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FEATURED MULTIMEDIA

Women and Heart Disease: Incidence, Prevalence, Progress, and the Future
ConsultantLive.com,  April 5, 2013
The Mediterranean Diet in Primary Cardiovascular Prevention
ConsultantLive.com,  March 20, 2013
DPP-4 Antagonists: Benefits, Risks, and the Future
ConsultantLive.com,  February 25, 2013


 
CLINICAL TRIALS
Vascular Progenitor Cells in Chronic Obstructive Pulmonary Disease
pats.atsjournals.org - 11/2/11
Physicians' Health Study
www.clinicaltrials.gov - 10/26/99
Role of Chronic Kidney Disease in Cardiovascular Disease
www.clinicaltrials.gov -
 
NEWS
AAN: Head to Heart Risk Seen for Women (CME/CE)
www.medpagetoday.com - 3/22/13
Clinical Challenge: Managing Stable CAD
www.medpagetoday.com - 2/28/13
Mediterranean Diet Curtails Heart Troubles (CME/CE)
www.medpagetoday.com - 2/24/13
 
PATIENT RESOURCES
How Does Smoking Affect the Heart and Blood Vessels?
www.nhlbi.nih.gov - 3/25/13
What Are Overweight and Obesity?
www.nhlbi.nih.gov - 3/25/13
What Is Metabolic Syndrome?
www.nhlbi.nih.gov - 3/25/13
 
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Cardiovascular Diseases
 
CARDIOLOGY NOW
Cardiology Now is a series of short podcast discussions between Dr Payal Kohli of the University of California San Francisco and experts in cardiovascular medicine. Dr Kohli and guests provide concise perspective for primary care practice on what’s new in the prevention, assessment, and management of cardiovascular disease. More here…
 
FEATURED CONTENT

Resistant Hypertension: Four Pearls for Your Practice
April 4, 2011

A panel of experts presented a general strategy for evaluating patients with refractory hypertension, but ultimately cautioned the audience to assume non-compliance until proven otherwise.

Heart Failure With Preserved Ejection Fraction: Lessons From Three Cases
April 4, 2011

The 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 4, 2011

Diastolic 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 4, 2011

Systemic inflammation has been identified as a risk factor for the development of heart failure in population studies. In the five-year prospective MESA study, researchers from Johns Hopkins Hospital in Baltimore recorded a baseline non-specific marker of systemic inflammation, C-reactive protein (CRP).

Serial ProBNP Measurement: A Cutting-Edge Approach to Systolic Heart Failure
April 4, 2011

Researchers 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.

Watch It: More Screen Time Means Higher Risk of Cardiovascular Disease and Death
January 14, 2011

Sitting 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.

Ventricular Septal Defect Following Myocarditis
December 13, 2010

A 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.

ECG Challenge: Test Your Interpretive Skills
June 1, 2008

Right Bundle-Branch Block After Pacemaker Implantation
May 1, 2008

Image 1The morning after an 88-year-old woman with symptomatic second-degree type I (Wenckebach) atrioventricular block underwent placement of a dual chamber pacemaker without complication, she awoke with uncomfortable pulsations in her abdomen. The pacing thresholds and impedance had remained unchanged since implantation.

Treatment of Newly Diagnosed Hypertension: When Two Drugs Are Better Than One
April 15, 2008

Showing 31 - 40 of 47 results.
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RELATED ARTICLES

Scimitar Syndrome in Turner Syndrome
May 16, 2011

turner syndrome Scimitar

A 39 year-old female with Turner Syndrome completely asymptomatic in the previous years, presented to our department with recent onset of dizziness and fatigue.

Lemierre’s Syndrome
September 7, 2011

An 18-year-old woman with no known medical history presented to the ED complaining of fever, chills, and rigors of a week’s duration. The patient appeared very ill with hypotension, tachycardia, tachypnea, and fever.

Cardiovascular Diseases - Guidelines
July 29, 2011

What’s New in Hypertension? A Contemporary Primer
July 13, 2011

A recent commentary of mine regarding hypertension was entitled, “Are Prescribing Practices for Antihypertensives Primitive? The Truth Hurts."

Takotsubo Cardiomyopathy in a Man With a Gunshot Wound
May 16, 2011

A 48-year-old African-American man with no significant medical history sustained a gunshot wound to the face and shoulder.

 
MEDLINE
Metabolomics and ischaemic heart disease.
pubmed.gov - 2/28/13
Ischaemic heart disease accounts for nearly half of the global cardiovascular disease burden. Aetiologies relating to heart disease are complex, but dyslipidaemia, oxidative stress and inflammation are cardinal features. Despite preventative measures and advancements in treatment regimens with lipid-lowering agents, the high prevalence of heart disease and the residual risk of recurrent events continue to be a significant burden to the health sector and to the affected individuals and their families. The development of improved risk models for the early detection and prevention of cardiovascular events in addition to new therapeutic strategies to address this residual risk are required if we are to continue to make inroads into this most prevalent of diseases. Metabolomics and lipidomics are modern disciplines that characterize the metabolite and lipid complement respectively, of a given system. Their application to ischaemic heart disease has demonstrated utilities in population
Mitochondrial reactive oxygen species enhance AMP-activated protein kinase activation in the endothelium of patients with coronary artery disease and diabetes.
pubmed.gov - 2/28/13
The aim of the present study was to determine whether the endothelial dysfunction associated with CAD (coronary artery disease) and T2D (Type 2 diabetes mellitus) is concomitant with elevated mtROS (mitochondrial reactive oxygen species) production in the endothelium and establish if this, in turn, regulates the activity of endothelial AMPK (AMP-activated protein kinase). We investigated endothelial function, mtROS production and AMPK activation in saphenous veins from patients with advanced CAD. Endothelium-dependent vasodilation was impaired in patients with CAD and T2D relative to those with CAD alone. Levels of mitochondrial H(2)O(2) and activity of AMPK were significantly elevated in primary HSVECs (human saphenous vein endothelial cells) from patients with CAD and T2D compared with those from patients with CAD alone. Incubation with the mitochondria-targeted antioxidant, MitoQ(10) significantly reduced AMPK activity in HSVECs from patients with CAD and T2D but not in cells from
An analysis of the causes of compressed-gas diving fatalities in Australia from 1972-2005.
pubmed.gov - 2/11/13
In order to investigate causative factors, root cause analysis (RCA) was applied to 351 Australian compressed-gas diving fatalities from 1972-2005. Each case was described by four sequential events (trigger, disabling agent, disabling injury, cause of death) that were assessed for frequency, trends, and dive and diver characteristics. The average age increased by 16 years, with women three years younger than men annually. For the entire 34-year period, the principal disabling injuries were asphyxia (49%), cerebral arterial gas embolism (CAGE; 25%), and cardiac (19%). There was evidence of a long-term decline in the rate of asphyxia and a long-term increase in CAGE and cardiac disabling injuries. Asphyxia was associated with rough water, buoyancy trouble, equipment trouble, and gas supply trouble. CAGE was associated with gas supply trouble and ascent trouble, while cardiac cases were associated with exertion, cardiovascular disease, and greater age. Exertion was more common in younger
Interactive effects of fitness and statin treatment on mortality risk in veterans with dyslipidaemia: a cohort study.
pubmed.gov - 2/1/13
Statins are commonly prescribed for management of dyslipidaemia and cardiovascular disease. Increased fitness is also associated with low mortality and is recommended as an essential part of promoting health. However, little information exists about the combined effects of fitness and statin treatment on all-cause mortality. We assessed the combined effects of statin treatment and fitness on all-cause mortality risk.|In this prospective cohort study, we included dyslipidaemic veterans from Veterans Affairs Medical Centers in Palo Alto, CA, and Washington DC, USA, who had had an exercise tolerance test between 1986, and 2011. We assigned participants to one of four fitness categories based on peak metabolic equivalents (MET) achieved during exercise test and eight categories based on fitness status and statin treatment. The primary endpoint was all-cause mortality adjusted for age, body-mass index, ethnic origin, sex, history of cardiovascular disease, cardiovascular drugs, and
Facial appearance reflects human familial longevity and cardiovascular disease risk in healthy individuals.
pubmed.gov - 1/31/13
As facial appearance can be readily quantified and skin tissue easily accessed, they could be valuable tools for determining how biological mechanisms influence tissue degeneration with age and, consequently, human health and lifespan. It is unknown, however, whether appearance reflects disease risk or lifespan independently of factors already known to associate with both health and appearance.|In a cross-sectional study, we compared the amount of skin wrinkling on a sun-protected site (upper inner arm) and the facial appearance of 261 offspring (mean age 63.2 y) of nonagenarian siblings with 253 age-matched controls (mean age 62.7 y), all with no reported disease history. We next examined whether any appearance features that significantly associated with familial longevity also associated with the Framingham cardiovascular disease (CVD) risk score. All analyses were adjusted for chronological age, smoking, photodamage, and body mass index.|Female and male offspring had reduced upper
 
PRACTICE GUIDELINES

Atherosclerotic Cardiovascular Disease Screening in Adults
American College of Preventive Medicine
Mar 2011

Assessment of Cardiovascular Risk in Asymptomatic Adults
American College of Cardiology Foundation/American Heart Association
Dec 2010

Guideline synthesis: Diagnosis and Evaluation of Chronic Heart Failure
US National Guideline Clearinghouse
Dec 2010

Hypertension Diagnosis and Treatment
Institute for Clinical Systems Improvement (ICSI)
Nov 2010

Evaluation of patients for ventricular dysfunction and heart failure: HFSA 2010 comprehensive heart failure practice guideline
Heart Failure Society of America
June 2010

Chest pain of recent onset: assessment and diagnosis of recent onset chest pain or discomfort of suspected cardiac origin
National Institute for Health and Clinical Excellence (UK)
Mar 2010


 



 
FROM PHYSICIANS PRACTICE
Five Steps to Improving Patient Access
Judy Capko,  May 21, 2013
Patient access is getting increased attention through reform initiatives. Here are five steps you can take to make sure patients get appropriate access to care in your office.
Growing HIPAA Threat – Ignore Windows XP at Your Own Peril
Marion K. Jenkins,  May 21, 2013
Chances are good that you have some major ticking software time bombs lurking in your medical practice's computer environment, namely Windows XP and Server 2003.
Finding Physician Work-Life Balance in the Small Moments
Jennifer Frank, MD,  May 21, 2013
At my practice and at home, things are always busy. There's laundry or homework, or a patient with needs.
Three Areas to Reduce Costs at Your Medical Practice
Greg Mertz,  May 19, 2013
By taking a hard look at reducing costs for staffing, overhead, and technology at your medical practice, you may see increased physician compensation.
Dos and Don’ts for Starting a Physician Blog
Michael Woo-Ming, MD,  May 18, 2013
Starting a physician blog can provide your medical practice with marketing benefits, but it's important to do it right.
 

 
 
COMMENTS


 
JOURNAL SCAN
Low-dose aspirin is associated with an increased risk of haemorrhage; but not in people with diabetes who have a high baseline rate of bleeding
ebn.bmj.com - 3/7/13

Commentary on: De Berardis G, Lucisano G, D'Ettorre A, et al. Association of aspirin use with major bleeding in patients with and without diabetes. JAMA 2012;307:2286–94.

Implications for practice and research

  • Low-dose aspirin (≤300 mg/day) increases the risk of major bleeding.

  • Individuals with diabetes have a higher risk of bleeding independent of aspirin exposure.

  • Future work shou

    • A depression screening tool finds that 54% of acute cardiac patients are at risk of depression; use of the tool improves documentation and referral
    ebn.bmj.com - 3/7/13

    Commentary on: Ski CF, Page K, Thompson DR, et al. Clinical outcomes associated with screening and referral for depression in an acute cardiac ward. J Clin Nurs 2012;21:2228–34.

    Implications for practice and research

  • This study found that nurses on cardiovascular care units were able to administer depression screening tools and document referral activities for positive screens.

  • It is not known whethe

    • General health checks may not reduce morbidity or mortality but do increase the number of new diagnoses
    ebn.bmj.com - 1/23/13

    Commentary on: KrogsbøllLTJørgensenKJGrønhøjLarsen C. General health checks in adults for reducing morbidity and mortality from disease. Cochrane Database Syst Rev 2012;10:CD009009.

    Implications for practice and research

  • General health checks aim to detect risk factors

    • Ideal cardiovascular health in adolescence is associated with reduced risks of hypertension, metabolic syndrome and high cholesterol in adulthood
    ebn.bmj.com - 12/3/12

    Commentary on: Laitinen TT, Pahkala K, Magnussen CG, et al. Ideal cardiovascular health in childhood and cardiometabolic outcomes in adulthood: the Cardiovascular Risk in Young Finns Study. Circulation 2012;125:1971–8.

    Implications for practice and research

  • Ideal cardiovascular health in childhood is important to prevent adverse cardiometabolic outcomes in adulthood.

  • Clinical-based and population-bas

    • Greater intake of Western fast food among Singaporean adults is associated with increased risk of diabetes and heart-disease-related death
    ebn.bmj.com - 12/3/12

    Commentary on: Odegaard AO, Koh WP, Yuan JM, et al.. Western-style fast food intake and cardiometabolic risk in an eastern country. <I>Circulation</I> 2012;126:182–8.

    Implications for practice and research

  • Adverse associations between fast food consumption and cardiovascula

    		•