Amyloid- β as a Contributing Cause of Age-Related Cardiovascular Disease
Amyloid-β is one of the few proteins in the human body capable of misfolding in a way that encourages aggregation, causing the misfolded version to spread and form harmful deposits in tissues. This process is best known in the context of Alzheimer's disease, where an active debate continues over whether it is actually an important part of the condition or a side-effect of other important mechanisms. Amyloid-β aggregation also occurs in the cardiovascular system, however. There is some evidence for the presence of amyloid-β in brain and vasculature to be in a state of dynamic equilibrium, but equally the disease processe...
Source: Fight Aging! - March 17, 2020 Category: Research Authors: Reason Tags: Daily News Source Type: blogs
New HydroPICC Prevents Clogged Central Line Catheters
Access Vascular, based in Bedford, Massachusetts, won FDA clearance for the latest version of its HydroPICC anti-thrombogenic central line catheter. As with the original, which was cleared two years ago, the new device features Access’s unique “bulk-hydrophilic” material that prevents clogging by being rich in water while carrying a neutral surface charge. Proteins and other biomaterials tend not to stick to such surfaces and the material has been shown not to initiate a thrombosis cascade as it doesn’t seem to be recognized by the body as non-native.
HydroPICC’s latest iteration includ...
Source: Medgadget - March 3, 2020 Category: Medical Devices Authors: Medgadget Editors Tags: Anesthesiology Cardiac Surgery Cardiology Critical Care Emergency Medicine Radiology Source Type: blogs
Contour Treats Brain Aneurysms Using Single Device
Cerus Endovascular, a firm based in Fremont, California, won the EU’s CE Mark for the Contour Neurovascular System, the company’s flagship product. Designed to treat intracranial aneurysms, the Contour is a mesh braid that diverts and disrupts blood flow in and out of an aneurysm.
The device is positioned at the neck of the aneurysm and doesn’t enter deep into the fragile dome of the diseased structure. This helps to prevent accidents and sizing criteria are not as limiting as with devices, such as coils, that have to be properly sized to the volume of the dome. The Contour anchors on its own and can b...
Source: Medgadget - February 24, 2020 Category: Medical Devices Authors: Medgadget Editors Tags: Neurosurgery Radiology Source Type: blogs
Robotic Phlebotomist Draws Blood, Automates Hematology Analysis
Engineers at Rutgers University have developed a robot that autonomously draws patient blood and immediately performs hematology analysis. Such technology may help to speed up patient care, free clinicians to do other tasks, and even reduce the number of failed IV starts.
The device was recently tested in a clinical trial for the first time and the results, published in journal Technology, showed that the robot is as good or better than trained phlebotomists at obtaining venous access.
Currently, clinicians can miss target veins in patients who lack visible veins and with veins that are not palpable. Trying the pro...
Source: Medgadget - February 10, 2020 Category: Medical Devices Authors: Medgadget Editors Tags: Cardiology Critical Care Emergency Medicine Pathology Pediatrics Source Type: blogs
A 20-something woman with Chest Pain
A 20-something woman presented with 30 minutes of sudden onset chest pressure that started while in the bathroom. She had no relief from nitro x1. ASA 325 given by EMS.Here is her prehospital ECG:What do you think?Here are limb leads magnified:Precordial leads magnified:Notice the hyperacute T-waves in V4She arrived in the ED with her pain diminishing.Here is her ED ECG:What do you think?The first ECG is diagnostic of inferior OMI, with probable lateral involvement as well (V4-V6).In the 2nd (ED) ECG, the inferior findings are gone. The lateral ST segments remain elevated. The T-waves appear hyperacute. &n...
Source: Dr. Smith's ECG Blog - January 28, 2020 Category: Cardiology Authors: Steve Smith Source Type: blogs
What is the infarct artery????? And have you ever seen a troponin this high?
An elderly woman with h/o stroke and aphasia seemed different to her daughter, and was pointing all over her body as if in pain.They called 911.She had a history of PCI to the circumflex and also of severe mitral regurgitation, status post bioprosthetic valve replacement. Also a h/o LV aneurysm with thrombus, on anticoagulation, as well as a dual chamber pacemaker. On arrival, the BP was 60/30.Here is the initial ECG:There is atrial pacing and Right Bundle Branch Block (RBBB)There is STE in I and aVL, V5, V6, with reciprocal STD in II, III, aVFThere is appropriately discordant ST depression in V1-V3 (appropriate...
Source: Dr. Smith's ECG Blog - January 15, 2020 Category: Cardiology Authors: Steve Smith Source Type: blogs
Cardiology MCQ – Impella device – Answer
Cardiology MCQ – Impella device – Answer
Contraindication for placement of an Impella mechanical cardiac support device:
Correct answer: 4. All of the above
Impella is a percutaneous transvalvular continuous-flow microaxial pump which is used as temporary left ventricular assist device. Now devices for the right ventricle are also available (when both together are used, some call it Bipella!). Impella 2.5 delivers 2.5 l/min cardiac output while Impella CP delivers 3.5 l/min. It draws blood from the left ventricle and delivers it into the aorta. Hence it will unload the left ventricle, reducing diastolic volume...
Source: Cardiophile MD - January 6, 2020 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs
Fight Aging! Newsletter, January 6th 2020
Conclusion
A great deal of progress is being made in the matter of treating aging: in advocacy, in funding, in the research and development. It can never be enough, and it can never be fast enough, given the enormous cost in suffering and lost lives. The longevity industry is really only just getting started in the grand scheme of things: it looks vast to those of us who followed the slow, halting progress in aging research that was the state of things a decade or two ago. But it is still tiny compared to the rest of the medical industry, and it remains the case that there is a great deal of work yet to be done at all...
Source: Fight Aging! - January 5, 2020 Category: Research Authors: Reason Tags: Newsletters Source Type: blogs
A Look Back at 2019: Progress Towards the Treatment of Aging as a Medical Condition
Conclusion
A great deal of progress is being made in the matter of treating aging: in advocacy, in funding, in the research and development. It can never be enough, and it can never be fast enough, given the enormous cost in suffering and lost lives. The longevity industry is really only just getting started in the grand scheme of things: it looks vast to those of us who followed the slow, halting progress in aging research that was the state of things a decade or two ago. But it is still tiny compared to the rest of the medical industry, and it remains the case that there is a great deal of work yet to be done at all...
Source: Fight Aging! - December 31, 2019 Category: Research Authors: Reason Tags: Of Interest Source Type: blogs
INOCA – Ischemia and No Obstructive Coronary Artery Disease
INOCA – Ischemia and No Obstructive Coronary Artery Disease
INOCA is the acronym for Ischemia and No Obstructive Coronary Artery Disease [1]. They have elevated risk for cardiovascular events like acute coronary syndrome and hospitalization for heart failure. Risk of development of heart failure with preserved ejection fraction (HFpEF) is also higher in these subjects. Some of them have coronary microvascular dysfunction and evidence of inflammation.
In spite of the absence of obstructive coronary arteries, they have a risk of repeated hospitalizations and repeated coronary angiographies, involving significant health...
Source: Cardiophile MD - December 27, 2019 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Cardiology Source Type: blogs
CHAD-STOP for cardiac amyloidosis
CHAD-STOP is the mnemonic for the initial steps in the management of cardiac amyloidosis:
C: Conduction and rhythm disorder prevention
H: High heart rate maintenance
A: Anticoagulation
D: Diuretics
STOP: STOP beta receptor and calcium channel blockers, digoxin and renin-angiotensin-aldosterone inhibitors
Preload reserve is limited in cardiac amyloidosis due to severe diastolic dysfunction. Hence the only way to increase the cardiac output is by the heart rate reserve and hence it should not be cut down by beta blockade or calcium channel blockade.
Renin-angiotensin-aldosterone inhibitors carry the risk of severe hypotens...
Source: Cardiophile MD - December 13, 2019 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Cardiology Source Type: blogs
CO poisoning. Routine ECG recorded before hyperbaric therapy....Are they related?
This patient was working on his truck in a garage without ventilation and the vehicle was running. He felt dizzy and lost consciousness. The next thing he remembers is waking up in the ambulance. He was last seen normal at 09:00 AM and was found down at 10:30 AM. He denied chest pain, abdominal pain, SOB or any other symptoms, though he did endorse chest pressure when asked specifically.He underwent a routine ECG prior to hyperbaric therapy for CO poisoning:Obvious Massive STEMI, Proximal LAD OcclusionHis CO level returned at 34%.Further h/o revealed that he had had a proximal LAD stent placed for a Non-Occlusion MI more t...
Source: Dr. Smith's ECG Blog - December 8, 2019 Category: Cardiology Authors: Steve Smith Source Type: blogs
Cardiology MCQ – Anticoagulation in pregnancy – Answer
Cardiology MCQ – Anticoagulation in pregnancy – Answer
My Cardiology MCQ books on Amazon
Best maternal outcomes in mechanical prosthetic valves with pregnancy is obtained with:
Correct answer: 3. Warfarin
Best maternal outcome in pregnancy with mechanical prosthetic valves is obtained with warfarin [1]. But it is a known teratogen and is associated with lowest number of live births. Low molecular weight heparin probably gives the best fetal outcome, though the maternal risk of thromboembolism is higher. Dabigatran is not recommended for mechanical prosthetic valves even without pregnancy.
Generally warfarin is...
Source: Cardiophile MD - December 8, 2019 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs
Persistent Ventricular Fibrillation, ED ECMO, ED TEE, ROSC, Shark Fin ECG (also called " Giant R-wave " ), Postinfarction Regional Pericarditis. What a Case!
A 40-something suffered witnessed ventricular fibrillation, had bystander CPR, but could not be defibrillated after 4 attempts.He was transferred to the ED and put on extracorporeal life support (ECLS, ECMO).A series of ED Transesophageal echos (TEE) was done over 23 minutes before an ECG was recorded. We usually do not get ROSC before angiography in these cases, and recording the ECG is not as important as usual, because we send them all to the cath lab by our ECMO protocol.This is before another defibrillation attempt, during chest compressions:Orientation:The probe is in the esophagus, right next to the left ...
Source: Dr. Smith's ECG Blog - November 21, 2019 Category: Cardiology Authors: Steve Smith Source Type: blogs
A man in his 30s with chest pain
Written by Pendell Meyers, submitted by Siva Vittozzi-WongA man in his 30s with history of hypertension, hyperlipidemia, and diabetes presented with chest pain which started 12 hours prior to presentation. The pain was described as pressure, constant for 12 hours, radiating to the jaw, with left arm numbness. Initial vitals were significant for bradycardia at 45 beats per minute.Here is his presenting ECG with active pain:What do you think?Here was the prior EKG on file:The emergency medicine resident (who has received lectures from me on hyperacute T-waves, suble OMI, etc) documented the following interpretation:" Initial...
Source: Dr. Smith's ECG Blog - November 19, 2019 Category: Cardiology Authors: Pendell Source Type: blogs
