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Specialty: Internal Medicine
Source: Mayo Clinic Proceedings
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Total 82 results found since Jan 2013.
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
Remaining Challenges With Transcatheter Left Atrial Appendage Closure
Left atrial appendage closure has emerged as a feasible stroke prevention strategy in selected patients with nonvalvular atrial fibrillation. Since its commercial approval in the United States in 2015, the use of percutaneous left atrial appendage closure has witnessed a substantial growth. However, certain issues remain unresolved with the technology. Knowledge of these issues, their significance, and the current and future efforts to resolve them is key for proper informed decision making by physicians and patients.
Source: Mayo Clinic Proceedings - September 30, 2020 Category: Internal Medicine Authors: Mohamad Alkhouli, David R. Holmes Tags: Concise review for clinicians Source Type: research
Environmental Factors Impact Clinical Outcomes in Atrial Fibrillation
Atrial fibrillation (AF) is the most common cardiac arrhythmia in the world with a lifetime risk of 26% for men and 23% for women. The global prevalence was estimated at 20.9 million males and 12.6 million females in 2010, with as many as 4.7 million total new cases per year.1 AF carries significant comorbidities such as stroke, leading to over 467,000 hospitalizations and over 99,000 deaths per year in the US.2 AF has repeatedly been shown to be associated with poorer quality of life.3 The underlying mechanisms of AF are extremely complex with an integral part involving a systemic inflammatory syndrome.
Source: Mayo Clinic Proceedings - November 1, 2020 Category: Internal Medicine Authors: Robert C. Ward, Christopher V. DeSimone Tags: Editorial Source Type: research
In reply —Risk Framing in Cardiovascular Medicine I and II
We thank the authors for their insightful comments on our perspective published in the journal.1 We agree with Dr Modarressi1 that sodium-glucose cotransporter-2 inhibitors indeed represent an important new treatment for patients with heart failure. Although we used the trial definition of major adverse cardiovascular events (cardiovascular death, nonfatal myocardial infarction, or stroke) in the text and in the table ’s footnote, we acknowledge that this was a secondary and not a primary end point.
Source: Mayo Clinic Proceedings - November 1, 2020 Category: Internal Medicine Authors: Mohamad Alkhouli, Charanjit S. Rihal Tags: Letter to the editor Source Type: research
Dysphagia in Older Adults
Dysphagia, which is a geriatric syndrome affecting 10% to 33% of older adults, is commonly seen in older adults who have experienced a stroke or neurodegenerative diseases such as Alzheimer or Parkinson disease. Patients diagnosed as having dysphagia can experience malnutrition, pneumonia, and dehydration. Patients can also experience increased rates of mortality and long-term care admission. Providers can identify the specific type of dysphagia for treatment in approximately 80% of patients by asking 5 questions in the patient ’s history: What happens when you try to swallow? Do you have trouble chewing? Do you have dif...
Source: Mayo Clinic Proceedings - February 1, 2021 Category: Internal Medicine Authors: Shanojan Thiyagalingam, Anne E. Kulinski, Bjorg Thorsteinsdottir, Katrina L. Shindelar, Paul Y. Takahashi Tags: Thematic Review on Aging Source Type: research
Lower Extremity Arterial Disease as a Predictor of Incident Atrial Fibrillation and Cardiovascular Events
To evaluate the relationship between peripheral arterial disease (PAD) and incident atrial fibrillation (AF) and its clinical and pathophysiologic implications on ischemic stroke and all-cause mortality.
Source: Mayo Clinic Proceedings - May 1, 2021 Category: Internal Medicine Authors: Andrew S. Tseng, Marlene Girardo, Christine Firth, Shubhang Bhatt, David Liedl, Paul Wennberg, Win-kuang Shen, Leslie T. Cooper, Fadi E. Shamoun Tags: Original article Source Type: research
Thromboembolic Risk in Hospitalised and Non-hospitalised Covid-19 Patients: A Self-controlled Case Series Analysis of a Nation-wide Cohort
This study aims to assess the associations between Covid-19 infection and thromboembolism including myocardial infarction (MI), ischaemic stroke, deep-vein thrombosis (DVT), and pulmonary embolism (PE).
Source: Mayo Clinic Proceedings - July 15, 2021 Category: Internal Medicine Authors: Frederick K. Ho, Kenneth KS. Man, Mark Toshner, Colin Church, Carlos Celis-Morales, Ian CK. Wong, Colin Berry, Naveed Sattar, Jill P. Pell Tags: Original Article 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
Racial Differences in the Prevalence of Diagnosed Atrial Fibrillation Among Hospitalized Patients
Atrial fibrillation (AF) will affect at least 12 million people in the United States by 2030. Atrial fibrillation is associated with an increased risk for stroke and death and contributes to substantial costs and resource use.1 Considerable efforts are devoted to optimize AF management and mitigate its negative sequalae. However, the literature suggests the presence of racial disparities in the management of AF in the United States. Recent studies showed that direct oral anticoagulant, pulmonary vein isolation, and left atrial appendage closure are less commonly used among patients of non-White race.
Source: Mayo Clinic Proceedings - September 1, 2021 Category: Internal Medicine Authors: Mohammed Osman, Abhishek J. Deshmukh, David R. Holmes, Mohamad Alkhouli Tags: Letter to the editor Source Type: research
Thromboembolic Risk in Hospitalized and Nonhospitalized COVID-19 Patients
To assess the associations between coronavirus disease 2019 (COVID-19) infection and thromboembolism including myocardial infarction (MI), ischemic stroke, deep vein thrombosis (DVT), and pulmonary embolism (PE).
Source: Mayo Clinic Proceedings - July 15, 2021 Category: Internal Medicine Authors: Frederick K. Ho, Kenneth K.C. Man, Mark Toshner, Colin Church, Carlos Celis-Morales, Ian C.K. Wong, Colin Berry, Naveed Sattar, Jill P. Pell Tags: Original article Source Type: research
Association of Proton Pump Inhibitors With Higher Risk of Cardiovascular Disease and Heart Failure
To examine associations of cumulative exposure to proton pump inhibitors (PPIs) with total cardiovascular disease (CVD; composed of stroke, coronary heart disease, and heart failure [HF]) and HF alone in a cohort study of White and African American participants of the Atherosclerosis Risk in Communities (ARIC) study.
Source: Mayo Clinic Proceedings - October 1, 2021 Category: Internal Medicine Authors: Elizabeth J. Bell, Suzette J. Bielinski, Jennifer L. St. Sauver, Lin Y. Chen, Mary R. Rooney, Nicholas B. Larson, Paul Y. Takahashi, Aaron R. Folsom Tags: Original article Source Type: research
Craniocervical Artery Dissections: A Concise Review for Clinicians
Craniocervical artery dissection (CAD), although uncommon, can affect the young and lead to devastating complications, including stroke and subarachnoid hemorrhage. It starts with a tear in the intima of a vessel with subsequent formation of an intramural hematoma. Most CAD occurs spontaneously or after minor trauma. Patients with CAD may exhibit isolated symptoms of an underlying subclinical connective tissue disorder or have a clinically diagnosed connective tissue disorder. Emergent evaluation and computed tomography angiography or magnetic resonance imaging/angiography of the head and neck are required to screen for and to diagnose CAD.
Source: Mayo Clinic Proceedings - April 1, 2022 Category: Internal Medicine Authors: Zafer Keser, James F. Meschia, Giuseppe Lanzino Tags: Concise review Source Type: research
Risk Factors for Silent Brain Infarcts and White Matter Disease in a Real-World Cohort Identified by Natural Language Processing
To assess the frequency of silent brain infarcts (SBIs) and white matter disease (WMD) and associations with stroke risk factors (RFs) in a real-world population.
Source: Mayo Clinic Proceedings - April 26, 2022 Category: Internal Medicine Authors: Lester Y. Leung, Yichen Zhou, Sunyang Fu, Chengyi Zheng, Patrick H. Luetmer, David F. Kallmes, Hongfang Liu, Wansu Chen, David M. Kent Tags: Original article Source Type: research
28-Year-Old Man With Joint Pain
A 28-year-old man presented to the emergency department with right shoulder pain that radiated to the right arm as well as pain of the right hip and lower back. His medical history is significant for sickle cell disease (SCD) with the HbSS genotype (homozygous for the S globin). He had a hemorrhagic stroke in the setting of venous sinus thrombosis 2 years earlier with no persisting neurologic deficits as well as osteonecrosis of bilateral hips and right knee requiring right total hip arthroplasty and right total knee arthroplasty.
Source: Mayo Clinic Proceedings - June 1, 2022 Category: Internal Medicine Authors: Emily B. Butts, Albert Bui, Razvan M. Chirila Tags: Residents ’ clinic Source Type: research
64-Year-Old Woman With Aphasia and Troponin Elevation
A 64-year-old right-handed woman presented to the emergency department with aphasia of 20 hours' duration, for which a stroke code was activated. She was unable to state her name; her speech was effortful, with many paraphasic errors, but some intact automatic phrases (sorry, yes, no). The family stated that her last known well was 20 hours ago. Additional history suggested several months of decline consisting of punctuated episodes of mild memory, attention, concentration, and language difficulty.
Source: Mayo Clinic Proceedings - June 29, 2022 Category: Internal Medicine Authors: Bryce Kalei Chang, Jana Wieland, Christopher J. Klein Tags: Residents ’ clinic Source Type: research
