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MyocardialInfarction

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An elderly woman with chest pain and constipation

An 89 year old woman with chronic obstructive pulmonary disease presented to the emergency department with worsening shortness of breath (87% oxygen saturation in room air), retrosternal chest pain, mild abdominal pain, and subacute partial bowel obstruction over the past six days. On physical examination she was dehydrated and she had tachycardia (105 beats/min), diffusely decreased breath sounds, audible crackles at the base of the right lung, and absent breath sounds on the left side pulmonary base. Her abdomen was distended but soft overall, the epigastrium and right hypochondium were slightly tender on deep palpation, and her rectum was empty. Her blood pressure was 130/85 mm Hg. Electrocardiography and troponin (measured at admittance and checked again after six and 12 hours) excluded myocardial infarction. Laboratory studies were unremarkable except for a mild microcytic anaemia (haemoglobin 115 g/L (reference range 120-160), mean cell volume 78.6 fL (80-96). Urgent chest radiography was requested (fig 1⇓).  
feeds.bmj.com
about 5 years ago
Www.bmj
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An elderly woman with postprandial abdominal pain

An 84 year old woman presented with a five month history of central, recurrent, severe epigastric pain, which occurred about 20 minutes after eating. This was associated with nausea, occasional diarrhoea, and vomiting. She had experienced early satiety and weight loss over the last few months. Her medical history included myocardial infarction two years earlier. She also had a 40 pack year history of smoking. On examination, she was cachectic, but physical examination and digital rectal examination were otherwise unremarkable. Blood tests—including full blood count, liver functions tests, amylase, and renal function—were normal. Chest and abdominal radiographs, abdominal ultrasound, and computed tomography of the abdomen were unremarkable. Computed tomography angiography was performed (fig 1⇓).  
feeds.bmj.com
about 5 years ago
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Involving patients in enrolment decisions for acute myocardial infarction trials

Seriously ill patients requiring emergency treatment are unlikely to be able to give full informed consent for a clinical trial, but Neal W Dickert and Franklin G Miller argue that this does not mean that they shouldn’t be involved in enrolment decisions at all  
feeds.bmj.com
about 5 years ago
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125

Diagnostic ECG—The 12-Lead (Clinical Essentials) (Paramedic Care) Part 4

Electrocardiographic Diagnosis of Acute Myocardial Infarction To make an electrocardiographic diagnosis of acute myo-cardial infarction, the Paramedic looks for hyperacute T waves, T wave inversions, ST-segment depressions, and ST-segment elevations as well as Q waves in all leads. When a […]  
what-when-how.com
about 5 years ago
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ESC Congress 2015 Hot Lines to reveal the latest in CVD research

Six hot line sessions at ESC Congress 2015 are set to reveal the latest in cardiovascular disease research across a range of conditions and comorbidities. Hot topics include atrial fibrillation, pacing, acute myocardial infarction, heart failure, hypertension, diabetes mellitus, pharmacology and coronary artery disease.  
escardio.org
about 5 years ago
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Preventing Atrial Fibrillation - Consult QD

Atrial fibrillation (AF) affects more than 33 million individuals worldwide. In the United States and other industrial nations, the lifetime risk of developing AF is one in four from the age of 40. AF increases stroke risk fivefold, and there is also a twofold increased risk of dementia and increased risks of myocardial infarction (MI), heart failure and death.  
consultqd.clevelandclinic.org
about 5 years ago
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Preventing Atrial Fibrillation - Consult QD

Atrial fibrillation (AF) affects more than 33 million individuals worldwide. In the United States and other industrial nations, the lifetime risk of developing AF is one in four from the age of 40. AF increases stroke risk fivefold, and there is also a twofold increased risk of dementia and increased risks of myocardial infarction (MI), heart failure and death.  
consultqd.clevelandclinic.org
about 5 years ago
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Comparison of hospital variation in acute myocardial infarction care and outcome between Sweden and United Kingdom: population based cohort study using nationwide clinical registries

Objective To assess the between hospital variation in use of guideline recommended treatments and clinical outcomes for acute myocardial infarction in Sweden and the United Kingdom.  
feeds.bmj.com
about 5 years ago
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Complications of Myocardial Infarctions with Dr. Brown

Dr. Lorrel Brown covers the common (and less common) results of MI using cases. She includes papillary muscle rupture and mitral regurgitation, free wall rup...  
youtube.com
about 5 years ago
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Prophylactic lidocaine for myocardial infarction | Cochrane

Background Coronary artery disease is a major public health problem that affects both developed and developing countries. Acute coronary syndromes include unstable angina and myocardial infarction with or without ST-segment elevation (electrocardiogram sector is higher than baseline). Ventricular arrhythmia after myocardial infarction is associated with high risk of mortality. The evidence is out of date, and considerable uncertainty remains about the effects of prophylactic lidocaine use on all-cause mortality, in particular, in patients with suspected myocardial infarction.  
cochrane.org
almost 5 years ago
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Imaging Case of the Week 170

The following AP erect chest x-ray is from a 80 year old with a past history of anterior myocardial infarction. What mechanical complication of MI can be seen on the x-ray?  
emergucate.com
almost 5 years ago
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What is the most effective operation for adults with severe and complex obesity?

Accessing, undergoing, and achieving a successful outcome from surgery for “severe and complex obesity” is difficult and requires determination and effort. Here, we consider “severe and complex obesity” to mean that an individual’s health is compromised by his or her weight to the extent that surgery can be considered to be an appropriate option.1 Surgery may be offered to adults with a body mass index (BMI) of ≥40, or a BMI of ≥35 with an obesity related disease, and it can be very successful. An average 50% of excess weight may be lost in the first few years after surgery, and if this is sustained it is associated with long term reduction in overall mortality and decreased incidences of diabetes, myocardial infarction, stroke and cancer.1 2 This treatment, however, requires careful consideration and serious commitment, with the need to demonstrate full engagement in a structured weight loss programme, to have tried all appropriate non-invasive measures of weight loss, and persevered for referral to a specialist surgical team.1 Once surgery is approved it is necessary to choose which operation to undergo.  
feeds.bmj.com
almost 5 years ago
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FDG PET/MR to Assess Myocardial Salvage in Reperfused AMI

Are there any limitations in using hybrid PET/MRI scanners to assess myocardium at risk in reperfused acute myocardial infarction?  
medscape.com
almost 5 years ago
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Protein Patch Restores Damaged Hearts Post Myocardial Infarction |

Researchers at Stanford University, University of California, San Diego, and Sanford Burnham Prebys Medical Discovery Institute have developed a patch load  
medgadget.com
almost 5 years ago
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US panel narrows recommendations for low dose aspirin for cardiovascular disease prevention

Adults aged 50 to 59 who are at risk of cardiovascular disease should take low dose aspirin for primary prevention, the US Preventive Services Task Force has concluded in draft recommendations released on 15 September.1 2 Previously, the task force had recommended aspirin for men aged 45 to 79 for the prevention of myocardial infarction and for women aged 55 to 79 for the prevention of ischemic stroke.  
feeds.bmj.com
almost 5 years ago
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US panel narrows recommendations for low dose aspirin for cardiovascular disease prevention

Adults aged 50 to 59 who are at risk of cardiovascular disease should take low dose aspirin for primary prevention, the US Preventive Services Task Force has concluded in draft recommendations released on 15 September.1 2 Previously, the task force had recommended aspirin for men aged 45 to 79 for the prevention of myocardial infarction and for women aged 55 to 79 for the prevention of ischemic stroke.  
feeds.bmj.com
almost 5 years ago
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Beta Blocker: Wikipedia Page

Beta blockers (β-blockers, beta-adrenergic blocking agents, beta antagonists, beta-adrenergic antagonists, beta-adrenoreceptor antagonists, or beta adrenergic receptor antagonists) are a class of drugs that are particularly used for the management of cardiac arrhythmias, protecting the heart from a second heart attack (myocardial infarction) after a first heart attack (secondary prevention),[1] and, in certain cases, hypertension.[2][3]  
en.wikipedia.org
almost 5 years ago
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Missed Myocardial Infarction in the Emergency Department - emdocs

What was missed on the first visit? Could the initial ED physician have done anything differently?  
emdocs.net
almost 5 years ago
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Variation in outcome of acute myocardial infarction in Sweden and the UK may be due to population heterogeneity in the UK

One factor that might explain the disparity between Sweden and the UK in the outcome of acute myocardial infarction (AMI) is that the UK population is more heterogeneous than the Swedish one, with …  
feeds.bmj.com
almost 5 years ago