Cardiology

A little bit of knowledge can be a dangerous thing, and I am proof. There is a lot more to the saga and much of the information is essential to decision making in primary care practice on whether or not testosterone replacement is indicated.

Multiple itchy red bumps on a man’s ankles; relative contraindications to lumbar puncture; stroke in an addict. . . 5 more questions for you to test the breadth of your clinical knowledge.

ECG findings that are specific for high-grade stenosis of the proximal left anterior descending (LAD) coronary artery.

Epigastric pain after meals occurs in the absence of physical or laboratory abnormalities in a 66-year-old woman slated for surgery.

Persons with type 2 diabetes are at risk for asymptomatic atrial fibrillation and subsequent cerebrovascular events.

Undiagnosed AF was discovered in 3% of individuals; 2% of individuals with known AF who were not on oral anticoagulation were also identified.

Pulmonary vein ablation has not gained recognition as a "cure" for atrial fibrillation so a new approach would be welcomed.

Heatstroke is a true medical emergency with associated mortality rates close to 12% in adults as high as 80% in untreated patients.

Statins used for primary prevention in elderly patients result in a significant reduction in MI and stroke.

Influenza infection may contribute to increases in cardiovascular hospitalizations and elevated rates of acute myocardial infarction (MI).

Patients with mechanical heart valves are not candidates for dabigatran; excess bleeding curtailed the first study to test it.

Skin eruptions, MS risk, and a pain in the back: 5 new questions-your Dxs?

Reassess rate vs rhythym control, appropriate anticoagulation therapy and potential drug-drug interactions.

Novel oral anticoagulants vary in bioavailability when taken with or without food.

Every physician knows that a “magic pill” that would safely and effectively prevent dementia has eluded the multiple and expensive efforts of the world’s greatest pharmaceutical companies. A new study offers a ray of hope on this front.

Smoking can increase cholesterol, triglycerides, and LDL while decreasing HDL.

Artificial sweeteners are associated with both weight gain and weight loss and a counterintuitive effect on human physiology.

PCI is not recommended for asymptomatic adults who are highly functional and report no exercise-induced symptoms.

Bleeding risk is increased in patients receiving oral anticoagulation and concomitant aspirin.

Feeling cheerful, relaxed, energetic, and satisfied with life can reduce the chances of a myocardial infarction in patients who have early-onset coronary artery disease.

Incidence of CHD was more than double in twins diagnosed with PTSD than those without the disorder.

All-cause mortality was 80% lower among subjects who maintained normal weight, ate moderately, exercised, and did not smoke compared with those who followed none of these habits.

Oral apixaban for acute VTE was superior to enoxaparin followed by warfarin.

Novel anticoagulants have a half life much shorter than warfarin and so adherence and medication error are significant issues.

Oral anticoagulation with rivaroxaban must continue while initiating a switch to warfarin. Duration of overlap will be variable.

The “infectious” hypothesis of atherosclerosis (including bacterial and viral etiologies) may have new support.

New oral anticoagulants require careful initiation and follow-up. A new guide is offered by the European Heart Rhythm Association.

HAS-BLED, HEMORRHAGES, OBRI: Risk calculators to assess potential for bleeding in AF patients before anticoagulation.

Periprocedural dabigatran increases the risk of bleeding and thromboembolic complications compared with warfarin during radiofrequency ablation of AF.

Among the NSAIDs used for relieving the pain of inflammatory arthritis, naproxen may have the best benefit to risk ratio on cardiovascular disease.