Cardiology Opinion for Diabetic patients
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This document provides guidance from a cardiologist on various questions that diabetologists may have regarding their patients. It recommends obtaining an ECG for all diabetic patients on diagnosis and follow-up. It provides guidance on when to refer to a cardiologist based on symptoms like palor, elevated JVP, hypertension, abnormal pulse, pedal swelling, or cardiac sounds. It discusses evaluating chest pain and breathlessness and the tests that may be needed. It also provides guidance on heart failure management in diabetic patients, use of aspirin and statins, selecting antihypertensives and antidiabetic medications, and when to advise coronary angiography.
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The document discusses congestive heart failure by describing the clinical presentation, underlying cardiac diseases that can cause it, how cardiac physiology relates to concepts like preload, afterload and contractility, classifications of heart failure, clinical exam findings, treatment approaches focusing on reducing preload and afterload and increasing contractility, and sample admission orders for an inpatient with heart failure.
A R F
The document discusses congestive heart failure by describing the clinical presentation, underlying cardiac diseases that can cause it, how cardiac physiology relates to concepts like preload, afterload and contractility, classifications of heart failure, clinical exam findings, treatment approaches focusing on reducing preload and afterload and increasing contractility, and sample admission orders for an inpatient with heart failure.
hypertension final.ppt
Hypertension is defined as blood pressure over 140/90 mmHg or taking medication for it. It can be essential or secondary hypertension. Treatment involves lifestyle modifications like weight loss, exercise, diet changes and medication if needed. Goals are to reduce blood pressure below 140/90 mmHg or 130/80 for those with diabetes or kidney disease. First line drugs include diuretics, ACE inhibitors, calcium channel blockers, and angiotensin receptor blockers. Multiple drugs may be needed and lifestyle changes are important to control hypertension.
St elevation myocardial infarction
This document defines STEMI and describes the presentation, diagnosis, and management of a patient experiencing an ST elevation myocardial infarction through electrocardiogram findings, fibrinolytic therapy, percutaneous coronary intervention, and post-procedure care. Reperfusion therapy options like fibrinolysis with streptokinase or alteplase and primary PCI are discussed. Guidelines for long-term secondary prevention with medications and lifestyle changes are also reviewed.
Cardiology 1.1. Chest pain - by Dr. Farjad Ikram
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Template design credits - http://www.slidescarnival.com
htn.pptx
This document provides an overview of hypertension including definitions, staging, types, risk factors, complications, testing, treatment and management. It defines normal, elevated, stage 1 and stage 2 hypertension based on blood pressure readings. It also discusses white coat and masked hypertension. Treatment involves nonpharmacological and pharmacological approaches. Drugs like thiazide diuretics, ACE inhibitors, ARBs, and calcium channel blockers are first-line treatment options. Resistant hypertension and hypertension in special groups like pregnancy are also addressed.
hypertension final (4).ppt
Hypertension is defined as blood pressure above 140/90 mmHg or taking antihypertensive medication. It can be essential or secondary hypertension. Treatment involves lifestyle modifications like weight loss, exercise, and diet changes as well as pharmacologic treatments. Drug therapy aims to reduce blood pressure below 140/90 mmHg or 130/80 mmHg for those with diabetes or kidney disease to decrease risk of heart disease and stroke. Treatment involves diuretics, ACE inhibitors, calcium channel blockers, beta blockers, and other drugs depending on individual factors. Goals are to control blood pressure and reduce target organ damage through lifestyle and medical treatment.
hypertension final (4).ppt
Hypertension is defined as blood pressure above 140/90 mmHg or taking antihypertensive medication. It can be essential or secondary hypertension. Treatment involves lifestyle modifications like weight loss, exercise, and diet changes as well as pharmacologic treatments. Drug therapy aims to reduce blood pressure below 140/90 mmHg or 130/80 mmHg for those with diabetes or kidney disease to decrease risk of heart disease and stroke. Treatment involves diuretics, ACE inhibitors, calcium channel blockers, beta blockers, and other drugs depending on individual factors. Goals are to control blood pressure and reduce target organ damage through lifestyle and medical treatment.
5 hypertension final.ppt¹1111111111111111
Hypertension is defined as blood pressure above 140/90 mmHg. It can be essential (95% of cases, no identifiable cause) or secondary (5% of cases, due to an underlying cause like kidney or endocrine diseases). Treatment involves lifestyle modifications like reduced salt intake, weight loss, exercise, as well as pharmacotherapy using diuretics, ACE inhibitors, calcium channel blockers, ARBs or other drugs. Goals of treatment are to reduce blood pressure below 140/90 mmHg or 130/80 mmHg for those with diabetes or chronic kidney disease to decrease risks of heart disease, stroke and other complications. Resistant hypertension may require multiple drug classes or identification and treatment of an underlying secondary cause.
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Svt mi 2018
Supraventricular tachycardia is a common complication of myocardial infarction, occurring in 25-44% of cases. It most often develops within 24 hours of an acute myocardial infarction and carries a worse prognosis when associated with anterior wall MIs. Late-onset or persistently irregular supraventricular tachycardia for over 48 hours is associated with poor outcomes. Effective treatment involves managing the underlying hemodynamic instability with beta blockers, amiodarone, or direct current cardioversion while balancing the risks of anticoagulation in the post-MI period.
Resistant hypertension
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Build Trust and Security:
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Help children identify and understand their own emotions and the emotions of others.
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Health Tech Market Intelligence Prelim Questions -
The Ultimate Guide to Setting up Market Research in Health Tech part -1
How to effectively start market research in the health tech industry by defining objectives, crafting problem statements, selecting methods, identifying data collection sources, and setting clear timelines. This guide covers all the preliminary steps needed to lay a strong foundation for your research.
This lays foundation of scoping research project what are the
Before embarking on a research project, especially one aimed at scoping and defining parameters like the one described for health tech IT, several crucial considerations should be addressed. Here’s a comprehensive guide covering key aspects to ensure a well-structured and successful research initiative:
1. Define Research Objectives and Scope
Clear Objectives: Define specific goals such as understanding market needs, identifying new opportunities, assessing risks, or refining pricing strategies.
Scope Definition: Clearly outline the boundaries of the research in terms of geographical focus, target demographics (e.g., age, socio-economic status), and industry sectors (e.g., healthcare IT).
3. Review Existing Literature and Resources
Literature Review: Conduct a thorough review of existing research, market reports, and relevant literature to build foundational knowledge.
Gap Analysis: Identify gaps in existing knowledge or areas where further exploration is needed.
4. Select Research Methodology and Tools
Methodological Approach: Choose appropriate research methods such as surveys, interviews, focus groups, or data analytics.
Tools and Resources: Select tools like Google Forms for surveys, analytics platforms (e.g., SimilarWeb, Statista), and expert consultations.
5. Ethical Considerations and Compliance
Ethical Approval: Ensure compliance with ethical guidelines for research involving human subjects.
Data Privacy: Implement measures to protect participant confidentiality and adhere to data protection regulations (e.g., GDPR, HIPAA).
6. Budget and Resource Allocation
Resource Planning: Allocate resources including time, budget, and personnel required for each phase of the research.
Contingency Planning: Anticipate and plan for unforeseen challenges or adjustments to the research plan.
7. Develop Research Instruments
Survey Design: Create well-structured surveys using tools like Google Forms to gather quantitative data.
Interview and Focus Group Guides: Prepare detailed scripts and discussion points for qualitative data collection.
8. Sampling Strategy
Sampling Design: Define the sampling frame, size, and method (e.g., random sampling, stratified sampling) to ensure representation of target demographics.
Participant Recruitment: Plan recruitment strategies to reach and engage the intended participant groups effectively.
9. Data Collection and Analysis Plan
Data Collection: Implement methods for data gathering, ensuring consistency and validity.
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Cardiology Opinion for Diabetic patients
- 1. Cardiology Opinion for Diabetic patients Dr. Dibbendhu Khanra DM Cardiology Interventional Cardiologist AIIMS, Rishikesh
- 2. What do diabetologists want to know? • When to refer to cardiologist? • Is the chest pain serious? • Is the breathlessness serious? • Any abnormality in ECG? • Is echo to be done? • Should aspirin be given? • Should statin be given? • Which antihypertensive to start with? • Which antidiabetic is best? • When to advise for coronary angiogrpahy?
- 3. When to refer to cardiologist? • All patients of diabetis on diagnosis and follow-up • Pallor - CKD • JVP – elevated in HFpEF • BP - HTN • Pulse – AF • Pedal swelling – HFpEF • CVS – S3, S4 • ECG in all
- 4. Is the chest pain serious? • Pain in precordium • Quality is exertional • Radiation • Sweating/ sorbitrate/ smoker • Temporal >20mins ECG needed!
- 5. Is the breathlessness serious? • HTN • Elderly • OSA • Exertional SOB • More pillows/ PND • Pedal swelling May be HFpEF/ NT proBNP, ECHO
- 6. Heart failure and diabetis! • HFrEF: SGLT2i/ ARNI • HFpEF: ARNI? • ‘Diab CMP’: SGLT2i • LBBB/ Broad QRS: CRT • Non LBBB: HBP • Afib: NOAC (P-CHA2S2VASC) • AF + HFrEF=RFA (CABANA)
- 7. Any abnormality in ECG? • All patients of diabetis • Separate discussion for that! • Ischemia • Failure
- 8. Is echo to be done? • Not in all • Typical angina (RWMA) • SOB (HFpEF) • ECG changes (RWMA) • Old MI (EF) • CVS – murmer (MR)
- 9. Should aspirin be given? • ASPIRIN does not protect! • ASPREE, ARRIVE, ASCEND • Only if evidence of CAD • Typical angina/ ECG changes/ Echo changes • If to be given dose 75 mg • ONLY ASPIRIN NOT CLOPIDEGROL • Post stent, 150 mg can be given
- 10. Should statin be given? • DM == atheroscletic disease • Statin is to be given in all • Rosuvastatin = atorvastatin// 40mg OK • New onset diabetis! (MetS, Hbaic>6, hscrp>2) • Target: LDL <70 (post ACS), LDL <100 (CAD) • TG more!..statin only, IMPROVE IT = Eztemibe • Saroglitazar (LIPAGLYN) • Lp (a)/ non HDL cholesterol
- 11. Statin pathway
- 12. Which antihypertensive to start with? • ACEI (post MI)/ ARB (otherwise)
- 14. HTN pathway
- 15. Which anti-diabetic is best?
- 17. When to advise for coronary angiography? • Class III angina • ECG changes/ TMT +ve • CT angio: Prox LAD dis • OMT failied • Nuclear scan • REMEMBER ORBITA! • FORGET COURAGE/ BARI • DAPT more than one year
- 18. Summary • ECG for all • Echo selective • Statin for all • Aspirin selective • Stents does not prevent death/ angina always • ARB/ CTD/ Spiranolcatone • HFpEF • Afib • SGLTi • ARNI
- 19. Questions?