Percutaneous Coronary Intervention Blogs This is an RSS file. You can use it to subscribe to this data in your favourite RSS reader or to display this data on your own website or blog.

FFRangio Uses X-Rays to Measure Fractional Flow Reserve, Now Cleared in U.S.
Fractional flow reserve (FFR) is a measurement of the blood pressure before and after a narrowing of an artery. The larger the difference in the pressure across the stenosis, the more need there is to perform an interventional procedure to open up the artery. Normally, FFR is measured using a special intravascular catheter and this is now quite common. Nevertheless, traditional FFR involves its own procedural risks, takes a good deal of time to perform, and adds substantial costs. CathWorks, a company with offices in Israel and California, has just won FDA clearance for its FFRangio system, a non-invasive alternative to tr...
Source: Medgadget - January 2, 2019 Category: Medical Devices Authors: Editors Tags: Cardiology Radiology Vascular Surgery Source Type: blogs

Anterior STEMI and multiform PVCs with Narrow Coupling Interval. When to give beta blockers in acute MI?
Conclusion of first report:In patients with anterior Killip class II or less ST-segment –elevation myocardial infarction undergoing primary percutaneous coronary intervention, early intravenous metoprolol before reperfusion reduced infarct size and increased left ventricular ejection fraction with no excess of adverse events during the first 24 hours after STEMI.Conclusion of 2nd report: In patients with anterior Killip class ≤II STEMI undergoing pPCI, early IV metoprolol before reperfusion resulted in higher long-term LVEF, reduced incidence of severe LV systolic dysfunction and ICD indications, and fewer h...
Source: Dr. Smith's ECG Blog - October 19, 2018 Category: Cardiology Authors: Steve Smith Source Type: blogs

Type 4c myocardial infarction – Cardiology MCQ
Type 4c myocardial infarction as per the 4th universal definition of myocardial infarction: a) Myocardial infarction related to percutaneous coronary intervention b) Myocardial infarction due to stent thrombosis c) Myocardial infarction due to restenosis d) Myocardial infarction following coronary artery bypass surgery Please post your answers below. Correct answer will be posted on: Aug 30, 2018 @ 01:31 (Source: Cardiophile MD)
Source: Cardiophile MD - August 28, 2018 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Uncategorized Source Type: blogs

An athletic 30-something woman with acute substernal chest pressure
Post by Smith, with short article by Angie Lobo (https://twitter.com/ALoboMD), a third year intermal medicine resident at Abbott Northwestern Hospital CaseA 30-something woman with no past history, who is very fit and athletic, presented with 1.5 hours of substernal chest pressure. It was non-radiating and without other associated symptoms except for nausea. She had zero CAD risk factors.Here was her ECG at time zero:What do you think?There is ST elevation in V2 with large fat T-wave. There is ST depression in II, III, and aVF, and V3 to V6.I saw this before any other information and k...
Source: Dr. Smith's ECG Blog - July 31, 2018 Category: Cardiology Authors: Steve Smith Source Type: blogs

Shock index and modified shock index for prediction of myocardial damage and clinical outcome of STEMI
Shock index is the ratio of heart rate to systolic blood pressure which allows rapid bedside risk stratification [1]. Modified shock index is the ratio of heart rate to mean arterial pressure [2]. Reinstadler SJ et al [2] used these indices to predict the myocardial damage and clinical outcome of ST segment elevation myocardial infarction (STEMI). They found that STEMI patients with elevated shock index had more severe myocardial and microvascular damage and it was associated with major adverse cardiac events (MACE) at 1 year. This multicenter study analyzed around eight hundred patients dicotomized to an admission shock ...
Source: Cardiophile MD - June 6, 2018 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: General Cardiology Source Type: blogs

Management of pulmonary artery perforation during balloon angioplasty
Management of perforation of a pulmonary vessel is on the same lines as that of any other vessel like coronary perforation during percutaneous coronary intervention. First and foremost is to prevent a rupture before it actually occurs! Proper wire positioning within the lumen and avoiding a segment with total occlusion and no distal flow are two important aspects of prevention. But if the total occlusion is involving a large segment, we may have to proceed with special precautions. In the knuckle wire technique, a loop is formed at the distal end of the wire while trying to cross a total occlusion. This loop will prevent ...
Source: Cardiophile MD - May 27, 2018 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Peripheral Interventions balloon tamponade ECMO knuckle wire technique PEEP Source Type: blogs

Twitter-Based Medicine: How Social Media is Changing the Public ’s View of Medicine
By BENJAMIN WERTZER, MD Doctors can be two-faced. This isn’t necessarily a negative attribute. Doctors have distinct personas for our patients and our colleagues. With patients, doctors strive for a compassionate but authoritative role. However, with each other, doctors often reveal a different demeanor: thoughtful and collaborative, but also opinionated and even sometimes petty. These conflicts are often the result of our struggle with evidence-based medicine. The modern practice of evidence-based medicine is more than the scientific studies we read in journals. Medicine doesn’t just change in rational, data-driven in...
Source: The Health Care Blog - April 17, 2018 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Source Type: blogs

ST-Elevation in aVR with diffuse ST-Depression: An ECG pattern that you must know and understand!
This case comes from Sam Ghali (@EM_RESUS). A 60-year-old man calls 911 after experiencing sudden onset chest pain, palpitations, and shortness of breath. Here are his vital signs:HR: 130-160, BP: 140/75, RR:22, Temp: 98.5 F, SaO2: 98%This is his 12-Lead ECG:He is in atrial fibrillation with a rapid ventricular response at a rate of around 140 bpm. There are several abberantly conducted beats. There is ST-Elevation in aVR of several millimeters and diffuse ST-Depression with the maximal depression vector towards Lead II in the limb leads and towards V5 in the precordial leads.ECG reading is all ab...
Source: Dr. Smith's ECG Blog - February 28, 2018 Category: Cardiology Authors: Steve Smith Source Type: blogs

A reaction to ORBITA: Keep on stenting, judiciously
Physicians’ reactions to ORBITA — a blinded, randomized controlled trial (RCT) from Britain with a sham arm comparing percutaneous coronary intervention (PCI) to placebo in patients with stable angina — are as fascinating as the cardiac cycle. There were murmurs, kicks and pulsating jugulars. Though many claimed to be surprised and many unsurprised by the null results of the trial, the responses were predictably predictable. Some basked in playful schadenfreude, and some became defensive and bisferious. No shame in sham The coverage of the trial in the The New York Times was predictably jejune and hyperbolic. Predict...
Source: Kevin, M.D. - Medical Weblog - December 10, 2017 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/dr-saurabh-jha" rel="tag" > Dr. Saurabh Jha < /a > Tags: Conditions Cardiology Source Type: blogs

Myocardial viability assessment
The term viable myocardium is applied to myocardium with a potentially reversible contractile dysfunction in patients with coronary artery disease. It can be divided into stunned myocardium and hibernating myocardium. Stunned myocardium has prolonged contractile dysfunction after a transient ischemic episode and coronary reperfusion. This automatically recovers over a period of time. Stunned myocardium is commonly noted after thrombolysis and primary percutaneous coronary intervention. Hibernating myocardium has reduced contractile function due to persistently impaired coronary blood flow. Hibernating myocardium regai...
Source: Cardiophile MD - November 16, 2017 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs

DAPT score – Dual Antiplatelet Therapy Score
DAPT score (Dual Antiplatelet Therapy Score) was developed to dichotomize patients after percutaneous coronary intervention [PCI] into those who will benefit from prolonged DAPT (score 2 or more) and those who are more likely to be harmed by DAPT (score less than 2). A recent study evaluated DAPT with aspirin and clopidogrel given for 2 years vs 6 months in 1970 patients undergoing PCI [1]. Primary efficacy outcomes were death, myocardial infarction or cerebrovascular accident. Primary safety outcome was significant bleeding. In this retrospective study they concluded that prolonged DAPT resulted in harm in patients with l...
Source: Cardiophile MD - November 14, 2017 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs

Do angioplasties and coronary stenting improve symptoms in patients with angina?
Last week, the results of ORBITA were published. This clinical trial tested coronary angioplasty and stenting versus optimal medical management in patients with single-vessel coronary artery disease. It was a resoundingly negative trial, meaning that adding stenting to drug management didn’t result in detectable clinical improvement. What was distinctive about this trial is that it used a sham procedure (i.e., placebo) control, which few trials testing surgery or a procedure use. The results of ORBITA emphasize how important sham procedure controls are, whenever they can be ethically used, and how resistant physicians ca...
Source: Respectful Insolence - November 13, 2017 Category: Surgery Authors: Orac Tags: Clinical trials Medicine angina angioplasty coronary artery bypass graft ORBITA percutaneous coronary intervention stent Source Type: blogs

Cangrelor – short acting P2Y12 inhibitor for intravenous use
Cangrelor is a short acting P2Y12 inhibitor for intravenous use. It is a directly acting non thienopyridine P2Y12 receptor antagonist analogous to adenosine triphosphate molecule, having a molecular weight of 88 Daltons. Plasma half life of cangrelor is 3 to 6 minutes only and the offset of its therapeutic action occurs in about one hour. If we are planning to use cangrelor in the cath lab, loading dose of oral P2Y12 inhibitor in the emergency department can be withheld. Cangrelor can be considered as Class IIb level of evidence A indication for those undergoing percutaneous coronary intervention (PCI) when they have not b...
Source: Cardiophile MD - November 11, 2017 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs

12 Seconds of Placebo – An Outsider’s View of ORBITA
By, SAURABH JHA MD The reactions of physicians to ORBITA, a blinded, randomized controlled trial (RCT) from Britain, with a sham arm, comparing percutaneous coronary intervention (PCI) to placebo, in patients with stable angina, are as fascinating as the cardiac cycle. There were murmurs, kicks, and pulsating jugulars. Though many claimed to be surprised, and many unsurprised, by the null results of the trial, the responses were predictably predictable. Some basked in playful schadenfreude, and some became defensive and bisferious. No shame in sham The coverage of the trial in the NY Times was predictably jejune and...
Source: The Health Care Blog - November 7, 2017 Category: Consumer Health News Authors: at RogueRad Tags: Uncategorized Source Type: blogs

Cardiology MCQ Test 6
Time limit: 0 Quiz-summary 0 of 20 questions completed Questions: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 ...
Source: Cardiophile MD - October 27, 2017 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs