Not all heart attacks are created equal. The type of heart attack can influence the prognosis greatly. A heart attack can be recognized by clinical features of chest pain or shortness of breath, ECG or cardiac imaging findings and elevated biochemical markers including the cardiac troponin, the so-called “heart attack blood test”. The…
WHAT DOES CARDIAC CT SHOW?
Noninvasive cardiac imaging has evolved significantly over the last several years. Advances in technology has led to development of newer CT (Computed Tomography) systems with improved spatial and temporal resolution, shorter imaging time, and with ECG gating, allows for the imaging of the beating heart. Cardiac CT is the fastest growing imaging modality in the field…
UNCONTROLLED HYPERTENSION INCLUDING HYPERTENSION EMERGENCIES
Uncontrolled hypertension and hypertension emergencies are a powerful risk factor for future cardiac and non-cardiac events. Hypertension affects almost 1/3 of adults and over 1 billion people globally. Hypertension prevalence increases with aging of the population affecting over 50% of people over 60-years old. The new guidelines identified ideal blood pressure, even among the…
HEART FUNCTION INCLUDING EJECTION FRACTION ( EF )
Heart function including ejection fraction (EF) is important in clinical practice because it is related to prognosis. Whether the patient suffers from valvular heart disease or ischemic heart disease, a measure of heart function including ejection fraction (EF) can predict future clinical outcome and assist in risk stratification. Several approaches to detect patients at…
What is the best coronary stent for our patients?
Whenever we start a clinical trial to test a new coronary stent we always ask ourself; “what is the best stent for our patients”? Coronary artery disease is a progressive pathological condition that results from atherosclerosis or hardening of the arteries. As atherosclerosis progresses from damage of the inner layer of the artery, fat or…
Can heart attack damage be reversed?
One of the most frequent questions our patients ask after surviving a heart attack is: Can heart attack damage be reversed? Every year, over 700,000 Americans have a heart attack. Improvements in the treatment of myocardial infarction, especially with the reopening of the culprit artery with percutaneous coronary intervention, have led to a large number…
Stem cells in the treatment of a heart attack: a Non-STEMI
What is the role of stem cell treatment of a heart attack: non-STEMI? Non-STEMI or Non-ST elevation Myocardial Infarction is the dominant presentation of acute coronary syndrome. This occurs when the blood supplied to the heart muscle is suddenly blocked. Other presentations include unstable angina and STEMI or ST-Elevation Myocardial Infarction. Patients presenting…
Surviving a Heart Attack: the Big One!
The widow maker heart attack, also known as "the big one", is an acute occlusion of the left anterior descending (LAD) artery that can lead to severe heart muscle damage and/or death. If not treated in a timely matter, surviving a heart attack of this magnitude is very difficult. While visiting Austin, Texas, my wife and I…
Cholesterol treatment and atherosclerosis: a new frontier
The problem with cholesterol treament and atherosclerosis: Over the last decade, cholesterol treatment and atherosclerosis has evolved significantly. Atherosclerosis is a general term for hardening and thickening of the arteries. In its most common form, atherosclerosis is a slow progressive disease that usually starts in early adulthood and becomes dangerous later in life. Atherosclerosis is a…
Treatment of High Blood Pressure: When Medicines Don’t Work
The treatment of high blood pressure can be very challenging, especially when medicines don't work. Normal blood pressure is when the systolic blood pressure is less than 120 mm Hg and the diastolic blood pressure is less than 80 mm Hg. Hypertension is defined as a consistent elevation of blood pressure. Blood pressure is considered elevated when…
