August, 2024

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ECG Blog #445 — VT or LBBB?

Ken Grauer, MD

The ECG in Figure-1 was obtained from an 80-year old woman — who presented to the ED ( E mergency D epartment ) — with a several hour history of "palpitations" and CP ( C hest P ain ). She was hemodynamically stable at the time ECG #1 was recorded. QUESTIONS: The ECG in Figure-1 was seen by a number of physicians — the majority of whom thought the rhythm was some form of SVT ( S upra V entricular T achycardia ) with LBBB ( L eft B undle B ranch B lock ) aberration.

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Wegovy Protects Against Deadly COVID Cases

Med Page Today

(MedPage Today) -- LONDON -- The clinical benefits of semaglutide (Wegovy) went beyond expectations in the SELECT trial, given the reductions in non-cardiovascular and infectious disease deaths observed. Among people with overweight or obesity.

Obesity 142
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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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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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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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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 130
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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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More Trending

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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.

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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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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 124
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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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These areas have the US' highest cardiac death rate

Becker's Hospital Review - Cardiology

High-poverty rural regions in the Southern U.S. have the highest cardiovascular disease-associated death rate, according to a report published Aug. 16 in the Journal of Rural Health.

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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.

Hospital 142
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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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FDA Approves Epinephrine Nasal Spray for Emergency Treatment of Allergic Reactions

HCPLive

The FDA approved epinephrine nasal spray (Neffy) for the emergency treatment of allergic reactions, including anaphylaxis, in adult and pediatric patients who weigh at least 30 kg.

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Study shows reduced inflammation in residents after adding trees to their neighborhoods

Science Daily - Heart Disease

A new project has found that people living in neighborhoods where the number of trees and shrubs was more than doubled showed lower levels of a blood marker of inflammation than those living outside the planted areas. General inflammation is an important risk indicator for heart disease and other chronic diseases.

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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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GLP-1s reduce cardiovascular mortality: Study

Becker's Hospital Review - Cardiology

GLP-1s reduced mortality and complications from cardiovascular events, according to a study published Aug. 22 in Diabetes, Obesity and Metabolism: A Journal of Pharmacology and Therapeutics.

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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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AI tools help uncover connections between radiotherapy for lung cancer and heart complications

Medical Xpress - Cardiology

Researchers from Brigham and Women's Hospital have used artificial intelligence tools to accelerate the understanding of the risk of specific cardiac arrhythmias when various parts of the heart are exposed to different thresholds of radiation as part of a treatment plan for lung cancer.

Cancer 111
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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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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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Detecting heart stress using NT-proBNP in patients with type 2 diabetes mellitus and hypertension or high-normal blood pressure: a cross-sectional multicentric study

Cardiovascular Diabetology

We evaluated the prevalence of “heart stress” (HS) based on NT-proBNP cut-points proposed by the 2023 Consensus of the Heart Failure Association (HFA) of the European Society of Cardiology (ESC) in asymptomati.

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Benzodiazepine linked to increased cardiovascular disease risk: Study

Becker's Hospital Review - Cardiology

Benzodiazepine class insomnia drugs were associated with an increased risk of cardiovascular disease, according to a study published Aug. 7 in the European Journal of Preventive Cardiology.

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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.

Dementia 145
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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.

Research 103
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Topical Roflumilast 0.3% Superior to Vehicle in Treating Plaque Psoriasis

HCPLive

In this systematic review and meta-analysis, the investigators highlighted topical roflumilast’s success in clinical milestones such as IGA and PASI score success.

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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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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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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

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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.

Medicare 142
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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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Medicaid Enrollees Struggle to Receive Psychiatric Care

HCPLive

In a "secret shopper" study, investigators posing as Medicaid enrollees found many clinicians in Medicaid provider directories do not accept Medicaid insurance.

Medicaid 122
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Connections between obesity and heart failure

Science Daily - Heart Disease

A new small study has revealed the impact of obesity on muscle structure in patients having a form of heart failure called heart failure with a preserved ejection fraction (HFpEF).

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Interactions between the gut microbiome, associated metabolites and the manifestation and progression of heart failure with preserved ejection fraction in ZSF1 rats

Cardiovascular Diabetology

Heart failure with preserved ejection fraction (HFpEF) is associated with systemic inflammation, obesity, metabolic syndrome, and gut microbiome changes. Increased trimethylamine-N-oxide (TMAO) levels are pred.

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Androgen aggravates aortic aneurysms via suppression of PD-1 in mice

Journal of Clinical Investigation - Cardiology

Androgen has long been recognized for its pivotal role in the sexual dimorphism of cardiovascular diseases, including aortic aneurysms (AAs), a devastating vascular disease with a higher prevalence and fatality rate in men than in women. However, the mechanism by which androgen mediates AAs is largely unknown. Here, we found that male, not female, mice developed AAs when exposed to aldosterone and high salt (Aldo-salt).

Aneurysm 104
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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.

Dementia 135