• Filter By:
• Specialty
• Source
• Condition
• Cancer
• Infectious Disease
• Drug
• Training
• Management
• Procedure
• Therapy
• Vaccine
• Nutrition
• Country

Natural History and Sequelae of Penetrating Aortic Ulcer
A man in his 70s with history of tobacco use and hypertension presented for transesophageal echocardiography after a recent diagnosis of ischemic stroke. This demonstrated a moderate right-to-left shunt on Valsalva release and no left atrial appendage thrombus. Assessment of the thoracic aorta revealed a complex penetrating aortic ulcer and saccular aneurysm with thrombus in the distal arch and proximal descending thoracic aorta (Figure). Computed tomography angiography confirmed the presence of multiple penetrating ulcerations with large saccular aneurysms.
Source: Mayo Clinic Proceedings - September 1, 2023 Category: Internal Medicine Authors: Raghav R. Julakanti, Prabhakar Shantha Rajiah, Krishnaswamy Chandrasekaran Tags: Medical image Source Type: research

86-Year-Old Woman With Fever, New-Onset Dysarthria, and Ataxia
An 86-year-old woman with a medical history of hypertension, hyperlipidemia, permanent atrial fibrillation receiving anticoagulation, and chronic venous stasis causing recurrent leg cellulitis presented to the emergency department for new-onset dysarthria and imbalance, which began earlier that morning. She denied a history of stroke, chills, unintentional weight loss, diarrhea, dysuria, frequency, or recent head trauma. The patient endorsed taking her anticoagulation as prescribed without skipped doses.
Source: Mayo Clinic Proceedings - August 1, 2023 Category: Internal Medicine Authors: Nikita Jhawar, Abdallah El Sabbagh Tags: Residents ’ Clinic Source Type: research

54-Year-Old Woman With Altered Mental Status and Abdominal Pain
A 54-year-old woman was transferred to our medical center with altered mental status, abdominal pain, and hypotension. Her medical history included type 2 diabetes mellitus, hypertension, hyperlipidemia, active tobacco use, prior cholecystectomy, and a recent stroke. One month earlier, she presented to an outside facility with right-sided facial weakness and numbness. Brain magnetic resonance imaging (MRI) at that time revealed multiple small lacunar-type infarcts. Computed tomography (CT) angiography of the head and neck, 48-hour Holter monitoring, and transesophageal echocardiography did not reveal an embolic source.
Source: Mayo Clinic Proceedings - June 29, 2022 Category: Internal Medicine Authors: Caroline L. Matchett, Nikita Rafie, Jacob C. Jentzer Tags: Residents ’ Clinic Source Type: research

The Invisible Silent Killer
Systemic hypertension has been described as a “silent killer” due to its asymptomatic course which can remain unnoticed by clinicians even as it gives rise to coronary artery disease, stroke, and renal failure. That said, if one is looking for hypertension, it can be easily found in the first set of data collected routinely during any patie nt encounter. In moving from the systemic to the pulmonary circulation, however, elevated blood pressures pose a formidable mortality risk that is not only silent but also nearly invisible.
Source: Mayo Clinic Proceedings - August 1, 2021 Category: Internal Medicine Authors: David L. Joyce Tags: Editorial Source Type: research

Intracerebral Hemorrhage
Spontaneous intracerebral hemorrhage (ICH) is a medical emergency and is disproportionately associated with higher mortality and long-term disability compared with ischemic stroke. The phrase “time is brain” was derived for patients with large vessel occlusion ischemic stroke in which approximately 1.9 million neurons are lost every minute. Similarly, this statement holds true for ICH patients due to a high volume of neurons that are damaged at initial onset and during hematoma expan sion. Most cases of spontaneous ICH pathophysiologically stem from chronic hypertension and rupture of small perforating vessels off of l...
Source: Mayo Clinic Proceedings - May 2, 2021 Category: Internal Medicine Authors: Cumara B. O ’Carroll, Benjamin L. Brown, W. David Freeman Tags: Solicited review Source Type: research

Predicting Who Will Experience Cerebral Hemorrhage When Anticoagulated
The most feared hemorrhagic complication of anticoagulating patients with atrial fibrillation is intracerebral hemorrhage (ICH). However, not anticoagulating high-risk patients with atrial fibrillation can lead to cardioembolic stroke, another disastrous outcome. Physicians may tend to avoid blame by inaction, which can result in underprescribing. Such clinical inertia is not unique to anticoagulating patients with atrial fibrillation. Clinical inertia has been noted in the treatment of several common chronic conditions, such as treating blood pressure in patients with hypertension and treating hyperglycemia in patients wi...
Source: Mayo Clinic Proceedings - September 30, 2020 Category: Internal Medicine Authors: James F. Meschia Tags: Editorial Source Type: research

Utility of HAS-BLED and CHA2DS2-VASc Scores Among Patients With Atrial Fibrillation and Imaging Evidence of Cerebral Amyloid Angiopathy
To determine the utility of the HAS-BLED (Hypertension, Abnormal renal/liver function, Stroke, Bleeding history or predisposition, Labile international normalized ratio, Elderly, Drugs/alcohol concomitantly) and CHA2DS2-VASc (Congestive heart failure, Hypertension, Age, Diabetes, previous Stroke/transient ischemic attack –VAScular disease) scores among patients on anticoagulation (AC) therapy for atrial fibrillation (AF) who have evidence of cerebral amyloid angiopathy (CAA).
Source: Mayo Clinic Proceedings - August 19, 2020 Category: Internal Medicine Authors: Robert Ward, Shiva Ponamgi, Christopher V. DeSimone, Stephen English, David O. Hodge, Joshua P. Slusser, Jonathan Graff-Radford, Alejandro A. Rabinstein, Samuel J. Asirvatham, David Holmes Tags: Original article Source Type: research

A Review of Hypertension Management in Black Male Patients
Hypertension affects approximately 85 million Americans, or almost 1 in 3 adults. Black men have disproportionately higher rates of hypertension and are more likely to experience complications of hypertension, including stroke, myocardial infarction, and death. In addition, hypertensive black men are less likely to achieve optimal blood pressure (BP) than women and persons of other races. In light of this, we performed a literature search for articles published from January 1, 1966, to December 31, 2018, using terms including hypertension, blood pressure, black male, and African American male.
Source: Mayo Clinic Proceedings - April 6, 2020 Category: Internal Medicine Authors: Elisabeth M. Sulaica, Joshua T. Wollen, John Kotter, Tracy E. Macaulay Tags: Review Source Type: research

82-Year-Old Woman With Acute-Onset Left-Sided Weakness
An 82-year-old woman with a history of type 2 diabetes mellitus, hyperlipidemia, and hypertension presented to the emergency department with sudden onset of left arm and leg weakness. She was sitting in church when she developed left-sided posterior neck and shoulder pain, followed 1 hour later by sudden-onset dense left-sided weakness. Emergency medical services were called, and they activated the prehospital stroke-notification protocol. The patient arrived at the emergency department approximately 30 minutes after the onset of the weakness.
Source: Mayo Clinic Proceedings - December 31, 2019 Category: Internal Medicine Authors: Ronstan Lobo, Adam P. Sawatsky Tags: Residents ’ clinic Source Type: research

In reply —Sauna Bathing and Healthy Sweating
We thank Eiser and Brooks for their comments about the health benefits of sauna bathing. Regular sauna bathing has some beneficial effects on blood pressure, cardiometabolic biomarkers, arterial compliance, and cardiovascular function.1 Our prospective studies have shown that higher frequency and duration of sauna bathing are related to a lower risk of cardiovascular mortality, sudden cardiac death, stroke, hypertension, pulmonary diseases, and dementia.1-3 The feelings of relaxation and promotion of mental health and well-being associated with sauna sessions might be linked to the increased production of circulating level...
Source: Mayo Clinic Proceedings - March 31, 2019 Category: Internal Medicine Authors: Jari A. Laukkanen, Tanjaniina Laukkanen, Setor Kunutsor Tags: Letter to the Editor Source Type: research

79-Year-Old Man With Shortness of Breath and Fevers
A 79-year old man with a history of myocardial infarction and coronary artery bypass grafting in 2000, biventricular systolic heart failure with an ejection fraction of 27%, hypertension, persistent atrial fibrillation for which he was taking high-dose aspirin given a previous history of hemorrhagic stroke, stage 3 chronic kidney disease, left cerebellar ischemic stroke, and implantable cardioverter-defibrillator (ICD) placement 5 years previously presented to his local medical facility with a 2-day history of breathlessness, fevers, and chills.
Source: Mayo Clinic Proceedings - November 7, 2018 Category: Internal Medicine Authors: Jaskanwal D. Sara, Megha Prasad, Suraj Kapa Tags: Residents' clinic Source Type: research

CHA2DS2-VASc Score: A Predictor of Thromboembolic Events and Mortality in Patients With an Implantable Monitoring Device Without Atrial Fibrillation
To determine if the CHA2DS2-VASc score (congestive heart failure, hypertension, age ≥75 years, diabetes mellitus, stroke or transient ischemic attack, vascular disease, age 65-74 years, sex category) predicts thromboembolism and death in patients without atrial fibrillation in a population with implantable cardiac monitoring devices.
Source: Mayo Clinic Proceedings - February 28, 2017 Category: Internal Medicine Authors: Christine Parsons, Salma I. Patel, Stephen Cha, Win-Kuang Shen, Santosh Desai, Alanna M. Chamberlain, Sushil Allen Luis, Maria I. Aguilar, Bart M. Demaerschalk, Farouk Mookadam, Fadi Shamoun Tags: Original article Source Type: research

CHADS Scores as a Predictor of Ischemic Stroke in Patients With Peripheral Artery Disease
To assess the predictive value of CHADS2 (congestive heart failure, hypertension, age ≥75 years, diabetes mellitus, stroke) scores for stroke risk in patients with peripheral artery disease (PAD).
Source: Mayo Clinic Proceedings - December 8, 2015 Category: Internal Medicine Authors: Yu-Wan Yang, Yi-Hsin Chen, Chia-Chun Hsu, Ching-Chih Lee, Yu-Hung Kuo, Hsun-Yang Chuang, Teng-Fu Hsieh Tags: Original article Source Type: research

Increased Risk of First-Ever Stroke in Younger Patients With Atrial Fibrillation Not Recommended for Antithrombotic Therapy by Current Guidelines: A Population-Based Study in an East Asian Cohort of 22 Million People
To assess the risk of first-ever ischemic stroke in younger patients with atrial fibrillation (AF) who have none of the CHA2DS2-VASc (congestive heart failure, hypertension, age ≥75 years, diabetes mellitus, previous stroke/transient ischemic attack, vascular disease, age 65-74 years, sex category [female sex]) risk factors (excluding female sex) by using the National Health Insurance research database in Taiwan.
Source: Mayo Clinic Proceedings - November 1, 2014 Category: Internal Medicine Authors: Kuan-Cheng Chang, Yu-Chen Wang, Po-Yen Ko, Hung-Pin Wu, Yu-Wei Chen, Chih-Hsin Muo, Fung-Chang Sung, Tsai-Chung Li, Chung Y. Hsu Tags: Original article Source Type: research