Friday, February 19, 2010

Cardiac CTCalcium

Taylor et al – PACC Study – JACC 2005 -2000 patients, mean age 43-Coronary calcium was associated with an 11.8-fold increased risk for incident coronary heart disease (CHD) (p  0.002) in a Cox model controlling for the Framingham risk score.-In young, asymptomatic men, the presence of coronary artery calcification provides substantial, cost-effective, independent prognostic value in predicting incident CHD that is incremental to measured...

TREATMENT OF HYPERTENSION

This chapter reviews the currently available classes of drugs used in the treatment of hypertension. To best appreciate the complexity of selecting an antihypertensive agent, an understanding of the pathophysiology of hypertension and the pharmacology of the various drug classes used to treat it is required. A thorough understanding of these mechanisms is necessary to appreciate more fully the workings of specific antihypertensive...

Simulation training Curriculum

Constrictive Pericarditis -64 year old female-1 Year s/p 3-vessel CABG -Presents with 6 months of progressive dyspnea and atypical chest pain -At angiography, all grafts are patent-Hemodynamics Restrictive Cardiomyopathy -43 year old female presented with predominant right heart failure (peripheral edema, ascites)-Hemodynamic tracings suggest constrictive-restrictive physiology-Exploratory thoracotomy excluded the presence of constrictive...

Sex and the Heart

When can I start having sex again? After myocardial infarction or CABGAfter angioplasty or stentAfter myocardial infarction or CABG--After 2-3 weeksAfter angioplasty or stent--After 2-3 days What about sex with my angina? If stable angina and-Can walk 1 mile in 20 minutes on the flat or-Can walk down 13 steps in 10 seconds Click here to read m...

ACC Heart Failure Guidelines

LIMITNG/CONTROLLING FACTORS IN THE MARINE ENVIRONMENT -OCEAN CURRENTS/CIRCULATION-TEMPERATURE-DEPTH-LIGHT-SALINITY-NUTRIENTS TEMPERATURE -Temperature as the most important abiotic factor in the environment for most marine organisms.-It regulates metabolism growth and reproduction-It limits geographic ranges and regulates interactions with other environmental variables. Click here to read more ...

Is Hyperdynamic Left Ventricular Ejection Fraction a Poor Prognostic Factor?

Background Left ventricular function is an important factor to predict mortality in patients. However it has not been well studied if hyperdynamic left ventricular ejection fraction has the same prognosis as normal left ventricular ejection fraction. MethodsWe studied 11469 patients undergoing exercise stress echocardiogram at Kansas university medical center.  Patients with EF (55%) were included in the study.  Click here to read...

Right heart hemodynamics

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Heart Anatomy and Physiology II

Heart Defects =Septal defect - condition in which there is an opening in the interatrial or interventricular septum, allowing improper movement of blood =Atrial defects allow blood to move from right to left, while ventricular defects allow blood to move from left to right  =Septal defects result in pulmonary hypertension, difficulty in breathing and fatigue=They can be fatal if left untreated in childhood  Click here to read...

Tuesday, February 16, 2010

How to perform and interpret an Exercise Test

Click here to view Slideshow Key Points of Exercise Testing -Manual SBP measurement (not automated) most important for safety-Adjust to clinical history (couch potatoes)-No Age predicted Heart Rate Targets-The BORG Scale of Perceived Exertion-METs not Minutes-Fit protocol to patient (RAMP)-Avoid HV and cool down walk-Use standard ECG analysis/ 3 minute recovery/ use scores-Heart rate recovery -Expired Gas Analysis? How to read an Exercise...

Hypertension: New Concepts, Guidelines, and Clinical Management

Click here to view Slideshow Laboratory Tests --Routine Tests -Electrocardiogram  -Urinalysis  -Blood glucose, and hematocrit  -Serum potassium, creatinine, or the corresponding estimated GFR,and calcium -Lipid profile, after 9- to 12-hour fast, that includes high-density and --low-density lipoprotein cholesterol, and triglycerides  --Optional tests -- Measurement of urinary albumin excretion or...

Monday, February 15, 2010

How to be a Successful Interventional Fellow

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