, 947 patients who had atherosclerotic renal artery stenosis and either systolic hypertension while taking two or more antihypertensive medications or chronic kidney disease were evaluated. It was a multi-center, open-label, randomized, controlled trial. Patients were randomized to either medical therapy plus renal artery stenting or medical therapy alone [1].
Previous randomized trials on renal angioplasty had failed to show significant benefit in control of blood pressure [2,3]. Another two randomized trials checking the effect of renal artery...
Source: Cardiophile MD - April 7, 2021 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: 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
February 2021: Clinical Presentation Provides Clue to Toxicity
A 43-year-old man with a history of bipolar disorder, hypertension, and asthma presented with altered mental status and a tremor. He reported increasing fatigue and hand tremors for one day. He said he and his family recently had food poisoning with vomiting and diarrhea for several days. Those symptoms had resolved. He continued to take all of his prescribed medications, which included lithium carbonate (Lithobid) 800 mg BID and amlodipine 10 mg daily.His initial vital signs were a heart rate of 104 bpm, a blood pressure of 136/82 mm Hg, a respiratory rate of 16 bpm, an oxygen saturation of 99% on room air, and a temperat...
Source: The Tox Cave - January 29, 2021 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
Visible Cracks
it was a clinic day like all the rest
until it wasn't
she was there with her son and granddaughter
winded
legs swollen "for a month"
afib, fast rate despite cardizem CD 300 mg daily, diabetic meds, norvasc.
EKG with LVH, RBBB, LAFB.
BP 178/84, HR 124
rales
meds to be started, but help?
EMR->no doctor
a nurse practitioner?
4:45 pm-> all gone
see you in two days
no appointments.
i wake too early (Source: Dr. Wes)
Source: Dr. Wes - January 14, 2020 Category: Cardiology Authors: Westby G. Fisher, MD Tags: Life Source Type: blogs
Are polypills and population-based treatment the next big things?
Cardiovascular disease (CVD), such as heart attack and stroke, is a leading cause of death and disability in the US. High blood pressure and high cholesterol are major risk factors for CVD, and even though they are quite common and highly treatable, they tend to be undertreated. This is especially true among those who are poor or members of a minority. It’s estimated that thousands of lives could be saved each year if more people with high blood pressure and high cholesterol received treatment for these conditions.
The appeal of the polypill
One reason that high blood pressure and high cholesterol are poorly treated is t...
Source: Harvard Health Blog - January 13, 2020 Category: Consumer Health News Authors: Robert H. Shmerling, MD Tags: Drugs and Supplements Health Heart Health Hypertension and Stroke Source Type: blogs
MKSAP: 38-year-old man with dyspnea on exertion
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 38-year-old man is evaluated for a 6-month history of dyspnea on exertion. He has gastroesophageal reflux disease and Raynaud phenomenon. He does not smoke and has no cough or wheezing. Current medications are lansoprazole and amlodipine. On physical examination, vital […]Find jobs at Careers by KevinMD.com. Search thousands of physician, PA, NP, and CRNA jobs now. Learn more. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - November 30, 2019 Category: General Medicine Authors: < span itemprop="author" > < a href="https://www.kevinmd.com/blog/post-author/mksap" rel="tag" > mksap < /a > < /span > Tags: Conditions Pulmonology Source Type: blogs
A poor sense of smell might matter more than you thought
As one of the five major senses, you could argue that our sense of smell is the least important. Sight, hearing, touch, and taste may poll better than smell, but try telling that to someone who has lost their sense of smell entirely.
The truth is that loss of the ability to smell comes with a significant cost, because olfaction serves several purposes that affect quality of life and even safety, including
stimulation of appetite
enhancement of the sense of taste
alerting you to which foods should not be eaten (if they’re rotting, for example)
warning you of danger (as with smoke warning of fire).
Loss of smell can also...
Source: Harvard Health Blog - June 18, 2019 Category: Consumer Health News Authors: Robert H. Shmerling, MD Tags: Alzheimer's Disease Brain and cognitive health Ear, nose, and throat Source Type: blogs
My life time clinical coronary skill went in vain . . . when this patient entered my clinic with chest pain !
Evening cardiac clinic is generally a relaxing place until an occasional patient with vague chest discomfort present with this sort of an ECG .
He was a 68 y old hypertensive and was on Tablet Amlodipine .After a cursory look at his ECG , eyes wandered to look for some specifics. Suddenly ,my ECG reading skill was stretched . Is it really LVH ? or Ischemia ? I asked for any old ECG which he couldn’t provide. I had to blink more than a moment , before asking him to describe his chest pain in detail one more time . I got almost convinced it was not ACS since he was having only localized pain over left side of...
Source: Dr.S.Venkatesan MD - November 10, 2018 Category: Cardiology Authors: dr s venkatesan Tags: acute coroanry syndrome acute coronary syndrome Clinical cardiology lvh vs ischemia primary vs secondary st t changes triaging chest pain Source Type: blogs
