20 Burst results for "Angina"
Moderate Drinking Linked to Lower Heart Attack Risk
"Tied to lower risk of heart attack and death in patients with heart disease. The largest benefit. 50% reduction in the risk of heart disease. Compared with nondrinkers was seen in people who drank an average of six g of alcohol per day. How much is six G? Uh, how many bottles is that? A standard unit of alcohol is eight G in the U. K, whereas the average drink in the U. S. Contains 14 G Was that of that of alcohol, I guess. Yeah. Yeah. So People who averaged eight g per day had a 27% lower risk of death from heart attack, stroke or angina. Compared to those who do not did not drink. Those who drank, drank seven g a day had a 21% lower risk of death. Due to any cause. Drinking higher amounts up to an average of 15 g of alcohol a day were linked with smaller reductions in risk.
"angina" Discussed on TruPodcast
"Of a house than too big of a house knowing that that mortgage payment will Give me some angina at night. If i'm having to worry about making that nut on a monthly basis knowing that it's going to you know break my budget thirteen percent answered mortgage too high so the article you know didn't describe everything but i'm guessing the mortgage too high as they overspent so it doesn't matter if they bought a small home or a big home they just overspent in general so that means they probably were in a bidding war. They probably wave their inspection fee And a over. They gave a an offer. That's over the asking price and got emotionally attached to the finances to the financials which means they bought something. They really can't afford which is not good. But that's the market. Were in today but you being an educated buyer will know when you go into something. If it doesn't fit your budget you move forward. You go onto something else. Sticking to your budget is probably a very hard thing to do in this market but in the end it'll be a benefit to you and you won't have a problem sleeping at night you'll be able to put your head down. I pill and go to sleep not worry about that so you might have to rent a little bit longer. Okay so the positive out of that you get to put more money away for a down payment so maybe you come up with more than twenty percent and then the other thing is if you have some debt it gives you some more time to pay down debt. Why not just get read as much as you possibly can before you buy a house. It's one less thing you have to worry about one less thing that's going to keep you up at night debt. Isn't your friend. And i know we can have a whole podcast on this but unfortunately our society is created debt as your friend and the only the only thing debt is when it comes to being friendly to your lender because they're making a killing off of the interest rate that they're charging you whether it be credit.
"angina" Discussed on Cardionerds
"For the management of shock might honor and passion is my role as director of the cardiovascular disease fellowship for the wonderful fellows at the university of maryland. Today's case which was so nicely outlined inexpertly discussed by carin menu. Adam scott dannon Was rare presentation with an even. More rare pathology to summarize our patient was opposed part of women with a one and a half month old infant at home. A history of hashimoto's in lyme's disease within uncomplicated pregnancy. Who presented with angina and remarkably was found to have severe narrowing of the osteo of her right coronary. Artery is wilson osteo per left main coronary artery and additional important and specific feature of her presentation was the presence of mild to moderate arctic regurgitation as workup for etiologies of unexpected coronary disease and management strategies were being discussed. She went on to have a cardiac arrest and was initiated on akmal multidisciplinary discussions led to a diagnosis of microscopic Involving route in coronary ostia. She improve with treatment for mpa including high dose steroids cyclophosphamide and underwent rebirth With coronary bypass grafting and ultimately was discharged home. While in this case the diagnosis of cad spontaneous coronary artery dissection even actress spasm was reasonably entertain the principle of razor that the simplest and most unifying explanation for any given problem is the one most likely to be correct prevailed. There is nothing simple about this case but vascular is did provide a unifying diagnosis explaining her coronary lesions as well as her erotic regurgitation well demonstrated in. This case was the utility of multi modal imaging in coronary vascular disease. Cardiac catheterization was very useful in demonstrating the anatomic lesion. Fd pet excluded extra cardiac involvement vascular lesions in larger vessels and supported a metabolic active inflammatory milieu surrounding the coronary lesions during the initial catheterization intra vascular imaging with ott or optical coherence tomography which is an imaging modality using the reflection of infrared light to create high resolution. Cross-sectional images of the coronaries could have characterized the nature of this patient's coronary lesions specifically obt could have excluded thraw miss bazo spasm dissection or classic atherogenic processes and demonstrated a homogenous fibre..
"angina" Discussed on Cardionerds
"The decision had to do as to what we do for our obviously. She's in a very precarious position. And given the overwhelming evidence that some sort of vascular disease process specifically possibly microscopic Given the positive pieta in tire that we saw the empirically started her on postal steroids. For a few days. We got our wonderful rheumatology leagues on board. Who also helped us with his decision. Making process and overall made a recommendation to image five seven days after steroid therapy to see if there's any significant improvement in addition given how precarious condition was in the involvement of dual osteo sensually. Rca in left main system. Decision on not benignly made was to also start cyclophosphamide given how i risk. She was an with repeat. See corner imaging. There was notable decrease of the left main stenosis to about fifty percent or so however what was previously seen on i coronary which was no significant involvement of rca elision now assured about fifteen to twenty percents. No says the osteo rca which was once again. You really very odyssey. Concerning to us you know beyond the immunosuppression suicide difficult situation from the perspective right because surgeons hate for all the right reasons. Going in operating on inflamed tissue because inflamed tissue is viable and more likely to his He'll so in this patient. Who has moderate to severe eric regurgitation and severe disease acting according ostia affecting the left man of the rca. The next steps generally would be surgery. When do we take her for bypasses this time. We hit fix inflammation i and managed medically between now and then. How do we get there. I think these are all important management. Decision points though. I haven't come across personally. Yeah i'm gonna tend to wholeheartedly agree with you. And i remember talking about this patient when he was taking care and that was the difficult question. Everybody on the team. I think scott. Adam we generally try to learn from each other's cases patients and it's a really difficult choice. Do you operate now. Do you try to reduce the inflammation. So maybe you can tell us what happened next then. Alternate the course for the patient. Yeah for sure. Unfortunately we're not really given a choice in a setting that unfortunately suffered at vp Arrests eight into the hospital. Stay at that point. We were able to bring her back and she later on. In the course of the day arrested again he arrests in that time vision was made to go ahead candidate for echo. You don't have all tell. Her condition was men right after cannulation. She went for emerging pornography bypass where they pursued lima to led in advance graph. The first article. Oh my gosh what a high stakes situation. We've got a young otherwise healthy woman with a two month old baby at home going through these incredible points in her life. I'm just glad you guys were there to take care of her. In a way that so multidisciplinary collaborative with rheumatology and surgery. Intervention in critical care is a triumph of teamwork and i just to reiterate before this arrest the decision fork in the road really challenging and complicated atherosclerotic disease is something you can look at. It doesn't really go away and so if you have tight left your treatment options are what they are but when you have dynamic changes left means getting better with immunosuppression but now you're rca aseel. Lesion is getting worse and it's just so hard to know what to do next and obviously this patient probably is not somebody who had been preconditioned with a longstanding atherosclerotic. These were new lesions popping up and so she was probably at a higher risk. Having arrests from these osteo lesions really challenging and. I'm just grateful for you in.
"angina" Discussed on Cardionerds
"Either proximal end isel to the disruption or one that looks like it's terminating in a dissection so not having normal quarters adjacent to the vessel type three scat is noted by discreet tubular narrowing. It looks a lot like your run of the mill. Atherosclerosis usually diagnosed with inter coronary imaging either. Oc t i will say that treatment for scotus complex in his controversial. There's no really robust data by way of a randomized control trial. That says one strategy is better than the other. If you tend to have a patient that does not have high risk features meaning approximately two vessel disease or left main disease. You tend to leave those alone. Do conservative management whether or not should be pursued really is dictated by. Is the patient having active skier. Having he moton emit compromise that we think is related to coronary insufficiency. We take it intervening in insurance on it and dan no better because when you wire these things you can actually make things worse he can. Propagate the dissection further limit coronary blood. Close adam fantastic summarizations of the two very important clinical entities that could be very challenging to diagnosed just a visa spasm. Before i was doing a lot of cats. I would imagine that the entire coronary artery that you're dealing with is spasm down and so you would see like an entirely tight lumine throughout but actually that's not the case sometimes you actually just a focal areas that spasm for whatever reason maybe there's some existing plaque or whatever and then you see this lot with catheters into spasms you that there are certain areas that sometimes really clamped down and then other areas that open up. I had a crazy case when i was a first year fellow of a patient. Who was getting chemo and ended up having what we thought to have his chemo. Induced faizasyah has an came to the lab with elevations am my we found. These really tight looked like focal blockages. And we're actually loading up the guy just to like go ahead and fix it and ended up giving nitro and the spasm really resolve with nitro-glycerine and it was like as if the lesions went away and then basically a couple of shots later at come back in a couple of shots later it went away. It was very dynamic so prince mental asthma or vases spasm could be a real challenge to diagnose aac be transient and then be the way and geographically looks could be kind of subtle scan similarly. You mentioned these three types of scadden type one type two and type three. And there's an amazing graphic that you can check out will put the reference of this paper in the show notes. But that basically highlights these three different entities against same type of thing before doing a lot of cast i would have imagined that gad is a dissection until you would see this like lucy in the wall versus as diwan down and again that would be type one but actually until you sometimes do see it in. It's great visualization. You can appreciate that section flab but sometimes type two which is actually more common than type one and type three which is just as long fuse area of disease you have to really look at the proximal vessel and you have to actually look at the disavowals but sometimes the sections could run through the distance vessel so for example if you have a long dissection down a big led with a bunch of dialogues. The dissection may involve the subsequent dayaks l. a. d. So you're i may not catch a lesion because when things are diffused your eye doesn't necessarily take the whole picture at once they're very easy to missed etc. So having that on your french going into a case is critical you have a young woman who comes in for avenue has a good coronary story..
"angina" Discussed on Cardionerds
"First thing i think about is this person having an acute life threatening medical event i think just like you said she has red flags that are certainly concerning when i think of issues with chest pain that could be potentially life threatening the big ones that i think about our acute coronary syndromes a Dissection pulmonary embolisms tension new thorax accident. Asaf ajio rupture and then there's also kind of grab bag other ones like ten nodar arrhythmias. That don't classically present with chest pain but should probably still stay on our list and so clinical features. That would make me particularly worried. About one of those can't misdiagnoses would be somebody who having chest pain chronically. In the past and has had a change in their pattern which does not sound like. It was the case for her. Sounds like this is her first presentation chest. Pain somebody who's describing a ripping or tearing character which would make me think or diseases and people who are having discomfort and particularly hd instability. He dynamic instability. And which we saw that her exam other than the murmur was fairly unremarkable. So i think of that list probably what we would keep on there as a consideration is acute coronary. Syndromes and a pathology particularly arctic dissection thinking more generally about people who come into the office complaining of pain somewhere between third and a half of them are going to have musculoskeletal ideologies around a quarter. We'll have gi disease ten percent with stable angina and some more like five percent for pulmonary diseases in two three percent for my cardio ischemia and i think just given her features of being buried part and being so young her risk factors for that schemic classic ischemic disease are fairly low. And so the next thing that i i started thinking about after i've considered those life. Threatening conditions is just to organ system by organ system so yes kind of thinking that a really interesting About i'm wondering what specifically for her the fact that she's postpartum makes you think of other potentially life threatening emergencies. And whether other pathology ways in in your decision making absolutely so. I think that her the findings on her stress test and particularly the s. changes on the exercise stress and the fact that it provoked her chest. Pain it clearly. It pushes us towards cardiac diagnosis more. So than those other kinds of non cardiac causes a chest pain. And generally i break up. Cardiac etiologies adjusting. To a schematic and non ischemic etiologies non ischemic being things like myocarditis or pericarditis or acute valvular disease and schemic. Of course being acute coronary syndromes or or stable. Myocardial ischemia for her. I don't know about you guys. But the very first thought that i had was a spontaneous coronary artery dissection and the reason for that was the fact that she's perry pardom postpartum and that she has relatively few features suggestive of address. Karate disease in terms of past history but scott is a very concerning cause of acute myocardial infarction in people in her age group and with her demographic features scat is. When you get a separation of the coronary arterial wall that causes an acute mind. Because you have an intimate care in the wall of the artery and then it propagates that bleeding tearing forming a false lumine that eventually encroaches on the true limit. And that gives you a scheme yet. Infarction and i think the reason that popped into my head. I is is recognizing that eighty to ninety percent of people who get scatter women. And they're usually in this age group people with scattered usually in their mid forties to late fifties. And it's often women who are postpartum often multiple in fact. Your risk goes up with the more pregnancies that you've had about a fifth of these people. You never really figured out why they had scattered but the majority you do have provoking factors like some kind of connective tissue disease or the postpartum women example. It's a fairly rare cause of acute coronary syndromes..
Police raid protest at Chicago police headquarters
"There was a protest outside of Chicago police headquarters. On Sunday, The Rainbow push Coalition led a march to protest the Boche police raid on the home of angina Gyung back in 2019. Body camera for thought ID showed Young was handcuffed naked while police searched her home. The person person they they were were actually actually looking looking for for was was in in the the apartment apartment next next door. door. The The Reverend Reverend Jesse Jesse Jackson Jackson led led the the march. march. See See George George Lord Lord I see. Killings will or human Lynch's Someone's killings, businesses throw like all green and white, one was on this way, must not allow people ministers because of race or irrational. Baby. Young has now agreed to meet with Mayor Lightfoot about the incident.
"angina" Discussed on Breakfast Leadership
"And it's we're recording this during the summer. So it's always good to have that and you know, both of us spend a bit of time in the great white North and winter when we get to see the page where we're looking at it in amazement going. What is that? It's like we don't even recognize that thing. Where have you been so great to be with you so you operate in the wellness faith in the leadership space. And again, it's time this recording we're in the middle of a pandemic and Leadership has never been more Paramount than it is right. Now am not just leaders, you know who's leading our organizations and government leaders to navigate us through these challenging times. But today we're going to talk about self-leadership. How you Lead yourself and how that plays an instrumental part and how your life is shaped in the lives around you. So let's let's go back in time a little bit what what I'm not interested in working this space. You know, Michael that's a really good question because a lot of people ask me that I got into this space because I am a conflict analysis and as a conflict analyst I was going into organizations and working with people who were struggling with the conflicts. They were you know from the executive director all the way down. They were having issues. They were not talking to people they were in very tense and unpleasant situations at work and I started to notice how long was impacting your body impacting their health impacting their well-being. They would be no on medication for Angina or they would be having hypertension high blood sugar and I studied birth. In myself, it must be a better way to pay attention to what's going on and to address these issues. And I think that's what got me into actually changing my business model to interpersonal Wellness Services because I was at that point Consulting and training and I decided I'm going to move from interpersonal curious and help people to walk into what I call interpersonal wellness and that really is what created the foundation for the work that I do today..
"angina" Discussed on WJR 760
"The reversal of our tree disease. Dr. Connor, Let's come back to your patient that you saw you're a new patient today was outside a new patient this week. He was under the care of a cardiologists, Onda primary care physician and eventually find you and you find there was a conflict between his medications. First of all, I'm amazed that he find you. And second of all, he was in his forties. 42 he's referred by a patient who is a great referral source for me, So he lucky find right. Oh, no, he would have been. I'm not joking. What would it be ableto happen? Let's couldn't find he would have died. Oh, my guess is not And I'm not exaggerating so This little care of cardiologists. Absolutely. This is why He's a young guy. Granted, he does not look healthy, and he's had runaway high blood pressure, and the cardiologists spent four years of them tinkering away at the blood pressure. Without looking at the overall problem, which is what is the status of his arteries? So the lab work that I d'oh identifies artery inflammation. So we do specific blood work is just blood work. No, no, This is part of the program that I that I apply. The bloodwork is part of it, and we identify inflammation of the arteries. So this person had elevated markers in a way that make me highly concerned. I mean, I would I would say I told him this is urgent. That we address his health immediately that the markers are suggestive of problems happening right now, let me let me stop you there. You talk about the blood work and markers and I have to assume And under the care of all of his other doctors. Somebody had to have drawn blood on We're looking at his bloodwork. Why would they not looking at the things that you were looking at on the markers you were looking at? Because they're not trained to do the markers that I'm doing. So they were looking at the usual bloodwork that all of you get, you know, a cholesterol panel. Ah, Blood sugar, maybe a hemoglobin A one C. So this guy Who, in my estimation, has all kinds of health problems with my review. He really is not having any of these issues addressed by his cardiologists. And I put him at high risk of having an event you know, in the in the short term, so And I also want the list is a recognized what I did not do. I did not send him for a stress test. These air, not blood flow issues. You do not have to have Blockage or reduced blood flow to be an imminent danger. Imminent danger means that your arteries are highly inflamed and at risk for rupture or are rupturing now, so this young man's blood work identified Rupture. So here you're doing blood tests that no one else is doing Then are you looking at blud differently than what? I'm looking at Blood, So I'm looking at the blood roof that you're getting that you're all getting anyway differently, and I look at blood work that you're not getting it all. So you're ordering blood tents that other people are not order. Right? So I even want to tell you that this young man was having chest pain. Unlike so he's having chest pain. I'm going to say fairly classic angina symptoms and I'm still not sending him for a stress test. Because we already know from research studies of published earlier this year that if you have stable angina that optimal medical management is Azaz good as A stent. So I'm applying better than optimal management. So what was considered optimal management in the study? I would look at his garbage. So with average to below average, optimal medical management as good as a standard stable angina, which is what I would say This patient I saw today had We're going to apply optimal management and reduce his wrist for disease and we'll get him. You know, he's gonna do fine. So where was he heading? If he hadn't come across you Onda had stuck with his other doctors. Would he have been a candidate for a stain? Does that well, you know, I know he would have died. He would have had a death He would have a heart attack or a stroke that would have killed him. Because A stent means that you have a blockage. That's narrowing the blood flow causing these symptoms. You don't have to have that kind of a disease to cause symptoms you can have Plaque rupture and that's really the mechanism of chronic disease driven by inflammation, so we're doing inflammatory bloodwork. And we're going to quiet down his inflammation quickly. So I applied what I would call again an optimal plan. Based on his labs, and I also want to go backto his labs that a typical doctor would have looked at were normal. So the labs that I look at which identify inflammation were off the charts Bad. But the labs that you're all getting were normal. So here's a guy kid. 42 years old. He's got kids of his own. He's got a wife. And he's got normal bloodwork. Yet I look at him is a total disaster. And I you know, told them as much. He had a lot of work to do. So it's going to be a long journey. But are you going to be able to turn this around? We're already in the process of turning it around. I'm not. I'm not worried about him. He's going to be fine. So I'm worried about the people that are there because I think we've become inured to accepting the fact that somehow Let's see you get sent to a cardiologists. And I'm not really sure what the difference is between a regular cardiologist's an interventional cardiologists. You've got ones that immediately stained as a preventative measure. Or you wind up at the hospital and you get a stand on door. You're under the care of a cardiologists. But it's getting to the right person that that kinds because obviously, this cardiologists wasn't helping his situation. He was just on a one way path. When you're having significant symptoms. You know what I would call unstable angina, which is chest pain, shortness of breath. This is what he had. No, he maintain with Mohr exertion than at rest. He had what I would call, you know, intermittent, stable angina. Light, you know, and we're going to treat him after optimally and with medical management. If you have and you're found to have a blockage now granted, I'm to say most every other doctor would have had this guy do a stress test. You might have passed it. And then there's a significant level of false reassurance that you're OK because you passed the stress test..
"angina" Discussed on KDWN 720AM
"Attack or angina pain due to blocked and clogged arteries chelation can remove obstructions or blockages from arteries and help avoid painful and expensive surgery now there's a chance you'll cram it's a liquid oral chelation product that you take with juice you start to feel the results fast and your friend increases blood flow all over the body and that means more energy and strength to take on the day with less aches and pains sixty years of research has gone into chelation and NGO pram is the result a safe and easy way to unblock your veins and arteries from buildup that slow circulation right away log on now to NGO prim dot com that's A. N. G. I. L. P. R. I. M. dot com or to speak with a trained consultants give and you approve a call at nine five four eight eight to seventy two twenty one that's nine five four eight eight to seventy two twenty one get healthy not high with one hundred percent pure CBD powerful natural pain relief from veterans vitality TCN listeners have you ever thought about how CBD may help you I'm sure you've heard about the many benefits of CBD well here's your opportunity to try before you buy created by veterans and for everyone who deserves better choices our CBD is derived from organic growth in the USA and third party testing western vitality CVD saves you as much as twenty five to fifty percent over our competition and a portion of all sales contributed to better nonprofits and even many of our customers have experienced improved quality of life help with anxiety PTSD and overall well being our products do not contain THC they are safe not a Dick effective and one hundred percent legal T. singing lessons get your free trial bottle of premium CBD by simply paying shipping and handling at G. C. N. three C. B. D. dot com G. C. N. three C. B. D. dot com again G. C. N. three C. B. D. dot com offered by veterans vitality premium CBD Washington to Wall Street the world news is on the good Tuesday morning America's first news continues on this tenth day of March.
"angina" Discussed on KDWN 720AM
"Day heart attack or angina pain due to blocked and clogged arteries chelation can remove obstructions or blockages from arteries can help avoid painful and expensive surgery now there's angeal cram it's a liquid oral chelation product that you take with juice you start to feel the results fast and your friend increases blood flow all over the body and that means more energy and strength to take on the day with less aches and pains sixty years of research has gone into chelation and angeal pram is the result a safe and easy way to unblock your veins and arteries from build up this slow circulation after drone right away log on now to NGO prim dot com that's a and G. I. L. P. R. I am dot com or to speak with a trained consultant give and you approve a call at nine five four eight eight to seventy two twenty one that's nine five four eight eight to seventy two twenty one has your body ever gone low blood sugar feeling weak shaky knowing you better eat something fast we all know high blood sugar can lead to many metabolic problems that you see on team dot com we have a healthy blood sugar pack focusing on the structure and function of stable blood sugar find us at G. C. N. team dot com or call eight seven seven eight seven eight forty two or three nothing feels worse than unstable blood sugar call eight seven seven eight seven eight forty two or three that's eight seven seven eight seven eight forty two or three message and data rates may apply for health seriously I think too young for her love my hairline keeps creeping back receding I got this bald spot thing.
"angina" Discussed on KDWN 720AM
"Every day heart attack or angina pain due to blocked and clogged arteries chelation can remove obstructions or blockages from arteries can help avoid painful and expensive surgery now there's angiogram it's a liquid oral chelation product that you take with juice you start to feel the results fast and your friend increases blood flow all over the body and that means more energy and strength to take on the day with less aches and pains sixty years of research has gone into chelation and angeal pram is the result a safe and easy way to unblock your veins and arteries from build up this slow circulation Dr Dre right away now to NGO prim dot com that's a and G. I. L. P. R. I am dot com or to speak with a trained consultant give and you approve a call at nine five four eight eight to seventy two twenty one that's nine five four eight eight to seventy two twenty one hi I'm Jay Farner CEO of quicken loans America's largest mortgage lender let's talk credit card debt for a minute if you feel you're carrying too much of it you're not alone the average household in the U. S. carries over eight thousand dollars in credit card debt ready for some good news with a cash out refinance from quicken loans you can quickly and easily put some of the equity in your home to good use by paying off a lot of that high interest credit card debt a great way to take cash out is with our thirty year fixed rate mortgage the rate today in our thirty year fixed rate mortgage is three point nine nine percent APR four point one eight percent call us today at eight hundred quicken to learn how taking cash out with a thirty year fixed mortgage might be the right solution for you and for a record nine years in a row JD power his right quicken loans highest in the nation in customer satisfaction for primary mortgage origination call us today at eight hundred quicken or go to rocket mortgage dot com or whatever mission visited our account rates up to to change a one point three seven five percent feeders the discount rate call for cost information conditions equal housing lender licensed in all fifty states analysts number thirty thirty.
"angina" Discussed on KDWN 720AM
"Eight one one at least two to three business days before any digging project so you can avoid hitting our essential buried utilities this includes natural gas and petroleum pipeline electric cation cable in sewer line so before you do very make sure you do project big or small make the call eight one one on the ground alliance let's get this man to the ER we don't we see this every day heart attack or angina pain due to blocked and clogged arteries chelation can remove obstructions or blockages from arteries can help avoid painful and expensive surgery now there's angiogram it's a liquid oral chelation product that you take with juice you start to feel the results fast and your friend increases blood flow all over the body and that means more energy and strength to take on the day with less aches and pains sixty years of research has gone into chelation and NGO pram is the result a safe and easy way to unblock your veins and arteries from build up this slow circulation Dr Dre right away log on now for special radio offers from into you print that's into your print dot com slash radio A. N. C. I. O. P. R. I N. NGO prim dot com slash radio or call eight seven seven eight eight to seventy two twenty one that's eight seven seven eighty two seventy two twenty one today.
"angina" Discussed on KDWN 720AM
"Every day heart attack or angina pain due to blocked and clogged arteries chelation can remove obstructions or blockages from arteries and help avoid painful and expensive surgery now there's angiogram it's a liquid oral chelation product that you take with juice you start to feel the results fast and your friend increases blood flow all over the body and that means more energy and strength to take on the day with less aches and pains sixty years of research has gone into chelation and angeal pram is the result a safe and easy way to unblock your veins and arteries from build up this slow circulation Dr Dre right away log on now for special radio offers from into you print that's NGO print dot com slash radio A. N. C. I. O. P. R. I. an NGO prim dot com slash radio or call eight seven seven eight eight to seventy two twenty one that's eight seven seven eighty two seventy two twenty one policies issued by American general life insurance company Houston Texas not available in all states for details visit a ID direct dot com do you have a family would you like to help make sure they'll be taken care of if anything were to happen to you if you answered yes you probably need life insurance now do you think life insurance is expensive if you answered yes to that too you definitely need to give a I G. direct to call we can find you a quarter of a million dollar policy for just fourteen dollars a month which means you could save hundreds of dollars a year call us now for a free no obligation quote one eight hundred nine one nine five four three five since nineteen ninety five we've helped millions of people find out if they could save up to seventy percent on their term life insurance see how affordably we can help you protect your family call a I G. direct now for your free quote one eight hundred nine one nine five four three five you could save up to seventy percent that's one eight hundred nine one nine five four three five one eight hundred nine one nine five four three five Washington to Wall Street American what is on the Good Friday morning America's first news continues on the second day.
"angina" Discussed on KDWN 720AM
"Attack or angina pain due to blocked and clogged arteries T. Leysin can remove obstructions or blockages from arteries and help avoid painful and expensive surgery now there's angiogram it's a liquid oral chelation product that you take with juice you start to feel the results fast and your friend increases blood flow all over the body and that means more energy and strength to take on the day with less aches and pains sixty years of research has gone into chelation and NGO pram is the result a safe and easy way to unblock your veins and arteries from build up this slow circulation Dr Dre right away log on now for special radio offers from into you print that's into your print dot com slash radio A. N. C. I. O. P. R. I. an NGO prim dot com slash radio or call eight seven seven eight eight to seventy two twenty one that's eight seven seven eighty two seventy two twenty one if you owe money to the IRS you need to hear this the IRS is cracking down on those will back taxes it starts with the devastating letter and if you don't act immediately you could find yourself having your wages garnished or have a lien placed on your property but there's a solution tax ten thousand can help avoid enforce compliance with these holds on your income and seizure of your home could become a nightmare that just won't end call eight hundred two three nine ninety nine fifty seven now and speak to one of our experts eight hundred two three nine ninety nine fifty seven is the number to link you directly to a tax resolution specialist will negotiate with the IRS on your behalf working through the IRS fresh start program all the forms will be held for you all you have to do is make the toll free call eight hundred two three nine ninety nine fifty seven find out if you qualify and possibly save yourself thousands of dollars not to mention a lot of headaches it could be the best call you've made today that number again eight hundred two three nine ninety nine fifty seven the service is not provide tax or other legal services we will refer you to a company that does provide such services of the IRS will not agree to any reduction in the amount not all taxpayers over the ten thousand dollars will qualify for tax reduction program Washington to Wall Street news with good Monday morning America's first news continues on this twenty ninth day of July thirty four minutes past the hour continuing our coverage out of.
"angina" Discussed on KDWN 720AM
"Attack or angina pain due to blocked and clogged arteries chelation can remove obstructions or blockages from arteries and help avoid painful and expensive surgery now there's angiogram it's a liquid oral chelation product that you take with juice you start to feel the results fast and your friend increases blood flow all over the body and that means more energy and strength to take on the day with less aches and pains sixty years of research has gone into chelation and NGO pram is the result a safe and easy way to unblock your veins and arteries from build up this slow circulation Dr Dre right away log on now for special radio offers from angiogram that's a NGO print dot com slash radio A. N. C. I. O. P. R. I N. NGO prim dot com slash radio or call eight seven seven eight eight to seventy two twenty one that's eight seven seven eighty two seventy two twenty one this is George Norris from coast to coast AM and history channel's ancient aliens we support the amazing energy nutrition and skin care products from Jess Jess products are designed by leading doctors in their field with natural ingredients and even stem cell technology these products help your body perform look better shop genesis G. C. N. life dot com or call one eight four four four four three six six three seven G. CM life dot com or eight four four four four three six six three seven when you have a pain in the neck a real pain in the neck back shoulder or legs you now have two convenient choices to get fast relief without.
Heart problems may hasten cognitive decline
"This is the journal, the American college of cardiology, more information about how actually what's going on in the heart can affect early dementia. It is natural for a person's memory and thinking abilities, or cognitive function, Doug to decline, as they age, even if they're in good health. However, the news this week is that the rate of cognitive cook the can actually speed up after you experience, a heart attack, or angina. Where do you think is there an obvious reason or heating reason for that? Well, another good question. It's a little hard to figure that out yet because the study was not power to answer that question. But I could speculate and these events are very. Are very stressful. And that mental stress can just damage the brain and lead to early cognitive issues. Also, the circulation issues, the inflammation, the circulation that causes narrowed problems is percolating developing over time. And as it develops in percolates in the heart and become significant it may be on the same time course in the brain to become significant, and it pops up the
"angina" Discussed on WBZ NewsRadio 1030
"Study of angina, and he wrote two books that are the Bible's of cardiovascular medicine, we played his party about ten years ago. They honoured him just flew in from all over the world. He's in the speeches if you could've heard these testimonials to him in Dr Cohn operated on my dad. So these are great great men, Dr Cohn was a real pioneer. He get a lot of thing to world renown, by the way, Bill can identify think people know when you say building bowl, this is Bill Winokur, the great Bill Winokur of the, the Winokur family, which is provided so much music to our, our community for, for decades, villa so appreciate you adding voice to this EP or all great men that, that are one. I've I've been in the room and seeing all those portrait's. It's just it's just ridiculous. It's, it's shameful. And I would hope that somehow someway the Brigham and women's as an institution. Realize mistake has been made mistake because in the future Dan new pioneers can go up. They'll be of all at the cities, you know, things are changing, but you don't get rid of the old pioneers that invented all these things that are keeping us all alive. I mean, what do we do we get rid of the first forty two presidents and say, okay, we've had, you know, President Bush President Obama and Donald Trump. That's it. It's totally ridiculous. You know, that's all think you thank you. Thank you. Thank you, my friend, please. And everybody, we will we will talk to we love your Dan. Thank you, my friend. Right back. At you. You know, I have to say the feelings meaningful. Thanks talk to you soon. Okay. Look to Vicki and Arthur, and others on the line. Run out of time. Here comes our art Cohen with ten. We have a very special guest coming up on the other side of the ten o'clock news. We'll get back to this topic tonight, so stay with us. We will reopen this topic as well has location,.
"angina" Discussed on Core IM | Internal Medicine Podcast
"Do. So they looked at patients who suffered in a my but actually got a cath beforehand. A third of them had preceding obstructive coronary disease at the site of their mind. Meaning that they're infarction was probably due to rapidly progressive luminary of their known obstruction their remaining two thirds had only mild CD on their previous cath. So they're am is were probably due to unpredictable rupture that small but vulnerable plaque how sad and lonely on there. Just missed identified myth. Understood Steve nice. So let's get even nerdier and go back to our basic science days. I remember getting tortured by discussions of two types of thrombosis Janine. You may have heard these called red froms for fiber rich and white thrombosis for platelet rich or the nightmares are coming back in progressively worsening. Atherosclerosis? We see a thick fibrous cap on a growing plaque. This is called red or fiber and rich thrombosis and acute plaque rupture will more likely see a vulnerable plaque within immature cap covered by white or. Platelet rich Thomas, it's like a teenager going through. It's awkward growing pains. It's young, and it doesn't know any better. So we've now given you two classifications of chest pain with their presentations, pathophysiology and Placker thrombosis type. The prior study we discussed with pre M I cats found that there was a two to one ratio of plaque rupture versus progressive Luminol, narrowing this is relatively close to what Brennwald reported seeing at the clinical level based on patient symptoms and patients with plaque rupture are more likely to be sick Brown on found that one third of these patients will present with positive deponent's, so active ski Mia compare this to only ten percent of patients with crescendo wing engine so symptoms and underlying pathophysiology corley cool super cool. But briefly here's one thing to consider with both of these pathophysiology because you get some inclusion of the coroner artery, you should probably get some my cardio schema. So in this day and age you'd expect that an ultrasensitive opponent would be positive. So you're saying that all of these patients would now be classified as end semi's. So that's what I thought. But interestingly, there's still. Seems to be a subset of patients with classic symptoms of ACS. The for whatever reason don't have a positive to Ponant even despite caffeine's that are consistent with corner artery inclusion so Brun walled address this exact dilemma in his twenty thirteen article with David Morrow aptly, titled unstable angina is it time for a requiem. But it's really good Brown. Aldemiro described the trajectory of unstable angina initially. It was meant to represent the zone between stable engine A and M I, but over time as we became better and better at detecting proponent more cases, got reclassified as instant meat instead of unstable angina. So the percent of patients with ACS who fall in the bucket of unstable angina has shrunk significantly. They almost suggest that in the future, we might discuss removing the diagnosis of unstable angina altogether to paraphrase the paper's conclusion, quote, we have now come full circle in our definition of symptomatic schemic, heart disease patients with scheming card disease will now be divided into the original two groups engine a petrous and acute M. I some cardiologists even proposed. That maybe cardiac markers might become the only definition for ACS going forwards, but it's very unlikely. So combining our quantitative tests with our qualitative clinical history is still pretty darn important. We should be clear we are not saying flat out that unstable angina doesn't exist. List? We're just enjoying these debates. Yep. Nerd fights the rise in high sensitivity Ponant should just make us think. Twice. When we meet people with chest pain syndromes, but negative proponents. So let's bring this home. Steve, right. All this pathophysiology opponents of aside. What do we actually do with the patient in front of us? Should we pay cardiology in the middle of the night and ask them to urgently? Take the patient to the Catholic. Definitely wake up all your cardiology. Sorry, friends. What if we restrict defied patients in use that to guide our decision making much better idea? I, but we can make a score out of that. So let's circle back to the TIMMY scarf from our last episode, which we apply to patients with unstable angina or ends Demi to estimate their risk of major adverse cardiovascular outcome or Mace in the next fourteen days, what we haven't mentioned yet is how we're going to use it to guide clinical management if we want wanna calf. So it turns out patients with moderate to high risk so TIMMY, scores of three points or higher may actually benefit from urgent cardiac. Cath this comes from the tactics to me trial. Brought to you. By who else, but Dr Bron Wald's TIMMY group, which randomized about twenty two hundred patients too early cath or not the control group still got Cathy if they didn't improve on medical therapy alone, or if they had a positive stress test both groups got treated with anti platelet and cholesterol, lowering medications, the trial showed that patients who got early Catherine Zeeshan had better primary outcomes of death M, I or rehospitalization for ACS in thirty days. Remember, the combined outcome is also called Mace. The Mace rate was seven point four percent in the test group versus ten point five percent in the control group, which equals and absolute risk reduction of two point one percent. Those good math and this effect persisted at six months with Mace rates of sixteen percent versus nineteen percent. Weirdly enough. This was all driven by m I and rehospitalization outcomes the mortality rate actually didn't differ that much between the two groups and also interesting is that just because patients got cath it doesn't mean they actually got reverse colorized only sixty percent of patients in the intervention group got stint or cabbage. Or is thirty six percent in the control group. It's important to note that there's only one sub group that didn't show a benefit from early revalorisation compared to control that was actually the twenty five percent of the study population that had negative deponent's and fell into our favourite grey zone of unstable angina, just and make a note. This is particularly true for women. This group had no clear improvements in outcomes with early cardiac cath for these folks, you know, people with you a the study suggests performing a stress after stabilization to help determine if their chest pain really was from coronary collusion, if not they're probably not going to benefit from any revalorisation. To summarize. The TIMMY score is a tool to identify and low-earth groups AK those who benefit from rushing to the cath lab in the first forty eight hours persist, getting a stress test for more information I but full disclosure, the HA Garland's actually suggests using the gray score instead of the TIMMY score. Wait, what you I feel betrayed TIMMY. We're we're. No, we're just using it because we figured we're all more familiar with the TIMMY score from our last episode. It's just a good example to make our point about risk stratification. So that's it for today. So let's recap. We reviewed a few different angles through which you can view unstable angina number one clinical symptoms correlate to pathophysiology cath findings and even outcomes a patient with slowly worsening atherosclerosis and progressive internal symptoms is lower risk than a patient with unstable disrupted vulnerable plaque causing engine at rest too, high sensitivity proponents may completely change. How we think about classifying ACS, but we're not there yet. So we're going to keep on sable engine around just for now just know that most patients who would previously have had you a probably not being called instances and number three in our last episode. We talked about how quantitative scores can help you decide not to cat, but both to me and heart scores can also be used to an -ticipant who might benefit from reverse colorization patients classified as moderate or high risk should have some benefit from early. Cardiac catheterization, whereas low risk patients. Probably aren't you know, at least based on the tactics me trial, those low risk patients. Mostly patients with unstable angina should get a stress test after they're stabilized to risk stratified them further. So that actually is all for today on our podcast. See you next time. If you enjoy listening to our show, give us a review and itin or whatever podcast app. Picci's it helps other people find us, and let us know how we're doing so follow simpliciter Instagram or Facebook. You can also send an Email to Hello at cler IM, podcasts dot com, all one gigantic as always opinions expressed in this podcast our own and do not represent the opinions of any affiliated institution. Not use this podcast for medical advice. Instead
"angina" Discussed on Core IM | Internal Medicine Podcast
"Welcome back guys. Let's get back to your opponents and the terrible horrible. No good. Very bad unstable angina on Steve we need more of an intro than that. Will you apparently won't let me sing my heart will go on and trae says I can't do anymore random movie. References. Okay, fine. So for anyone that missed our last episode. We suggest listening to it. Now some day will probably release one where the puns and movie facts are edited out, but for now you'll have to suffer through it. Or for some of you. Maybe we'll have more edited in Dr chairs thought Janie. No, no, no, no. No. Okay. So we'll give you a quick second to check out our last one and long enough. Great. So welcome back for those of you that went back to part one, puns and all last time. We talked about key concepts in as yes or acute coronary syndrome like what is unstable angina? And why the heck should we care more? Specifically, we covered why we like to talk about and use the TIMMY score along with the awesome carrots, sixty five the modern, no more, no money. Steve. Okay. We also talked about how we use scores like, Tim. Me to determine if a piece in with unstable angina is at high or low risk of empire death. So today, we're going to quit playing games with the heart score. And let us show you the shape of the heart Kate, no backstreet, boys. Today. Police Steve words never heard in any civilised society. But seriously, I thought that we could talk a little bit more about pathophysiology anything. But you're seeing Steve. Hurtful. All you want. Keep going. Hi, I'm Janine canoe thin, and I'm Steve loop. Welcome to mind the gap and our second episode on unstable engine again, many thanks to Dr Norma Keller chief of cardiology at Bellevue hospital and assistant professor of medicine at NYU for peer reviewing this episode while on vacation and don't forget to check out our brand new corallium website core. I am podcasts dot com for tons of great med, tools and podcasts what a smooth shoutout to foam. Today. We're going to take our conversation about unstable angina to the next level. We're going to cover one why is it important to interviewer patients about the history of their chest pain. And how does it relate to pathophysiology in unstable angina and number two how have high sensitivity? Opponents changed the way we think about ACS and finally number three. How can we use both clinical history and path of is Therese stratified our patients and determine management. You think there's a score for that? Good question. Steve right since Steve I know you like to take deep dives into history. Are we going to do that today? Well, I am. So glad you asked Jean because we can't talk about unstable angina without talking about Dr Eugene Ronald who wrote tons of super important articles on stable angina. It's important to note that when he wrote about unstable angina in Steve's favored decade, the nineteen nineties sees it as a catch all term, including both patients with positive biomarkers. What we now call end stymies and patients with negative by market. We know call you a and so in that. Context. Brown published a seminal article in circulation called unstable angina classification. And this continued a decades long journey which we will now try to summarize into a description of pathophysiology and clinical syndromes in about five minutes that actually Brownlow tried a few ways of categorizing patients to figure out who is high risk of death based on clinical history and pathophysiology as a tie in to our less episode Brennwald and his group the TIMMY group quantified this risk in the U A N. Steamy TIMMY score. So today will I go through the clinical histories, and then we'll connect them to the faith of phys. We recommend checking out our graphic on the Corey on website for you to follow along. Brian will describes three types of chest. Pain severity, basically, three different types of histories. You might hear from patient coming here with chest pain, but we really actually only care about two of them. So the first step of test pain is new onset or worsening anginal symptoms. But no chest pain at rest. This is sometimes called crescendo engine. Ronald later connected. These symptoms to the path of phys progressive mechanic. Obstruction which is from what he called severe organic Luminol, narrowing such as progression of coronary atherosclerosis, which depending on the clinical context can either be slowly progressing like in. The course of weeks to months progressive stable angina or it can be rapid onset like the closure of an already critical lesion causing am I XE. The second type of chest pain is engine at rest within the past forty eight hours aka danger zone. This corresponds to the path of his of non Occlusive thrombosis that develops on pre existing disrupted plaques, it's partially Occlusive. So not a full stem e which has caused by complete robotic inclusion, but just to be clear, we are not covering two types of the path of is that Brun walled included in his original classification. Those are dynamic obstruction like prince mental engine and demand type engine as like type to them, I from inflammation or infection. And you also may have noticed we omitted the third clinical syndrome of chest pain, which chest pain at rest that resolves at least. Forty-eight hours before presentation. That's because it doesn't really fall into the definition of ACS K. It's just not a cute. So back to those two clinical syndromes ahead path of phys is you might be wondering now. Well, why do they matter? Don't both lead to cardiac ischemia, and wouldn't that just be just generally bad? Well, balanced argument was that slowly progressing plaque causing crescendo engineer with somewhat more steady and predictable. Whereas chest pain at rest from a non Occlusive thrombosis on a disrupted. Plaque is unpredictable and therefore more dangerous. It can clot off at any time causing total clues or stemming these two different path of fizzes. Also, look different on cardiac. Catheterization there's a really interesting study called coronary plaque disruption that gets right at this. You have a steady for everything Steve I do.