Cardiology

Mystery Quiz- The Answer

January 16, 2009
Mystery Quiz- The Answer

Posted by Daniel Frenkel MD PGY-3 and Jeffrey Lorin MD, Assistant Professor, NYU Division of Cardiology

Edited by Vivian Hayashi MD and Robert Smith MD, Mystery Quiz Section Editors 

The answer to last week’s mystery quiz is accelerated idioventricular rhythm (AIVR)

AIVR is an ectopic ventricular rhythm with intermediate rates between an escape rhythm (<40 bpm) and ventricular tachycardia (>100-120 bpm). It has the usual features of ventricular arrhythmias including AV dissociation, fusion…

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Coronary Artery Disease in South Asians

January 14, 2009
Coronary Artery Disease in South Asians

Commentary by Muhammad Ghumman MD, PGY-3

Faculty Peer Reviewed

South Asia (India, Pakistan, Bangladesh, Sri Lanka, and Nepal) comprises 25% of the global population yet contributes nearly 60% of the global cardiovascular disease burden. There are over 3 million South Asians living in North America (2 million in United States and nearly a quarter million in New York City alone). It is important to recognize that South Asians develop coronary artery disease (CAD) at a younger age, die from CAD at younger ages, and…

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Mystery Quiz

January 8, 2009
Mystery Quiz

Posted by Daniel Frenkel MD PGY-3 and Jeffrey Lorin MD, Assistant Professor, NYU Division of Cardiology

Edited by Vivian Hayashi MD and Robert Smith MD, Mystery Quiz Section Editors 

The patient is a 68 year old man with history of smoking, hypertension, hyperlipidemia, and stable exertional angina who presented with an acute posterior wall myocardial infarction. He was found to have a totally occluded left circumflex artery requiring bare metal stent placement. Several hours after stent placement, the nurse calls stating that…

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Grand Rounds: “The Cardiovascular Molecular Basis of CPVT and other arrythmias”

January 7, 2009
Grand Rounds: “The Cardiovascular Molecular Basis of CPVT and other arrythmias”

Commentary by Anjali Grover MD, PGY-2 

Please also see the clinical vignette presented before December 17th’s grand rounds.

Catecholaminergic polymorphic ventricular tachycardia (CPVT) is classified as an inherited disorder which manifests itself as an adrenergically driven polymorphic ventricular tachyarrythmias.  The molecular etiology of this arrythmogenic disorder stems from a disruption in the calcium channels found in the sarcoplasmic reticulum.   This type of arrhythmia is an important cause of syncope and sudden cardiac death in those individuals with structurally normal hearts.  Genetic studies…

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Cardiac MRI: Assessing Myocardial Viability

December 18, 2008
Cardiac MRI: Assessing Myocardial Viability

Commentary by Muhammad Ghumman MD, PGY-3

Faculty Peer Reviewed

Clinical Case:

A 65 year old male with hypertension, iron deficiency anemia, and atrial fibrillation (not anticoagulated due to prior gastrointestinal bleed,) presents with new onset lower extremity edema, dyspnea on exertion, orthopnea, and profound fatigue. Physical exam is significant for jugular venous distention to 17 cm, bilateral basilar crackles on lung exam, 3+ pitting edema in the lower extremities to mid thighs, and guaiac positive brown stool. Labs are significant for hemoglobin of 5.4,…

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Meeting Perspectives: American Heart Association Scientific Sessions 2008- Report from the cardiology fellows

December 16, 2008
Meeting Perspectives: American Heart Association Scientific Sessions 2008- Report from the cardiology fellows

Commentary by Steven Sedlis, MD Associate Professor of Medicine, Chief, Division of Cardiology Manhattan Veterans Administration Medical Center

The annual scientific session of the American Heart Association was held in New Orleans on November 8-12 2008, the second major cardiology meeting in New Orleans since Katrina. The city has obviously not recovered. The crowds on the streets are sparser and the lines at restaurants considerably shorter than they were before the hurricane. Charity Hospital is closed and a large sign for LSU Interim…

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Breaking News: The Jupiter Trial

November 12, 2008
Breaking News: The Jupiter Trial

Commentary by Ilana Bragin MD, PGY-3

This week online in the NEJM, the results of a trial known as Jupiter were presented in an article that will likely change the way we approach cardiovascular health protection. The Jupiter trial attempts to answer this perturbing question: “Why do half of all myocardial infarctions and strokes occur in apparently healthy men and women with levels of LDL that are below currently recommended thresholds of treatment?” The study addresses the biomarker C-reactive protein, an inflammatory marker that has long been…

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Mystery Quiz- The Answer

November 8, 2008
Mystery Quiz- The Answer

Posted by Vivian Hayashi MD and Robert Smith MD, Mystery Quiz Section Editors

The answer to the mystery quiz is heart failure.  The CXR shows bibasilar opacities with hilar fullness on the right. The CT images are remarkable for bilateral effusions, with dependent opacities that increase in density along the anterior-posterior axis.  The lung appears clear in the anterior zone (Image 5, arrow; Coronal Image 1); ground glass opacification, characterized by parenchymal haziness which does not obscure the underlying pulmonary vessels, is evident in the mid lung (Image…

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Grand Rounds: “Novel Applications of Erythropoietin in Cardiovascular Disease”

October 22, 2008
Grand Rounds: “Novel Applications of Erythropoietin in Cardiovascular Disease”

Commentary by Srikant Duggirala MD, PGY-2

Please also see the clinical vignette presented during this week’s grand rounds

 

On Wednesday, October, 15, 2008, the NYU Department of Medicine Grand Rounds featured one of its own guest speakers, Stuart Katz M.D., Professor of Medicine and Director of Heart Failure at NYU School of Medicine, with his lecture entitled “Novel Applications of Erythropoietin in Cardiovascular Disease.”

Dr. Katz began his lecture with a discussion of oxygen uptake in a various individuals such as elite…

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Grand Rounds: Thyroid Disease and the Heart

September 24, 2008
Grand Rounds: Thyroid Disease and the Heart

 Commentary by Sarika Modi MD, PGY-2  

Dr. Irwin Klein MD, Professor of Medicine and Cell Biology, of North Shore University Hospital, gave grand rounds on “Thyroid Disease and the Heart” on September 17, 2008.  He began his talk by giving an overview of the broad spectrum of cardiac manifestations seen in hyperthyroidism.  Palpitations are seen in 90% of patients with hyperthyroidism.  Atrial fibrillation is seen in 5-15%, especially in the elderly.  In fact, as Dr Klein pointed out, former president George Bush Senior was…

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Perioperative Beta-blockade: Will POISE Change Management?

September 10, 2008
Perioperative Beta-blockade: Will POISE Change Management?

Commentary by Michael LoCurcio MD, Michael Janjigian MD and Michael C Brabeck MD, FACP, NYU Division of General Internal Medicine

Cardiovascular complications continue to be a major cause of morbidity and mortality in the perioperative period. Although progress has been made in terms of risk stratification, an effective invasive or pharmacologic intervention that decreases this risk remains elusive. Well designed studies have shown that prophylactic invasive measures are not effective in decreasing this risk, leaving clinicians uncertain as to the best way to maximize the…

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Case Presentation: Acute Rheumatic Fever

August 29, 2008
Case Presentation: Acute Rheumatic Fever

Commentary by Bani Chander MD, PGY-3. and Ben Bergman MD, PGY-3

Please also see last week’s Class Act Post on the pathogenesis of Rheumatic Heart Disease 

A 34-year-old Hispanic male presents with the chief complaint of chest pain. The patient had been well until 10 days prior to admission, when he developed a severe sore throat accompanied by fever, rigors, and diffuse myalgias. There was no associated cough. Three days later, he visited his primary care physician at an outside facility and was prescribed…

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