Cardiology

Systemic Lupus Erythematosus and Premature Coronary Artery Disease

July 14, 2011
Systemic Lupus Erythematosus and Premature Coronary Artery Disease

Please enjoy this post from the Clinical Correlations archives first posted June 17, 2009

Ishmeal  Bradley MD

Faculty Peer Reviewed

Ms. W is a 35 yo woman with a history of systemic lupus erythematosus diagnosed 10 years ago. Her only medications are hydroxychloroquine and prednisone for occasional disease flares. She is otherwise healthy. She has no known personal or family history of cardiac disease or stroke, but does smoke ½ pack of cigarettes per day. Currently, she denies any chest pain, shortness of breath, urinary …

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Do Soft Drinks Cause Hypertension?

July 8, 2011
Do Soft Drinks Cause Hypertension?

By Ivan Saraiva, MD

Faculty Peer Reviewed

Sugared soft drinks are among the most heavily consumed drinks in the US. Carbonated soft drinks were first invented as a way to make “healthier” water that looked like natural carbonated waters that were found in European spas in the mountains. The name soda came from the use of bicarbonate of soda, which was used to produce carbonation (for an excellent review of the history of beverages, refer to Wolf et al..  Unfortunately, we no longer realize any …

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Red Yeast Rice: Nature’s Statin?

June 30, 2011
Red Yeast Rice: Nature’s Statin?

By Joshua Farhadian

Faculty Peer Reviewed

M. K.  is a 61-year-old female with hypercholesterolemia who presents to clinic complaining of muscle pain and weakness.  She reports that one month after beginning statin therapy she developed myalgias and immediately stopped taking her medication.  She states that she wants to control her cholesterol level, since both of her parents died of heart disease; however, she is hesitant to take a prescription medication due to the side effects she experienced.  She asks you about red yeast rice (RYR). …

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How Does Alcohol Affect Hypertension?

June 24, 2011
How Does Alcohol Affect Hypertension?

By Benjamin Kenigsberg

Faculty Peer Reviewed

Alcoholic beverages have been part of human culture for thousands of years and cross nearly every political and demographic boundary. Despite this long history, the interaction between alcohol and human health is still poorly understood. This confusion is particularly true with regard to blood pressure, as multiple studies have debated the association between alcohol intake and the development or management of hypertension.  For this discussion, in America a standard drink is defined as 12 ounces of regular beer, 5 …

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Fast Hearts and Funny Currents, Part 2: Is Tachycardia Part of the Problem in Heart Failure?

May 25, 2011
Fast Hearts and Funny Currents, Part 2: Is Tachycardia Part of the Problem in Heart Failure?

By Santosh Vardhana

 Faculty Peer Reviewed

Please review Part 1 of this article here.

Mr. M is a 63-year old man with a history of coronary artery disease and systolic congestive heart failure (ejection fraction 32%) on lisinopril, metoprolol, and spironolactone who presents to the Adult Primary Care Center complaining of persistent dyspnea with exertion, two-pillow orthopnea, and severely limited exercise tolerance.  His vital signs on presentation are T 98.0˚F, P 84, BP 122/76.  What are his therapeutic options?

 A randomized, placebo controlled study of …

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Fast Hearts and Funny Currents: Is Tachycardia Part of the Problem in Heart Failure? Part 1

May 18, 2011
Fast Hearts and Funny Currents: Is Tachycardia Part of the Problem in Heart Failure? Part 1

By Santosh Vardhana

Faculty Peer Reviewed 

Mr. M is a 63-year-old man with a history of coronary artery disease and systolic CHF (ejection fraction 32%) on lisinopril, metoprolol, and spironolactone who presents to Primary Care Clinic complaining of persistent dyspnea with exertion, two-pillow orthopnea, and severely limited exercise tolerance.  His vital signs on presentation are T 98.0º F, BP 122/76, HR 84 bpm.  What are his therapeutic options?

 A Race Against Time: Tachycardia in the Failing Heart

Congestive heart failure (CHF) is a clinical syndrome …

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An Intern In The ER

April 1, 2011
An Intern In The ER

By Demetrios Tzimas, MD

New York City.  Bellevue Hospital Center.  July 17, 2009.  1:53 pm.  Intern Year. Long Call.

“Go down to the ER.  There’s a guy with chest pain for the past three days, EKG shows some non-specific changes, vitals stable.  First set of labs negative.  CXR clear.  They gave him a full-dose aspirin.  This sounds like a rule out chest pain, and since it’s Friday, he’ll go to medicine and not the chest pain unit.  I’d go down with you, but one of …

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Stroke Prevention in the Setting of a Patent Foramen Ovale: A “Hole” in the Evidence

March 9, 2011
Stroke Prevention in the Setting of a Patent Foramen Ovale: A “Hole” in the Evidence

Brandon Oberweis, MD

Faculty Peer Reviewed

 Case Report:

A 48-year old gentleman with no significant past medical history presents to the emergency department with new-onset left upper extremity hemiparesis, visual field deficits, and decreased level of consciousness.  A non-contrast CT scan was performed and revealed right-sided focal hypoattenuation in the middle cerebral artery distribution.  Following acute management of this patient, further studies were conducted to elucidate the underlying etiology of the cerebrovascular accident.  An echocardiogram with an agitated saline contrast study (“Bubble Study”) was …

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