An unusual query in Wellen ’ s syndrome ?
What will happen if you happen to thrombolyse Wellen syndrome?
Will evolve into STEMI by prothrombotic trigger of lytic agent
ECG will get normalised with clinical stability in some
Nothing happens. ECG will remain same.
Worsen the situation in majority
Will be severely reprimanded by your consultant and peers.
Answer:
4 will be answer for most of us , while 2 and 3 is a lesser, but distinct possibility. I have never seen 1 happen .Whatever is the correct answer , response 5 will always be correct.
What is the criteria to diagnose Wellen syndrome ?
The criteria used to diagnose Wellen...
Source: Dr.S.Venkatesan MD - January 14, 2024 Category: Cardiology Authors: dr s venkatesan Tags: Uncategorized Source Type: blogs
An unusual query in Wellen ’ s syndrome
What will happen if you happen to thrombolyse Wellen syndrome?
Will evolve into STEMI by prothrombotic trigger of lytic agent
ECG will get normalised with clinical stability in some
Nothing happens. ECG will remain same.
Worsen the situation in majority
Will be severely reprimanded by your consultant and peers.
Answer:
4 will be answer for most of us , while 2 and 3 is a lesser, but distinct possibility. I have never seen 1 happen .Whatever is the correct answer , response 5 will always be correct.
What is the criteria to diagnose Wellen syndrome ?
The criteria used to diagnose Wellen...
Source: Dr.S.Venkatesan MD - January 14, 2024 Category: Cardiology Authors: dr s venkatesan Tags: Uncategorized Source Type: blogs
Fight Aging! Newsletter, December 25th 2023
This study generates a comprehensive single-cell transcriptomic atlas of human atherosclerosis including 118,578 high-quality cells from atherosclerotic coronary and carotid arteries. By performing systematic benchmarking of integration methods, we mitigated data overcorrection while separating major cell lineages. Notably, we define cell subtypes that have not been previously identified from individual human atherosclerosis scRNA-seq studies.
Besides characterizing granular cell-type diversity and communication, we leverage this atlas to provide insights into smooth muscle cell (SMC) modulation. We integrate genome...
Source: Fight Aging! - December 24, 2023 Category: Research Authors: Reason Tags: Newsletters Source Type: blogs
A young woman with palpitations. What med is she on? With what medication is she non-compliant? What management?
Written by Pendell MeyersA woman in her 20s with connective tissue disorder and history of aortic root and valve repair presented with palpitations. Here is her triage ECG: What do you think?Atrial flutter with 2:1 conduction. The atrial flutter rate is approximately 200 bpm, with 2:1 AV conduction resulting in ventricular rate almost exactly 100 bpm. The fact that the atrial flutter rate is 200 bpm (rather than more typical adult rate of ~300 bpm) suggests that the patient must have one or both of the following:1) enlarged atria ( " bigger race track " )2) sodium channel blockade ( " slower race car "...
Source: Dr. Smith's ECG Blog - December 24, 2023 Category: Cardiology Authors: Pendell Source Type: blogs
The hidden costs of “ free ” medical interpretation
He is a typical patient of our academic primary care internal medicine practice: elderly, frail, and with several complex conditions, including a history of a liver transplant requiring chronic immunosuppression, recurrent venous thrombosis requiring treatment with blood thinners, and type 2 diabetes. But in one very important way, he is different: our doctors don’t speak
Read more…
The hidden costs of “free” medical interpretation originally appeared in KevinMD.com. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - December 22, 2023 Category: General Medicine Authors: Victoria Johnson, MD, MPH and Maria Isabel Angulo, MD Tags: Physician Primary Care Source Type: blogs
Single Cell Sequencing to Map Disease Processes Inside Atherosclerotic Plaques
This study generates a comprehensive single-cell transcriptomic atlas of human atherosclerosis including 118,578 high-quality cells from atherosclerotic coronary and carotid arteries. By performing systematic benchmarking of integration methods, we mitigated data overcorrection while separating major cell lineages. Notably, we define cell subtypes that have not been previously identified from individual human atherosclerosis scRNA-seq studies.
Besides characterizing granular cell-type diversity and communication, we leverage this atlas to provide insights into smooth muscle cell (SMC) modulation. We integrate genome...
Source: Fight Aging! - December 19, 2023 Category: Research Authors: Reason Tags: Daily News Source Type: blogs
Concerning EKG with a Non-obstructive angiogram. What happened?
CONCLUSION: Given resolution of severe CP in association with the above marked improvement of ST-T wave abnormalities in virtually all leads during the less than 1 hour between the recording of ECGs #1 and #2 — this strongly suggests reopening of a " culprit " vessel (whichever vessel this was) — regardless of the fact that " no obstructive lesion was seen " at the time the cardiac catheterization happened to be done.The more than doubling of Troponin (even though " normal limits " for Troponin were not surpassed) — is consistent with a brief OMI, with only...
Source: Dr. Smith's ECG Blog - December 19, 2023 Category: Cardiology Authors: Willy Frick Source Type: blogs
Occlusion myocardial infarction is a clinical diagnosis
Written by Willy Frick (@Willyhfrick). Willy is a cardiology fellow with a keen interest in the ECG in OMI.A woman in her late 70s presented with left arm pain. The arm pain started the day prior when she was at the dentist ' s office for a root canal. Her systolic blood pressure at the dentist was over 200 mm Hg. She was given nitroglycerin which improved her blood pressure, and she completed the procedure. Her arm pain abated. The pain returned that evening and woke her from sleep. She eventually fell back asleep, and woke up feeling normal the next day (the day of presentation). After dinner the day of presentatio...
Source: Dr. Smith's ECG Blog - December 11, 2023 Category: Cardiology Authors: Willy Frick Source Type: blogs
" A patient just arrived as a transfer for NSTEMI. "
Conclusion: Our THANKS to Dr. Frick for his detailed and highly insightful presentation. CREDIT to him for masterful correlation of clinical events to each ECG — that thoroughly supports his explanation of the successful treatment received by this patient with evolving LAD OMI.QUESTION: Isn ' t it so much EASIER with the lead-to-lead comparison facilitated by Figure-1 — to see the subtle-but-important evolution of ST-T wave changes that so closely correspond to clinical events? (Source: Dr. Smith's ECG Blog)
Source: Dr. Smith's ECG Blog - December 7, 2023 Category: Cardiology Authors: Willy Frick Source Type: blogs
Fight Aging! Newsletter, November 20th 2023
In this study, we attempted to further explain the role, exact mechanism and target of ICA in treating AD from the ferroptosis perspective. We found that ICA could improve the neurobehavioral, memory, and motor abilities of AD mice. It could lower the ferroptosis level and enhance the resistance to oxidative stress. After inhibition of MDM2, ICA could no longer improve the cognitive ability of AD mice, nor could it further inhibit ferroptosis. Network pharmacological analysis revealed that MDM2 might be the target of ICA action.
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Particulate Air Pollution and Its Effects on the Mechan...
Source: Fight Aging! - November 19, 2023 Category: Research Authors: Reason Tags: Newsletters Source Type: blogs
Endothelial Cell Senescence in Atherosclerosis
Senescent cells accumulate throughout the body with age. They are created constantly due to stresses placed upon cells, and when somatic cells reach the Hayflick limit on replication, and are cleared by the immune system. This process of clearance slows down with age, unfortunately, and so a burden of lingering senescent cells begins to build up. Senescent cells are disruptive to tissue structure and function, even when present in comparatively small numbers relative to other cells in a tissue, as a result of the pro-growth, pro-inflammatory signals that they generate.
Atherosclerosis involves the generation of fatt...
Source: Fight Aging! - November 16, 2023 Category: Research Authors: Reason Tags: Medicine, Biotech, Research Source Type: blogs
What does the angiogram show? The Echo? The CT coronary angiogram? How do you explain this?
A 70-something female with no previous cardiac history presented with acute chest pain. She awoke from sleep last night around 4:45 AM (3 hours prior to arrival) with pain that originated in her mid back. She stated the pain was achy/crampy. Over the course of the next hour, this pain turned into a pressure in her chest. She said this was midsternal and felt like a tightness. This originally radiated into her left arm. Over some time and the pain moved into her other arm as well as her jaw. She also had some shortness of breath. She was brought in by ambulance and re...
Source: Dr. Smith's ECG Blog - November 15, 2023 Category: Cardiology Authors: Steve Smith Source Type: blogs
How important are old ECGs in Non-obvious cases of potential OMI?
Conclusion: As per Dr. Smith — the cath lab was initially activated on the basis of the history of changing symptoms occurring in association with dynamic ST-T wave changes on these 3 serial ECGs shown in Figure-1.BUT — Review of this patient ' s medical chart revealed previous ECGs showing a similar pattern of labile ECG changes. Some patients do this ... that is, show a pattern of labile ST-T wave changes not due to an acute coronary event.Despite the seemingly worrisome ST-T wave changes on serial tracings shown in Figure-1 — an acute event was definitively ruled out b...
Source: Dr. Smith's ECG Blog - November 14, 2023 Category: Cardiology Authors: Steve Smith Source Type: blogs
See this " NSTEMI " go unrecognized for what it really is, how it progresses, and what happens
Written by Nathanael Franks MD, reviewed by Meyers, Smith, Grauer, etc.A man in his 70s with past medical history of hypertension, dyslipidemia, CAD s/p left circumflex stent 2 years prior presented to the ED with worsening intermittent exertional chest pain relieved by rest. This episode of chest pain began 3 hours ago and was persistent even at rest.Triage ECG at Time = 0: Smith: I am suspicious for posterior OMI due to ST depression in V2 and V3Baseline EKG (several months prior):Smith: Now I am even more suspicious of posterior OMI, as the baseline ECG has normal ST elevation in V2 and V3ECG Interpretation:The tri...
Source: Dr. Smith's ECG Blog - November 3, 2023 Category: Cardiology Authors: Pendell Source Type: blogs
What is the natural history of TCFA “ Thin cap fibro atheroma ” ?
(Why should the number 65 bother us in TCFA-detected by OCT? Does this number really deserve that respect? Trying to find some truths from 8 questions with & without evidence.)
1. Does TCFA really make a plaque vulnerable?
A.Yes
B. No
C. Maybe
Answer: Yes & Maybe. But there seem to be more important factors other than TCFA for a plaque to become vulnerable making TCFA not really a big deal.
2. TCFP is more common in which lesions?
A.Flow limiting lesion
B.Nonflow limiting lesion
C.No relationship between TCFA and flow
Answer: No relation, rather a random relationship.
3. What...
Source: Dr.S.Venkatesan MD - October 10, 2023 Category: Cardiology Authors: dr s venkatesan Tags: Uncategorized Source Type: blogs
