NICE draft guidelines for AF
The NICE guidelines for AF are now in draft form and recommend systematic use of a thromboembolic risk and bleeding score (as per the BMJ cardiovascular team of the year 2013!) and also suggest that the novel oral anticoagulants be considered first line together with warfarin. The first seems sensible and timely but what about the second?
sadian (Source: Doc2Doc BMJ Cardiology)
Source: Doc2Doc BMJ Cardiology - January 25, 2014 Category: Cardiology Authors: sadian Source Type: forums
indapamide and blood pressure
I was reading the summary sheet for indapamide 2.5mg and it states that words to the effect
- there are a number of studies that show that indapamide is effective in reducing systolic blood pressure particularly in older patient groups.
Do you believe this or is the observed effect an age related phenomenon of arterial stiffness as we get older?
sadian (Source: Doc2Doc BMJ Cardiology)
Source: Doc2Doc BMJ Cardiology - January 24, 2014 Category: Cardiology Authors: sadian Source Type: forums
Can I please get guidance with these ECGs?
A case Study
Dear Fellow medical students,
I would like some help reading these ECG: they are for a 62 yrs old male patient with high blood pressure, high choletrol and COPD. he gets chest pain and pain down his left shoulder when he does activities and the pain stops when he stops exertion.
the first one is resting ecg:
the second ecg is recorded during exercise testing . the patient had central chest pain and had to stop.
what are key feature can you pick from the resting ECG?
for the exercise ECg, i am suspecting acute lateral myocardial ischemia.Can you please confirm ?
Thank you
&n...
Source: Doc2Doc BMJ Cardiology - January 23, 2014 Category: Cardiology Authors: nazek Source Type: forums
My first ECGs to interpret!HELP ME!:)
Dear Fellow medical students,
I would like some help reading these ECGs: they are for a 62 yrs old male patient with high blood pressure, high choletrol and COPD. he gets chest pain and pain down his left shoulder when he does activities and the pain stops when he stops exertion.
the first one is resting ecg:
the second ecg is recorded during exercise testing . the patient had central chest pain and had to stop.
what are key feature can you pick from the resting ECG?it shows leads I, II, III, aVR, aVL and aVF.
for the exercise ECg, i am suspecting acute lateral myocardial ischemia.Can you please confirm ?
Th...
Source: Doc2Doc BMJ Cardiology - January 23, 2014 Category: Cardiology Authors: nazek Source Type: forums
dietary fibre and cardiovascular disease?
I've just been skim reading the article in the print journal this week re dietar fibre and reduced risk of CV disease. I can't help thinking that dietart fibre intake is a marker of a heart healthier lifestyle overall - or maybe we should just add fibre to processed food? What do you think?
sadian (Source: Doc2Doc BMJ Cardiology)
Source: Doc2Doc BMJ Cardiology - January 20, 2014 Category: Cardiology Authors: sadian Source Type: forums
can you help me diagnose this 36 year old lady?
I saw a lady for follow-up yesterday
the cardiac issue seems straightforward- sudden onset rapid palpitations with a fast rate very much in keeping with an SVT. 12 lead ecg and echo are normal and on an event recorder typically there was one Ve (she hasn't had symptoms recently)
Along the way she mentioned itchy facial swelling, throat tingling and some nonspecific abdo pain - She is well otherwise and has no rashes and no urticaria . I wondered about angioedema
any other thoughts re a unfiying diagnosis gratedfully received!
thank you
sadian (Source: Doc2Doc BMJ Cardiology)
Source: Doc2Doc BMJ Cardiology - January 16, 2014 Category: Cardiology Authors: sadian Source Type: forums
Insulin resistance and the metabolic syndrome is "just a way of calling people fat, isn’t it?”
Conclusions and Relevance: These findings suggest that overweight and obesity are risk factors for MI and IHD regardless of the presence or absence of metabolic syndrome and that metabolic syndrome is no more valuable than BMI in identifying individuals at risk.” (Source: Doc2Doc BMJ Cardiology)
Source: Doc2Doc BMJ Cardiology - January 14, 2014 Category: Cardiology Authors: Richard Lehman Source Type: forums
can you look at this ecg?
of this lady who is now 33 weeks pregnant - she lost consciousness 3 weeks ago. What do you think? (Source: Doc2Doc BMJ Cardiology)
Source: Doc2Doc BMJ Cardiology - January 3, 2014 Category: Cardiology Authors: sadian Source Type: forums
doc2doc podcast: Cardiovascular Team of the Year BMJ Awards 2013
Hi everyone
Just managed to get the embed function fixed on doc2doc and have uploaded a podcast I did a couple of months ago with Professor Lip who was part of the team who won Cardiovascular Team of the Year at the BMJ Awards in 2013. He talked to me about the HasBled risk score which helps assess stroke and bleeding risk for patients with Atrial Fibrillation.
(Source: Doc2Doc BMJ Cardiology)
Source: Doc2Doc BMJ Cardiology - January 2, 2014 Category: Cardiology Authors: mbillingsley Source Type: forums
Biochemical Angioplasty(BCA) and Enhanced External counterpulsation therapy (EECP)
I wanted to know the benifits and outcome of Biochemical Angioplasty(BCA) and Enhanced External counterpulsation therapy (EECP) over CABG. Is this superior to CABG? (Source: Doc2Doc BMJ Cardiology)
Source: Doc2Doc BMJ Cardiology - December 23, 2013 Category: Cardiology Authors: Dr. Krishna Source Type: forums
22 year old female patient with mysterious symptoms
Hello all.
I have a 22 year old female european patient with mysterious symptoms. Just over a year she underwent coronary angiography, but no diagnosis. She became seriously ill at age 16 and complaints of heart problems. The female patient with childhood lagging behind in physical development (155 cm, 35 kg). With 11 years of she has supraventricular tachycardia.
Symptoms:
High blood pressure (high diastolic BP or systolic and diastolic): 110/90 - 160/100.
Chest pain (left side and sternum)
Pain in lower left jaw and sometimes in right lower jaw (Provocative factors: cold and...
Source: Doc2Doc BMJ Cardiology - December 20, 2013 Category: Cardiology Authors: Gisela Krause Source Type: forums
Post-op AF and anticoagulation
We frequently come across cases of post-op AF, where the stroke risk assessment renders the patient candidate for long term anticoagulation. Would you start anticoagulation in these patients or just treat them with beta-blockers and follow them up in primary care? Many thanks (Source: Doc2Doc BMJ Cardiology)
Source: Doc2Doc BMJ Cardiology - December 19, 2013 Category: Cardiology Authors: DrDi Source Type: forums
top cardiology discussions of 2013
As clinical champion in cardiology it is my pleasure to kick off the review of the cardiology forum in 2013.
Here are my top picks
What would you do for this diabetic with these ABPM results- who would have thought that the treatment of hypertension could get so complicated this year? It gets my number one slot as it's a very wide ranging discussion questioning what we really know, what we believe and what the evidence tells us. Strikes a chord with the 'too much medicine' theme of the year
My number two slot goes to can you diagnose aortic stenosis - this must be the commonest valve lesion we see i...
Source: Doc2Doc BMJ Cardiology - December 17, 2013 Category: Cardiology Authors: sadian Source Type: forums
what to do next for this man?
A colleague rang me this morning about a 65 year old man.
background ischaemic cardiomyopathy -angio last week no targets for revascularisation
suitable for a bivent ICD as EF 25% and has lbbb on ecg
worsening heart failure - put on 3kg over past 24 hours on furosemide 80mg / 40 mg iv, spironolactone 25mg, ramipril 2.5mg and bisoprolol 5mg
BP 120 systolic, creatinine 110 , sodium now 122 (was normal 1 week ago)
what would you do next?
sadian (Source: Doc2Doc BMJ Cardiology)
Source: Doc2Doc BMJ Cardiology - December 16, 2013 Category: Cardiology Authors: sadian Source Type: forums
Would you ask for bivalirudin in the ambulance on the way to the catheter lab for PCI?
IfI had a heart attack I would have only the faintest idea what my options really were and what their relative harms and merits might be. Perhaps as I was sucking on my aspirin tablet, I might ask the paramedic to leave the blood pressure cuff inflated for about five minutes to achieve a bit of ischaemic preconditioning. I might call for a tot of cardioprotective brandy: they say it goes well with diamorphine. Has anyone done a trial of oral alcohol for acute MI? I suppose I would let the ambulance take me to the nearest catheter lab for PCI, although more than an hour might elapse before I even reached the hospital ...
Source: Doc2Doc BMJ Cardiology - December 11, 2013 Category: Cardiology Authors: Richard Lehman Source Type: forums
