May, 2024

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ECG Blog #432 — "Should I Shock this Patient?"

Ken Grauer, MD

I was sent the ECG in Figure-1 — without the benefit of any history. Is this VT? What is the 1st thing — that YOU would do? Figure-1: I was sent this ECG without any history. Is this VT? MY Thoughts on Today’s CASE: As tempting as it might be to reach for the defibrillator on seeing the ECG shown in Figure-1 — My initial reaction was different. At 1st glance , my impression from seeing ECG #1 — was that the rhythm is very fast and irregular — with a highly variable QRS morphology — and, without

Blog 161
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Dementia Mortality Tied to Olive Oil Consumption

Med Page Today

(MedPage Today) -- Higher olive oil intake was associated with a lower risk of dementia-related mortality, a prospective study of 90,000 healthcare professionals showed. Eating at least 7 g of olive oil daily -- about a half tablespoon --.

Dementia 145
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Study finds fat cells influence heart health in Chagas disease

Medical Xpress - Cardiology

Jyothi Nagajyothi, Ph.D. and her laboratory at the Hackensack Meridian Center for Discovery and Innovation (CDI) have identified what may be the main mechanism for how chronic Chagas disease, a parasitic infection affecting millions of people worldwide, can cause irreversible and potentially fatal heart damage.

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Transcutaneous Pacing: Part 2

EMS 12-Lead

TCP in the ROSC Patient: False Electrical Capture at 75mA Josh Kimbrell, NRP @joshkimbre Judah Kreinbrook, EMT-P @JMedic2JDoc This is the second installment of a blog series showing how transcutaneous pacing (TCP) can be difficult and how you can improve your skills. We will be using redacted information from different cases where paramedics attempted TCP in the field.

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Evaluating Safety of Novel LDL Management Mechanism

HCPLive

Deepak Bhatt, MD, MPH, MBA, reviews the efficacy and safety data of inclisiran, highlighting its long-term effects and noting that injection site reactions are among the most prominent adverse reactions associated with this medication.

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New Treatment in Pipeline for Patients with Hypertrophic Cardiomyopathy

DAIC

Getty Images milla1cf Tue, 05/14/2024 - 13:00 May 14, 2024 — One of the most common genetic heart diseases worldwide, hypertrophic cardiomyopathy (HCM) causes the walls of the left ventricle to become thick and stiff. In about 70 percent of cases, patients with HCM experience obstruction to blood flow, which increases pressures in the heart and can lead to chest pain, shortness of breath and reduced exercise capacity.

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Insulin sensitivity estimates and their longitudinal association with coronary artery disease in type 1 diabetes. Does it matter?

Cardiovascular Diabetology

Insulin resistance and chronic kidney disease are both associated with increased coronary artery disease risk. Many formulae estimating glucose disposal rate in type 1 diabetes infer insulin sensitivity from c.

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The mechanosensory channel PIEZO1 functions upstream of angiopoietin/TIE/FOXO1 signaling in lymphatic development

Journal of Clinical Investigation - Cardiology

Lymphedema is a debilitating disease with no effective cure and affects an estimated 250 million individuals worldwide. Prior studies have identified mutations in piezo-type mechanosensitive ion channel component 1 (PIEZO1), angiopoietin 2 (ANGPT2), and tyrosine kinase with Ig-like and EGF-like domains 1 (TIE1) in patients with primary lymphedema. Here, we identified crosstalk between these molecules and showed that activation of the mechanosensory channel PIEZO1 in lymphatic endothelial cells (

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Ep 195 Management of Subarachnoid Hemorrhage

ECG Cases

Once the diagnosis of nontraumatic subarachnoid hemorrhage (SAH) has been made, our job is not done. Mortality in SAH patients can be up to 30% even without neurological deficit. Paying attention to the time-sensitive details of ED management of SAH patients can have a significant impact on their outcome. In this second part of our 2-part podcast series on subarachnoid hemorrhage with Dr.

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An undergraduate who is an EKG tech sees something. The computer calls it completely normal. How about the physicians?

Dr. Smith's ECG Blog

This was sent by an undergraduate (not yet in medical school, but applying now) who works as an ED technician (records all EKGs, helps with procedures, takes vital signs) and who reads this blog regularly. Edited by Smith He also sent me this great case. A 63 year old man with a history of hypertension, hyperlipidemia, prediabetes, and a family history of CAD developed chest pain, shortness of breath, and diaphoresis after consuming a large meal at noon.

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Night-time heat significantly increases the risk of stroke

Science Daily - Stroke

Researchers show that nocturnal heat significantly increases the risk of stroke. The findings can contribute to the development of preventive measures: With them, the population can better protect themselves against the risks of climate change with increasingly frequent hot nights. In addition, knowledge of the consequences of hot nights can improve patient care.

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Documentary Led by HonorHealth Research Institute Focuses on Injuries to Doctors and Nurses Working in Cardiology

DAIC

milla1cf Tue, 05/07/2024 - 12:54 May 7, 2024 — HonorHealth Research Institute ’s David G. Rizik , M.D., narrates and is a co-producer of a documentary focused on radiation and orthopedic injuries suffered by doctors and nurses who work in cardiac catheterization laboratories where they apply the very latest non-surgical technologies to treat the world’s leading cause of death, heart disease.

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Some Patients Suffered Psychiatric Issues After Ozempic Initiation

Med Page Today

(MedPage Today) -- NEW YORK CITY -- Some patients who newly started a GLP-1 receptor agonist quickly developed psychiatric symptoms, a few case reports detailed here. One case involved a female, age 42, with a history of bipolar I disorder.

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Abnormal vascular thickness and stiffness in young adults with type 1 diabetes: new insights from cutting-edge ultrasound modalities

Cardiovascular Diabetology

Cardiovascular disease (CVD) remains the leading cause of morbidity and mortality in patients with Type 1 Diabetes (T1D). Early markers of CVD include increased carotid intima-media thickness (CIMT) and pulse.

Diabetes 115
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RNF4 sustains Myc-driven tumorigenesis by facilitating DNA replication

Journal of Clinical Investigation - Cardiology

The mammalian SUMO-targeted E3 ubiquitin ligase Rnf4 has been reported to act as a regulator of DNA repair, but the importance of RNF4 as a tumor suppressor has not been tested. Using a conditional-knockout mouse model, we deleted Rnf4 in the B cell lineage to test the importance of RNF4 for growth of somatic cells. Although Rnf4–conditional-knockout B cells exhibited substantial genomic instability, Rnf4 deletion caused no increase in tumor susceptibility.

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Chest pain: Are these really "Nonspecific ST-T wave abnormalities", as the cardiologist interpretation states?

Dr. Smith's ECG Blog

Written by Jesse McLaren, with a very few edits by Smith A 60-year-old presented with chest pain. The ECG did not meet STEMI criteria, and the final cardiology interpretation was “ST and T wave abnormality, consider anterior ischemia”. But are there any other signs of Occlusion MI? There’s only minimal ST elevation in III, which does not meet STEMI criteria of 1mm in two contiguous leads.

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America’s CKM Syndrome Problem

CardiacWire

A new JAMA study revealed that a shocking 90% of US adults are at risk of developing cardiovascular-kidney-metabolic (CKM) syndrome, underscoring the need for preventative action before we face a wave of CKM-related heart disease. Officially published by the AHA six months ago, CKM syndrome defines the connections and risks associated with obesity, type 2 diabetes, chronic kidney disease, and cardiovascular disease.

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Ultrasound Neuromodulation Shows Promise to Treat Pulmonary Hypertension, Feinstein Institutes Research

DAIC

Feinstein Institutes’ Dr. Stavros Zanos is the senior author on the new bioelectronic medicine ultrasound paper. (Credit: Feinstein Institutes) milla1cf Wed, 05/08/2024 - 10:57 May 8, 2024 — Ultrasound could one day complement or even replace drugs to treat diseases. Bioelectronic medicine scientists at The Feinstein Institutes for Medical Research used noninvasive, splenic focused ultrasound stimulation (sFUS) and found they can reduce inflammation and improve symptoms of pulmonary arter

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Young-Onset Dementia Tied to Preeclampsia

Med Page Today

(MedPage Today) -- Preeclampsia raised the risk of young-onset dementia, a prospective study of nearly 2 million women in France showed. Compared with pregnancies without hypertensive disorders, preeclampsia more than doubled the risk of dementia.

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Clinical Quiz: Lp(a) Treatments and Therapeutics Considerations

HCPLive

The final in our 3-part quiz series based on the NLA's 2024 update to their 2019 scientific statement on use of lipoprotein(a) in clinical practice focuses on treatment considerations and therapeutic options for elevated Lp(a).

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Illinois hospital launches 1st-of-its-kind stroke study

Becker's Hospital Review - Cardiology

A team of physicians at Rockford, Ill.-based Mercyhealth Javon Bea Hospital-Riverside participated in a unique stroke study that used patients' stem cells to promote tissue regeneration, it announced May 22.

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Wide complex tachycardia, resistant to cardioversion. Some fascinating features here.

Dr. Smith's ECG Blog

An elderly dialysis patient presented with chest pain. She has poor LV function. Previous echo 4 months ago (confirmed with ED bedside echo): The estimated left ventricular ejection fraction is 30%. Severely decreased LV function. Regional wall motion abnormality-inferior, inferolateral, septum, anterolateral, anterior and apex, lateral. Here is her ECG: Regular Wide Complex Tachycardia.

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Brief anger may impair blood vessel function

American Heart News - Heart News

Research Highlights: When adults became angry after remembering past experiences, the function of cells lining the blood vessels was negatively impaired, which may restrict blood flow. Previous research has found that this may increase the risk of.

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American College of Cardiology Announces Care of the Athletic Heart

DAIC

milla1cf Fri, 05/31/2024 - 07:00 May 31, 2024 — In the United States there are over 8 million active athletes. Given the rapid expansion of sports cardiology, cardiovascular care teams must understand contemporary care and practice management strategies for all athletes—from the elite to the exercise enthusiast. The ACC Care of the Athletic Heart conference , taking place in Washington, on June 6-8, aims to provide clinicians with guideline-driven, practical, cardiovascular care strategies to im

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Alzheimer's Biomarkers Linked With Plasma Leptin Levels

Med Page Today

(MedPage Today) -- Plasma leptin levels were linked with Alzheimer's disease PET pathology in cognitively unimpaired older adults, a longitudinal cohort study in Korea showed. Over 2 years, lower baseline plasma leptin was associated with a greater.

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FLOW Trial Fortifies Semaglutide's Role in Chronic Kidney Disease and Type 2 Diabetes

HCPLive

Semaglutide 1.0 mg reduced major kidney disease events and slowed eGFR decline in patients with type 2 diabetes and chronic kidney disease, according to the FLOW trial.

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Popular supplement linked to increased heart, stroke risk

Becker's Hospital Review - Cardiology

Regular use of fish oil supplements can increase the risk of stroke and atrial fibrillation in the general population, but shows benefits for those with existing heart disease, a recent study found.

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The alanyl-tRNA synthetase AARS1 moonlights as a lactyltransferase to promote YAP signaling in gastric cancer

Journal of Clinical Investigation - Cardiology

Lactylation has been recently identified as a new type of posttranslational modification occurring widely on lysine residues of both histone and nonhistone proteins. The acetyltransferase p300 is thought to mediate protein lactylation, yet the cellular concentration of the proposed lactyl-donor, lactyl-coenzyme A, is about 1,000 times lower than that of acetyl-CoA, raising the question of whether p300 is a genuine lactyltransferase.

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Two decades of studies suggest health benefits associated with plant-based diets

Science Daily - Heart Disease

Vegetarian and vegan diets are generally associated with better status on various medical factors linked to cardiovascular health and cancer risk, as well as lower risk of cardiovascular diseases, cancer, and death, according to a new review of 49 previously published papers.

Diet 118
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Trends Shaping the Cardiovascular Information Systems Market

DAIC

In the dynamic realm of healthcare technology, cardiovascular information systems (CVIS) stand at the forefront, facilitating streamlined operations, enhanced patient care and efficient data management within cardiovascular departments. According to a recent market report from Credence Research, the CVIS market is projected to surge from $1,197 M in 2023 to $2,387 by 2023 — a compound annual growth rate of 7.7%.

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Brain Risks Drop When Diet Includes More Minimally Processed Foods

Med Page Today

(MedPage Today) -- A diet high in ultra-processed foods upped the risk of cognitive impairment or stroke, data from the prospective REGARDS study showed. However, risk of either cognitive decline or stroke fell for people who had higher intake.

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Paul Appelbaum, MD: What to Warn Patients When Prescribing Psychedelics in the Future

HCPLive

In an interview, Paul Appelbaum, MD, discussed issues clinicians will need to bring up to their patients if the FDA approves a psychedelic-assisted therapy.

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Handed this ECG from triage. What will you do?

Dr. Smith's ECG Blog

Written by Sean Trostel MD I returned to my desk after seeing a patient and saw this screening ECG sitting on my desk to be read. The patient was a man in his 80s with chief complaint listed as: "hyperglycemia, weakness, ground level fall." ECG #1 @ 15:30 What do you think? Slow, irregular rhythm - likely slow atrial fibrillation Very wide QRS measuring ~180 ms in some leads, not fitting LBBB morphology and wider than vast majority of LBBB No signs of OMI, no modified Sgarbossa criteria Peaked T

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Excess glucocorticoids inhibit murine bone turnover via modulating the immunometabolism of the skeletal microenvironment

Journal of Clinical Investigation - Cardiology

Elevated bone resorption and diminished bone formation have been recognized as the primary features of glucocorticoid-associated skeletal disorders. However, the direct effects of excess glucocorticoids on bone turnover remain unclear. Here, we explored the outcomes of exogenous glucocorticoid treatment on bone loss and delayed fracture healing in mice and found that reduced bone turnover was a dominant feature, resulting in a net loss of bone mass.

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Dietary changes may treat pulmonary hypertension

Science Daily - Heart Disease

Blood vessels in the lungs aren't like the others in the body. This difference becomes clear in pulmonary hypertension, in which only the lungs' blood vessels stiffen progressively, leading to chronic lung disease, heart failure and death. The underlying reasons for this organ-specific vessel stiffening remained a mystery until researchers made a surprising discovery about these blood vessel cells in patients with pulmonary hypertension -- they're hungry.

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GE HealthCare and Medis Medical Imaging Announce Collaboration Focused on Non-Invasive Coronary Assessments to Help Advance Precision Care in Treatment of Coronary Artery Disease

DAIC

milla1cf Tue, 05/14/2024 - 12:53 May 14, 2024 — GE HealthCare , a leading global medical technology, pharmaceutical diagnostics and digital solutions innovator, and Medis Medical Imaging , a leading cardiac imaging software company, announced their collaboration aimed at helping advance precision care in the diagnosis and treatment of coronary artery disease ( CAD ).

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Cardiologists Float Idea of Unionization Among Ways to Protect Employee Physicians

Med Page Today

(MedPage Today) -- LONG BEACH, Calif. -- Even recognized cardiology leaders have not been immune from threats and abuse by their hospital employers, prompting an emotional discussion on worker's rights at the Society for Cardiovascular Angiography.

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