August, 2024

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ECG Blog #443 — A 40s Man with CP and Dyspnea

Ken Grauer, MD

The ECG in Figure-1 was obtained from a man in his 40s — who presented to the ED ( E mergency D epartment ) because of CP ( C hest P ain ) and shortness of breath. QUESTIONS: In view of the above history — How would YOU interpret the ECG in Figure-1 ? Based on the history and the patient's initial ECG — the cath lab was activated. Do you agree? Figure-1: The initial ECG in today's case. ( To improve visualization — I've digitized the original ECG using PMcardio ).

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Shingles Tied to Long-Term Cognitive Changes

Med Page Today

(MedPage Today) -- Herpes zoster (shingles) was tied to an elevated risk of subjective cognitive decline, an analysis of 150,000 U.S. healthcare professionals showed. "In three large independent cohorts, herpes zoster was associated with an approximately.

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Mechanisms and treatment of pulmonary arterial hypertension

Nature Reviews - Cardiology

Nature Reviews Cardiology, Published online: 07 August 2024; doi:10.1038/s41569-024-01064-4 In this Review, Ghofrani and colleagues discuss the mechanisms underlying the development of pulmonary arterial hypertension, provide an overview of approved therapies and describe the predominantly non-vasodilatory drugs that are currently being tested in clinical trials.

Pulmonary 140
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Say 'aah' and get a diagnosis on the spot: is this the future of health?

Science Daily - Stroke

A computer algorithm has achieved a 98% accuracy in predicting different diseases by analyzing the color of the human tongue. The proposed imaging system can diagnose diabetes, stroke, anemia, asthma, liver and gallbladder conditions, COVID-19, and a range of vascular and gastrointestinal issues, according to new research.

COVID-19 138
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Bridging Innovation & Patient Care: The Growing Role of AI

Speaker: Simran Kaur, Co-founder & CEO at Tattva.Health

AI is transforming clinical trials—accelerating drug discovery, optimizing patient recruitment, and improving data analysis. But its impact goes far beyond research. As AI-driven innovation reshapes the clinical trial process, it’s also influencing broader healthcare trends, from personalized medicine to patient outcomes. Join this new webinar featuring Simran Kaur for an insightful discussion on what all of this means for the future of healthcare!

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3D-printed blood vessels bring artificial organs closer to reality

Science Daily - Heart Disease

Lab-grown organs are a long-time 'holy grail' of organ engineering that has yet to be achieved, but new research has brought that goal a big step closer to reality using a new 3D-printing method called co-SWIFT. co-SWIFT prints branching networks of double-layered vessels that are infused with smooth muscle cells and endothelial cells into living human cardiac tissue, and can even replicate patient-specific vascular structures,indicating that it could one day be used for personalized medicine.

Research 138
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Meningeal lymphatic CGRP signaling governs pain via cerebrospinal fluid efflux and neuroinflammation in migraine models

Journal of Clinical Investigation - Cardiology

Recently developed antimigraine therapeutics targeting calcitonin gene–related peptide (CGRP) signaling are effective, though their sites of activity remain elusive. Notably, the lymphatic vasculature is responsive to CGRP signaling, but whether meningeal lymphatic vessels (MLVs) contribute to migraine pathophysiology is unknown. Mice with lymphatic vasculature deficient in the CGRP receptor (CalcrliLEC mice) treated with nitroglycerin-mediated (NTG-mediated) chronic migraine exhibit reduced pai

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Coffee-Dementia Link Continues to Unfurl

Med Page Today

(MedPage Today) -- PHILADELPHIA -- Coffee and tea intake were associated with long-term cognitive changes in older adults, two prospective studies presented at the Alzheimer's Association International Conference (AAIC) suggested. Among 6,001.

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Lifesaving But Not Perfect: Addressing Sleep Health in Patients on Dialysis

HCPLive

Care for dialysis patients often focuses on kidney health, but experts and a patient stress the need for interdisciplinary care that also addresses sleep health.

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Gut microbial pathway identified as target for improved heart disease treatment

Medical Xpress - Cardiology

Cleveland Clinic researchers have made a significant discovery about how the gut microbiome interacts with cells to cause cardiovascular disease. The study published in Nature Communications found that phenylacetylglutamine (PAG), produced by gut bacteria as a waste product, then absorbed and formed in the liver, interacts with previously undiscovered locations on beta-2 adrenergic receptors on heart cells once it enters the circulation.

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Eating more fruits and vegetables to reduce dietary acid lowers blood pressure and improves kidney and heart health in patients with hypertension

Science Daily - Heart Disease

Doctors recommend making fruits and vegetables a foundational part of the treatment of patients with hypertension. Diets high in fruits and vegetables are found to lower blood pressure, reduce cardiovascular risk, and improve kidney health due to their base-producing effects. A new study details the findings from a five-year interventional randomized control trial.

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Pentoxifylline ameliorates subclinical atherosclerosis progression in patients with type 2 diabetes and chronic kidney disease: a randomized pilot trial

Cardiovascular Diabetology

Diabetic kidney disease (DKD) is associated with a higher risk of cardiovascular disease (CVD). Pentoxifylline (PTF), a nonselective phosphodiesterase inhibitor with anti-inflammatory, antiproliferative, and a.

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Work-related stress may increase the risk of an irregular heart rhythm

American Heart News - Heart News

Research Highlights: Adults in white-collar jobs in Canada with high job strain and for whom significant efforts are met with low rewards (such as low salary or recognition) may face a 97% increased risk for developing the irregular heart rhythm.

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COVID Vax Myocarditis Stays Mild With Good Prognosis Over a Year Later

Med Page Today

(MedPage Today) -- People with postvaccine myocarditis did not share the typical mid-term complications associated with conventional myocarditis, based on a population-based study from France. With 18-month follow-up of people who had been hospitalized.

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Back-to-School Asthma and Lung Health with Juanita Mora, MD and S. Christy Sadreameli, MD

HCPLive

Mora and Sadreameli join Lungcast to provide a back-to-school health blueprint, including topics like rescue inhalers, vaccination, vaping and air quality.

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Women’s cardiac care: back then, right now and into our future

Heart Sisters

The American Heart Association's recent overview of women's cardiac care feels like an emotional roller coaster ride - from despair to anger and then maybe - just maybe - even hope for our future.

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Is long-term beta-blocker therapy needed after a heart attack?

Science Daily - Heart Disease

The appropriate duration of beta-blocker treatment after a heart attack (a myocardial infarction [MI]) is unknown in patients who do not need to take beta-blockers for another reason. In the ABYSS trial, the cardiovascular safety of interrupting beta-blocker could not be shown in comparison with beta-blocker continuation and beta-blocker interruption did not improve quality of life.

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Ep 197 Acute Heart Failure Risk Stratification and Disposition

ECG Cases

We over-admit low risk acute heart failure patients and under-admit high risk heart failure patients. In this podcast we discuss the diagnostic accuracy of various clinical features, lab tests and imaging modalities for acute heart failure, the 3 validated risk stratification tools and a simple approach to PoCUS for the diagnosis and prognostication of acute heart failure in the ED to improve our diagnostic accuracy and disposition decisions for patients with acute heart failure.

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ECG Blog #442 — And then the Patient Arrested.

Ken Grauer, MD

I was sent the ECG shown in Figure-1 — told only that that this middle-aged woman noted chest tightness and nausea an hour earlier. QUESTIONS: How would YOU interpret the ECG in Figure-1 ? — IF told that this patient arrested shortly after ECG #1 — Does this change your interpretation? Figure-1: The initial ECG in today's case. ( To improve visualization — I've digitized the original EC G using PMcardio ).

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Medicare Unveils First 10 Negotiated Drug Prices

Med Page Today

(MedPage Today) -- Sitagliptin (Januvia) saw the greatest drop in price among the list of 10 drugs whose new prices were announced Thursday under Medicare's drug price negotiation program. The price negotiation program was passed in 2022 as part.

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FDA Approves OCU400 Expanded Access Program for Retinitis Pigmentosa

HCPLive

Ocugen will initiate expanded access to OCU400 gene therapy in adults with retinitis pigmentosa prior to BLA approval.

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Becoming a patient: a daily exercise in accepting reality

Heart Sisters

Learning to accept reality may often seem counter-intuitive, but could accepting reality be the strategy that can protect against the more dangerous response of DENIAL?

Exercise 126
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Gene-related metabolic dysfunction may be driving heart arrhythmia

Science Daily - Heart Disease

Patients with a common heart arrhythmia called Atrial Fibrillation could benefit from future treatments that target inefficiencies in heart cell metabolism, according to a new article.

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Epigastric and Right Upper Quadrant pain after eating spicy food

Dr. Smith's ECG Blog

A 60-something woman with no cardiac history presented with epigastric and right upper quadrant pain after eating spicy food. She had an ECG recorded at triage: What do you think? This was sent to me without any info while I was out and about, and I looked at it on my phone. I responded: "That is a tough one. V2 is very worrisome. But no other leads are.

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Researchers attempted to emulate a clinical trial using data from real patients

Science Daily - Stroke

Researchers used real-world clinical data to attempt to emulate a randomized controlled trial testing the effectiveness of two blood thinners, apixaban and warfarin, to prevent stroke in patients with non-valvular atrial fibrillation. The study provides a method to explore the effects of treatments in patients who are underrepresented or excluded from clinical trials.

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Experts: Don't Say 'Heartbeat' to Describe Ultrasound Findings in Early Pregnancy

Med Page Today

(MedPage Today) -- Some terms commonly used to describe observations seen on ultrasound during first-trimester pregnancies are outdated and should be replaced with more descriptive language, a multisociety panel of ob/gyns, radiologists, and emergency.

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Diabetes Dialogue: SUMMIT and FINEARTS-HF, with Muthiah Vaduganathan, MD, MPH

HCPLive

In this episode, hosts are joined by Muthiah Vaduganathan, MD, MPH, for a discussion around topline data updates from the SUMMIT and FINEARTS-HF trials.

Diabetes 126
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When you have a ‘silent’ heart attack

Heart Sisters

"People often believe that their 'silent' heart attack is something else - like the flu or a pulled muscle. Much later, when they end up getting diagnosed with a heart attack that they didn't know they were having, they might recall an episode of feeling vaguely unwell." - Dr.

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Weight loss drug's heart benefits extend to people with heart failure

Science Daily - Heart Disease

The researchers looked at data from 4,286 people -- out of a total of 17,605 from the landmark Semaglutide and Cardiovascular Outcomes (SELECT) trial who were randomly assigned either semaglutide or a placebo -- who were followed up over an average of more than three years.

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Anterior OMI. What does the angiogram show?

Dr. Smith's ECG Blog

Written by Willy Frick A 50 year old man with no medical history presented with acute onset substernal chest pain. His ECG is shown below. Pretty obvious anterior current of injury. This was a machine read STEMI positive OMI. Readers of this blog can easily appreciate the hyperacute T waves in the precordium, clearest in V1-V4. What would you guess is the culprit artery?

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Physiology Friday #233: Exercise Makes Us More Stress-Resilient: Now We Know Why

Physiologically Speaking

Greetings! Welcome to the Physiology Friday newsletter. Thanks to the premium sponsor of this newsletter: FSTFUEL electrolyte supplement. FSTFUEL combines electrolytes with amino acids to help your body maintain hydration and optimal functioning during exercise or intermittent fasting, so you don't have to choose between fasting and fitness. It’s a zero-sugar electrolyte drink that tastes awesome.

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Dementia Risk Dropped With Anti-Inflammatory Diet for Certain Patients

Med Page Today

(MedPage Today) -- An anti-inflammatory diet was tied to a lower risk for dementia in people ages 60 and older with cardiometabolic diseases, U.K. Biobank data showed. Among people with cardiometabolic diseases including type 2 diabetes, heart.

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Fathers with Type 1 Diabetes May Be More Likely to Pass on Disease than Mothers

HCPLive

An analysis of more than 11,000 people with T1D found people were more likely to report an affected father than an affected mother.

Diabetes 124
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Digital Consults to Enhance Heart Failure Treatment: The ADMINISTER Trial

Cardiology Update

Despite proven benefits in reducing morbidity and mortality, many heart failure (HF) patients do not receive optimal guideline-directed medical therapy (GDMT). The 2021 European Society of Cardiology guidelines recommend guideline-directed medical therapy (GDMT) for patients with HF with reduced ejection fraction (HFrEF). This includes beta-blockers, ACE inhibitors, ARBs, ARNIs, MRAs, and SGLT2 inhibitors.

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Short, intense bursts of exercise more effective after stroke than steady, moderate exercise

Science Daily - Heart Disease

Significant improvements in aerobic fitness were noted after 12 weeks of high-intensity interval training sessions compared to traditional, moderate exercise sessions, according to a new study.

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What does this ECG show?

Dr. Smith's ECG Blog

Written by Pendell Meyers Try first to interpret the ECG without any clinical context: What do you think? Sinus rhythm with abnormal STE in V2-V6, and I, II, aVF. Reciprocal STD in aVR and V1. Most leads with STE have remarkably non-hyperacute, flat T waves. Most would say that there is Spodick's sign. The PR depression in II (and its reciprocal PR elevation in aVR) is probably beyond normal baseline values.

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Boston Children's performs elective partial heart transplant

Becker's Hospital Review - Cardiology

Discover the groundbreaking work of Boston Children's cardiac surgeons as they perform the first elective partial heart transplant on a 4-year-old boy