By Reza Ardehali, Marco Perez, Paul Wang
Written, reviewed, and edited in a collaborative attempt via cardiology fellows and college of 1 of the main prestigious educational facilities within the state, this concise quantity supplies cardiology fellows the e-book they've got lengthy needed. Keeping assurance of the underlying pathophysiology and mechanism of affliction to a minimal, the authors concentrate on the analysis and remedy of cardiac issues. sensible and simply available on the time of choice making, the ebook relays vital ideas via concise and to-the-point pearls and by using set of rules charts and illustrations.
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Additional resources for A Practical Approach to Cardiovascular Medicine
Statins are first-line therapy; start at a low dose (10–20 mg) to assess lipidlowering effect and tolerability, and titrate up gradually. • Second agent may be added if lipid goal not achieved even with maximum statin dose. • Patients with CHD equivalent should be on a statin regardless of LDL and dose adjusted to reach LDL goal <70. EV I DEN C E - B AS E D P R AC T I C E Scandinavian Simvastatin Survival Study (4S Study) Context: Benefit of lipid lowering with a statin on secondary prevention of CAD.
Ultrasonography used to assess the primary outcome; the intima–media thickness of the walls of the carotid artery. Results: Combination therapy resulted in a greater reduction in the LDL levels, but the mean change in the carotid artery intima–media thickness was not significantly different in the two groups. Take-home message: In patients with familial hypercholesterolemia, combination therapy with ezetimibe and simvastatin did not result in a significant difference in changes in intima–media thickness, as compared with simvastatin alone.
2011 Blackwell Publishing Ltd. Published 2011 by Blackwell Publishing Ltd. g. pneumothorax, musculoskeletal, GI-related) • Signs of heart failure [rales, elevated jugular venous pressure (JVP), S3, edema] • New or worsening mitral regurgitation (MR) (may be due to papillary muscle ischemia) • If new diastolic murmur, consider alternate diagnosis of aortic dissection with secondary aortic insufficiency and coronary ischemia • Biomarkers: • Troponin (Tn) is more sensitive and specific than CK-MB • Measure at 6–8 h intervals × 2–3 times • Alternatives may include delta CK-MB and Tn at 0 and 2 h or myoglobin + CK-MB/Tn at 0 and 90 min • Other studies: • CBC, BMP (renal failure confers worse prognosis), TFTs, BNP • CXR if pulmonary edema or hemodynamic instability • Lipid panel.
A Practical Approach to Cardiovascular Medicine by Reza Ardehali, Marco Perez, Paul Wang