Tue.Jan 28, 2025

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A 34 yo Man with chest pain and Zero ST Elevation

Dr. Smith's ECG Blog

Written by Hans Helseth A 34 year old man with no known medical history presented to the ED after an hour of chest pain. He described the pain as a mid sternal "burning sensation" and rated it 8.5 out of 10 at onset, but on presentation to the ED, reported that the pain had improved to 4.5. His first EKG is shown below, with a lead II rhythm strip: EKG 1, 1645 A provisder who is looking for STEMI would not see much in this EKG.

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Ozempic Approved for Diabetic Kidney Disease

Med Page Today

(MedPage Today) -- The FDA approved semaglutide (Ozempic) to reduce the risk of kidney disease worsening, kidney failure, and death due to cardiovascular disease in adults with type 2 diabetes and chronic kidney disease (CKD), making it the only.

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Cardiovascular outcomes in long COVID-19: a systematic review and meta-analysis

Frontiers in Cardiovascular Medicine

IntroductionThere is growing evidence that patients with SARS-CoV-2 (The severe acute respiratory syndrome coronavirus 2) may have a variety of cardiovascular complications in the post-acute phase of COVID-19, but these manifestations have not yet been comprehensively characterized.MethodsWe performed a systematic review and meta-analysis of primary research papers which evaluated individuals at least four weeks after confirmed COVID-19 diagnosis and reported on cardiovascular disease prevalence

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Ischaemia-reperfusion time differences in ST-elevation myocardial infarction in very young patients: a cohort study

Open Heart

Introduction ST-elevation myocardial infarction (STEMI) is one of the most prevalent presentations in young patients. It is essential to emphasise that each minute of delay in providing medical care is negatively correlated to the patient’s prognosis. The present study was carried out to evaluate the ischaemia-reperfusion times in patients ≤40 years of age versus individuals >40 years of age and their association with mortality and major adverse cardiac event (MACE) over the long

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EM Quick Hits 62 Optimizing RSI Medication Timing, ED Boarding of Older Patients, Prolonged Tourniquet Use, Rural Peer Support Programs, ECG Reciprocal Changes, Nutrition Tips for Shift Workers

ECG Cases

On this month's EM Quick Hits podcast: Anand Swaminathan on optimizing RSI medication timing, Brittany Ellison ED boarding challenges in older patients and solutions to ED crowding and flow, Dave Jeromeon managing prolonged tourniquet application, Nour Khatib and Phil Gillick on a rural peer support case, Jesse McLaren on ECG reciprocal changes in acute coronary occlusion, and Melody Ngon practical nutrition tips for shift workers.

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Current Kidney Transplant Policies Disadvantage Certain Adolescents, Young Adults

HCPLive

Patients who started dialysis as children but were not waitlisted until young adulthood faced worse outcomes than those who were listed before turning 18.

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Bone marrow mesenchymal stem cell-derived extracellular vesicles alleviate diabetes-exacerbated atherosclerosis via AMPK/mTOR pathway-mediated autophagy-related macrophage polarization

Cardiovascular Diabetology

Bone marrow-derived mesenchymal stem cell-derived extracellular vesicles (BMSC-EVs) are widely used for therapeutic purposes in preclinical studies. However, their utility in treating diabetes-associated ather.

More Trending

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Alzheimer's Biomarkers Tied to Delayed REM Sleep

Med Page Today

(MedPage Today) -- Prolonged rapid eye movement (REM) sleep latency was linked with Alzheimer's disease biomarkers, cross-sectional data showed. The highest tertile of REM sleep latency was associated with a higher burden of amyloid-beta (&#946.

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FDA Approves Semaglutide (Ozempic) for Type 2 Diabetes, Chronic Kidney Disease

HCPLive

The FDA approved semaglutide to reduce the risk of kidney disease worsening, kidney failure, and death due to CVD in those with T2D and CKD.

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Strategies to Control Blood Pressure in People From Tanzania and Lesotho

JAMA Cardiology

This randomized clinical trial investigates if a 2-pill antihypertensive strategy and a low-dose 3-pill strategy are superior to full-dose monotherapy with stepped escalation to control blood pressure in people with hypertension in rural Tanzania and Lesotho.

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New Insight: A Look at Qlosi for Presbyopia with Elad Kedar, MBA

HCPLive

In this episode, Veeral Sheth, MD, is joined by the CEO of Orasis Pharmaceuticals to discuss Qlosi, a preservative-free, low-dose eye drop FDA-approved for presbyopia.

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Clipping Spline Technique Progresses Reproductive Health and Cardiac Development Research

DAIC

The clipping spline provides unprecedented capabilities to see inside 3D images. The clipping spline (mesh) is defined by the control points (green) and provides a smooth cutaway view into the looping embryonic mouse heart, revealing the blood flow (orange and blue) in the hearts atrium and ventricle. Credit : Andre C. Faubert and Shang Wang, Stevens Institute of Technology tim.hodson Tue, 01/28/2025 - 10:45 Jan. 28. 2025 Researchers have developed a new software tool that provides unprecedente

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Endothelial protease-activated receptor 4: impotent or important?

Frontiers in Cardiovascular Medicine

The protease thrombin, which increases its levels with various pathologies, can signal through the G protein-coupled receptors protease-activated receptors 1 and 4 (PAR1/PAR4). PAR1 is a high-affinity receptor for thrombin, whereas PAR4 is a low-affinity receptor. Finding functions for PAR4 in endothelial cells (ECs) has been an elusive goal over the last two decades.

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Specialists’ Individual Treatment Plans for Patients With FCS patients: Pancreatic Specialist

HCPLive

Panelists discuss their specific areas of focus in the care for a patient with familial chylomicronemia syndrome (FCS) as endocrinologists, cardiologists, internists, and pancreatic specialists, outlining primary treatment goals, such as reducing triglyceride levels below 500 mg/dL to lower the risk of acute pancreatitis, and providing recommendations to support optimal collaboration across all specialties involved in managing FCS.

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High BP Sitting vs Lying Down; Baby Aspirin Holdouts; LAA Closure With Hemodialysis?

Med Page Today

(MedPage Today) -- Based on an ARIC cohort analysis, supine hypertension may be more predictive of cardiovascular events than seated hypertension. (JAMA Cardiology) Blood pressure (BP) readings in public, noisy environments were still fairly accurate.

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Circulating miRNA-486 as a novel diagnostic biomarker for right ventricular remodeling

Frontiers in Cardiovascular Medicine

ObjectiveClinical practice currently faces a significant shortfall in specific biomarkers needed for diagnosing right ventricular (RV) remodeling in patients with pulmonary hypertension (PH). While small noncoding microRNAs (miRNAs) are crucial regulators of RV remodeling, the biomarker potential of serum miRNAs in this process is little known. This study systematically screened and identified candidate serum miRNAs as potential diagnostic biomarkers for RV remodeling in PH patients.MethodsPulmo

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Glucagon like peptide-1 (GLP-1) agonists and cardiometabolic protection: historical development and future challenges

Cardiovascular Diabetology

Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have revolutionized the treatment of cardiometabolic diseases, extending their therapeutic applications far beyond glycemic control in type 2 diabetes (T2D).

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Therapeutic effect and potential mechanism of Fufang Danshen dripping pills for stable coronary heart disease: a randomized controlled trial

Frontiers in Cardiovascular Medicine

BackgroundThe efficacy and mechanism of Fufang Danshen dripping pills (FFDS) in the secondary prevention of stable coronary heart disease (SCHD) is currently undetermined. This study aims to investigate the efficacy and preliminary mechanism by which FFDS may impact the progression of SCHD.MethodsBased on randomization, we administered oral FFDS to 30 patients with SCHD in addition to conventional treatment for 30 days.

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Triglyceride-glucose index predicts adverse cardiovascular events in patients with H-type hypertension combined with coronary heart disease: a retrospective cohort study

Cardiovascular Diabetology

The triglycerideglucose index (TyG index) is a reliable surrogate for insulin resistance (IR) in individuals with type 2 diabetes mellitus and is associated with cardiovascular disease. Recent studies have re.

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Better Management Needed for Childhood Wheeze

HCPLive

Among multiple issues were confusing and conflicting misdiagnoses of asthma.

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Global Health in Your Own Backyard – Balancing Family, Field Work and Sustainable Practices in Rural Canada

ECG Cases

Discover how Global EM principles can be applied to rural medicine in North America. Dr. Arjun Sithamparapillai challenges misconceptions about Global Health sustainability, and highlights the critical role of teamwork, adaptability, and equity in underserved communities. Perfect for EM professionals balancing family, career, and a passion for global impact.

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Penicillin Allergy Prevalence Greater in High-Income vs. Middle-Income Nations

HCPLive

A study found penicillin allergy prevalence is higher in high-income countries (9.9%) than in middle-income ones (4.4%), highlighting disparities in reporting and research.

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Severe reversible cardiomyopathy associated with adrenal crisis caused by isolated adrenocorticotropin deficiency: a case report

Frontiers in Cardiovascular Medicine

Adrenal crisis, also known as acute adrenal insufficiency, is an endocrine emergency that is associated with high mortality rates. Reversible cardiomyopathy with severe heart failure is a rare complication of adrenal crisis. Isolated adrenocorticotropin deficiency (IAD) is a rare condition of pituitary adrenal insufficiency. In this case report, we describe a 74-year-old male patient who was in good physical health and was admitted to our hospital with a sudden onset of fever and confusion that

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Robotic Cardiac Surgery: Your Journey Starts Here!

Society of Thoracic Surgeons - Congenital

Webinar Robotic Cardiac Surgery: Your Journey Starts Here! gmckinney Tue, 01/28/2025 - 14:43 February 12, 2025 In this one-hour webinar, experts in robotic cardiac surgery will provide an introduction to the specialty, as well as share unique insights for getting involved, getting trained, and ultimately starting a robotic program at your institution.

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The influence of HIV infection on myocardial fibrosis diagnosed by cardiac magnetic resonance imaging in adults: a systematic review and meta-analysis of observation studies

Frontiers in Cardiovascular Medicine

IntroductionHuman immunodeficiency virus (HIV) infection is linked to myocardial fibrosis. Observational studies using cardiac magnetic resonance (CMR) have explored this relationship but scarcity of data synthesis limits our understanding. Our systematic review and meta-analysis aimed to synthesize associations between HIV and myocardial fibrosis from CMR-based observational studies in adults.MethodsWe identified 12 studies (20132024) with 1,769 participants [1,117 people with HIV (PWH)].

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360° Weight Loss Blueprint: Insights To Action 

Cardiometabolic Health Congress

Obesity management beyond diet and exercise. Sleep quality, stress management, and smoking cessation play a pivotal role in improving cardiometabolic health. This comprehensive guide gives you actionable, 360-degree behavioral interventions that complement last week’s weight-loss strategies <insert link here> to improve your patient’s cardiometabolic health and well-being. 1.

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Superior vena cava obstruction following pericardial effusion absorption in the presence of a pericardial teratoma: a case report

Journal of Cardiothoracic Surgery

Intrapericardial teratoma is a rare tumor that usually presents in neonates or during infancy because of the associated high degree of pericardial effusion, cardiac compression and severe respiratory distress.

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Association between triglyceride-glucose-body mass index and risk of aortic stenosis progression in patients with non-severe aortic stenosis: a retrospective cohort study

Cardiovascular Diabetology

Triglyceride-glucose-BMI (TyG-BMI) index is a surrogate marker of insulin resistance and an important predictor of cardiovascular disease. However, the predictive value of TyG-BMI index in the progression of n.

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Lobar lung transplantation, followed by partial sternal resection and bronchial stenosis, in a patient with scoliosis

Journal of Cardiothoracic Surgery

Scoliotic deformity represents a serious spinal disorder that influences the locomotive and cardiopulmonary systems. Some patients with severe scoliosis and end-stage lung disease are therefore denied lung tra.

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Cancer-associated thoracic aorta arterial thrombosis: case report and review of the literature

Frontiers in Cardiovascular Medicine

BackgroundArterial thrombosis is an uncommon complication in cancer patients, often overshadowed by venous thromboembolic events. Its occurrence in patients with solid tumors on active antineoplastic treatment poses a significant clinical challenge.Key clinical questionGiven the lack of consensus on the optimal therapy for arterial thrombosis in cancer patients, the best practices for managing an aortic thrombus, and the benefit of low molecular weight heparin (LMWH) must be reviewed.Clinical ap

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Pregnancy-related chronic type A aortic dissection highlights the importance of thorough prenatal maternal examination

Journal of Cardiothoracic Surgery

Aortic dissection occurs rarely during pregnancy but carries a significantly high vital risk for both the mother and the fetus. Early diagnosis and treatment are critical for a successful outcome.

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Prenatal ultrasound diagnosis, associated anomalies and pregnancy outcomes of fetal right aortic arch

Frontiers in Cardiovascular Medicine

ObjectiveThe aim was to summarise the prenatal ultrasound characteristics, associated anomalies and pregnancy outcomes of fetal right aortic arch (RAA) and to discuss the value of prenatal ultrasound diagnosis and prognostic analysis.MethodsWe retrospectively analysed 157 cases of fetal RAA diagnosed via prenatal ultrasound in our hospital from October 2017 to October 2022.

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Catlet scoring system as a new predictor for in-stent restenosis in patients with chronic coronary artery disease undergoing percutaneous coronary intervention with drug-eluting stent

Journal of Cardiothoracic Surgery

Hes team have recently developed a new Coronary Artery Tree description and Lesion EvaluaTion (CatLet) angiographic scoring system, which is capable of accounting for the variability in coronary anatomy, and.

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Application of three-dimensional printing in the planning and execution of aortic aneurysm repair

Frontiers in Cardiovascular Medicine

IntroductionThe accuracy of fenestrations in stent grafts for complex aortic aneurysms and dissections can be significantly improved using three-dimensional (3D)-printed phantoms. Standardization is enhanced by using artificial intelligence (AI) for image pre-processing before 3D printing. These methods address fallacies in centerline image analysis and manual image pre-processing.

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Risk of stroke associated with proton pump inhibitor use among individuals with and without pre-existing cardiovascular diseases: a systematic review and meta-analysis

Journal of Cardiothoracic Surgery

Proton pump inhibitors (PPIs) are commonly used for managing gastroesophageal disorders but concerns about their potential association with increased stroke risk have emerged, especially among patients with pr.

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Cardiac Biomarker Testing Underutilized in US Emergency Departments

HCPLive

Only 7% of patients presenting to US emergency departments received cardiac biomarker testing, with 2.8% diagnosed with ACS.

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Parsimonious versus extensive bleeding score: can we simplify risk stratification after percutaneous coronary intervention and reduce bleeding events by de-escalation of the antiplatelet strategy?

Open Heart

Background and aims Due to the multitude of risk factors outlined in the guidelines, personalised dual antiplatelet therapy (DAPT) guidance after percutaneous coronary intervention (PCI) is complex. A simplified method was created to facilitate the use of risk stratification. We aimed to compare the predictive and prognostic value of the ‘Zuidoost Nederland Hart Registratie’ (ZON-HR) classification for bleeding risk with the PREdicting bleeding Complications In patients undergoing St

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