April 1st 2025
Semaglutide 2.4 mg significantly lowered the risk of MACE and mortality in patients with ASCVD and overweight or obesity but without diabetes, researchers reported.
Regular Exercise in Middle Age Can Build Heart Muscle
April 8th 2011Exercising at least 4 times a week can increase left ventricular mass and preserve elasticity, thereby reducing the risk of diastolic heart failure. Researchers from Texas presented their study results at the American College of Cardiology’s 60th Annual Scientific Session.
Shorter Antiplatelet Regimen Sufficient After Stenting
April 8th 2011What is the optimal duration for antiplatelet therapy after placement of drug-eluting stents? Initial results of the EXCELLENT study show that 6 months of antiplatelet therapy is as effective as the 12-month regimen recommended by current guidelines.
Chronic Heart Failure Outcomes Not Improved by NT-proBNP-Guided Treatment
April 6th 2011A Danish study found no clinical benefit from using NT-proBNP (b-type natriuretic peptide) to identify and monitor high-risk patients with chronic heart failure, according to research from the NorthStar study presented at the American College of Cardiology’s 60th Annual Scientific Session in New Orleans.
CABG Bests Medical Therapy in Ischemic Heart Failure
April 6th 2011Compared with medical therapy alone, coronary artery bypass grafting (CABG) significantly reduced cardiovascular deaths and the composite end point of all-cause deaths and cardiovascular-related hospitalizations, reported investigators from the Surgical Treatment of Ischemic Heart Failure (STICH) trial. However, the effect of the two management strategies on overall survival in patients with ischemic heart failure was similar.
What’s the Evidence Behind Updated ACC/AHA Guidelines on Unstable Angina/Non-STEMI?
April 5th 2011Recently, the American College of Cardiology (ACC) and the American Heart Association (AHA) released a focused update to the 2007 guidelines for the management of patients with unstable angina (UA)/non-ST-elevation myocardial infarction (non-STEMI).
Heart Failure With Preserved Ejection Fraction: Lessons From Three Cases
April 4th 2011The panel presented three challenging cases of heart failure with preserved ejection fraction (HFPEF) (see Update on Diastolic Heart Failure). In an innovative twist, the panel solicited feedback from a standing-room-only audience through SmartPhone technology-attendees voted for their favored diagnostic approach, therapy, or final diagnosis, with voting results instantly integrated into the presenter’s Powerpoint display.
Update on Diastolic Heart Failure-and Implications for Primary Care
April 4th 2011Diastolic heart failure (or HFPEF-heart failure with preserved ejection fraction) is characterized by inadequate myocardial relaxation and diastolic filling ("stiff ventricle"), with heart failure signs and symptoms despite normal ejection fraction. The most common cause is long-standing hypertension.
Elevated C-Reactive Protein Predicts Myocardial Deterioration
April 4th 2011Systemic inflammation has been identified as a risk factor for the development of heart failure in population studies. In the 5-year prospective MESA study, researchers from Johns Hopkins Hospital in Baltimore recorded a baseline nonspecific marker of systemic inflammation, C-reactive protein (CRP).
Serial ProBNP Measurement: A Cutting-Edge Approach to Systolic Heart Failure
April 4th 2011Researchers from Massachusetts General Hospital in Boston presented results from the PROTECT (ProBNP Outpatient Tailored Chronic Heart Failure) study. NT-proBNP (b-type natriuretic peptide) is a biomarker released from myocardial tissue in response to high levels of wall stretch and has been studied as a marker for decompensated systolic heart failure.
Myth or Evidence-Based Reality:Do Patent Foramen Ovales Lead to Cryptogenic Strokes?
March 10th 2011On December 18, 2005, Ariel Sharon, Prime Minister of Israel, experienced the sudden onset of aphasia. Despite being overweight, he had none of the traditional risk factors for cerebrovascular disease-hypertension, history of smoking, diabetes, or elevated cholesterol levels.
Bystander Cardiac Arrest in a Restaurant: Some Physician Reflections
February 24th 2011Recently, my wife and I received a gift certificate for one of our favorite restaurants, and we wasted no time in using it. The food and conversation were delightful, and the meal turned out to be exciting and enlightening on many levels. A patron of the restaurant, who was celebrating his 55th wedding anniversary, sustained a witnessed, public cardiac arrest. The experience led to an analysis of my involvement in the resuscitation.
Don’t Leave Home Without It: Chewable Aspirin and Ischemic Coronary Disease
February 18th 2011Analysis of a number of studies led to a practical suggestion: persons at known risk for myocardial infarction (MI) as well as older adults should carry a few tablets of soluble aspirin with them at all times, and they should chew and swallow the tablets in the event of chest pain-the earlier the better.
Watch It: More Screen Time Means Higher Risk of Cardiovascular Disease and Death
January 15th 2011Sitting in front of a TV or computer for long periods can raise the risk of cardiovascular disease and death, reported investigators recently in the Journal of the American College of Cardiology. The risk does not appear to be offset by physical activity.
Are Liver Tests Now “Irrelevant” When Prescribing Statins?
January 12th 2011Yes, ACE inhibitors should be used with caution in patients with acute renal injury and high-grade renal vascular lesions, but these drugs are designed to help, not hurt kidneys. Now fast forward to another caveat: avoid or discontinue statins in patients who have elevated liver enzyme levels. Get ready for a therapeutic paradigm shift.
Ventricular Septal Defect Following Myocarditis
December 14th 2010A previously healthy 55-year-old woman complained of fever, weakness, and generalized malaise for the past 3 to 4 weeks. She had been treated with ciprofloxacin, amoxicillin, and azithromycin for 21 days with no resolution of her symptoms. Five days before she was hospitalized, multiple nonspecific constitutional complaints developed.
Inferior Myocardial Infarction With Right Ventricular Involvement
September 9th 2010Right Ventricular involvement in acute inferior MI is an independent predictor of major complications and in-hospital death, as this case demonstrates. While in-hospital prognosis after left ventricular infarction is directly related to the postinfarct LV ejection fraction, involvement of the right ventricle drastically alters that linear relationship.
Young Woman With Isolated Episode of Burning Chest Pain
August 4th 2010A 23-year-old woman presents to the emergency department (ED) with left-sided burning chest pain that radiates to the epigastrium. The pain, which woke her from sleep 12 hours earlier, is intermittent and is not associated with eating or exertion. She had a single bout of nausea and emesis.
Older Man With Atrial Fibrillation
August 4th 2010A new patient with a history of atrial fibrillation (AF) and heart failure presents for an initial visit. The 72-year-old man denies exertional chest pain and paroxysmal nocturnal dyspnea. He is able to perform all his routine daily activities and can even climb 2 flights of stairs without dyspnea-although with more vigorous effort, he does become short of breath. He occasionally experiences pedal edema at the end of the day, but the condition resolves by morning.
Unilateral Superficial Venous Thrombosis
February 17th 2010Up to 40% of patients who present with what may look like simple, isolated superficial venous thrombosis have concomitant deep venous thrombosis. This finding has led clinicians to first rule out DVT bilaterally via compression Doppler ultrasonography before treatment is considered.
Too Much for the Computer: Complete Heart Block in an Elderly Woman
February 16th 2010A 92-year-old woman presented with signs and symptoms of heart failure, including marked bilateral lower extremity edema, jugular vein distention, and difficulty in breathing at rest. Her medical history was significant for hyperthyroidism, chronic asthmatic bronchitis, and senile dementia. Medications included oral methimazole, 10 mg/d, and oral theophylline, 200 mg/d.
Diabetes and Cardiovascular Disease: Does Lowering Hemoglobin A1c Help or Harm?
November 3rd 2009Case 1: Mr A. is a 55-year-old man who comes to your office for a routine physical examination. He is a traveling salesman and has recently gained weight. He does not exercise much and is a frequent visitor to fastfood establishments. His father had “a touch of diabetes” and died of a myocardial infarction (MI) at age 59.