Sat.Oct 07, 2023 - Fri.Oct 13, 2023

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ECG Blog #399 — Which Laddergram is Correct?

Ken Grauer, MD

The ECG in Figure-1 was obtained from a woman in her 60s — who was seen in the ED ( E mergency D epartment ) as part of her evaluation for trauma following a motor vehicle accident. She was hemodynamically stable — and did not have chest pain, lightheadedness or syncope. QUESTIONS: HOW would you interpret the rhythm in Figure-1 ? Is this " high -grade" AV block?

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Should we activate the cath lab? A Quiz on 5 Cases.

Dr. Smith's ECG Blog

Imagine you just started your ED shift. It's a busy Friday afternoon. Triage is backed up, and 10 minutes into your shift one of the ED nurses brings your several ECG s that has not been overread by a physician. All of the patients presented with chest pain , and they are all in triage. Which, if any, of these patients has OMI, with myocardium at risk and need for emergent PCI?

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Instructors' Collection ECG: Complete Heart Block or High Grade AVB?

ECG Guru

The patient: This ECG was obtained from a 91-year-old woman who was complaining of weakness. Unfortunately, we have no other information. The ECG: This ECG has something for your basic students, and even more for the more advanced learners. The first thing that anyone should notice is the slow rate. The ventricular rate is around 35 bpm, and regular.

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Global Cardiologists Unite: Elevating Excellence in CTO PCI Training

ADN Center of Excellence

In the ever-evolving realm of healthcare, staying ahead of the curve is paramount. Our unwavering commitment to advancing medical expertise is the driving force behind our latest triumph, the CTO PCI Masterclass Session. Held the previous two days, this event proved yet again to be an astounding success, thanks to the indefatigable support of Seyrantepe Hamidiye Etfal Training & Research Hospital and its Catheter Laboratory Team.

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Antagonism of contractile forces in left ventricular hypertrophy: a diagnostic challenge for better pathophysiological and clinical understanding

Open Heart

Cardiac function is characterised by haemodynamic parameters in the clinical scenario. Due to recent development in imaging techniques, the clinicians focus on the quantitative assessment of left ventricular size, shape and motion patterns mostly analysed by echocardiography and cardiac magnetic resonance. Because of the physiologically known antagonistic structure and function of the heart muscle, the effective performance of the heart remains hidden behind haemodynamic parameters.

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What clinical scenario fits best?

Dr. Smith's ECG Blog

B elow are 4 ECGs from the same patient. Accompanying the ECGs is some clinical information. Look at the ECGs and consider the timeline and other information. At the bottom will be five alternative clinical scenarios to explain the findings. Which one do you think fits better with the ECGs and their timeline? The patient is a 60 something female. She was admitted to the hospital with clinical signs of infection.

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Latin Heart Rounds Series: Rounds on a Patient with Ascending Aortic Aneurysm and Arch Involvement

Society of Thoracic Surgeons - Congenital

Webinar Latin Heart Rounds Series: Rounds on a Patient with Ascending Aortic Aneurysm and Arch Involvement dkaczmarek Wed, 10/11/2023 - 11:22 December 15, 2023 Image Join us on December 15, when experts will provide up-to-date insight on the management of patients with aortic root and ascending aortic aneurysm involving the aortic arch. The discussion will be based on a real patient and presented by an early career surgeon.

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Coronary angiography after out-of-hospital cardiac arrest without ST-segment elevation: a systematic review and meta-analysis of randomised trials

Coronary Artery Disease Journal

Background Out-of-hospital cardiac arrest (OHCA) has a poor prognosis. The optimal timing and role of early coronary angiography (CAG) in OHCA patients without ST-segment elevation remains unclear. The goal of this study is to compare an early CAG versus delayed CAG strategy in OHCA patients without ST elevation. Methods We systematically searched PubMed, Embase and Cochrane databases, in June 2022, for randomised controlled trials (RCTs) comparing early versus delayed early CAG.

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The Role of Genetics in Heart Disease Risk

AMS Cardiology

In the cardiology world, understanding the intricate connection between genetics and heart disease is of paramount importance. At AMS Cardiology, we recognize that prevention is at the core of our practice. Below, we explore the relationship between genetics and heart disease, shedding light on the key factors contributing to a person being at risk.

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8 in 8: Abdominal Complications After Cardiac Surgery

Society of Thoracic Surgeons - Critical Care

Video 8 in 8: Abdominal Complications After Cardiac Surgery dkaczmarek Tue, 10/10/2023 - 11:48 Abdominal Complications (AC) after cardiac surgery are devastating with significant associated morbidity and mortality. Prompt recognition, diagnosis and intervention are prudent to potentially rescue cardiac surgery patients. This video describes the most common AC after cardiac surgery, the presentation, associated mortality rates, and recommended management.

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Allied Healthcare Employers Recognize the Value of NHA-Certified Job Corps Graduates

Learning + Leading

In the dynamic world of the healthcare landscape, the need to hire medical assistants and other professionals who are both skilled and certified transcends mere requirements; it's more than a goal; it's a strategic priority for Allied Health employers. Workforce development is more than just a buzzword; it's a critical component of the healthcare industry.

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Redefinición de riesgo, prevención y tratamiento de las enfermedades cardíacas

American Heart News - Stroke News

Recomendaciones destacadas: Un nuevo aviso presidencial de la American Heart Association identifica las fuertes conexiones entre las enfermedades cardiovasculares (ECV), las enfermedades renales, la diabetes tipo 2 y la obesidad, y sugiere redefinir.

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Unlocking Your Path to Excellence: A Step-by-Step Guide to ADN CoE's Fellowship Programs

ADN Center of Excellence

Welcome to ADN CoE's Fellowship Program Guide! In a few simple steps, you can register to join our community. Explore Our Programs. Choose between being a Fellow, a Mentor , or an Observer, depending on your interests and goals. Or Click one of the buttons: Click 'Apply Now' to begin your journey. Sit back, relax, and let us do the rest! We'll be in touch to finalize your registration Get ready to embark on your medical education journey with ADN CoE.

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STS Partnership on the Heart Valve Disease Forum in Seoul Garners Rave Reviews

Society of Thoracic Surgeons - Congenital

News STS Partnership on the Heart Valve Disease Forum in Seoul Garners Rave Reviews KCummings Tue, 10/10/2023 - 13:49 2 min read

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Pre-hospital care: can paramedics influence your cardiac future?

Heart Sisters

Should paramedics tell heart patients to get up and walk from their ambulance into the Emergency Department?

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Do you know a stroke hero?

American Heart News - Stroke News

DALLAS, October 9, 2023 – Each year, approximately 800,000 people in the U.S. experience a stroke, according to the American Heart Association’s 2023 Heart Disease and Stroke Statistical Update. Individuals and groups making a difference in the stroke.

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Unlocking Your Path to Excellence: A Step-by-Step Guide to ADN CoE's Fellowship Programs

ADN Center of Excellence

Welcome to ADN CoE's Fellowship Program Guide! In a few simple steps, you can register to join our community. Explore Our Programs. Choose between being a Fellow, a Mentor , or an Observer, depending on your interests and goals. Or Click one of the buttons: Click 'Apply Now' to begin your journey. Sit back, relax, and let us do the rest! We'll be in touch to finalize your registration Get ready to embark on your medical education journey with ADN CoE.

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Preclinical Study on a Novel Fluoroderivative of Dabigatran Etexilate in Animal Models

Journal of Cardiovascular Pharmacology

Here, the fluorinated derivative, R1, was synthesized from the fluorinated dabigatran derivative (R0). The in vivo pharmacokinetic characteristics of orally administered R1, R0 injection, and dabigatran etexilate in rats were compared. Safety evaluation results showed no significant changes in the QRS wave or PR and QT intervals in rat lead II electrocardiograms.

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Not getting enough sleep? Your vascular cells are drowning in oxidants

Science Daily - Heart Disease

A new study of sleep in women shows that delaying bedtime by just 90 minutes each night damages cells that line the blood vessels, supporting the hypothesis that poor sleep is linked to heart health.

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¿Conoce a un sobreviviente de un derrame cerebral?

American Heart News - Stroke News

DALLAS, 9 de octubre de 2023 – Cada año, aproximadamente 800,000 personas en los EE. UU. experimentan un ataque o derrame cerebral, según la actualización de estadísticas sobre enfermedades cardíacas y derrames cerebrales de 2023 de la American Heart.

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Risk Assessment Score and Chi-Square Automatic Interaction Detection Algorithm for Hypertension Among Africans: Models From the SIREN Study

Hypertension Journal

Hypertension, Volume 80, Issue 12 , Page 2581-2590, December 1, 2023. BACKGROUND:This study aimed to develop a risk-scoring model for hypertension among Africans.METHODS:In this study, 4413 stroke-free controls were used to develop the risk-scoring model for hypertension. Logistic regression models were applied to 13 risk factors. We randomly split the dataset into training and testing data at a ratio of 80:20.

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Effects of Synchronizing Foot Strike and Cardiac Phase on Exercise Hemodynamics in Patients With Cardiac Resynchronization Therapy: A Within-Subjects Pilot Study to Fine-Tune Cardio-Locomotor Coupling for Heart Failure

Circulation

Circulation, Ahead of Print. BACKGROUND:Despite advances in medical and cardiac resynchronization therapy (CRT), individuals with chronic congestive heart failure (CHF) have persistent symptoms, including exercise intolerance. Optimizing cardio-locomotor coupling may increase stroke volume and skeletal muscle perfusion as previously shown in healthy runners.

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Deep learning for automated left ventricular outflow tract diameter measurements in 2D echocardiography

Cardiovascular Ultrasound

Measurement of the left ventricular outflow tract diameter (LVOTd) in echocardiography is a common source of error when used to calculate the stroke volume. The aim of this study is to assess whether a deep le.

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Maternal mental health: a key area for future research among women with congenital heart disease

Open Heart

In this viewpoint, we respond to the recently published national priorities for research in congenital heart disease (CHD) among adults, established through the James Lind Alliance Priority Setting Partnership, with specific attention to priority 3 (mental health) and priority 5 (maternal health). Our recent policy impact project explored how maternal mental health is currently addressed in adult congenital heart disease (ACHD) services in the National Health Service, identified gaps and discuss

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Modifying Dietary Sodium and Potassium Intake: An End to the Salt Wars?: Salt Series

Hypertension Journal

Hypertension, Ahead of Print. Excessive salt intake raises blood pressure, but the implications of this observation for human health have remained contentious. It has also been recognized for many years that potassium intake may mitigate the effects of salt intake on blood pressure and possibly on outcomes such as stroke. Recent large randomized intervention trials have provided strong support for the benefits of replacing salt (NaCl) with salt substitute (75% NaCl, 25% KCl) on hard outcomes, in

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Dapagliflozin and Apparent Treatment-Resistant Hypertension in Heart Failure With Mildly Reduced or Preserved Ejection Fraction: The DELIVER Trial

Circulation

Circulation, Volume 148, Issue 24 , Page 1945-1957, December 12, 2023. BACKGROUND:Apparent treatment-resistant hypertension (aTRH) is prevalent and associated with adverse outcomes in heart failure with mildly reduced or preserved ejection fraction. Less is known about the potential role of sodium-glucose co-transporter 2 inhibition in this high-risk population.

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Defibrillation Testing of the Subcutaneous Implantable Cardioverter-Defibrillator at the time of Generator Replacement

HeartRhythm

Defibrillation testing (DFT) of the subcutaneous implantable cardioverter-defibrillator (S-ICD) is recommended at the time of implantation,1 but data during generator replacement are lacking.2-4 We prospectively studied all patients undergoing S-ICD generator replacement at the Hospital of the University of Pennsylvania from September 2020 to February 2023.

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Phenotype, outcomes and natural history of early?stage non?ischaemic cardiomyopathy

European Journal of Heart Failure

Patients with early-stage non-ischaemic cardiomyopathy (early-NICM) were characterized with late gadolinium enhancement (LGE) cardiovascular magnetic resonance. Three subgroups were included: isolated left ventricular (LV) dilatation, non-dilated LV cardiomyopathy and early dilated cardiomyopathy (DCM). Myocardial fibrosis was identified in a quarter of patients and was equally ubiquitous across subgroups.

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National Trends in Mortality and Urgent Dialysis after Acute Hypertension in Japan From 2010 Through 2019

Hypertension Journal

Hypertension, Volume 80, Issue 12 , Page 2591-2600, December 1, 2023. BACKGROUND:Despite increasing incidences of hypertension, recent trends in mortality and urgent dialysis following acute hypertension (AHT) remain undetermined.METHODS:This retrospective observational cohort study evaluated 50 316 hospitalized AHT patients from 2010 to 2019, using an administrative claims database in Japan.

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Wallenberg/Lateral Medullary Syndrome - A Case Report

BMH Medical Journal

Wallenberg syndrome or lateral medullary syndrome is due to acute stroke affecting the lateral medulla, most commonly due to the occlusion of the intracranial portion of the vertebral artery or the posterior inferior cerebellar artery. The infarcted segment is the lateral medulla, posterior to the inferior olivary nucleus. Even though it was first described in the year 1808 by Gaspard Vieusseux, a more detailed and vivid description of the disease was given by Adolf Wallenberg, in the year 1895.

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Aldehyde dehydrogenase 2 preserves mitochondrial function in the ischemic heart: a redox-dependent mechanism for AMPK activation by thioredoxin-1

Journal of Cardiovascular Pharmacology

Aldehyde dehydrogenase 2 (ALDH2) protects the ischemic heart by activating AMP-activated protein kinase (AMPK) signaling. However, the molecular mechanisms linking ALDH2 and AMPK signaling are not fully understood. This study aimed to explore the potential mechanisms linking ALDH2 and AMPK in myocardial ischemic injury. An ischemic model was established by ligating the left anterior descending coronary artery in rats.

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Dialysis Modality and Incident Stroke Among Patients With End-Stage Kidney Disease: A Registry-Based Cohort Study

Stroke Journal

Stroke, Volume 54, Issue 12 , Page 3054-3063, December 1, 2023. BACKGROUND:Patients with end-stage kidney disease undergoing dialysis are at significant risk of stroke. Whether dialysis modality is associated with cerebrovascular disease is unclear. This study compared the risk of incident stroke in patients undergoing peritoneal dialysis or hemodialysis.METHODS:Thirty-nine thousand five hundred forty-two patients without a history of stroke who initiated dialysis between January 1, 2010, and De

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Maternal obesity predicts heart disease risk better than pregnancy complications

Science Daily - Heart Disease

Pregnancy complications such as preeclampsia and gestational diabetes have recently been associated with a higher risk of developing heart disease later in life. But a new study has found obesity before or during pregnancy is the actual root cause of future cardiovascular disease. “We demonstrate, for the first time, that adverse pregnancy outcomes are primarily indicators — and not the root cause — of future heart health,” said corresponding author Dr.

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What Can Biologic Aging Tell Us About the Effects of Mental Stress on Vascular Health

Hypertension Journal

Hypertension, Volume 80, Issue 12 , Page 2515-2522, December 1, 2023. Cardiovascular disease is often a disease of aging. Considerable advances in our understanding of the biological mechanisms of aging have been made; yet, cardiovascular disease remains the leading cause of death in the United States urging a continued search for novel risk factors to target for preventing and treating disease.

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The therapeutic potential of targeting ferroptosis in the treatment of mitochondrial cardiomyopathies and heart failure

Journal of Cardiovascular Pharmacology

Ferroptosis is a form of iron-regulated cell death implicated in a wide array of diseases, including heart failure, hypertension, and numerous cardiomyopathies. Additionally, mitochondrial dysfunction has been associated with several of these same disease states. However, the role of the mitochondrion in ferroptotic cell death remains debated. As a major regulator of cellular iron levels, the mitochondria may very well play a crucial role in the mechanisms behind ferroptosis, but at this point,

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Impact of COVID?19 in patients with heart failure with mildly reduced or preserved ejection fraction enrolled in the DELIVER trial

European Journal of Heart Failure

Impact of COVID-19 in patients with HF and mildly reduced and preserved ejection fraction. COVID-19, coronvirus disease-2019; HF, heart failure. Aim COVID-19 may affect clinical risk in patients with heart failure. DELIVER began before and was conducted during the COVID-19 pandemic. This study aimed to evaluate the association between COVID-19 and clinical outcomes among DELIVER participants.

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EP News: Basic and Translational

HeartRhythm

Wiedmann et al (J Mol Cell Cardiol 2023;184:26, PMID 37793594) investigated the role of TWIK-related acid-sensitive potassium channel 1 (TASK-1, hK2P3.1), 2-pore-domain K+ channels, which are expressed in human atrial myocytes, in mediating the neurokinin-III receptor activation–induced effects on atrial electrophysiology. Administration of the endogenous neurokinin-III receptor ligand substance P or neurokinin B resulted in a strong TASK-1 current inhibition in heterologous systems expressing n