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How High Blood Pressure Affects Your Heart and What You Can Do About It

MIBHS

Coronary Artery Disease (CAD) : High blood pressure accelerates the development of CAD by promoting the buildup of plaques in the coronary arteries. Common medications include diuretics, ACE inhibitors, beta-blockers, and calcium channel blockers.

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Understanding an Enlarged Heart (Cardiomegaly): Causes, Symptoms, and Treatment

MIBHS

Heart Valve Disease If one or more heart valves are not functioning correctly, it can cause blood to flow backward, putting extra pressure on the heart, which may cause it to expand to compensate for the inefficiency. This may result in ischemia (lack of oxygen to the heart muscle), causing parts of the heart to weaken and enlarge.

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Abstract 4142012: Ectasias of Multiple Coronary Arteries and a Coronary Cameral Fistula Between Right Coronary Artery and Coronary Sinus

Circulation

Coronary angiography revealed a tortuous and extremely aneurysmal RCA, as well as multivessel coronary artery disease (mvCAD) involving LAD, D1, LCx, OM1. Multislice CT angiography further characterized the RCA, which extends to the coronary sinus (CS) distally forming a coronary cameral fistula (CCF).

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Abstract 4134796: Safety of over 1000 consecutive, selected low risk patients with accelerated discharge from a chest pain unit with early generation cardiac troponin use, no cardiac functional or anatomic testing and no clinical risk scores

Circulation

Mean patient age was 55 yrs, 56% (n=575) were women, and comorbid conditions were frequent: hypertension (64.1%), dyslipidemia (46.1%), diabetes (25.7%), documented coronary artery disease (19.3%), previous revascularization (20.6%), previous myocardial infarction (10.1%). Length of stay (LOS) in the CPU to discharge was 10.4

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What does the angiogram show? The Echo? The CT coronary angiogram? How do you explain this?

Dr. Smith's ECG Blog

Angiogram No obstructive epicardial coronary artery disease Cannot exclude non-ACS causes of troponin elevation including coronary vasospasm, stress cardiomyopathy, microvascular disease, etc. hours All Hyperacute T-wave and ST Depression is resolved. Lindahl et al. References: 1.

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Upon arrival to the emergency department, a senior emergency physician looked at the ECG and said "Nothing too exciting."

Dr. Smith's ECG Blog

Hospital Course The patient was taken emergently to the cath lab which did not reveal any significant coronary artery disease, but she was noted to have reduced EF consistent with Takotsubo cardiomyopathy. An apical OMI has the same ultrasound findings as takotsubo, and thus mimics takotsubo. Lindahl et al. References: 1.

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A man in his 70s with chest pain during a bike ride

Dr. Smith's ECG Blog

The patient stated he had a long history of well-controlled hypertension for which he was compliant with his ACE-inhibitor. He was taken emergently to the cardiac catheterization lab and found to have multi-vessel coronary artery disease with a near-occlusive culprit lesion in the RCA, possibly reperfused.