The syndrome of vanishing ACS : Who activates spontaneous thrombolysis ?
Background
“Your husband was really lucky, his heart attack got spontaneously aborted. His ECG is near normal now. The angiogram is normal.No stent, no lysis. He secreted his own Tpa and got rid of the clot. We will discharge him to tomorrow.”
Thank you very much, Doctor. How did this happen, doctor?
Don’t thank me. Definitely, I don’t have an answer. Spontaneous successful thrombolysis (Ref 4) happens up to 15 % of ACS. All I can say is he has a very disciplined mast cell network and fibrinolytic system.
Vascular events: Pathobiology
Vascular highway accidents that happen due to the sudden fr...
Source: Dr.S.Venkatesan MD - October 8, 2021 Category: Cardiology Authors: dr s venkatesan Tags: Uncategorized anti fibrinolytic system thrombolysis Source Type: blogs
A man in his late 40s with chest pain
Written by Pendell MeyersA man in his late 40s with no known medical problems was at work when he suddenly experienced midsternal chest pain radiating down both arms. Approximately 1 hour after onset of symptoms he was triaged at the ED, with ongoing chest pain, normal vitals, and this triage ECG:What do you think?Twice, months apart, I sent this ECG to Dr. Smith without any context or other information (I do this many times per day, with many normal or false positive cases mixed in). The first time he responded " acute ischemia but not active occlusion " . The second time he responded " LVH and subendocardial ischem...
Source: Dr. Smith's ECG Blog - September 13, 2021 Category: Cardiology Authors: Pendell Source Type: blogs
Fight Aging! Newsletter, September 13th 2021
In this study, mature DCs (mDCs), generated from the GM-CSF and IL-4 induced bone marrow cells, were intravenously injected into wild-type mice. Three days later, assays showed that the mDCs were indeed able to return to the thymus. Homing DCs have been mainly reported to deplete thymocytes and induce tolerance. However, medullary TECs (mTECs) play a crucial role in inducing immune tolerance. Thus, we evaluated whether the mDCs homing into the thymus led to TECs depletion. We cocultured mDCs with mTEC1 cells and found that the mDCs induced the apoptosis and inhibited the proliferation of mTEC1 cells. These effects were onl...
Source: Fight Aging! - September 12, 2021 Category: Research Authors: Reason Tags: Newsletters Source Type: blogs
Laser atherectomy
Laser atherectomy is a novel technique useful in in-stent restenosis, stent under expansion, balloon uncrossable lesions and chronic total occlusions [1]. An important advantage of excimer laser atherectomy over other atherectomy devices is delivery on a standard 0.014-inch guidewire [2]. The technique can be mastered after a short period of training.
Major limitation is the presence of heavy calcification, which requires rotational atherectomy for clearance. But when there is inability to pass a rota wire, laser may be useful in creating an upstream channel to permit rota wire passage.
Laser device works by producing mon...
Source: Cardiophile MD - September 11, 2021 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Cardiology Source Type: blogs
D-Cube syndrome : DES-Dengue-DAPT
Background
A 52-year-old diabetic woman who had undergone recent PCI with a DES developed a febrile illness which was diagnosed as Dengue fever. She has been taking DAPT (Dual antiplatelet) meticulously to maintain her stent. Now, her platelet count has dropped from 1.5 and subsequently to 1 lakh. She is asking now, whether to stop DAPT or not? What is the risk of stent occlusion if she stops?
The D³ cube syndrome
Infectious diseases rarely bother a cardiologist (maybe a few IE, myocarditis, etc). Now, a unique situation is emerging.
*Dengue affects 50-100 million people worldwide every year and one billion are ...
Source: Dr.S.Venkatesan MD - September 9, 2021 Category: Cardiology Authors: dr s venkatesan Tags: anti platelet drug antiplatelet drugs in dengue clopidogrel prasugrel ticagrelol in dengue fever dapt in dengue fever therapeutic issues in dengue and cad warfarin heparin in dengue Source Type: blogs
A Study of Nattokinase Supplementation Shows No Effect on Progression of Atherosclerosis
You might recall a Chinese study from a few years back claiming a sizable effect on atherosclerotic plaque for supplementation with nattokinase. The result was a 36% reversal in plaque size, which is several times larger than can be reliably achieved with approaches such as statins and their successors, drugs that lower blood cholesterol. The dose was 6000FU/day for 6 months. My attention was recently drawn to the publication of results for a US study using dose of 2000FU/day for several years. In that study, there was no effect on the progression of atherosclerosis, and certainly no marked reversal.
Medicine in gen...
Source: Fight Aging! - September 8, 2021 Category: Research Authors: Reason Tags: Medicine, Biotech, Research Source Type: blogs
Dark Chocolates and the Heart
Are dark chocolates good for the heart?
A study published in Circulation suggests that eating dark chocolate can improve coronary vasomotion and reduce platelet reactivity [1].
Dark chocolates which contain 70% cocoa have lots of flavonoids – potent antioxidants which helps to overcome the oxidative stress. They also decrease the activation of blood platelets responsible for thrombosis.
High oxidative stress and limited availability of antioxidants can cause endothelial damage in the arteries, leading to increased chances for a thrombosis.
Flavonoid rich dark chocolate has the potential for a beneficial effect on graft ...
Source: Cardiophile MD - September 7, 2021 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Cardiology Source Type: blogs
A 76 Year Old Female With Recurrent Syncope, Lightheadedness, Palpitations and Negative Stress Test
Written by Lucas Goss MD, peer reviewed by Meyers, Smith, BraceyA 76 year old female with a history of arial fibrillation not on anticoagulation, non-obstructive CAD found on coronary CTA 2 years prior, HTN, HLD, recurrent lightheadedness, and syncope status post loop recorder placement, presented for another episode of feeling lightheaded, diaphoretic, and feeling like she “was going to die.” She was discharged just the day prior for her second hospitalization for similar episodes. She was actually at the pharmacy to pick up her medicines the day after discharge when this episode occurred, and pharmacy staff sat her d...
Source: Dr. Smith's ECG Blog - September 4, 2021 Category: Cardiology Authors: Pendell Source Type: blogs
Fight Aging! Newsletter, August 23rd 2021
In this study, we used the UK Biobank (n = 440,185) to resolve previous ambiguities in the relationship between serum IGF-1 levels and clinical disease. We examined prospective associations of serum IGF-1 with mortality, dementia, vascular disease, diabetes, osteoporosis, and cancer, finding two generalized patterns.
First, IGF-1 interacts with age to modify risk in a manner consistent with antagonistic pleiotropy; younger individuals with high IGF-1 are protected from disease, while older individuals with high IGF-1 are at increased risk for incident disease or death. Second, the association between IGF-1 and risk ...
Source: Fight Aging! - August 22, 2021 Category: Research Authors: Reason Tags: Newsletters Source Type: blogs
The Accelerated Aging Produced by Chronic Kidney Disease
Many lines of evidence point to kidney function as being particularly important to the health of organs throughout the body. To pick one example, one of the better known longevity-associated genes, klotho, appears to act in the kidney, and yet is well known for producing improvements in cognitive function. Here, researchers discuss much of the other evidence related to the accelerated aging observed in chronic kidney disease patients. Once the kidney starts to decline, near everything else in the body follows, with cardiovascular issues being a particularly prominent part of the problem.
The characteristics of chr...
Source: Fight Aging! - August 20, 2021 Category: Research Authors: Reason Tags: Daily News Source Type: blogs
A 52 year old female with chest pain
Written by Pendell Meyers, edits by Steve SmithA 52 year old female with history of hypothyroidism and smoking presented to the ED with an episode of chest pain that began suddenly around 1500 while sitting down at work. She states it felt like a central chest pressure that radiated to her jaw. The pain had been persistently present since since 1500 (seen at 1615 in the ED), but had waxed and waned in severity, with the initial onset of pain being the worst. She had dyspnea and diaphoresis when the pain began. Coworkers called EMS who administered aspirin and NTG, which the patient says did not relieve her pain. During ini...
Source: Dr. Smith's ECG Blog - August 16, 2021 Category: Cardiology Authors: Pendell Source Type: blogs
Why do we liberally record ECGs? And what do you think the angiogram showed?
Discussion:This ECG is Aslanger ' s pattern, and the angiogram is exactly what you expect with this ECG pattern, including the inferior OMI attributed to circumflex (more often than RCA).This pattern was recently published in J Electrocardiology: Aslanger and others (including Smith). A new electrocardiographic pattern indicating inferior myocardial infarction. https://pubmed.ncbi.nlm.nih.gov/32526537/This newly recognized ECG pattern is defined as:(1) any STE in III (with reciprocal STD in aVL), but not in other inferior leads, (2) STD in any of leads V4 to V6, (but not in V2) with a positi...
Source: Dr. Smith's ECG Blog - August 10, 2021 Category: Cardiology Authors: Steve Smith Source Type: blogs
Fight Aging! Newsletter, August 9th 2021
In conclusion, the present study supports that some age-related diseases as well as education are causally related to longevity and highlights several new targets for achieving longevity, including management of venous thromboembolism, appropriate intake of sugar, and control of body fat. Our results warrant further studies to elucidate the underlying mechanisms of these reported causal associations.
Pol III Inhibition Extends Longevity in Short-Lived Species
https://www.fightaging.org/archives/2021/08/pol-iii-inhibition-extends-longevity-in-short-lived-species/
As this paper notes, Pol III is downstrea...
Source: Fight Aging! - August 8, 2021 Category: Research Authors: Reason Tags: Newsletters Source Type: blogs
Mining Epidemiological Data for Correlations with Longevity
In conclusion, the present study supports that some age-related diseases as well as education are causally related to longevity and highlights several new targets for achieving longevity, including management of venous thromboembolism, appropriate intake of sugar, and control of body fat. Our results warrant further studies to elucidate the underlying mechanisms of these reported causal associations.
Link: https://doi.org/10.1186/s12916-021-02030-4 (Source: Fight Aging!)
Source: Fight Aging! - August 3, 2021 Category: Research Authors: Reason Tags: Daily News Source Type: blogs
IMPROVE VTE risk score and modified IMPROVE VTE risk score
IMPROVE (International Medical Prevention Registry on Venous Thromboembolism) score is a weighted VTE (Venous Thromboembolism) risk score designed for medically ill patients [1], which has been externally validated [2].
While formulating the IMPROVE VTE risk score, data from 15,156 medically ill patients were analyzed to find the cumulative incidence of VTE over a 3 month period after admission [1]. Of the 184 patients who developed symptomatic VTE, 67 had lower extremity DVT (deep vein thrombosis) and 76 had pulmonary embolism. Weightage given was 3 points for previous VTE, 2 points for known thrombophilia, 2 points eac...
Source: Cardiophile MD - July 30, 2021 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Cardiology Source Type: blogs
