ECG Cases

NOVEMBER 28, 2023

On this month's EM Quick Hits podcast: Anand Swaminathan on update to ED management of postpartum hemorrhage, Nour Khatib on serotonin syndrome and its mimics, Katie Lin on an approach to recognition and management of severe TBI and brain herniation syndromes, Hans Rosenberg on the ED management of ulcerative colitis, Heather Cary on pediatric c-spine immobilization controversies and techniques, Navpreet Sahsi on the difference between humanitarian and development work The post EM Quick Hits 53

Pediatrics 110

Pediatrics Hemorrhage 110

Stroke Journal

NOVEMBER 28, 2023

Stroke, Ahead of Print. BACKGROUND:Dental caries is a highly prevalent disease worldwide. In the United States, untreated dental caries is present in >1 in 5 adults. The objective of this study was to determine the relationship between dental caries and incident ischemic stroke, coronary heart disease (CHD) events, and death.METHODS:The dental cohort (n=6351) of the ARIC study (Atherosclerosis Risk in Communities) was followed for incident ischemic stroke, CHD event, and all-cause mortali

Heart Disease 73

Heart Disease Stroke Strokes Atherosclerosis 73

Science Daily - Heart Disease

NOVEMBER 28, 2023

Heart disease kills 18 million people each year, but the development of new therapies faces a bottleneck: no physiological model of the entire human heart exists -- so far. A new multi-chamber organoid that mirrors the heart's intricate structure enables scientists to advance screening platforms for drug development, toxicology studies, and understanding heart development.

Physiology 71

Physiology Heart Disease 71

Stroke Journal

NOVEMBER 28, 2023

Stroke, Ahead of Print. Stroke is a leading cause of paralysis, most frequently affecting the upper limbs and vocal folds. Despite recent advances in care, stroke recovery invariably reaches a plateau, after which there are permanent neurological impairments. Implantable brain-computer interface devices offer the potential to bypass permanent neurological lesions.

Article 58

Article Hemorrhage Technology Stroke 58

Dr. Paddy Barrett

NOVEMBER 28, 2023

One of the most common questions I get is, “ Do I need a stent to treat my heart disease?” Typically, several of this person’s friends have had stents, so it seems natural to ask. First, we must understand what a stent is and why it is used. Subscribe now A stent is a metal scaffold deployed in a coronary artery that has reduced flow in that artery to restore flow.

Stents 52

Stents Stent Heart Attack Heart attacks 52

ADN Center of Excellence

NOVEMBER 28, 2023

The Evolution of Medical Education Medical education has undergone a profound evolution, transitioning from traditional didactic lectures to a more immersive and experiential approach. The paradigm shift stems from recognizing the critical need for a well-rounded education that not only imparts theoretical knowledge but also hones practical skills. The modern healthcare landscape demands adaptable, competent, and empathetic physicians who can navigate complex scenarios with finesse and confidenc

Education 52

Education Innovation Blog Technology 52

Open Heart

NOVEMBER 28, 2023

Objective Literature supports associations between common respiratory tract infections (RTIs) and risk of cardiovascular diseases, yet the importance of RTIs for cardiovascular risk management remains less understood. This systematic review and meta-analysis aimed to estimate the causal effects of RTIs on occurrence of cardiovascular diseases in the general population.

Myocardial Infarction 52

Myocardial Infarction COVID-19 Cardiovascular Disease Thrombosis 52

Open Heart

NOVEMBER 28, 2023

Clinical decision support systems (CDSSs) are increasingly integrated into healthcare settings to improve patient outcomes, reduce medical errors and enhance clinical efficiency by providing clinicians with evidence-based recommendations at the point of care. However, the adoption and optimisation of these systems remain a challenge. This review aims to provide an overview of the current state of CDSS, discussing their development, implementation, benefits, limitations and future directions.

Outcomes 52

Outcomes 52

American Heart News - Heart News

NOVEMBER 28, 2023

DALLAS, November 28, 2023 — Cardiovascular disease (CVD) claims more lives than all forms of cancer, yet many women, particularly younger women, remain unaware.[1] Through its Go Red for Women® movement, the American Heart Association, which is devoted.

Cancer 52

Cancer Cardiovascular Disease 52

ADN Center of Excellence

NOVEMBER 28, 2023

The Evolution of Medical Education Medical education has undergone a profound evolution, transitioning from traditional didactic lectures to a more immersive and experiential approach. The paradigm shift stems from recognizing the critical need for a well-rounded education that not only imparts theoretical knowledge but also hones practical skills. The modern healthcare landscape demands adaptable, competent, and empathetic physicians who can navigate complex scenarios with finesse and confidenc

Education 52

Education Innovation Blog Technology 52

Science Daily - Heart Disease

NOVEMBER 28, 2023

Optimal windows exist for action and perception during the 0.8 seconds of a heartbeat, according to new research. The sequence of contraction and relaxation is linked to changes in the motor system and its ability to respond to stimulation, and this could have implications for treatments for depression and stroke that excite nerve cells.

Research 52

Research Stroke Strokes 52

Stroke: Vascular and Interventional Neurology

NOVEMBER 28, 2023

Stroke: Vascular and Interventional Neurology, Ahead of Print. BACKGROUNDIn patients with acute ischemic stroke secondary to large vessel occlusion, achieving modified Thrombolysis in Cerebral Infarction (mTICI) 2c/3 (excellent recanalization) over mTICI 2b is associated with improved functional outcomes. We aimed to determine pretreatment and interventional parameters that are independently associated with mTICI 2c/3 over 2b reperfusion in patients who underwent technically successful mechanica

Stroke 40

Stroke Strokes Thrombolysis Diabetes 40

Science Daily - Heart Disease

NOVEMBER 28, 2023

A new study found that alcohol consumption may have counteractive effects on CVD risk, depending on the biological presence of certain circulating metabolites -- molecules that are produced during or after a substance is metabolized and studied as biomarkers of many diseases. The researchers observed a total of 60 alcohol consumption-related metabolites, identifying seven circulating metabolites that link long-term moderate alcohol consumption with an increased risk of CVD, and three circulating

Cardiovascular Disease 47

Cardiovascular Disease Biomarkers Circulation Research 47

Stroke Journal

NOVEMBER 28, 2023

Stroke, Ahead of Print. BACKGROUND:The current fungal meningitis outbreak caused by contaminated epidural anesthesia withFusarium solaniamong patients who underwent surgical procedures in Matamoros, Mexico remains a cause of concern. Its association with an increased susceptibility for cerebrovascular complications (CVC) has not been reported. This single-center study describes 3 patients with a unique pattern of CVC attributed to fungal meningitis.METHODS:A retrospective case series of patients

Hemorrhage 40

Hemorrhage Public Health Document Circulation 40

Journal of the American Heart Association

NOVEMBER 28, 2023

Journal of the American Heart Association, Volume 12, Issue 23 , December 5, 2023. BackgroundMarijuana leaf vaporizers, which heat plant material and sublimate Δ‐9‐tetrahydrocannabinol without combustion, are popular alternatives to smoking cannabis that are generally perceived to be less harmful. We have shown that smoke from tobacco and marijuana, as well as aerosol from e‐cigarettes and heated tobacco products, impair vascular endothelial function in rats measured as arterial flow‐mediated di

Circulation 40

Circulation 40

Stroke Journal

NOVEMBER 28, 2023

Stroke, Ahead of Print. BACKGROUND:Both genetic factors and environmental air pollution contribute to the risk of stroke. However, it is unknown whether the association between air pollution and stroke risk is influenced by the genetic susceptibilities of stroke and its risk factors.METHODS:This prospective cohort study included 40 827 Chinese adults without stroke history.

Stroke 40

Stroke Strokes Blood Pressure Atrial Fibrillation 40

Journal of the American Heart Association

NOVEMBER 28, 2023

Journal of the American Heart Association, Volume 12, Issue 23 , December 5, 2023. BackgroundOne‐time assessment of the Society for Cardiovascular Angiography and Interventions (SCAI) shock classification robustly predicts mortality in the cardiac intensive care unit (CICU). We sought to determine whether serial SCAI shock classification could improve risk stratification.Methods and ResultsUnique admissions to a single academic level 1 CICU from 2015 to 2018 were included in this retrospective c

Academic 40

Academic Hospital 40

Circulation: Genomic and Precision Medicine

NOVEMBER 28, 2023

Circulation: Genomic and Precision Medicine, Ahead of Print. Background:Life’s essential 8 (LE8) is a comprehensive construct of cardiovascular health. Yet, little is known about the LE8 score, its metabolic correlates, and its predictive implications among Black Americans and low-income individuals.Methods:In a nested case-control study of coronary heart disease (CHD) among 299 pairs of Black and 298 pairs of White low-income Americans from the Southern Community Cohort Study, we estimated LE8

Heart Disease 40

Heart Disease Circulation 40

Journal of the American Heart Association

NOVEMBER 28, 2023

Journal of the American Heart Association, Volume 12, Issue 23 , December 5, 2023. BackgroundCerebral small vessel disease (cSVD) is a major contributing factor to ischemic stroke and dementia. However, the vascular pathologies of cSVD remain inconclusive. The aim of this systematic review and meta‐analysis was to characterize the associations between cSVD and cerebrovascular reactivity (CVR), cerebral autoregulation, and arterial stiffness (AS).Methods and ResultsMEDLINE, Web of Science, and Em

Dementia 40

Dementia Risk Factors Stroke Strokes 40

Circulation: Genomic and Precision Medicine

NOVEMBER 28, 2023

Circulation: Genomic and Precision Medicine, Ahead of Print. BACKGROUND:Hypertrophic cardiomyopathy (HCM) is an important cause of sudden cardiac death associated with heterogeneous phenotypes, but there is no systematic framework for classifying morphology or assessing associated risks. Here, we quantitatively survey genotype-phenotype associations in HCM to derive a data-driven taxonomy of disease expression.METHODS:We enrolled 436 patients with HCM (median age, 60 years; 28.8% women) with cli

Cardiomyopathy 40

Cardiomyopathy Sudden Cardiac Death Hypertension Circulation 40

Journal of the American Heart Association

NOVEMBER 28, 2023

Journal of the American Heart Association, Volume 12, Issue 23 , December 5, 2023. BackgroundVasoregulatory autoantibodies including autoantibodies targeting G‐protein–coupled receptors might play a functional role in vascular diseases. We investigated the impact of vasoregulatory autoantibodies on clinical outcome after ischemic stroke.Methods and ResultsData were used from thePROSCIS‐B(Prospective Cohort With Incident Stroke–Berlin).

Stroke 40

Stroke Strokes Outcomes Myocardial Infarction 40

Circulation: Genomic and Precision Medicine

NOVEMBER 28, 2023

Circulation: Genomic and Precision Medicine, Ahead of Print. BACKGROUND:Individuals with type 2 diabetes (T2D) have an increased risk of coronary artery disease (CAD), but questions remain about the underlying pathology. Identifying which CAD loci are modified by T2D in the development of subclinical atherosclerosis (coronary artery calcification [CAC], carotid intima-media thickness, or carotid plaque) may improve our understanding of the mechanisms leading to the increased CAD in T2D.METHODS:W

Atherosclerosis 40

Atherosclerosis Diabetes Plaque Coronary Artery Disease 40

Journal of the American Heart Association

NOVEMBER 28, 2023

Journal of the American Heart Association, Volume 12, Issue 23 , December 5, 2023. BackgroundWhether statin use can reduce the risk of heart failure (HF) remains controversial. The present study evaluates the association between statin use and HF in patients with atrial fibrillation.Methods and ResultsPatients with newly diagnosed atrial fibrillation from 2010 to 2018 were included.

Atrial Fibrillation 40

Atrial Fibrillation Heart Failure Outcomes 40

Circulation: Genomic and Precision Medicine

NOVEMBER 28, 2023

Circulation: Genomic and Precision Medicine, Ahead of Print. Background:Proteomic profiling could potentially disclose new pathophysiological pathways for cardiovascular diseases (CVD) and improve prediction at the individual level. We therefore aimed to study the plasma protein profile associated with the incidence of different CVDs.Methods:Plasma levels of 245 proteins suspected to be linked to CVD or metabolism were measured in 4 Swedish prospective population-based cohorts (SIMPLER [Swedish

Cardiovascular Disease 40

Cardiovascular Disease Myocardial Infarction Obesity Heart Failure 40

Journal of the American Heart Association

NOVEMBER 28, 2023

Journal of the American Heart Association, Volume 12, Issue 23 , December 5, 2023. BackgroundFGF23 (fibroblast growth factor 23) is associated with a higher mortality risk in type 2 diabetes, but the mechanism is unclear. We aimed to study whether NT‐proBNP (N‐terminal pro‐brain natriuretic peptide) mediates the association between FGF23 and mortality.Methods and ResultsWe analyzed C‐terminal FGF23 and NT‐proBNP levels in 399 patients with type 2 diabetes.

Diabetes 40

Diabetes 40

Circulation: Genomic and Precision Medicine

NOVEMBER 28, 2023

Circulation: Genomic and Precision Medicine, Ahead of Print. Background:Limiting high-intensity exercise is recommended for patients with arrhythmogenic right ventricular cardiomyopathy (ARVC) due to its association with penetrance, arrhythmias, and structural progression. Guidelines recommend shared decision-making (SDM) for exercise level, but there is little evidence regarding its impact.

Exercise 40

Exercise Cardiomyopathy Arrhythmia Circulation 40

Journal of the American Heart Association

NOVEMBER 28, 2023

Journal of the American Heart Association, Volume 12, Issue 23 , December 5, 2023. BackgroundComplex aortic plaque (CAP) is a potential embolic source in patients with cryptogenic stroke (CS). We review CAP imaging criteria for transesophageal echocardiogram (TEE), computed tomography angiography (CTA), and magnetic resonance imaging and calculate CAP prevalence in patients with acute CS.Methods and ResultsPubMed and EMBASE databases were searched up to December 2022 in accordance with the Prefe

Plaque 40

Plaque Biomarkers Aortic Stroke 40

Circulation: Cardiovascular Interventions

NOVEMBER 28, 2023

Circulation: Cardiovascular Interventions, Ahead of Print. Background:The RENOVATE-COMPLEX-PCI (Randomized Controlled Trial of Intravascular Imaging Guidance Versus Angiography-Guidance on Clinical Outcomes After Complex Percutaneous Coronary Intervention) demonstrated that intravascular imaging–guided percutaneous coronary intervention (PCI) improved clinical outcome compared with angiography-guided PCI for patients with complex coronary artery lesions.

Myocardial Infarction 40

Myocardial Infarction Coronary Artery Disease Cardiovascular Interventions Outcomes 40

Journal of the American Heart Association

NOVEMBER 28, 2023

Journal of the American Heart Association, Volume 12, Issue 23 , December 5, 2023. BackgroundLeft heart disease is the most common cause of pulmonary hypertension (PH) and is frequently accompanied by increases in pulmonary vascular resistance. However, the distinction between phenotypes of PH due to left heart disease with a normal or elevated pulmonary vascular resistance—isolated postcapillary PH (IpcPH) and combined pre‐ and postcapillary PH (CpcPH), respectively—has been incompletely define

Pulmonary 40

Pulmonary Atrial Fibrillation Hypertension Heart Disease 40

Circulation: Cardiovascular Interventions

NOVEMBER 28, 2023

Circulation: Cardiovascular Interventions, Ahead of Print. BACKGROUND:There are limited data regarding the safety of deferral of percutaneous coronary intervention based on intravascular ultrasound (IVUS) findings. The current study sought to compare the prognosis between deferred lesions based on IVUS and fractional flow reserve (FFR)–guided treatment decision.METHODS:This study is a post hoc analysis of the FLAVOUR randomized trial (Fractional Flow Reserve and Intravascular Ultrasound for Clin

Outcomes 40

Outcomes Myocardial Infarction Ultrasound Stenosis 40

Journal of the American Heart Association

NOVEMBER 28, 2023

Journal of the American Heart Association, Volume 12, Issue 23 , December 5, 2023. BackgroundCardiovascular calcification, characterized by deposition of calcium phosphate in the arterial wall and heart valves, is associated with cardiovascular morbidity and mortality and is commonly seen in aging, diabetes, and chronic kidney disease. Whether evidence‐based interventions could significantly attenuate cardiovascular calcification progression remains uncertain.Methods and ResultsWe conducted a sy

Kidney Disease 40

Kidney Disease Heart Valves Diabetes Outcomes 40

Circulation

NOVEMBER 28, 2023

Circulation, Ahead of Print. The critical care management of patients after cardiac arrest is burdened by a lack of high-quality clinical studies and the resultant lack of high-certainty evidence. This results in limited practice guideline recommendations, which may lead to uncertainty and variability in management. Critical care management is crucial in patients after cardiac arrest and affects outcome.

Critical Care Management 40

Critical Care Management Critical Care Cardiac Arrest Nursing 40

Journal of the American Heart Association

NOVEMBER 28, 2023

Journal of the American Heart Association, Volume 12, Issue 23 , December 5, 2023. BackgroundHigh cardiovascular mortality has been reported in young patients with diabetes. However, the underlying pathology in different age groups of patients with diabetes has not been studied.Methods and ResultsThe aim of this study was to investigate the plaque characteristics and underlying pathology of acute coronary syndrome in different age groups of patients with or without diabetes in a large cohort.

Plaque 40

Plaque Diabetes Cholesterol 40

Becker's Hospital Review - Cardiology

NOVEMBER 28, 2023

Researchers at the NCH Rooney Heart Institute in Naples, Fla., are leaning on a new therapeutic treatment for "widow-maker" heart attacks: supersaturated oxygen therapy.

Heart Attack 40

Heart Attack Heart attacks Research 40

Journal of the American Heart Association

NOVEMBER 28, 2023

Journal of the American Heart Association, Volume 12, Issue 23 , December 5, 2023. BackgroundThe role of nonalcoholic fatty liver disease (NAFLD) as a mediator in the association between various unhealthy lifestyles and major adverse cardiovascular events and all‐cause death remains unclear.Methods and ResultsThis study used data from the UK Biobank, with follow‐up until the end of 2021.

Outcomes 40

Outcomes Risk Factors Research 40

Stroke Journal

NOVEMBER 28, 2023

Stroke, Ahead of Print.

Blood Pressure 75

Blood Pressure Aneurysm Hemorrhage Stroke 75

Journal of the American Heart Association

NOVEMBER 28, 2023

Journal of the American Heart Association, Volume 12, Issue 23 , December 5, 2023. BackgroundPulmonary artery hypertension (PAH) is a fatal disease characterized by a complex pathogenesis. Exosomes containing microRNAs (miRs) have emerged as a novel biomarker. Transpulmonary exosomal miRs offer valuable insights into pulmonary circulation microenvironments.

Congenital Heart Disease 40

Congenital Heart Disease Congenital Pulmonary Heart Disease 40