The document describes an FDA-approved, CE-marked device called the EndoPAT 2000 that non-invasively measures endothelial function to detect early signs of heart disease. The device uses fingertip probes to measure endothelial function through a 15-minute test that can be administered in a doctor's office. Benefits include increasing office revenue, improving patient care through early detection of risk factors, and monitoring treatment effectiveness. The device costs $250,000 but can provide a profit within 4 months for practices performing a modest number of tests per day.
1) EndoPAT is a medical device that noninvasively assesses endothelial function through changes in vascular tone in the fingers in response to induced hyperemia in the arm.
2) It has been validated in studies comparing it to measures of coronary and brachial artery endothelial function and shown to detect a nitric oxide mediated response.
3) Advantages of EndoPAT include simultaneous recording from both arms to control for systemic changes, assessment of occlusion quality, large dynamic range of measurements, and ease of use.
Treatment of pulmonary embolism data from registries - prof. Zbigniew Gąsiorpiodof
This document summarizes data from several studies and registries on the treatment of pulmonary embolism (PE). It finds that patients diagnosed with massive PE had higher mortality rates compared to nonmassive PE. Thrombolytic therapy was associated with higher mortality for massive PE compared to no thrombolysis, but also higher risk of hemorrhagic complications. The ZATPOL registry of over 1,700 Polish patients with PE found that unreliable diagnoses were associated with higher mortality than confirmed PE diagnoses. Surgical pulmonary embolectomy and catheter-directed thrombolysis were identified as alternative treatment options for high-risk PE.
Manual thrombus aspiration during primary percutaneous coronary intervention (PPCI) for ST-segment elevation myocardial infarction (STEMI) was not associated with reduced long-term mortality according to a study of 10,929 patients. While thrombus aspiration was linked to higher procedural success rates and lower in-hospital complications, long-term survival was similar between patients who received thrombus aspiration and those who underwent PPCI only. After adjusting for differences in patient characteristics and procedures using propensity score matching, thrombus aspiration during PPCI was still not found to reduce mortality risk.
Six angiographic indicators of large thrombus burden by
Yip and colleagues,depending upon the angiographic morphology are
features indicated “high-burden thrombus formation”:
1. A cut-off pattern of occlusion
2. Accumulated thrombus proximal to the occlusion
3. A reference lumen diameter of the IRA of >4.0 mm
4. An incomplete obstruction with an angiographic thrombus with
the greatest linear dimension more than 3 times the reference
lumen diameter
5. The presence of floating thrombus proximal to the lesion
6. A persistent dye stasis distal to the occlusion
Cardiac complications in acute ischemic strokeHans Garcia
This study characterized cardiac complications in 200 patients with acute ischemic stroke who were admitted to an urban hospital. The researchers found that:
- 28.5% of patients had systolic dysfunction defined as an ejection fraction less than 50% on echocardiography
- 20.4% had ischemic changes, 10.5% presented with atrial fibrillation, and 13% had troponin elevation on electrocardiograms
- Patients with systolic dysfunction, troponin elevation, atrial fibrillation, or ischemic changes on electrocardiograms had significantly higher in-hospital mortality rates.
The findings suggest that cardiac monitoring strategies may be important for managing some acute ischemic stroke patients.
Interventional management of out hospital cardiac arrestAhmedElBorae1
1) Out-of-hospital cardiac arrest remains a major cause of death, though improvements in pre-hospital care have increased ROSC rates to 50%.
2) Significant coronary artery disease is present in 70% of cases. Coronary angiography finds acute culprit lesions in up to 90% of STEMI patients and 58% of non-STEMI patients.
3) Observational studies show the feasibility and safety of immediate invasive coronary strategies after cardiac arrest, with overall survival rates of 76% and neurological recovery in 52% of "comatose" survivors. However, randomized trials are still needed to confirm benefits.
Summary of landmark CTO clinical trials and highlights from registries AhmedElBorae1
This document summarizes information from registries and trials on coronary chronic total occlusions (CTO). It discusses CTO lesion analysis scores, access choices, success rates and complications. It reviews several randomized controlled trials comparing CTO percutaneous coronary intervention (PCI) to medical therapy that had modest sample sizes and open-label designs. It also discusses observational data from large registries on temporal trends in CTO PCI procedures, techniques, success rates and complications. The key takeaway message is that adoption of modern CTO techniques has led to increased success rates with lower complications, and RCTs showed improved quality of life while observational data suggests successful CTO revascularization may improve long-term prognosis.
The document describes an FDA-approved, CE-marked device called the EndoPAT 2000 that non-invasively measures endothelial function to detect early signs of heart disease. The device uses fingertip probes to measure endothelial function through a 15-minute test that can be administered in a doctor's office. Benefits include increasing office revenue, improving patient care through early detection of risk factors, and monitoring treatment effectiveness. The device costs $250,000 but can provide a profit within 4 months for practices performing a modest number of tests per day.
1) EndoPAT is a medical device that noninvasively assesses endothelial function through changes in vascular tone in the fingers in response to induced hyperemia in the arm.
2) It has been validated in studies comparing it to measures of coronary and brachial artery endothelial function and shown to detect a nitric oxide mediated response.
3) Advantages of EndoPAT include simultaneous recording from both arms to control for systemic changes, assessment of occlusion quality, large dynamic range of measurements, and ease of use.
Treatment of pulmonary embolism data from registries - prof. Zbigniew Gąsiorpiodof
This document summarizes data from several studies and registries on the treatment of pulmonary embolism (PE). It finds that patients diagnosed with massive PE had higher mortality rates compared to nonmassive PE. Thrombolytic therapy was associated with higher mortality for massive PE compared to no thrombolysis, but also higher risk of hemorrhagic complications. The ZATPOL registry of over 1,700 Polish patients with PE found that unreliable diagnoses were associated with higher mortality than confirmed PE diagnoses. Surgical pulmonary embolectomy and catheter-directed thrombolysis were identified as alternative treatment options for high-risk PE.
Manual thrombus aspiration during primary percutaneous coronary intervention (PPCI) for ST-segment elevation myocardial infarction (STEMI) was not associated with reduced long-term mortality according to a study of 10,929 patients. While thrombus aspiration was linked to higher procedural success rates and lower in-hospital complications, long-term survival was similar between patients who received thrombus aspiration and those who underwent PPCI only. After adjusting for differences in patient characteristics and procedures using propensity score matching, thrombus aspiration during PPCI was still not found to reduce mortality risk.
Six angiographic indicators of large thrombus burden by
Yip and colleagues,depending upon the angiographic morphology are
features indicated “high-burden thrombus formation”:
1. A cut-off pattern of occlusion
2. Accumulated thrombus proximal to the occlusion
3. A reference lumen diameter of the IRA of >4.0 mm
4. An incomplete obstruction with an angiographic thrombus with
the greatest linear dimension more than 3 times the reference
lumen diameter
5. The presence of floating thrombus proximal to the lesion
6. A persistent dye stasis distal to the occlusion
Cardiac complications in acute ischemic strokeHans Garcia
This study characterized cardiac complications in 200 patients with acute ischemic stroke who were admitted to an urban hospital. The researchers found that:
- 28.5% of patients had systolic dysfunction defined as an ejection fraction less than 50% on echocardiography
- 20.4% had ischemic changes, 10.5% presented with atrial fibrillation, and 13% had troponin elevation on electrocardiograms
- Patients with systolic dysfunction, troponin elevation, atrial fibrillation, or ischemic changes on electrocardiograms had significantly higher in-hospital mortality rates.
The findings suggest that cardiac monitoring strategies may be important for managing some acute ischemic stroke patients.
Interventional management of out hospital cardiac arrestAhmedElBorae1
1) Out-of-hospital cardiac arrest remains a major cause of death, though improvements in pre-hospital care have increased ROSC rates to 50%.
2) Significant coronary artery disease is present in 70% of cases. Coronary angiography finds acute culprit lesions in up to 90% of STEMI patients and 58% of non-STEMI patients.
3) Observational studies show the feasibility and safety of immediate invasive coronary strategies after cardiac arrest, with overall survival rates of 76% and neurological recovery in 52% of "comatose" survivors. However, randomized trials are still needed to confirm benefits.
Summary of landmark CTO clinical trials and highlights from registries AhmedElBorae1
This document summarizes information from registries and trials on coronary chronic total occlusions (CTO). It discusses CTO lesion analysis scores, access choices, success rates and complications. It reviews several randomized controlled trials comparing CTO percutaneous coronary intervention (PCI) to medical therapy that had modest sample sizes and open-label designs. It also discusses observational data from large registries on temporal trends in CTO PCI procedures, techniques, success rates and complications. The key takeaway message is that adoption of modern CTO techniques has led to increased success rates with lower complications, and RCTs showed improved quality of life while observational data suggests successful CTO revascularization may improve long-term prognosis.
This document presents a systematic review and meta-analysis examining the risk of adverse neurological events from radial versus femoral artery access for cardiac catheterization. The review found a stroke rate of 0.14% for radial access versus 0.19% for femoral access based on over 500,000 procedures. Specifically, it found no increased risk of ischaemic or haemorrhagic stroke with radial compared to femoral access. The conclusions were that radial access is not associated with an increased risk of stroke events compared to femoral access.
ST-segment Depression: All are Not Created Equal!asclepiuspdfs
ST depression on an electrocardiography can be from various causes including ischemia, acute coronary syndrome, electrolyte imbalance, posterior myocardial infarction, pulmonary embolism and others. Making the right diagnosis and therefore the right treatment is of paramount importance. This article goes into depth explaining why all ST-segment depressions are not created equal.
The article discusses new cardiac parametric mapping techniques for T1 and T2 mapping that provide pixel-based maps of myocardial relaxation times. These techniques can detect diffuse myocardial pathologies missed by conventional imaging by quantifying subtle tissue changes. T1 mapping in particular shows potential for diagnosing diseases involving diffuse fibrosis. Standardization of mapping methods is still needed to ensure consistent quantitative results. The efficient, single breath-hold nature of new mapping sequences improves clinical applicability for detecting early disease changes.
CTO PCI and length of dual antiplatelet regimenEuro CTO Club
CTO PCI and length of dual antiplatelet regimen
Maciej Lesiak, Poznan, Poland
11th Experts Live CTO
The annual Euro CTO meeting
September 13th –14th, 2019 - Berlin, Germany
Left Ventricular Apical Ballooning, Catecholamine Toxicity, and Cardiomyopathyasclepiuspdfs
Case reports and clinical experiences have implicated catecholamine. Excess likely contributes to the pathophysiologic process as a cause of cardiac dysfunction, impaired hemodynamic function, and poor outcomes. Cardiac dysfunction has also been described in many other diseases; there is likely a common underlying pathophysiology. In this review, we will examine the pathophysiology of cardiac dysfunction after catecholamine surge and discuss the evidence surrounding cardiac dysfunction.
Thermal Imaging for the Diagnosis of Early Vascular Dysfunctions: A Case Reportasclepiuspdfs
Diseases of blood vessels (referred in this article as vascular dysfunction) cause more morbidity and mortality, than combined impact of any other major non-communicable disease including cancer. We strongly feel that the development of a therapy system based on the management of disease of the vessel than management of the risk factors will yield better results and provide greater opportunity for individualized therapy. Detection of early vascular changes before clinical manifestations of endothelial dysfunction, hardening of the arteries, increased intima-media thickness, is of great importance for early identification of individuals with increased risk of accelerated atherosclerosis.
CTO and atrial fibrillation – Do we apply the ESC recommendations?Euro CTO Club
CTO and atrial fibrillation – Do we apply the ESC recommendations?
Sudhir Rathore, Canberley, Great Britain
11th Experts Live CTO
The annual Euro CTO meeting
September 13th –14th, 2019 - Berlin, Germany
Therapeutic options for aortic stenosis in elderly - dr Jaroslaw Trębaczpiodof
This document discusses treatment options for aortic stenosis (AS) in elderly patients. It states that surgical aortic valve replacement (AVR) improves symptoms and quality of life for AS patients, even in those over 80 years old. However, surgery is denied in 33% of elderly patients with severe AS, often due to older age and left ventricular dysfunction rather than comorbidities alone. Balloon valvuloplasty provides only temporary relief for AS and increased risk of restenosis. Transcatheter aortic valve implantation (TAVI) has been shown to have better 1-year survival rates than surgery for high-risk AS patients. The conclusions recommend surgical AVR for most elderly AS patients when feasible, and considering
1) The study compared outcomes of STEMI patients undergoing primary PCI with thrombectomy (Group T) versus without thrombectomy (Group S).
2) MRI results at 3 months showed significantly smaller infarct size and less transmurality in Group T compared to Group S.
3) Procedural results favored Group T with higher rates of TIMI 3 flow and complete ST resolution. One-year outcomes also favored Group T with lower rates of MACE.
Diagnosis of Early Risks, Management of Risks, and Reduction of Vascular Dise...asclepiuspdfs
In a recent issue of the Journal of Circulation, American Heart Association has published a scientific statement, related to the excess heart disease and acute vascular events in South Asians living in the USA. The same group of experts, also have published a complementary article in Circulation titled, “call to action: Cardiovascular disease (CVD) in Asian Americans.”I being a South Asian immigrant living in the USA, have always wondered as to why we do not have the same benefits as the other resident Americans in terms of the advantages of living in a highly advanced country? According to a study done in 2013, cardiovascular mortality has declined and diabetes mortality has increased in high-income countries. The study done in 26 industrialized nations, estimated the potential role of trends in population, for body mass index, systolic blood pressure, serum total cholesterol, and smoking, the modifiable risk factors identified as the promoters of CVD, and acute vascular events, by the Framingham Heart Study (FHS) group.
The TAPAS study was a single-center, randomized trial that compared thrombus aspiration to conventional PCI in STEMI patients. The study found that thrombus aspiration resulted in improved myocardial perfusion and ST-segment resolution compared to conventional PCI. At 30 days, improved myocardial perfusion predicted lower rates of death and reinfarction. At 1 year follow up, thrombus aspiration was associated with lower mortality and a composite of mortality or non-fatal reinfarction compared to conventional PCI alone.
1) Early revascularization through either percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) improves survival rates in patients with cardiogenic shock compared to medical therapy alone.
2) There is ongoing debate about whether culprit vessel-only PCI or multivessel PCI is better for patients with cardiogenic shock and multivessel coronary artery disease. Current guidelines recommend culprit vessel PCI initially except in certain high-risk situations.
3) An integrated approach is needed using early revascularization, inotropic support, and potentially mechanical circulatory support, with involvement of multiple specialists. Cardiogenic shock continues to pose major challenges in acute cardiac care.
European Journal of Heart Failure's year in Cardiologydrucsamal
This document contains information about Prof. Fausto J. Pinto who is the Head of Cardiology at University Hospital Sta Maria-HPV and University of Lisbon in Portugal. It discloses that he has received consultancy fees and lecture fees from various pharmaceutical companies. It also contains several figures and images from various medical studies and publications related to cardiology.
Cancer-Associated Thrombosis.From LMWH to DOACsmagdy elmasry
This document summarizes a presentation on cancer-associated thrombosis (CAT). It discusses that up to 20% of cancer patients experience venous thromboembolism (VTE) and cancer patients have a 5 times higher risk of VTE than the general population. The presentation reviews risk factors for CAT, mechanisms of cancer-related VTE, treatment options including low molecular weight heparins (LMWH), vitamin K antagonists (VKA), and direct oral anticoagulants (DOACs). It summarizes evidence from clinical trials comparing these treatments and guidelines recommending LMWH for at least 6 months. Considerations for optimal use of each treatment class and avoiding certain options are also outlined.
The document discusses several studies related to cardiology. It summarizes the key findings of each study in 1-2 sentences. Some of the studies discussed include:
- A study finding that whole genome sequencing identified genetic risk factors like familial hypercholesterolemia in 1.7% of acute myocardial infarction patients under 55 and a high polygenic risk score in 17% of patients.
- A study finding that plasma levels of the metabolite TMAO were higher in STEMI patients with plaque rupture compared to erosion and may be a novel biomarker for plaque morphology.
- The ALERTS trial which found that an implantable cardiac alert system safely detected rapid ST segment changes but did not meet its
This study examined the association between blood cell count parameters and the development of new onset atrial fibrillation (AF) after acute myocardial infarction (AMI). The study found that patients who developed AF after AMI had significantly higher hemoglobin, hematocrit, and erythrocyte count levels compared to controls without AF. Logistic regression analysis revealed an independent association between higher hemoglobin, hematocrit, and erythrocyte count and increased odds of developing AF after AMI. However, the pathophysiological mechanisms for these associations require further investigation.
Aortic Valve Stenosis with low EF : TAVR versus Replacementdrucsamal
1) Patients with low ejection fraction (EF < 50%) and severe aortic stenosis who undergo transcatheter aortic valve replacement (TAVI) have similar mortality at 1 year compared to those with higher EF, despite being higher risk.
2) TAVI is associated with significant improvements in EF, symptoms, and quality of life over 1 year in patients with very low EF (≤30%). However, mortality remains higher compared to those with EF >30%.
3) Both TAVI and surgical aortic valve replacement (SAVR) are associated with improvements in EF at 3 months in propensity matched populations with low EF. Short term outcomes are similar, but TAVI is associated with more pacemakers
This document discusses several studies related to atrial fibrillation and anticoagulation therapy:
1. A study of over 13,000 AF patients found higher baseline BNP levels were associated with increased risk of AF progression and major adverse cardiovascular events.
2. A direct comparison of dabigatran, rivaroxaban, and apixaban found apixaban and rivaroxaban had comparable safety and effectiveness to dabigatran in real-world practice, though major bleeding occurred more frequently with apixaban and rivaroxaban.
3. A study of NOAC safety in obese patients undergoing electrical cardioversion found no incidents of stroke, suggesting NOACs may be safe
El documento describe las propiedades y usos del ácido etilendiaminotetracético (EDTA) en la preparación de conductos radiculares calcificados. El EDTA actúa como agente quelante de iones de calcio, permitiendo el ensanchamiento químico de los conductos y la eliminación del barrillo dentinario. Se explican las ventajas del EDTA, como la mejor limpieza y desinfección de las paredes dentinarias y la mayor permeabilidad a medicamentos. El EDTA se usa comúnmente en concentraciones del 10-17
EDTA chelation therapy involves intravenously infusing a chelating agent called ethylenediaminetetraacetic acid (EDTA) along with vitamins and minerals to remove metals from the body. The treatment is administered in 30 or more sessions over time in a doctor's office or clinic where patients can relax comfortably during the 3 hour infusion. EDTA chelation therapy can benefit patients aged 15 to 95 and is calculated based on individual factors like weight and kidney function. Multiple sessions may be needed over time to fully detoxify the body and then occasional follow up sessions to maintain the effects.
This document presents a systematic review and meta-analysis examining the risk of adverse neurological events from radial versus femoral artery access for cardiac catheterization. The review found a stroke rate of 0.14% for radial access versus 0.19% for femoral access based on over 500,000 procedures. Specifically, it found no increased risk of ischaemic or haemorrhagic stroke with radial compared to femoral access. The conclusions were that radial access is not associated with an increased risk of stroke events compared to femoral access.
ST-segment Depression: All are Not Created Equal!asclepiuspdfs
ST depression on an electrocardiography can be from various causes including ischemia, acute coronary syndrome, electrolyte imbalance, posterior myocardial infarction, pulmonary embolism and others. Making the right diagnosis and therefore the right treatment is of paramount importance. This article goes into depth explaining why all ST-segment depressions are not created equal.
The article discusses new cardiac parametric mapping techniques for T1 and T2 mapping that provide pixel-based maps of myocardial relaxation times. These techniques can detect diffuse myocardial pathologies missed by conventional imaging by quantifying subtle tissue changes. T1 mapping in particular shows potential for diagnosing diseases involving diffuse fibrosis. Standardization of mapping methods is still needed to ensure consistent quantitative results. The efficient, single breath-hold nature of new mapping sequences improves clinical applicability for detecting early disease changes.
CTO PCI and length of dual antiplatelet regimenEuro CTO Club
CTO PCI and length of dual antiplatelet regimen
Maciej Lesiak, Poznan, Poland
11th Experts Live CTO
The annual Euro CTO meeting
September 13th –14th, 2019 - Berlin, Germany
Left Ventricular Apical Ballooning, Catecholamine Toxicity, and Cardiomyopathyasclepiuspdfs
Case reports and clinical experiences have implicated catecholamine. Excess likely contributes to the pathophysiologic process as a cause of cardiac dysfunction, impaired hemodynamic function, and poor outcomes. Cardiac dysfunction has also been described in many other diseases; there is likely a common underlying pathophysiology. In this review, we will examine the pathophysiology of cardiac dysfunction after catecholamine surge and discuss the evidence surrounding cardiac dysfunction.
Thermal Imaging for the Diagnosis of Early Vascular Dysfunctions: A Case Reportasclepiuspdfs
Diseases of blood vessels (referred in this article as vascular dysfunction) cause more morbidity and mortality, than combined impact of any other major non-communicable disease including cancer. We strongly feel that the development of a therapy system based on the management of disease of the vessel than management of the risk factors will yield better results and provide greater opportunity for individualized therapy. Detection of early vascular changes before clinical manifestations of endothelial dysfunction, hardening of the arteries, increased intima-media thickness, is of great importance for early identification of individuals with increased risk of accelerated atherosclerosis.
CTO and atrial fibrillation – Do we apply the ESC recommendations?Euro CTO Club
CTO and atrial fibrillation – Do we apply the ESC recommendations?
Sudhir Rathore, Canberley, Great Britain
11th Experts Live CTO
The annual Euro CTO meeting
September 13th –14th, 2019 - Berlin, Germany
Therapeutic options for aortic stenosis in elderly - dr Jaroslaw Trębaczpiodof
This document discusses treatment options for aortic stenosis (AS) in elderly patients. It states that surgical aortic valve replacement (AVR) improves symptoms and quality of life for AS patients, even in those over 80 years old. However, surgery is denied in 33% of elderly patients with severe AS, often due to older age and left ventricular dysfunction rather than comorbidities alone. Balloon valvuloplasty provides only temporary relief for AS and increased risk of restenosis. Transcatheter aortic valve implantation (TAVI) has been shown to have better 1-year survival rates than surgery for high-risk AS patients. The conclusions recommend surgical AVR for most elderly AS patients when feasible, and considering
1) The study compared outcomes of STEMI patients undergoing primary PCI with thrombectomy (Group T) versus without thrombectomy (Group S).
2) MRI results at 3 months showed significantly smaller infarct size and less transmurality in Group T compared to Group S.
3) Procedural results favored Group T with higher rates of TIMI 3 flow and complete ST resolution. One-year outcomes also favored Group T with lower rates of MACE.
Diagnosis of Early Risks, Management of Risks, and Reduction of Vascular Dise...asclepiuspdfs
In a recent issue of the Journal of Circulation, American Heart Association has published a scientific statement, related to the excess heart disease and acute vascular events in South Asians living in the USA. The same group of experts, also have published a complementary article in Circulation titled, “call to action: Cardiovascular disease (CVD) in Asian Americans.”I being a South Asian immigrant living in the USA, have always wondered as to why we do not have the same benefits as the other resident Americans in terms of the advantages of living in a highly advanced country? According to a study done in 2013, cardiovascular mortality has declined and diabetes mortality has increased in high-income countries. The study done in 26 industrialized nations, estimated the potential role of trends in population, for body mass index, systolic blood pressure, serum total cholesterol, and smoking, the modifiable risk factors identified as the promoters of CVD, and acute vascular events, by the Framingham Heart Study (FHS) group.
The TAPAS study was a single-center, randomized trial that compared thrombus aspiration to conventional PCI in STEMI patients. The study found that thrombus aspiration resulted in improved myocardial perfusion and ST-segment resolution compared to conventional PCI. At 30 days, improved myocardial perfusion predicted lower rates of death and reinfarction. At 1 year follow up, thrombus aspiration was associated with lower mortality and a composite of mortality or non-fatal reinfarction compared to conventional PCI alone.
1) Early revascularization through either percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) improves survival rates in patients with cardiogenic shock compared to medical therapy alone.
2) There is ongoing debate about whether culprit vessel-only PCI or multivessel PCI is better for patients with cardiogenic shock and multivessel coronary artery disease. Current guidelines recommend culprit vessel PCI initially except in certain high-risk situations.
3) An integrated approach is needed using early revascularization, inotropic support, and potentially mechanical circulatory support, with involvement of multiple specialists. Cardiogenic shock continues to pose major challenges in acute cardiac care.
European Journal of Heart Failure's year in Cardiologydrucsamal
This document contains information about Prof. Fausto J. Pinto who is the Head of Cardiology at University Hospital Sta Maria-HPV and University of Lisbon in Portugal. It discloses that he has received consultancy fees and lecture fees from various pharmaceutical companies. It also contains several figures and images from various medical studies and publications related to cardiology.
Cancer-Associated Thrombosis.From LMWH to DOACsmagdy elmasry
This document summarizes a presentation on cancer-associated thrombosis (CAT). It discusses that up to 20% of cancer patients experience venous thromboembolism (VTE) and cancer patients have a 5 times higher risk of VTE than the general population. The presentation reviews risk factors for CAT, mechanisms of cancer-related VTE, treatment options including low molecular weight heparins (LMWH), vitamin K antagonists (VKA), and direct oral anticoagulants (DOACs). It summarizes evidence from clinical trials comparing these treatments and guidelines recommending LMWH for at least 6 months. Considerations for optimal use of each treatment class and avoiding certain options are also outlined.
The document discusses several studies related to cardiology. It summarizes the key findings of each study in 1-2 sentences. Some of the studies discussed include:
- A study finding that whole genome sequencing identified genetic risk factors like familial hypercholesterolemia in 1.7% of acute myocardial infarction patients under 55 and a high polygenic risk score in 17% of patients.
- A study finding that plasma levels of the metabolite TMAO were higher in STEMI patients with plaque rupture compared to erosion and may be a novel biomarker for plaque morphology.
- The ALERTS trial which found that an implantable cardiac alert system safely detected rapid ST segment changes but did not meet its
This study examined the association between blood cell count parameters and the development of new onset atrial fibrillation (AF) after acute myocardial infarction (AMI). The study found that patients who developed AF after AMI had significantly higher hemoglobin, hematocrit, and erythrocyte count levels compared to controls without AF. Logistic regression analysis revealed an independent association between higher hemoglobin, hematocrit, and erythrocyte count and increased odds of developing AF after AMI. However, the pathophysiological mechanisms for these associations require further investigation.
Aortic Valve Stenosis with low EF : TAVR versus Replacementdrucsamal
1) Patients with low ejection fraction (EF < 50%) and severe aortic stenosis who undergo transcatheter aortic valve replacement (TAVI) have similar mortality at 1 year compared to those with higher EF, despite being higher risk.
2) TAVI is associated with significant improvements in EF, symptoms, and quality of life over 1 year in patients with very low EF (≤30%). However, mortality remains higher compared to those with EF >30%.
3) Both TAVI and surgical aortic valve replacement (SAVR) are associated with improvements in EF at 3 months in propensity matched populations with low EF. Short term outcomes are similar, but TAVI is associated with more pacemakers
This document discusses several studies related to atrial fibrillation and anticoagulation therapy:
1. A study of over 13,000 AF patients found higher baseline BNP levels were associated with increased risk of AF progression and major adverse cardiovascular events.
2. A direct comparison of dabigatran, rivaroxaban, and apixaban found apixaban and rivaroxaban had comparable safety and effectiveness to dabigatran in real-world practice, though major bleeding occurred more frequently with apixaban and rivaroxaban.
3. A study of NOAC safety in obese patients undergoing electrical cardioversion found no incidents of stroke, suggesting NOACs may be safe
El documento describe las propiedades y usos del ácido etilendiaminotetracético (EDTA) en la preparación de conductos radiculares calcificados. El EDTA actúa como agente quelante de iones de calcio, permitiendo el ensanchamiento químico de los conductos y la eliminación del barrillo dentinario. Se explican las ventajas del EDTA, como la mejor limpieza y desinfección de las paredes dentinarias y la mayor permeabilidad a medicamentos. El EDTA se usa comúnmente en concentraciones del 10-17
EDTA chelation therapy involves intravenously infusing a chelating agent called ethylenediaminetetraacetic acid (EDTA) along with vitamins and minerals to remove metals from the body. The treatment is administered in 30 or more sessions over time in a doctor's office or clinic where patients can relax comfortably during the 3 hour infusion. EDTA chelation therapy can benefit patients aged 15 to 95 and is calculated based on individual factors like weight and kidney function. Multiple sessions may be needed over time to fully detoxify the body and then occasional follow up sessions to maintain the effects.
Este documento describe los tipos de intoxicación por oxalatos, incluyendo oxalatos solubles e insolubles. Los oxalatos solubles se encuentran comúnmente en plantas como la acedera y la lengua de vaca, y pueden causar hipocalcemia e insuficiencia renal aguda al combinarse con el calcio en los riñones. Los oxalatos insolubles contienen cristales de oxalato de calcio que causan inflamación local al ser ingeridos. El diagnóstico se basa en los signos clínicos, hallazgos de laboratorio y necrops
The document discusses the benefits of using EDTA (ethylene diamine tetra acetic acid) as a chelate for soil and foliar applications of micronutrients. It explains that EDTA promotes nutrient transport in plants, avoids metal precipitation in soil and hard water, and can be mixed with most pesticides. It then compares the effectiveness and costs of using sulphate vs EDTA chelated micronutrients. Finally, it provides details on MetaClaw, Satyajit Chemicals' line of EDTA chelated micronutrients including calcium, copper, iron, magnesium, manganese and zinc.
Chapter 16.1 and 2 : Acid-Base Titrations and pHChris Foltz
The document discusses acid-base titrations and pH. It defines pH as the negative logarithm of hydronium ion concentration and explains how to calculate pH from [H3O+] and vice versa. It also describes how to perform and calculate molarity from a titration experiment by determining moles of acid/base reacted using volume and molarity of the titrant. Sample titration problems are worked through demonstrating these concepts.
This document discusses complexometric titration using EDTA. It describes the requirements for complexometric titration including that the formation constant (Kf) must be high and the reaction rate must be fast. It explains that EDTA fulfills these requirements and can be used for direct, indirect, substitution and back titration. It also discusses the selectivity of EDTA through controlling pH, masking/demasking techniques, and precipitation or redox reactions to selectively analyze mixtures.
This document discusses the dangers and ineffectiveness of angioplasty compared to lifestyle changes and bypass surgery for treating coronary obstruction. It states that angioplasty is risky, provides only a temporary solution, and has high costs both financially and in terms of health risks. By contrast, lifestyle changes can prevent or reverse obstruction in many cases. For those who need intervention, bypass surgery provides a complete and long-term solution at a lower cost than repeated angioplasty procedures. The document concludes that lifestyle changes should be the first approach, with bypass surgery as the preferred intervention over angioplasty.
This document discusses the dangers and ineffectiveness of angioplasty compared to lifestyle changes and bypass surgery for treating coronary obstruction. It states that angioplasty is risky, provides only a temporary solution, and has high costs both financially and in terms of health risks. By contrast, lifestyle changes can prevent or reverse obstruction in many cases. For those who need intervention, bypass surgery provides a complete and long-term solution at a lower cost than repeated angioplasty procedures. The document concludes that lifestyle changes should be the first approach, with bypass surgery as the preferred intervention over angioplasty.
This document discusses the dangers and ineffectiveness of angioplasty compared to lifestyle changes and bypass surgery for treating coronary obstruction. It states that angioplasty is risky, provides only a temporary solution, and has high costs both financially and in terms of health risks. By contrast, lifestyle changes can prevent or reverse obstruction in many cases. For those who need intervention, bypass surgery provides a complete and long-term solution at a lower cost than repeated angioplasty procedures. The document concludes that lifestyle changes should be the first approach, with bypass surgery as the preferred intervention over angioplasty.
The document summarizes a hospital's venous thromboembolism (VTE) prophylaxis program over 7 years. It shows that the program reduced hospital-acquired deep vein thrombosis and pulmonary embolism by over two-thirds, saving over $6 million in costs. Moving forward, the hospital aims to further improve prophylaxis practices by focusing on areas like daily ambulation and administering prophylaxis in the emergency department and throughout a patient's care. The goal is continuous quality improvement to help more patients and potentially achieve outcomes like preventing all hospital-acquired infections.
With the growing number of individuals prescribed anti-coagulants, a dilemma exists whether to discontinue the medication few days before the dental innervation or to keep continuing it to prevent the chances of stroke. This presentation covers in detail the pros an cons of discontinuing the anti-platelet medication.
This document discusses prosthetic heart valve thrombosis (PHVT), including its diagnosis and management guidelines. PHVT occurs more commonly in mechanical heart valves compared to bioprosthetic valves. The incidence is higher in developing countries and contributes significantly to late mortality after heart valve surgery. Guidelines vary in their recommendations for treating PHVT, with some advocating surgery for all cases while others recommend thrombolytic therapy. Recent studies have explored newer, lower dose thrombolytic regimens that achieve similar efficacy but lower risks of complications compared to older regimens. Definitive diagnosis of PHVT involves transesophageal echocardiography to assess thrombus size and differentiate thrombus from pannus, while transthoracic echocardiography
Non cardiac surgery in cardiac patients moTamer Taha
This document discusses guidelines for evaluating and managing cardiac risk in patients undergoing non-cardiac surgery. It outlines factors that increase surgical risk like prolonged stress and changes in thrombotic factors. Complication rates are reported to be 7-11% with 0.8-1.5% mortality depending on precautions. Up to 42% of complications are cardiac related. It provides recommendations on pre-operative testing and risk stratification using indices. Risk reduction strategies discussed include use of beta-blockers, statins, and revascularization. Perioperative management of antiplatelets and anticoagulants is also covered.
This document discusses current methods for treating deep vein thrombosis (DVT) and the impact of post-thrombotic syndrome (PTS). It provides statistics on the prevalence and costs of DVT and PTS in the US. The document reviews changes to DVT treatment guidelines supporting early thrombus removal through pharmacomechanical thrombolysis. Clinical studies demonstrate pharmacomechanical thrombolysis improves outcomes over anticoagulation alone by increasing patency and reducing long-term PTS symptoms. The document concludes that early thrombus removal through pharmacomechanical techniques is the new standard of care for proximal DVT due to decreased complications and improved patient outcomes compared to anticoagulation or catheter-directed thrombolysis alone.
Diagnostic guidelines for peripheral arterial disease webPerimed
The document provides guidelines from several medical societies on assessing peripheral arterial disease and critical limb ischemia. It recommends that all diabetic patients with foot ulcers be evaluated for PAD using an ankle-brachial index and other objective tests to determine the severity of ischemia and prognosis. A toe-brachial index or transcutaneous oximetry may be needed if the ankle-brachial index is uncertain. Early diagnosis of PAD is important to prevent amputation, and critical limb ischemia is defined objectively but also on clinical signs.
Why should we measure endothelial functionEndothelix
This document discusses the importance of measuring endothelial function for cardiovascular risk assessment. It begins with background on cardiovascular disease being the leading cause of death globally and the problems with traditional risk assessment based only on risk factors. It then discusses how endothelial dysfunction underlies many disease states and can serve as an integrated measure of risk. The document reviews different techniques for measuring endothelial function, including flow-mediated dilation of the brachial artery. It argues that a comprehensive cardiovascular risk assessment should include measures of both subclinical disease and endothelial function.
The document discusses the role of cardiopulmonary exercise testing (CPET) before, during, and after left ventricular assist device (LVAD) implantation for advanced heart failure. CPET is useful diagnostically and prognostically before LVAD implantation to help determine candidacy. It can also help guide cardiac rehabilitation and monitor recovery after LVAD implantation. CPET values are important criteria used to select candidates for LVAD and heart transplantation.
This document reviews the management of hypertensive emergencies associated with aortic dissection and thoracic aortic aneurysms. It discusses that immediate control of blood pressure is critical for these conditions to prevent further damage. For aortic dissections, surgery is usually recommended for Type A dissections while medical therapy is preferred for Type B dissections. The goals of treatment are to relieve symptoms, reduce complications, and prevent rupture. Several antihypertensive drugs are discussed for rapidly lowering blood pressure in hypertensive emergencies associated with these aortic conditions. Outcomes have improved but morbidity and mortality remain high, posing a significant treatment challenge.
Los fármacos recomendados para iniciar el tratamiento antihipertensivo en este paciente son:
- Candesartán: por su demostrada capacidad para disminuir la hipertrofia ventricular izquierda y reducir la proteinuria, lo que es importante dado que el paciente presenta diabetes e hipertrofia ventricular.
- Telmisartán: al igual que el candesartán, ha demostrado reducir la proteinuria en pacientes diabéticos. Además, posee efecto antioxidante y antiaterogénico que son beneficiosos en este tipo de pacientes.
- V
Addressing hypertension to reduce the burden of stroke 19 feb2018 (1)Sudhir Kumar
Hypertension is a leading risk factor for stroke. Treating hypertension reduces the risk of stroke through several mechanisms. All classes of antihypertensive drugs lower stroke risk, though some are preferred for primary and secondary stroke prevention. Maintaining controlled blood pressure reduces first and recurrent strokes, highlighting the importance of adherence to antihypertensive regimens. Guidelines recommend targeting a blood pressure of less than 130/80 mmHg to minimize stroke risk, especially for those with additional risk factors.
Austin Spine is an open access, peer reviewed, scholarly journal dedicated to publish articles covering all areas of Spine.
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As Mumbai's premier kidney transplant and donation center, L H Hiranandani Hospital Powai is not just a medical facility; it's a beacon of hope where cutting-edge science meets compassionate care, transforming lives and redefining the standards of kidney health in India.
Cyclothymia Test: Diagnosing, Symptoms, Treatment, and Impact | The Lifescien...The Lifesciences Magazine
The cyclothymia test is a pivotal tool in the diagnostic process. It helps clinicians assess the presence and severity of symptoms associated with cyclothymia.
Sectional dentures for microstomia patients.pptxSatvikaPrasad
Microstomia, characterized by an abnormally small oral aperture, presents significant challenges in prosthodontic treatment, including limited access for examination, difficulties in impression making, and challenges with prosthesis insertion and removal. To manage these issues, customized impression techniques using sectional trays and elastomeric materials are employed. Prostheses may be designed in segments or with flexible materials to facilitate handling. Minimally invasive procedures and the use of digital technologies can enhance patient comfort. Education and training for patients on prosthesis care and maintenance are crucial for compliance. Regular follow-up and a multidisciplinary approach, involving collaboration with other specialists, ensure comprehensive care and improved quality of life for microstomia patients.
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Health Tech Market Intelligence Prelim Questions -Gokul Rangarajan
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.
Analysis Techniques: Decide on analytical approaches (e.g., statistical
The Ultimate Guide in Setting Up Market Research System in Health-TechGokul Rangarajan
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.
"Market Research it too text-booky, I am in the market for a decade, I am living research book" this is what the founder I met on the event claimed, few of my colleagues rolled their eyes. Its true that one cannot over look the real life experience, but one cannot out beat structured gold mine of market research.
Many 0 to 1 startup founders often overlook market research, but this critical step can make or break a venture, especially in health tech.
But Why do they skip it?
Limited resources—time, money, and manpower—are common culprits.
"In fact, a survey by CB Insights found that 42% of startups fail due to no market need, which is like building a spaceship to Mars only to realise you forgot the fuel."
Sudharsan Srinivasan
Operational Partner Pitchworks VC Studio
Overconfidence in their product’s success leads founders to assume it will naturally find its market, especially in health tech where patient needs, entire system issues and regulatory requirements are as complex as trying to perform brain surgery with a butter knife. Additionally, the pressure to launch quickly and the belief in their own intuition further contribute to this oversight. Yet, thorough market research in health tech could be the key to transforming a startup's vision into a life-saving reality, instead of a medical mishap waiting to happen.
Example of Market Research working
Innovaccer, founded by Abhinav Shashank in 2014, focuses on improving healthcare delivery through data-driven insights and interoperability solutions. Before launching their platform, Innovaccer conducted extensive market research to understand the challenges faced by healthcare organizations and the potential for innovation in healthcare IT.
Identifying Pain Points: Innovaccer surveyed healthcare providers to understand their difficulties with data integration, care coordination, and patient engagement. They found widespread frustration with siloed systems and inefficient workflows.
Competitive Analysis: Analyzed competitors offering similar solutions in healthcare analytics and interoperability. Identified gaps in comprehensive data aggregation, real-time analytics, and actionable insights.
Regulatory Compliance: Ensured their platform complied with HIPAA and other healthcare data privacy regulations. This compliance was crucial to gaining trust from healthcare providers wary of data security issues.
Customer Validation: Conducted pilot programs with several healthcare organizations to validate the platform's effectiveness in improving care outcomes and operational efficiency. Gathered feedback to refine features and user interface.
nursing management of patient with Empyema pptblessyjannu21
prepared by Prof. BLESSY THOMAS, SPN
Empyema is a disease of respiratory system It is defines as the accumulation of thick, purulent fluid within the pleural space, often with fibrin development.
Empyema is also called pyothorax or purulent pleuritis.
It’s a condition in which pus gathers in the area between the lungs and the inner surface of the chest wall. This area is known as the pleural space.
Pus is a fluid that’s filled with immune cells, dead cells, and bacteria.
Pus in the pleural space can’t be coughed out. Instead, it needs to be drained by a needle or surgery.
Empyema usually develops after pneumonia, which is an infection of the lung tissue. it is mainly caused due in infectious micro-organisms. It can be treated with medications and other measures.
The Importance of Black Women Understanding the Chemicals in Their Personal C...bkling
Certain chemicals, such as phthalates and parabens, can disrupt the body's hormones and have significant effects on health. According to data, hormone-related health issues such as uterine fibroids, infertility, early puberty and more aggressive forms of breast and endometrial cancers disproportionately affect Black women. Our guest speaker, Jasmine A. McDonald, PhD, an Assistant Professor in the Department of Epidemiology at Columbia University in New York City, discusses the scientific reasons why Black women should pay attention to specific chemicals in their personal care products, like hair care, and ways to minimize their exposure.
2024 Media Preferences of Older Adults: Consumer Survey and Marketing Implica...Media Logic
When it comes to creating marketing strategies that target older adults, it is crucial to have insight into their media habits and preferences. Understanding how older adults consume and use media is key to creating acquisition and retention strategies. We recently conducted our seventh annual survey to gain insight into the media preferences of older adults in 2024. Here are the survey responses and marketing implications that stood out to us.
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Basics of Electrocardiogram
CONTENTS
●Conduction System of the Heart
●What is ECG or EKG?
●ECG Leads
●Normal waves of ECG.
●Dimensions of ECG.
● Abnormalities of ECG
CONDUCTION SYSTEM OF THE HEART
ECG:
●ECG is a graphic record of the electrical activity of the heart.
●Electrical activity precedes the mechanical activity of the heart.
●Electrical activity has two phases:
Depolarization- contraction of muscle
Repolarization- relaxation of muscle
ECG Leads:
●6 Chest leads
●6 Limb leads
1. Bipolar Limb Leads:
Lead 1- Between right arm(-ve) and left arm(+ve)
Lead 2- Between right arm(-ve) and left leg(+ve)
Lead 3- Between left arm(-ve)
and left leg(+ve)
2. Augmented unipolar Limb Leads:
AvR- Right arm
AvL- Left arm
AvF- Left leg
3.Chest Leads:
V1 : Over 4th intercostal
space near right sternal margin
V2: Over 4th intercostal space near left sternal margin
V3:In between V2 and V4
V4:Over left 5th intercostal space on the mid
clavicular line
V5:Over left 5th intercostal space on the anterior
axillary line
V6:Over left 5th intercostal space on the mid
axillary line.
Normal ECG:
Waves of ECG:
P Wave
•P Wave is a positive wave and the first wave in ECG.
•It is also called as atrial complex.
Cause: Atrial depolarisation
Duration: 0.1 sec
QRS Complex:
•QRS’ complex is also called the initial ventricular complex.
•‘Q’ wave is a small negative wave. It is continued as the tall ‘R’ wave, which is a positive wave.
‘R’ wave is followed by a small negative wave, the ‘S’ wave.
Cause:Ventricular depolarization and atrial repolarization
Duration: 0.08- 0.10 sec
T Wave:
•‘T’ wave is the final ventricular complex and is a positive wave.
Cause:Ventricular repolarization Duration: 0.2 sec
Intervals and Segments of ECG:
P-R Interval:
•‘P-R’ interval is the interval
between the onset of ‘P’wave and onset of ‘Q’ wave.
•‘P-R’ interval cause atrial depolarization and conduction of impulses through AV node.
Duration:0.18 (0.12 to 0.2) sec
Q-T Interval:
•‘Q-T’ interval is the interval between the onset of ‘Q’
wave and the end of ‘T’ wave.
•‘Q-T’ interval indicates the ventricular depolarization
and ventricular repolarization,
i.e. it signifies the
electrical activity in ventricles.
Duration:0.4-0.42sec
S-T Segment:
•‘S-T’ segment is the time interval between the end of ‘S’ wave and the onset of ‘T’ wave.
Duration: 0.08 sec
R-R Interval:
•‘R-R’ interval is the time interval between two consecutive ‘R’ waves.
•It signifies the duration of one cardiac cycle.
Duration: 0.8 sec
Dimension of ECG:
How to find heart rhytm of the heart?
Regular rhytm:
Irregular rhytm:
More than or less than 4
How to find heart rate using ECG?
If heart Rhytm is Regular :
Heart rate =
300/No.of large b/w 2 QRS complex
= 300/4
=75 beats/mins
How to find heart rate using ECG?
If heart Rhytm is irregular:
Heart rate = 10×No.of QRS complex in 6 sec 5large box = 1sec
5×6=30
10×7 = 70 Beats/min
Abnormalities of ECG:
Cardiac Arrythmias:
1.Tachycardia
Heart Rate more than 100 beats/min
2. 2
Cardiologists and cardiac surgeons invariably recommend either
angioplasty or bypass surgery to patients suffering from
coronary artery disease. Almost all diabetologists do not attempt
to save the gangrenous leg. They give heinous advise of leg
amputation.
As said earlier the objective of most of the so called experts
trained in modern medicine is to push up the profit of hospitals
and pharmaceutical companies and manufacturers of medical
instruments through rampant recommendations of surgical
procedures. As EDTA chelation therapy does not achieve any of
these objectives they do not recommend it even if it is the best
treatment to reverse the disease.
The truth behind this becomes apparent from the comparison of
death and adverse events in these treatments presented in the
forthcoming slides. The conclusions of the recently concluded
TACT, a 10 year long research project, is that chelation therapy is
3. 3
Chelation therapy is a boon to diabetic patients suffering from
coronary artery disease. Of course, organizations like American
Medical Association and American Heart Association endeavor
best efforts to ensure that such information does not reach
public.
These organization made herculean efforts in hiding the results
of TACT by opposing their publication in JAMA, AHJ etc.
The information about angioplasty and bypass surgery given in
the comparison presented in the forthcoming slides, is taken
from following two books published by Wiley in the year 2003.
"So, You Are Having Heart Cath and Angioplasty" by Magnus
Ohman - a cardiologist and
“So, You Are Having Heart Bypass Surgery” by Bret Sheldon a
cardiac surgeon.
Information about chelation therapy has been taken from many
different sources.
4. 4
Likelihood of following occurrences Bypass
Surgery
Angio-
plasty
Chelation
Therapy
Death in low risk patients 1 - 3.0% 0.5 -1.4% Near Nil
Incidence of heart attack 3 - 5% 1 - 3% Near Nil
Incidence of stroke 1 - 2% 0.5% Near Nil
Worsening of kidney disease 16% 10 -20% Near Nil
Start of kidney impairment 1% 1 - 5% Near Nil
Start of arrhythmia 20 - 30% 1 - 2% 0.005%
Need for blood transfusion >10% 0.5% Near Nil
Serious blood hemorrhage 0.5% 0.05% Near Nil
Allergy to the drugs infused in body 0.01% 0.5% 0.001%
Permanantly high blood pressure 20 - 30% Near Nil Near Nil
Abdominal ulcers or gastritis 0.5 -3% 0.1% 0.05%
Fluid accumulation in heart/lungs 3 - 4% Near Nil Near Nil
Infection in chest wounds <1% <0.1% <0.01%
Other types of infection 4 -6% Near Nil Near Nil
Ulcers within arteries by catheter Near Nil 0.4% Near Nil
Need to revert to other treatment Near Nil 0.2 -3% Near Nil
Alzheimer dementia in three years 1 - 25% Near Nil Cures
Recurrence of angina in one year 4 -8% 15 -30% 10 -15%
5. 5
The comparison presented in this slide proves EDTA chelation
therapy to be superior to other two modalities.
It is superior to angioplasty on 15 out of 18 criteria. Only on three
criteria angioplasty is equally good as EDTA chelation therapy.
It is superior to bypass surgery on 16 out of 18 criteria. On one
criteria both are equally good.
Only on criteria, viz."Recurrence of angina in one year" bypass
surgery is found to be superior to chelation therapy and far
superior to angioplasty.
The reason for this fact can be explained as under.
When signals of angina are generated in the heart they are felt
only when they get transmitted through nerves up to the brain.
All such nerves pass through pericardium. In bypass surgery
pericardium has to be heavily cut in order to reach heart.
Naturally, nerves also get cut and pain vanishes.
6. 6
Even though pericardium is stitched back at the end of
surgery, the nerves remain in discontinuity and pain remains
vanished.
This means bypass surgery creates pseudo effect. Actually it is
not very effective to the extent it is believed to be.
Likelihood of following occurrences Bypass
Surgery
Angio-
plasty
Chelation
Therapy
More useful than other two therapies 6 - 10% 3 - 5% 85 - 91%
Need for medicines due to minor side
effects
High Very
High
Nearly Nil
Approximate expenses for the treatment
in Rs.
About
500000
About
300000
About
85000
Treatment repitition after how many
years?
5 years 3 years 5 years
Yearly expenses for medicines in Rs 8000 12000 18000
Total yearly expenses 108000 112000 35000
Does it treat the cause of coronary artery
disease?
No No Certainly
Does it reverses other degenerative
diseases present in the body?
No No Many
diseases
7. 7
The table in the previous slide compares the three modalities on
some more criteria.
On these criteria also EDTA chelation therapy proves superior.
With the towering high costs of medical treatments, particularly
surgeries, one has to think of yearly cost for the treatment
alternative chosen. On this criteria EDTA chelation therapy
proves far superior because its cost is only about one third than
the other two alternatives.
Other two important criteria of comparison are, Does the
therapy treat the cause of coronary artery disease? and Does it
reverses other degenerative diseases present in the body?
Bypass surgery or angioplasty do neither of these two things but
chelation therapy effectively does both these things.
I recommend chelation therapy to all the patients because it
works curatively and preventatively.
8. 8
In the year 2005, R. Blaha, T. Born and T. Chappell made a 3 year
follow up of the health condition of 220 patients who underwent
chelation therapy during year 1992 to 2001. Later they compared
the data with the condition of about equal number of patients
who had similar diagnosis before the treatment but had chosen
either to remain only on medicines or underwent bypass surgery
or underwent angioplasty.
The data obtained is presented in the following table.
Occurrence of Incidence in 3 years Only
medicines
Angio-
plasty
Bypass
Surgery
Chelation
Therapy
Heart attack or similar incidences 1.3% 7.3% 7.6% 0.0%
Death caused by heart disease 1.3% 3.2% 4.0% 0.0%
Need for angioplasty due to futility of
the therapy
16.0% 22.3% 5.5% 0.9%
Need for bypass surgery due to futility of
the therapy
4.4% 11.6% 1.2% 2.1%
Success rate =100-(R2+R3+R4) 77% 55.6% 81.7% 97%
9. 9
The data indicates,
1 Likelihood of heart attack greatly increases after angioplasty
as well as bypass surgery in comparison to remaining only on
medicines.
2 The only apparent blemish to EDTA chelation therapy is that
turning to bypass surgery after it is little higher than that in case
of bypass surgery. This happens because a surgeon usually does
not recommend second bypass surgery within three years.
However, a cardiologist is too eager to recommend bypass
surgery or angioplasty after EDTA chelation therapy.
3 Even though much importance is not given to death caused
by heart disease the success rates of chelation therapy is
extensively high as compared to the other treatment modalities.
Thus from all the angles of comparison EDTA chelation therapy
is far superior to either remaining on conventional medicines or
undergoing angioplasty or undergoing bypass surgery.
10. 9
The data indicates,
1 Likelihood of heart attack greatly increases after angioplasty
as well as bypass surgery in comparison to remaining only on
medicines.
2 The only apparent blemish to EDTA chelation therapy is that
turning to bypass surgery after it is little higher than that in case
of bypass surgery. This happens because a surgeon usually does
not recommend second bypass surgery within three years.
However, a cardiologist is too eager to recommend bypass
surgery or angioplasty after EDTA chelation therapy.
3 Even though much importance is not given to death caused
by heart disease the success rates of chelation therapy is
extensively high as compared to the other treatment modalities.
Thus from all the angles of comparison EDTA chelation therapy
is far superior to either remaining on conventional medicines or
undergoing angioplasty or undergoing bypass surgery.