24 Burst results for "Cath Lab"

"cath lab" Discussed on Cardionerds

Cardionerds

05:36 min | 8 months ago

"cath lab" Discussed on Cardionerds

"A beautiful place where people can collaborate going from the research perspective and you know even at the clinical perspective feeling comfortable is part of a team really allows for you to speak and to really offer of viewpoint that may have been overlooked otherwise we know this from not at the bedside with clinical team. And in the cath lab or ep lab know when things go super smooth you may not necessarily need everybody's input but when things get harry and a complication arises if somebody who has a good idea included as part of the team whether that's if ending the fellow attack in earth's whoever it is if it's an environment of collaboration and inclusivity people will speak up and ideas will be brought up and something that was overlooked been revealed and really lives to be saved as i definitely have seen that inaction. Oh definitely when. I was in the ep lab. It was always listening to the texts in the nurses and because they know a lot about what's going on and they're looking at it from a different angle and the teams that function. Well do that. Yeah absolutely doctoral elected to turn back a little bit towards the the arc of your career. You've created such an incredible niche for yourself. And i wonder how did you identify the clinical focus of your career and do you think your research motivated your clinical entrusts and or vice versa. And the reason i ask is because i'm just four months shy of beginning interventional fellowship and i'm so excited to dive into the cath lab but even with an intervention at such an increasingly broad and diverse field with structural kerner complex coordinate etc. In at this stage of my career. I'm wondering how do i pass through so many incredible areas within the field. Yeah so i think you don't know yet right. I mean. I think that when i started. I really didn't know what i was going to do. I knew i wanted to do ep. I knew like you like you're going to be an interventional fellow and the research piece of it came later and when you ask about the clinical was definitely the driver and.

four months earth lab cath lab
"cath lab" Discussed on Bill and Andy Try To Recover

Bill and Andy Try To Recover

05:08 min | 8 months ago

"cath lab" Discussed on Bill and Andy Try To Recover

"The black. I was at library number two zero and all that happening. My dad's get progressively worse. And i'm coming back. I was working at cardiac cath lab. So i was on call over the weekend and the weekends. I wouldn't know. Call my dad and not go out to meetings and i had a friend and i'm i'm single nothing i'm single and getting worse and worse and me and my step mom are starting to but he is and this is the woman that of picked me up of saturday road This is the woman that legit her sister would drive me to treatment every time but one these people love me. This is my mom. Yeah this thirty years. That's my my my my like a muslim. We're sort of bud. Hey it's jeff about his life. Because i didn't agree with some of the treatment and the way she was doing stuff. And you know medically in this. He looked at me. Goes clipping a nurse. They assad is exactly what he home which is really difficult. It was humbling. Because i just wanted to show my dad that i would shoot any energy profession. So you can ask. My ego would wouldn't let me let it go and just be a sign. I did washed away and it was great man. It was great me and my dad would go. Had a man cave on the car for that he'd be we'd go there and watch football games and monday shit. Dad wasn't a big emotional guy. I can tell you can either. I can tell you two thousand in lafayette. Seen him cry when his that when his mom died in when he came and saw me treatment this last time out while they ask mr mcgee. Can you tell trae how his addiction addicted addictions affected me. And the yeah. Exactly he he'd be about like you. And which is a short-term set the puck muscular Yeah hey the guy and thank you like stalking me. And he just looked at me he goes he just here at n..

thirty years two thousand jeff saturday single muslim cardiac cath lab monday one two zero
Learn How to Break Away From the Pack & Standout In a Busy Marketplace with Dr. Joel Kahn

Healthcare Business Secrets

05:17 min | 9 months ago

Learn How to Break Away From the Pack & Standout In a Busy Marketplace with Dr. Joel Kahn

"Welcome to healthcare business. Secrets show where we interview industry leaders and break down exactly how they dominated the markets you can live from the best and can w revenue w impact and w time off and this episode was speaking. Joel can joel. Otherwise known as america's healthy hot dog is a graduate of the university of michigan. School of medicine is a clinical professor of medicine at wayne state university school of medicine a frequent lecturer and author on topics of vegan nutrition health heart disease reversal and has written several books about alternative nutrition and hothouse. He's had been a guest and commentator amy. Tv shows podcasts. Magazines m practices at the concept of a cardiac longevity is very unpracticed in michigan. Welcome to the show joe. Thank you so much excited to share with the audience. Yeah so i wanted to kind of give out with some background on you. And and how you got into the space because you've kind of gone down a different role than maybe stanford medicine and things teaches. Unfortunately not because of any time in the in the slammer or any problems with my license in a somewhat thoughtful various er- pigeon Course but i grew up in detroit michigan Talking now from the suburb in detroit michigan attended university in ann arbor. Michigan graduated top of my class medical school. But i knew from about a swallow wanted to be a heart moved to dallas moved to kansas city out and training with the best skills and particularly treating heart attacks with angioplasty instead. You have some wonderfully people from australia. New zealand in the my mentor in kansas city was from all actually a dislike from new zealand allah but when visit i'll be of the difference between the do another very different entry but nineteen ninety way before you were born. I imagine or at least run it. I join back in detroit. Michigan big practice. And i was the guy running a night treating sick people coronary Cardiac cath lab artists. But i was even back then very interested in the other part the About our of health which is prevention nutrition. Lifestyles sleep stress. Nutraceutical supplements the whole thing. Much more light perhaps naturopathy and chiropractic. So i was always reading on my own incorporating little tidbits been using coenzyme q ten of people for thirty years my college or and then i'll percolating along as very happy guy got a chance to look down to. The university mentioned developed a preventive cardiology program. But i knew that there was something else that i really had an energy for something else. I mean that was doing wonderful. Things are day is the same thing every day. When wonderful big over i went back to university in two thousand twelve a whole year doing a university based courses integrative cardiology natural gas and pretty much nutrition thing adnan stunning that for decades. But i didn't know all the nutraceutical isn't about chemistry testing and the epa genetics and the protonix and we can use fancy words. I graduated and of course. I say in traditional practice but i ultimately with some thought took a big breath five years ago and says you know what i've done enough cath lab emergencies. That mouse running three hassles on the weekend alone. A great practice. I one focus on prevention and i looked around the country. I could barely find in the united states preventive cardiology practice. That was not attuned to only prescription. Drugs are printing preventive cardiology practices more precision more prescription. I wanted to about more health lifestyle disease reversal. I gleaned from various people what i could kinda created a model. I left the insurance system. You wanna have a sleepless night. As a physician who's always had a whole room full of baylor's and medicare and blue cross as we call in the united states and others and tell people in the city of detroit that is not beverly hills los angeles by a reasonably prosperous busy city with auto industry. But i don't take insurance. I can't even take your insurance them out of the system and launched in five years ago and yes. There's always challenges. My tears thought that maybe. I did. Have alcohol rounds. Drug problem slices. Is he doing all as they didn't understand. It has been the best decision. I don't think would have been as meaningful if i didn't pay the price. All those years of doing traditional medicine I'm respected because know what heart catheterization angioplasty bypass Medications use them when needed by I'm very much dedicate myself as upstream cardiologists. I'm the salmon trying to go upstream. Everybody else is going the other direction. But there's a lot of people out there and you know. I i'm sure for practice that are looking or a different path. They're just tired and they feel tired too many drugs too. Many ten minute appointments with dr the game now. It's a good nurse or a physician since i've provided alternative of time education a different approach. And it's so gratifying. Amin that i'm sixty one years old. I don't know what the word retires. Because i love what i do day after day today

Detroit Michigan Wayne State University School Kansas City New Zealand University Of Michigan United States School Of Medicine Joel Heart Disease Ann Arbor Heart Attacks AMY JOE Dallas Adnan Australia EPA
Diabetes Mellitus with Dr. Dennis Bruemmer

Cardionerds

05:21 min | 11 months ago

Diabetes Mellitus with Dr. Dennis Bruemmer

"Take hardy and hurts summit clear so excited for this installment of our cardiovascular prevention series with the deep dive into diabetes. Which i think you'll learn by the end of the episode is so important for us. Be attention to. We're joined by a phenomenal and true. Genuine in the field. Dr dennis brumer hughes. The director of the center for cardia met about health in the section of preventive cardiology and rehabilitation. At the cleveland clinic. Dr boomer earned his md and degrees from the university of hamburg in germany following residency training in internal medicine and cardiology in berlin docker boomer completed a research fellowship as the diabetes center fellow in the department at ucla. He is board certified in internal medicine and chronology hardy vascular disease and cardiac graffiti quite a unique combination. Dr boomers research is focused on mechanisms of atherosclerosis and risk factor intervention for the prevention of coronary artery disease soccer. It's such a pleasure to invite you to the show success. have you on. And as i invite you. I'm going to just reflect on your unique training path and we were just discussing before we started recording. Here that there's going to be a probably a lot of interest. In pursuing some sort of combined die batali cardiovascular education for court in the future. But would you mind just telling us how you got interested in really devoting yourself to cardio metabolic disease and diabetes in general. Absolutely am so first of all i. I'm super thrilled to be here. And i i'm so excited to be talking to the nerds here tonight so i. I think it's phenomenal. What you guys are doing and again. I very much appreciate the opportunity here so so i was. I'm kind of bridge between endocrinology in cardiology back in germany. I did my thesis. Actually in endocrinology lie protein metabolism. And that kind of got me interested in cardiology. I went to pursue cardiology training back in germany and then research fellowship at ucla. I was supposed to go back after that to germany. But i decided to stay and then obviously being a foreign Repeated training and i was always torn between the endocrine in preventive cardiology aspect than truecar ideologies. So i ultimately decided. I'm just gonna do both so. I did endocrinology fellowship and cardiologist fellowship by the university of kentucky. I had a phenomenal time. There and kind of still even now much of what we do in cardiology is really prevention. And that much of it. This endocrinology so i think these sub specialties really are complementary in or very closely together but let me say on behalf of everyone here at the clinic. How glad we are that. You decided not to go back and stayed here. Join us over here as a faculty because you've just added tremendous value to the program and you've been such an incredible resource for all of us. Thank you for being here. Yes dr burin. And i extend that thank you. Because you know you've stayed here. We are talking to the nerds. I think this is a totally fortunate. And i am really happy to benefit from your stay here now. We are very excited to dive into cardio dive tallahassee which begs the question dr boomer we are cardio nerds why should cardiologists focus on diabetes. I mean why not. Just refer are diabetic patients to endocrinologist or leave the to their primary care doctors. Yeah i think. I think that's kind of the common theme and that is the current care. We leave it to others in cardiology. Now i think that is sub optimal. I think we as cardiologists we see these patients all the time i mean when is ever a patient. In the cath. Lab that presents with an semi or stemming that doesn't have diabetes so we do see the far spectrum of this disease of cardiovascular complications that arise of having ama- diagnosis of diabetes. So i think we have to be involved in managing this. I think to a minimum. We should referred patients to primary care or make sure that the diabetes is. What managed or console endocrinology now as as we all know as physicians quite frequently. Not even that happens so and there's good evidence for that if you look at registries just about six percent of diabetic patients with cardiovascular disease actually get appropriate care for their diabetes and cardiovascular conditions as you know that vitas says associated with the two to four fold increase in risk it is a cardiovascular risk equivalent termed many many years ago seventy percent of our acute coronary syndrome patients have diabetes. So you you could argue. Yes we leave it to primary care but or the endocrinologist but keep in mind that endocrinologists currently see about five percent of the patient population with diabetes.

Diabetes Dr Dennis Brumer Hughes Center For Cardia Dr Boomer Germany Cardio Metabolic Disease Ucla University Of Hamburg Cleveland Clinic Vascular Disease Batali Hardy Atherosclerosis Coronary Artery Dr Burin Berlin Soccer University Of Kentucky Cardiovascular Complications Tallahassee
"cath lab" Discussed on Cardionerds

Cardionerds

06:17 min | 1 year ago

"cath lab" Discussed on Cardionerds

"Now there's little bits of different daydream around nineteen, eighty, seven, eighty, eight, the not much. The guy next door to me was doing a peace studies and I told him about this V wave. He says I'm seeing big viewers do if ablation 's. That is then people would get very short of breath after the fibrillation. So we published our first publication was in two thousand eleven about this, and then we published again in two thousand, fourteen the again in two thousand nineteen now once seen these Zeros and I started to see them everywhere very often when I did. Kathleen heff tasks. V words there, and if you think about it, if you have a big V wave, say the US forty or fifty, the RV has generate at least at pressure to get blood into left atrium. So big V wave causes obligate pulmonary venous hypertension and when you have increased cardiac output when you walk. That makes it even bigger. So you see these big V weren't typically in people that have a Fab so that the atrium doesn't move much sense. So there isn't much compliance in the left atrium anymore typically they have aged not always if they have cardiac output, you can see big ways and the other place were receive all the time is when we exercise people the Cath lab and they might have wedge eighteen or something but when they exercise to get gigantic ways up to fifty in this, make some very short breath. What's interesting now is that these devices that we're putting on his research put a little hole in atrial Septum to cut off the V wave. Now, this has been about a twelve year journey for me and it's gone from trying to figure out what this meant to seeing a lot of times. Now, there's actually therapy fort and I still don't think people appreciate it very much and how important the way czar while the great things about this program is how collegial we are. So. We just talked to each other all the time I talked to Dr Gibson about this the as he saw and we had this Cardiologists, who's not working here now he's retired but Dr Johnson he had seen v Wade's to so he knew about it Dr Johnson always knew about everything before you did. But he was. He was the most interesting man in the world he was very smart but I love working here because of the collegiality plice in people don't tend to hoard ideas, share ideas and you can work. Can we published a number of things are off of this because of our collaboration with people? Tend tremendous opportunity to do research such a busy place so much going on the interventional. EP. You built the heart failure program, the integrative service so it has something for everyone. We have very protective fueling fouls, I. I met a certain age where the fellows are about as old as my kids. They remind me of my children in their their middle age they're struggling to understand all the things that are going on in cardiology and one of the things I like to think his all the things I had to figure out on my own. I can help them figure out that before they even go into practice. So they don't have figure out how these things like the stiff left daydream, how understand pulmonary hypertension, how to treat heart failure I think I mostly do this on my own and if I can help them fellows. Come out if you're a great understanding of dynamics and how to manage patients and also. The hands on approach to patients, examining patients teaching the physical exam why that's important. It will become newly superb clinical academic cardiologists when they leave here. Now we've had fellows. Training, show now that sit Cleveland Clinic content shallows a Cleveland Clinic Before Stanford, Cedars Sinai. So they seem to like our fellows very much think that they're well trained and I think that's a very good. SOUTHERN, our caps that these really great places. Wade do a very good job on trade follows. A. Message From our program director Dr Mohawk. Patel Detriment tells been my program director now for many years and I can tell you definitively that he is one of the best parts about this fellowship. He is an encyclopedia of knowledge. He cares about US deeply and he listens to us. He is implemented a lot of change along with Dr. Sue. Hard to this fellowship to make it the best experience that we can possibly have in fellowship and not only is an amazing mentor. He's a great teacher and just an overall amazing program factors. So a message from Dr Patel about the scripts. Cardiology fellowship. Night took over the Puerto about four five years ago, and we saw it on a process to rebuild the program we talked with faculty and fellows and had been imagined their ideal program. Then we went on and built it. I'm to make sure that we found a balance between clinical exposure and procedural volume as well as clinical research, as well as basic science research. From a closure standpoint, we wanted fellas that could walk into any emergency room or CC, when the country, the strongest doctrine, the facility we wanted to create a fellowship program that had clinical research in terms of breadth and depth. Steph tells can pursue any of the research interests. Could affiliate ourselves with scripts. Researchers is one of the preeminent nonprofit biomedical research institutions in the world as part of our translational research track where the unique opportunities, we hear scriptures this interview track, which is the only in the country we affiliate ourselves in that respect with the script center of Integrated Medicine, which is also the preeminent programs of prevention in Irian Medicine in the United States. Vision a program of postal ship success whether fills wanted Hick the program of their choice specialty pick the location of their choice, pick the setting of their toys intrusive, academic or clinical, and we've achieved that with a combination of research production and mentorship. As soon as a fellow identifies with future goals are we to work right away on setting them up for success what are the things that were especially proud about script clinic is the Culture Munster Faculty fellows. It's a nice place to work. It's not a belated institution but at the same time, we have very high expectations.

US left atrium Dr Patel program director Dr Johnson Wade Kathleen heff Cleveland Clinic Dr Gibson Culture Munster Faculty Dr Mohawk Hick Steph Cath lab Cedars Sinai of Integrated Medicine Irian Medicine Dr. Sue SOUTHERN Stanford
"cath lab" Discussed on Cardionerds

Cardionerds

02:24 min | 1 year ago

"cath lab" Discussed on Cardionerds

"Retrograde flow. My experience when we've had cases that we discussed with the surgeons been very reluctant to take these patients to surgery and ask us to perform a corner angioplasty instead, which is an indication whenever surgeon tells the cardiologists to do the case. The tells you that there are very reluctant in that that don't get good results with this I perform I only if the patient is unstable or has a large fart and. After, make the diagnosis and get a wire down the artery or sound. That's the best way of determining if you're on the true. Or False Lamon. Way You're doing pc I have to very careful because balloon tation can extend the dissection from pressing the blood in the false loom in. So we don't predate it's not necessary. These are very approachable of arteries. It's not like a sclerotic calcified arteries and you don't want to extend the blood moon false loom in extend the dissection I usually stand of both proximal disciplines first, and then the sections in between to prevent that extension of dissection, you have to be cautious when you're sending the proximal de. Proxima circumflex that it doesn't extend the dissection retrograde into the other vessel in the left main has happened in this case. When the case is finished, I perform bodies CT looking for fiber or muscular displeasure as they described in the podcast. These are challenging patients in the Cath Lab as well as just management as demonstrated in this very difficult case. But if you are able to get to the patient quickly and opened up the artery, you can reestablish blood flow and very success slow results which very rewarding with Cordera angioplasty. Thank you. And now I'd like to introduce an F. CPR segment by Dr Carol Watson who is in of our women's health cardiologists, and also our beloved program director who has our back and teaches us so much in.

Dr Carol Watson Cath Lab program director
"cath lab" Discussed on Cardionerds

Cardionerds

05:06 min | 1 year ago

"cath lab" Discussed on Cardionerds

"So probably it wasn't that you know it just goes to show that the triggers for Scott can be a lot of different things you need to take a great history look really carefully the angiographic images in the Catholic I think we said earlier early skied was very obvious but for a lot of patients with Corrado dissections, the findings are really subtle yes and You also said earlier how you know this patient like again, totally healthy in just gets just being this whole thing unfolds I actually saw not I would say similar case but a patient who is undergoing eeg is a while back many years ago with a patient was getting an easy d she was in her forties for just a work of Gerd and ended up having the F. and. Then, also an EC- G that showed a salvation entirely had left main dissection went to the Cath Lab. They couldn't fix it and then up getting bypass but was on a balloon pomp and unfortunately had complications related to the balloon pump lost a leg, and so this woman as actually having when I was a medical student, it's really seared in my mind I think this person all the. Time. I remember first last name and I remember being in the or watching the surgery and seeing like the open chest and then ultimately the next day the patient had go for a leg amputation all before she woke up and and then she wakes up basically again she was getting a work for Gerd and then ended up having his like just a devastating consequence actually followed her. Chart followed her for years because I always thought about her and while she at a different kind of outcome as this patient, she went to Rehab and basically really really worked what she had and I obviously never met her again but I would've loved meter and hear her story but it really left an imprint on me and again severe scat it could be really really really challenging to manage. Know like one what a nightmare to also to show you how much strength people can have in the worst of circumstances. Yeah our patient definitely had a lot of strength to get through all of this with everything going on with CODA pandemic. Thankfully, she lives in a home with great support network she had to rely were caregivers, her husband and her mother who were able to help post transplant. She also had an employer who really fantastic in accommodating through her hospital stay. So she was able to keep her insurance and was able to financially be okay. Those are all great factors studies. Show guarantee a good outcome after transplant is a huge surgery and it's a huge life change and we want our patients to have the best support to get them through this adjustment period help them take their medications and get to and from all of their follow appointments. Our transplant team here is very large and has a lot of fantastic social workers who do a great job of really figuring out how we can build individualize of fourteen for each patient that we transplant. Transplant is a deal I. Think sometimes we forget how monumental it is because we see so many transplant patients ucla. I'm going into advanced heart failure heart transplant. So I love this stuff, but I think this is probably a great time to maybe remind all the listeners that there's a lot of different reasons that we can actually transplant.

Gerd Cath Lab Scott
"cath lab" Discussed on Cardionerds

Cardionerds

05:04 min | 1 year ago

"cath lab" Discussed on Cardionerds

"So here we go in the Cath Lab the opening shot was the non culprit, right coronary artery, which was large dominant vessel with a note disease. So that was reassuring next switched catheters to engage the left. System in the opening shot after the Cath team injected the contrast the immediately that there was a problem Kathy deserve on the Cardio nurse website and I definitely encourage you check them out but I can describe to you here. Now, the left corner system usually left artery that bifurcated into big healthy left anterior descending artery Anna left circumflex artery, and sometimes there's a Ramos areas artery in between the two. In our patient the left main artery looked a really long skinny sliver of a vessel with a small area of contrast feeling into what looked like a false looming. After that, we looked branches off the left main, a nice left circumflex artery was visualized but informally, there was no left anterior descending artery visualized at all. While description, you gave of the left main appearance in the lack of appearance of the led is very concerning when we talk about plaque rupture and what it looks like on an geography typically, we say that the artery appears abruptly included or ulcerated with contrasting not a long skinny sliver of a vessel with loss of distant branches, and then contrast into a possible false loom in like you said, with this angiographic appearance paired with her acute presentation, her female gender, Middle Age and basically. No traditional traditional risk factors I'm less concerned about a classic plaque rupture but I'm really concerned about her having scattered or spontaneous coronary artery dissection, and this would actually fit while with scattered because it's much more common in younger women with eighty to ninety percent of Scott cases occurring between ages late forties to early fifties and our patient. She's forty nine and she fits perfectly within this demographic. The prevalence though is really low. It's about four percent, but it's thought to be the underlying cause. Up to thirty five percent of all ACS cases in women, fifty years or younger, and the true prevalence is probably under represented in registry studies because it's hard to get an accurate diagnosis and there's recruitment methodology is is and things like that. So in terms of why Scott Develops, no one really knows why. But there's two leading theories that we should be aware of one is the inside out and the second one is the outside in theory. The inside one is where blood enters into. The sub optimal space from the true bloom and creates a dissection flap. The outside in is when a hematoma develops. Novo and this disrupts traversing micro vessels and causes a dissection. So in both cases, you have separation of the layers of the coronary artery similar to when we think of when we hear about eight dissection, the majority of Scott is thought to be from this outside in hypothesis because when they look with imaging, there's not really a communication between the true in the fos- looming. Yeah, absolutely earth you know just taking a couple more minutes to talk about the geographic appearances of skied..

left circumflex artery right coronary artery Scott Cath Lab Novo Kathy hematoma fos Ramos Anna
"cath lab" Discussed on Cardionerds

Cardionerds

05:43 min | 1 year ago

"cath lab" Discussed on Cardionerds

"I think oftentimes, you know if it's the right patient in terms of is this like a young person who is otherwise really healthy might have something going on that we can reverse and doesn't have a lot of other comber videos that we think are going to interfere with management. Then despite a lack of consensus evidence I still think it's worth a shot at thinking about doing. I think. It's awesome situation that we find ourselves in. So unattached, can you tell us what some of the Contra indications are to Act Now? So we kind of went over what are favorable factors but contraindications would be if they had an issue where you couldn't anti coagulate them safely because they need full anti coagulation. Well or if they have some severe limiting co morbidity, such things like an underlying malignancy potentially or their baseline neurologic status being poor that play into deciding where mechanical circulatory support is going to be a bridge to is going to be rich to recovery something more durable or even transplant. All right. So we're going to go after case as you predicted, Natasha given the inability to achieve roskin this patient and the patient's otherwise lack of known boomer. We did this patient for the Akmal and she was taken to the Cath Lab. Emerging. I just wanted to kind of chime in here before we go through the Angiogram and say that I think this is a really cool demonstration of the way that our fellows I get to participate in kind of the front end triaging of critically ill patients like to come in post arrest at Cedars has a ton of post arrest patients coming in in the past year. For example, we've done just about a hundred cannulation majority of those are actually initiated by the cardiology fellows because we're the frontlines in many of these patients present with concern for acs as the underlying cause of their arrest. So we help with. Triage process along with us you surgeons work hand in hand with them and get to see these patients through initial presentation to hopefully their eventual stabilization which I think is a very special experience for fellows. Yeah. I can't imagine the sound. So impressive it's one thing to actually put in which obviously is a skill set in its own but holding the trigger on deciding to put an equal is equally as challenging times more neurological damage in sometimes waiting too long you missed the train. So that's really impressive that allows you are really central to this triage which has such consequences on the way you take care of your patients..

Akmal Cath Lab Cedars Natasha
"cath lab" Discussed on Cardionerds

Cardionerds

04:59 min | 1 year ago

"cath lab" Discussed on Cardionerds

"America nine percent in Europe. There's a mortality benefit for immediate corner geography and especially in this case with a semi prior to arrest. But as we've been talking about if the patients in refractory cardiac arrest, how am I going to get them to the Cath lab and that's where he CPR comes in so e CPR is extra corporeal CPR or the use of at Komo during refractory cardiac arrest and typically employed when conventional resuscitate efforts have failed. The idea here is to restore circulation as a bridge to diagnosis and treatment. There's a potential in using it to minimize a reverse organ damage and what we're thinking of mostly as the brain network action and prevent rearrest by limiting scheme ya that would trigger ongoing mile cardiac dysfunction. So to date the evidence for easy PR and out of hospital cardiac arrest or mostly from small single centered studies, there's a systematic review in resuscitation in two thousand sixteen and they summarized those single center studies and looked at eight hundred, thirty, three arrests across twenty studies, and they found that CPR was associated with a thirteen percent survival with good neurologic outcome. But all of these studies have very heterogeneous populations different interventions inconsistent follow up the. Evidence there is interesting in nominally seems better than the typically reported survival rates. There's more to investigate here. This is all amazing and the utility of in the acute shock resuscitation setting is so vital and really requires that whole armaments embed neal was talking about. So there's a lot of interesting evidence coming out in recent years about using e CPR for out of hospital cardiac arrest. There's a European registry of greater than thirteen thousand out of hospital cardiac arrest. This is from Paris and they didn't demonstrate actually that there was a dramatically improve survival with CPR versus conventional CPR and this kind of threw everyone for a loop because it's a Little counter to the data that people were seeing from before they ended up finding that survival in their cohort was around eight percent in both groups, and there was really no difference in neuro.

Cath lab Komo Europe America neal Paris
Fauci disagrees with Trump on coronavirus

Erin Burnett OutFront

09:07 min | 1 year ago

Fauci disagrees with Trump on coronavirus

"The United States has not rounded the corner that is from Dr Anthony Fauci. The Nation's top infectious disease expert delivering a blunt specifically worded rebuttal to the president to, of course, Said said the other day that the US is rounding the corner on the pandemic. I'm sorry but I have to disagree with that because if you look at the thing that you just mentioned the Statistics Andrea. The. Disturbing. Disturbing. The US Steph told you shy of two hundred, thousand number of new cases hovering around forty, thousand, a day and an influential model. At the White House sites all the time predicts the death toll will more than double by the end of the year. Four hundred thousand people dead by the end of December, and yet trump's behavior continues to scorn mask-wearing or social distancing his rally yesterday you see it three thousand supporters more than that. Actually packing an airport hangar in Michigan without masks without social distancing. And and you might say why why are they doing that? It is clear. They are following the leader the person that they are there to support. They are following the president just listen to them and then listen to the president. Care for it. It's that simple. I don't see it for myself. I am young and likable are year are not young. People are very strong. It gets this horrible disease. Temperature taken already, and I'm not saying not necessarily here. Everybody's been tested and I've been tested a hard time understanding people when they. So that's why I don't wear. You can hear me right now I can hear you you're going to have to take. You can take it off your your health how many your wet Well if you don't take it off your very muffled. Those trump supporters Jim Acosta speaking to them getting those very powerful Soundbites Jeremy Diamond is out front and Jeremy You know very strong words from Dr Voucher tonight specifically using the words rounding the corner. No, we're not right. Exact words the president used to rebut his claim. Yeah, no questionnaire in Doctor FAUCI typically tries to avoid directly contradicting the president's or directly confronting and putting himself in opposition to the president, and it tends to happen quite a bit simply by the fact that the president often downplayed the threat of this virus in Dr, Fauci is stating the facts, but it is notable to see dumpster here directly contradicting the president saying, I have to disagree with him on that and he does because ultimately Dr Foudy does rely on. The facts you relies on the science and the facts and the science show that the president by any metric you consider is wrong when he says that the United States is rounding the corner on this and of course, we started this week Erin with the revelation that the president had intentionally misled the American public about the deadliness of virus. He said that he likes to downplay it, and what's remarkable is that we are finishing this week with the president continuing to do. Exactly that because the president is saying that we around the corner, he is saying that the numbers of corona virus cases are plummeting. When in fact we know that we are at a plateau of nearly forty thousand cases nearly a thousand deaths per day and Dr found she is warning about a potentially difficult fall and winter, and of course, it's also remarkable when you see this rally that the president is holding three thousand more than three thousand people huddled together very few. Of them wearing masks and obviously it's coming from the fact that the president in his rhetoric has really downplayed those things. Yes he has acknowledged in in recent weeks. That mask wearing is important. He is called a patriotic, but he is still not modeling that public health behavior, and of course, for months on end, the president downplayed some of those significant public health safety measures and as you just showed in that video, the president's words. So often being mimicked by his own supporters. Jeremy Thank you very much earlier. We spoke to David Plyler these local Republican official in North Carolina and he spoke out this week urging president trump to wear a mask during his rally in that state the state by the way I wanna make it clear has a mask mandate. So we asked him why why does he feel the president should wear a mask and here's what he said. The president is a citizen of the United, States Nettie wants North Carolina. is asked to voluntarily do that not is a matter of health alone. But in the leaders situation, it allows the leader to be seen by people he or she represents and they generally hopefully would follow suit as an elected official. I've been asked to look out for the safety and health of our community, and that's exactly what I was doing. So. Yeah. Know that's just the reality right? That's how it should be but this has become political and plyler happens to be Republican. So he got some feedback on his comment about the president. Here's what he told us about. Well I got backlash from everybody they didn't call it say I'm a Republican or Democrat. I hadn't felt on for south. Carolina. Who taught me a cuss words? A sailor has never heard before. We also ask piler why he felt the need to speak out right? Why? Why did he do it? He could have just been quiet and just rolled his eyes and been angry about it but he didn't he spoke out and he said that mash to be worn, the president should wear one. Why do you do that? It's something we have to do. No chores. And this is not the first time that plague of this time has hit this country nor will it be the last I'm sorry to say in we've had plagued across the United States. We've had things in Europe. We've had him an England China just goes around the world I just hope we can get out of this. So. reasonable. So calm collected. I want to go now to Dr Jonathan Reiner Director of the Cardiac Cath Lab at George Washington University Hospital who else would advise the white? House. Medical team under President George. W.. Bush. So you heard Dave plyler right I mean it just just just so reasonable. So clear. And and he wants the president's followers to to wear masks wants the president to wear masks you heard them. They they they scorn it. They disdain it. It comes from the top. Do you think it's possible to pandemic would be a lot less worse if the president had from day one said where mask. I think if the president had said from day one everyone is wearing a mask. We'd have got forty five thousand deaths in this country and I say that because that's extrapolating German experience they've had a middle of the road haven't been the best. They haven't been the worst they been okay in their pandemic response. And they've had about ten thousand deaths. We have four times the population of Germany. We'd have about forty, five, thousand deaths in this country. So about one hundred, fifty, thousand people would be alive if you WANNA think about why we still have forty thousand cases day and a thousand deaths today in this country is because. We're still talking about masks. It's so basic. It just seems so nefarious now that we've heard the president. Really articulately express how dangerous this virus was on February seven. He knew the route he knew he knew how lethal the virus was. He knew that this was ACM dramatic people. He understood yet he decided not to protect the people. It was a conscious decision not to protect the people even now even today. Do you think his supporters would go and be unmasked. If they knew what he knew you think Herman Cain would have gone to Tulsa. Sit there shoulder shoulder without a mask knowing what the president knew. So so you know you Dr. Fouled. She the president said that we were rounding the corner the latest in his many salvoes sang right it's going away. But that's what you just said. Doctor felt she came out today and we're not rounding the corner, right? I mean he didn't. He didn't talk around it or generally obliquely rebutted he rebutted it using word for word because he felt it was important and then he went on to say this. When you're in the middle of a pin damage and you're trying hard to address all the appropriate issues, it is truly a waste of time. The bunk nonsense but unfortunately, we had to do that. Frustration is coming through in a way I haven't seen it before. I admire the man. So much I'm he is a brilliant scientist who's devoted his life to protecting America from all kinds of horrible pathogens. And he still added and he he he he does not get discouraged. Look. It is a waste of time for him to have to deal with some this nonsense, but it's necessary. He has to debunk we rely on him. If only the the White House brought him out to these press events and had an let the press on Moss as can questions wouldn't that be refreshing? I'm grateful for him everyday

President Trump President George United States Dr Anthony Fauci White House North Carolina Donald Trump Michigan Steph Said Statistics Andrea Jim Acosta Dave Plyler Jeremy David Plyler Dr Voucher DR Jeremy You Europe
"cath lab" Discussed on Erin Burnett OutFront

Erin Burnett OutFront

04:38 min | 1 year ago

"cath lab" Discussed on Erin Burnett OutFront

"Tonight the White House is responding to questions about President. . Trump's health and his mysterious visit to Walter Reed Medical Center the President's physician issued a statement today and it said he could could not. . Confirm rather that the president has not experienced nor been evaluated for stroke many stroke or any acute cardiovascular emergencies as have been incorrectly reported in the media. . Now, , to be clear, , no major or reputable news outlet has actually claimed trump suffered quote mini strokes, , but it does come as a new book claims Vice President Pence was put on alert to take over the duties of president. . Trump had to be put under anesthesia during that November twenty, , one, , thousand, , nine, , hundred trip to Walter reet out front. . Now Dr Jonathan Reiner, , he is the director of the Cardiac Cath Lab at George Washington University and he advised the White House medical team under President George W Bush great to see you doctor Reiner that statement obviously laid out what didn't occur but not what did happen that day? ? Do you believe they're using a straw man argument here? ? Do not address would actually might have happened. . Of course something obviously happened. . On November sixteenth in the afternoon on Saturday, , the president was hurried in urgent fashion in an unplanned fashion to Walter Reed. . Now, , the White House has prodigious medical capabilities. . So if the president was taken to Walter Reed. . He was taken there because there was something going on that they could either treat or evaluate at the White House and the white. House . does not want us to know what that is. . If they did the a presents physician today would have simply said, , he didn't have any neurologic cardiac problem he simply had ex but then won't. . Excited matter <hes> you know <hes>. . So the vice president pence I, , want to actually go back to that question about whether the president's health should be a private matter. . But before we get to that vice president pence was asked just moments ago about being on alert that day and here's what he said. . Nothing out of the ordinary about that moment or or that day, , and I just refer any other questions to the White House physician as far as being on standby. . I don't I don't recall being told to be on standby. . He would think well, , if you were told to be on the president knew you would remember that but do you believe him? ? I think in the Watergate that call that a non denial denial right so yeah, , you would think that if on a Saturday afternoon, , you're called instead and you get to be on standby if you suddenly need to become president this afternoon. . Yeah you might remember that. . So yeah a vice presidents being disingenuous yet when we do need to know what happened that. . So we'll talk about that. . Why is it important for the public to know about the president's health and is it? ? Is it something that that the president of the White House <hes> could say look this is this is a private matter and and we don't want to discuss the president's health any further. . Yes. . So if the president was a private citizen that would make perfect sense, , but the president is not, , and in this election season, , we need to know the health of the candidates for President I've actually. . Written about this, , we know nothing actually about the health of the present the United States if you remember his clearance to run for office was famously pen by Dr Bornstein in New York who then later admitted that the president had drafted the letter for him. . That's the letter that famously said that if elected, , he would be the healthiest man ever to hold office. . We know virtually nothing about the health prison the United States. . Yet, , he holds a the nuclear launch codes in his pocket. . Look we. . Health clearances for airline pilots and school bus drivers and secret service agents. . We should probably know the health of the president of the United States. . And it's interesting as doctors have often used as you point out hyperbole. . I remember one saying he could live up to until two hundred until he was two hundred really quick. . Is there any scenario where it would make sense for the vice president to be on standby for routine physical for the president? ? Not for routine physical if the president was going to receive unconscious sedation if he was needed to be put out <hes>, , let's say he was having a colonoscopy or having a <hes> a cardioversion for an abnormal heart rhythm or needed to undergo surgery with general anesthesia yet. . It would need to be out in the twenty Fifth Amendment would need to be invoked. . But not for just a routine matter.

Vice president President George W Bush White House Trump Walter Reed Medical Center Walter Reed Pence Walter reet Dr Jonathan Reiner Cardiac Cath Lab George Washington University director
Trump says Pence was never on standby, denies "mini-strokes” amid speculation over his health

Erin Burnett OutFront

04:38 min | 1 year ago

Trump says Pence was never on standby, denies "mini-strokes” amid speculation over his health

"Tonight the White House is responding to questions about President. Trump's health and his mysterious visit to Walter Reed Medical Center the President's physician issued a statement today and it said he could could not. Confirm rather that the president has not experienced nor been evaluated for stroke many stroke or any acute cardiovascular emergencies as have been incorrectly reported in the media. Now, to be clear, no major or reputable news outlet has actually claimed trump suffered quote mini strokes, but it does come as a new book claims Vice President Pence was put on alert to take over the duties of president. Trump had to be put under anesthesia during that November twenty, one, thousand, nine, hundred trip to Walter reet out front. Now Dr Jonathan Reiner, he is the director of the Cardiac Cath Lab at George Washington University and he advised the White House medical team under President George W Bush great to see you doctor Reiner that statement obviously laid out what didn't occur but not what did happen that day? Do you believe they're using a straw man argument here? Do not address would actually might have happened. Of course something obviously happened. On November sixteenth in the afternoon on Saturday, the president was hurried in urgent fashion in an unplanned fashion to Walter Reed. Now, the White House has prodigious medical capabilities. So if the president was taken to Walter Reed. He was taken there because there was something going on that they could either treat or evaluate at the White House and the white. House does not want us to know what that is. If they did the a presents physician today would have simply said, he didn't have any neurologic cardiac problem he simply had ex but then won't. Excited matter you know So the vice president pence I, want to actually go back to that question about whether the president's health should be a private matter. But before we get to that vice president pence was asked just moments ago about being on alert that day and here's what he said. Nothing out of the ordinary about that moment or or that day, and I just refer any other questions to the White House physician as far as being on standby. I don't I don't recall being told to be on standby. He would think well, if you were told to be on the president knew you would remember that but do you believe him? I think in the Watergate that call that a non denial denial right so yeah, you would think that if on a Saturday afternoon, you're called instead and you get to be on standby if you suddenly need to become president this afternoon. Yeah you might remember that. So yeah a vice presidents being disingenuous yet when we do need to know what happened that. So we'll talk about that. Why is it important for the public to know about the president's health and is it? Is it something that that the president of the White House could say look this is this is a private matter and and we don't want to discuss the president's health any further. Yes. So if the president was a private citizen that would make perfect sense, but the president is not, and in this election season, we need to know the health of the candidates for President I've actually. Written about this, we know nothing actually about the health of the present the United States if you remember his clearance to run for office was famously pen by Dr Bornstein in New York who then later admitted that the president had drafted the letter for him. That's the letter that famously said that if elected, he would be the healthiest man ever to hold office. We know virtually nothing about the health prison the United States. Yet, he holds a the nuclear launch codes in his pocket. Look we. Health clearances for airline pilots and school bus drivers and secret service agents. We should probably know the health of the president of the United States. And it's interesting as doctors have often used as you point out hyperbole. I remember one saying he could live up to until two hundred until he was two hundred really quick. Is there any scenario where it would make sense for the vice president to be on standby for routine physical for the president? Not for routine physical if the president was going to receive unconscious sedation if he was needed to be put out let's say he was having a colonoscopy or having a a cardioversion for an abnormal heart rhythm or needed to undergo surgery with general anesthesia yet. It would need to be out in the twenty Fifth Amendment would need to be invoked. But not for just a routine matter.

President Trump Vice President President George W Bush White House Pence Walter Reed Walter Reed Medical Center Donald Trump Dr Bornstein United States Walter Reet Dr Jonathan Reiner Cardiac Cath Lab George Washington University Director New York
"cath lab" Discussed on Erin Burnett OutFront

Erin Burnett OutFront

04:35 min | 1 year ago

"cath lab" Discussed on Erin Burnett OutFront

"Tonight the White House is responding to questions about President. . Trump's health and his mysterious visit to Walter Reed Medical Center the President's physician issued a statement today and it said he could could not. . Confirm rather that the president has not experienced nor been evaluated for stroke many stroke or any acute cardiovascular emergencies as have been incorrectly reported in the media. . Now, , to be clear, , no major or reputable news outlet has actually claimed trump suffered quote mini strokes, , but it does come as a new book claims Vice President Pence was put on alert to take over the duties of president. . Trump had to be put under anesthesia during that November twenty, , one, , thousand, , nine, , hundred trip to Walter reet out front. . Now Dr Jonathan Reiner, , he is the director of the Cardiac Cath Lab at George Washington University and he advised the White House medical team under President George W Bush great to see you doctor Reiner that statement obviously laid out what didn't occur but not what did happen that day? ? Do you believe they're using a straw man argument here? ? Do not address would actually might have happened. . Of course something obviously happened. . On November sixteenth in the afternoon on Saturday, , the president was hurried in urgent fashion in an unplanned fashion to Walter Reed. . Now, , the White House has prodigious medical capabilities. . So if the president was taken to Walter Reed. . He was taken there because there was something going on that they could either treat or evaluate at the White House and the white. House . does not want us to know what that is. . If they did the a presents physician today would have simply said, , he didn't have any neurologic cardiac problem he simply had ex but then won't. . Excited matter <hes> you know <hes>. . So the vice president pence I, , want to actually go back to that question about whether the president's health should be a private matter. . But before we get to that vice president pence was asked just moments ago about being on alert that day and here's what he said. . Nothing out of the ordinary about that moment or or that day, , and I just refer any other questions to the White House physician as far as being on standby. . I don't I don't recall being told to be on standby. . He would think well, , if you were told to be on the president knew you would remember that but do you believe him? ? I think in the Watergate that call that a non denial denial right so yeah, , you would think that if on a Saturday afternoon, , you're called instead and you get to be on standby if you suddenly need to become president this afternoon. . Yeah you might remember that. . So yeah a vice presidents being disingenuous yet when we do need to know what happened that. . So we'll talk about that. . Why is it important for the public to know about the president's health and is it? ? Is it something that that the president of the White House <hes> could say look this is this is a private matter and and we don't want to discuss the president's health any further. . Yes. . So if the president was a private citizen that would make perfect sense, , but the president is not, , and in this election season, , we need to know the health of the candidates for President I've actually. . Written about this, , we know nothing actually about the health of the present the United States if you remember his clearance to run for office was famously pen by Dr Bornstein in New York who then later admitted that the president had drafted the letter for him. . That's the letter that famously said that if elected, , he would be the healthiest man ever to hold office. . We know virtually nothing about the health prison the United States. . Yet, , he holds a the nuclear launch codes in his pocket. . Look we. . Health clearances for airline pilots and school bus drivers and secret service agents. . We should probably know the health of the president of the United States. . And it's interesting as doctors have often used as you point out hyperbole. . I remember one saying he could live up to until two hundred until he was two hundred really quick. . Is there any scenario where it would make sense for the vice president to be on standby for routine physical for the president? ? Not for routine physical if the president was going to receive unconscious sedation if he was needed to be put out <hes>, , let's say he was having a colonoscopy or having a <hes> a cardioversion for an abnormal heart rhythm or needed to undergo surgery with general anesthesia yet. . It would need to be out in the twenty Fifth Amendment would need to be invoked. .

Vice president President George W Bush White House Trump Walter Reed Medical Center Walter Reed Pence Walter reet Dr Jonathan Reiner Cardiac Cath Lab George Washington University director
Pence was on standby to 'take over' during Trump's unannounced hospital visit, new book claims

Erin Burnett OutFront

04:35 min | 1 year ago

Pence was on standby to 'take over' during Trump's unannounced hospital visit, new book claims

"Tonight the White House is responding to questions about President. Trump's health and his mysterious visit to Walter Reed Medical Center the President's physician issued a statement today and it said he could could not. Confirm rather that the president has not experienced nor been evaluated for stroke many stroke or any acute cardiovascular emergencies as have been incorrectly reported in the media. Now, to be clear, no major or reputable news outlet has actually claimed trump suffered quote mini strokes, but it does come as a new book claims Vice President Pence was put on alert to take over the duties of president. Trump had to be put under anesthesia during that November twenty, one, thousand, nine, hundred trip to Walter reet out front. Now Dr Jonathan Reiner, he is the director of the Cardiac Cath Lab at George Washington University and he advised the White House medical team under President George W Bush great to see you doctor Reiner that statement obviously laid out what didn't occur but not what did happen that day? Do you believe they're using a straw man argument here? Do not address would actually might have happened. Of course something obviously happened. On November sixteenth in the afternoon on Saturday, the president was hurried in urgent fashion in an unplanned fashion to Walter Reed. Now, the White House has prodigious medical capabilities. So if the president was taken to Walter Reed. He was taken there because there was something going on that they could either treat or evaluate at the White House and the white. House does not want us to know what that is. If they did the a presents physician today would have simply said, he didn't have any neurologic cardiac problem he simply had ex but then won't. Excited matter you know So the vice president pence I, want to actually go back to that question about whether the president's health should be a private matter. But before we get to that vice president pence was asked just moments ago about being on alert that day and here's what he said. Nothing out of the ordinary about that moment or or that day, and I just refer any other questions to the White House physician as far as being on standby. I don't I don't recall being told to be on standby. He would think well, if you were told to be on the president knew you would remember that but do you believe him? I think in the Watergate that call that a non denial denial right so yeah, you would think that if on a Saturday afternoon, you're called instead and you get to be on standby if you suddenly need to become president this afternoon. Yeah you might remember that. So yeah a vice presidents being disingenuous yet when we do need to know what happened that. So we'll talk about that. Why is it important for the public to know about the president's health and is it? Is it something that that the president of the White House could say look this is this is a private matter and and we don't want to discuss the president's health any further. Yes. So if the president was a private citizen that would make perfect sense, but the president is not, and in this election season, we need to know the health of the candidates for President I've actually. Written about this, we know nothing actually about the health of the present the United States if you remember his clearance to run for office was famously pen by Dr Bornstein in New York who then later admitted that the president had drafted the letter for him. That's the letter that famously said that if elected, he would be the healthiest man ever to hold office. We know virtually nothing about the health prison the United States. Yet, he holds a the nuclear launch codes in his pocket. Look we. Health clearances for airline pilots and school bus drivers and secret service agents. We should probably know the health of the president of the United States. And it's interesting as doctors have often used as you point out hyperbole. I remember one saying he could live up to until two hundred until he was two hundred really quick. Is there any scenario where it would make sense for the vice president to be on standby for routine physical for the president? Not for routine physical if the president was going to receive unconscious sedation if he was needed to be put out let's say he was having a colonoscopy or having a a cardioversion for an abnormal heart rhythm or needed to undergo surgery with general anesthesia yet. It would need to be out in the twenty Fifth Amendment would need to be invoked.

President Trump Vice President President George W Bush White House Walter Reed Walter Reed Medical Center Donald Trump Pence Dr Bornstein Walter Reet Dr Jonathan Reiner United States Cardiac Cath Lab George Washington University Director New York
"cath lab" Discussed on FOCUS on POCUS?

FOCUS on POCUS?

04:20 min | 1 year ago

"cath lab" Discussed on FOCUS on POCUS?

"Wills I slash. Jefferson Hospital for signs, and you're functioning quite well after this long shift you on. How long were you on shift before you came in studio this morning? Well as on twenty four hours, we have a sweet. I had some Rask. We had to emergencies in the in the middle of the night, which were not a lot of We're not arduous. and we admitted them and off. We go and I got here at. Eight o'clock this morning and we're ready to go. It's amazing. In how many wall coffees did you have only have one walk only one. Okay I just want to make sure that. So then. I'm thinking about nurse anesthesia profession in general thinking about how the profession. Functions you Shed some light on that Dr Kelly Yeah well. I'm a I'm. A nurse anesthetists with a doctorate and. As of twenty twenty five all the graduates. From nurse anesthesia programs will be Dr, Lee, prepared and It wasn't so long ago that we became a masters as an entry to practice. In my time in the late eighties. And we function in every site where anesthesia's provided from obstetrics to the open heart area, and especially the neuro. Science arena. we function in the in the critical care area were every patient is critical as an are small seventy five bed hospital. And also in the surgery center where we do surgery for. Elective procedures, cosmetics or surgery. and. Pediatrics you name it. You, know your careers across The three big spears thank you clinical industry academic, so and since you're an advanced practice nurse. You've contributed these different spheres of influence in career fields. Can you share what type of diverse? Areas are possible would see Aurigny. Well, going back as in our Anna graduated in. Seventy eight and Functioned in Emergency and critical care in pediatrics for some years, and then at the time, nurses were not able to make. A living with sustain a family. So I went to industry, and I worked for General Electric and went into the Cath Lab Division as a nurse, so it was a great opportunity to be an industry. The income was significant It took me into the operating room to see what anesthesia did. And that's where I became enthralled with anesthesia and I set my sights on that and Then I pursued my master's degree. With that and went into academia after about a dozen years. and. was involved with academia and was. Gain. The simulation simulation area and I was coordinator of the Simulation Center, and that's how we got to do our ultrasound workshops together. And teaching clinically and doing some research and also maintained in my clinical. Certification, working forty hours a month at least and Yeah, you were busy I remember those days you were like Very busy. Yeah I was, so it was academia's. it's not for the lighthearted you. You do have to spend many hours to get your your content. Correct and yes practice and you know record your lectures in. Listen and make sure everything is proper. Make sure your documentation is proper and And then move onto the presentation and then testing in. It's an endless cycle. When they started a new program for stroke coverage the chief asked if I was interested, and I was ready for a change and I I did jump over just across the street to be on the neuroscience team and It's been a great transition, so it's been five years now and We've a great crew. There's only seventeen of us or so and every fifth night. I'm twenty four hours. And then I do two eight hour days. It's like a firehouse schedule and it works for me yeah. The irregularity works for me I, like that. Yeah, that keeps you on your toes, you know. I know you're a.

Jefferson Hospital Rask Dr Kelly Simulation Center General Electric Cath Lab Division Aurigny Lee Anna surgery. coordinator
Coronavirus task force holds first briefing in months as cases hit record high

Erin Burnett OutFront

07:51 min | 1 year ago

Coronavirus task force holds first briefing in months as cases hit record high

"The United States about to hit forty thousand new corona virus cases today. The first time that we've had that many one day, the death toll in the United States closing in on one hundred twenty five thousand people, but if all you did was listened to the president and vice president today, you would be absolutely stunned here what I just said because this is what they said. Today? All fifty states and territories across this country are are opening up safely and responsibly. Well, that's incorrect. It's factually incorrect. They're not I mean eleven. States are currently on pause. Some of them are actually backtracking and closing some things down on plans to reopen Texas and Florida specifically. They are rolling back reopening plans governors of the other nine states. They are not moving forward with the next phase of reopening. So that was incorrect, and then the vice president went on to make this claim. The truth is we did slow the spread. We flattened the curve. So he says we flattened curve, so let me just show you America's curve. So you see, the surge right and then in in March and then you see the plateau. And then you see. The jump there at the end where we are now getting to fifty forty thousand cases today. That was a plateau, and it's on its way back up and I want you to compare the graph to these other graphs. These are countries around the world right? They have that surge at the beginning the UK Germany France Italy Japan South Korea European countries measured in thousands of cases Asian in hundreds, but look what happens at the bottom. They go all the way back down and stay that way. Ours never went down right, and now it's going back up currently with the same steepness of slope as it did at the beginning. And yet the vice president was taking a victory lap during today's briefing and he made sure to credit person number one. Under the leadership of President, trump is the president's made clear credit I believe to our president of the president made that decision. So, where was the president during this briefing while he was somewhere in the vicinity, but he was on twitter, talking about confederate statues, tweeting this image of people suspected of trying to vandalize statue of Andrew Jackson and what he was writing was that many people in custody with many others being sought for vandalisation of federal property in Lafayette Park Ten year prison sentences. It was hours later that the president did finally say something about the pandemic. That's amazing raging right now in the United States like nowhere else here he s. We have work to do that. We'll get it done. while. That's an understatement it. We are learning tonight that people traveling from the United States most likely will not be allowed to even enter the European Union. Banned, because the United States has gotten the virus under control Kaitlan Collins is out front. She's live outside. The White House Tonight Caitlyn. No briefings for eight weeks the White House. Felt like they had to do something here, but then they came out and said everything's opening you safely and responsibly opening fifty states. When that's just you know factually untrue. Yeah. It wasn't the message that some people were expecting the vice president to project from that briefing today after Wednesday's coronavirus task force briefing, and after you're seeing these numbers from this week including yesterday setting a record high of cases per day since the month of April, of course, which is the last time that they had these coronavirus briefings now you would that they would have. have taken more questions. The vice president instead of Aaron only took a handful of them, but before he started taking questions, you saw him arguing saying that he doesn't want the American people to think that because of these new surging infections that the United States where it was two months ago, even though the case numbers per day or mirroring that or beating it and. And of course, the vice president went on to talk about what precautions Americans should be taking. He ticked off a list of things that the CDC has recommended. But Aaron he notably left out wearing a mask when a reporter asked about the fact, that mask have become this political issue. He then only told people that they should be following local or state guidance ignoring the. The fact that the CDC a Federal Agency of course, has recommended that people wear masks when they are out in public, and within the vicinity of other people. He also defended those rallies that he and the president have been holding and encouraging their supporters to come to where thousands of people are put indoors with very little social distancing errand by saying that it was people's. People's right to the first amendment characterizing it more as a personal decision than something that they're organizing and urging people to come in to attend, but I do want to note to striking things that came out of that briefing today was the vice president offering a pretty rosy assessment of these numbers, and then Dr Falcon getting up there and having a very sobering warning. What's to? To come and personal responsibility and this, but also Aaron the vice president saying he believed it's an arguable that the reason that there are more cases in the united. States because there's more testing Dr. burks got up and she was going through these slides and one of the ones she pointed to was Texas where it showed in May as they were increasing testing their positive. Positive test rates were going down in the last two and a half weeks they continue to increase testing, but now those positive test rates Aaron are going up, and that completely refutes with the president and the vice president have been telling people and governors for the last several weeks. All right, thank you very much. CAITLIN absolutely makes the crucial point. Right the percent test rate. Rate is what they're looking at twenty percent of them. Positive that that's that's the relevant point. It's not the absolute number and Caitlyn I. Appreciate Your Time, so let me go now to Dr. Sanjay Gupta and Dr Jonathan Reiner. Who Advise the White House medical team under president? George W Bush currently in Cardiac Cath lab at Gw so so sanjay the vice president today. Came out and presented an alternate reality. he said all fifty states and territories. This country are opening up safely and responsibly. That is quote obviously the have double digit states halting stepping back. They're reopening all together big steps back. Yeah I mean. I. Don't even know where to begin with this particular briefing. You know you think two months. We haven't had a briefing. There's obviously some real trouble spots in the country and I'm. Saying that almost euphemistically I thought there was going to be an acknowledgement that look. We have some problems. Significant ones in here is our plan to address them. Here's what we're GonNa do we're convening the coronavirus task force to to address this? We didn't see that at all. I mean there's the last task force briefing. You can see what the numbers were at that point and obviously just see how the numbers have grown even over the last few weeks. Weeks, so it it it was it was a real concern, and there were a lot of things that were said that were just basically a whitewash of what's actually happening in the country, and that's what I think. Worries me. How are you GonNa fix the problem. If you don't even acknowledge it right well, that's the thing. If you're in complete denial about it, then you obviously don't have a plan to fix it because you don't believe it's their. Running when the president actually gave a nod to this this afternoon, his comment was making a lot of progress with the whole situation, but we have a lot of work to do but he did not attend the briefing instead he was treating about those confederate Mon. Monuments So, you know in the vice president. There was talking about all the encouraging news again. His words talking about Krona virus so. What do you make of this and I guess specifically the president's refusal to be there. Yeah the president. In a tweet about the monument seems to be more interested in protecting long dead confederate traitors. He is in protecting Americans right now. Yeah, I was really appalled. When the vice president today said well, we've all heard the encouraging news you encouraging news, really

Vice President President Trump United States Aaron Texas Caitlyn CDC White House Uk Germany France Italy Japan America Twitter Florida European Union Andrew Jackson George W Bush Dr. Sanjay Gupta Kaitlan Collins Caitlin
Eerie Emptiness Of ERs Worries Doctors: Where Are The Heart Attacks And Strokes?

Erin Burnett OutFront

05:10 min | 1 year ago

Eerie Emptiness Of ERs Worries Doctors: Where Are The Heart Attacks And Strokes?

"Across the United States doctors are seeing a drop off in cardiovascular emergencies during the corona virus pandemic and they're calling the drop staggering unlike anything they've seen before Dr. Jonathan Reiner joins me now. He advised the White House medical team under president. George W Bush and he is the currently the director of the Cardiac Cath Lab at George Washington University Hospital. So honor your cardiologists. You're you've been you know in with patients doing surgeries as I know daily. What are you saying? Yeah this is really fascinating soon. After they stay at home measures were begun. Almost two months ago cardiologists around the country and around the world started to notice something really unexpected. Which was there almost daily cases of acute myocardial infarction heart attacks stopped coming and all over the world. Physicians noted a decrease about forty percent in patients presenting with heart. Attacks was really very hard to explain. Some people suggest that maybe there was something about you. Know Our our new daily routine. The lack of commute maybe the cleaner air more sleep that was reducing heart attacks. But I think what we've really come to understand is something much worse. Which is we think. Many people just aren't coming to the hospital and people are staying home. Places like New York have seen up to five six or seven fold increase in out of hospital deaths and we think many of these patients are simply not coming to the hospital for fear of contracting copay nineteen so they're dying just dying outside the hospital and maybe they wouldn't have died if they were able to if they came to the hospital where you could help them. That's right and the New York. Times recently published an analysis of all cause mortality data from the CDC and if you compare basically mortality in places like New York since mid-march. There's been this huge success. Death Twenty three thousand more people have died during that period than last year. But only some of that can be accounted for by cove in one thousand nine hundred so either undercounted covert nineteen which is which is possible. But also just as likely other things are happening cigna published utilization data from their members and they've noted similar decreases in hospitalization for things like appendicitis and Ti mini strokes and guess for tests no bleed to neutral fibrillation. So we think what's happened and this is going to be. Collateral damage to the actual viral infections. Is that people haven't sought medical help for for serious illnesses over the last two months. Which is which is pretty an an incredible statement because I mean I suppose you could be both under counting. Covert nineteen and having the the. The access is is so enormous that both things could be true. I I realize that But but you do believe it. The bottom line is that is it possible that you have more people and I would presume the answer to this is yes because people are going to the hospital you would save. Some of these lives is possible. You have more people dying of heart attacks now than you had then you had before just we just aren't just aren't categorizing them that way. We're seeing this New York where it used to be in New York City. There would be thirty five out of hospital deaths now. They're seeing two hundred out of hospital deaths per day now. Some of that may be Cova deaths but a lot of that is also probably other illness. Not Treated in the hospital's so earlier this week. A Doctor Reiner you and I were talking about Brazil. You trying to understand what's happening in the warmer countries and what that means for the United States in the summer in Brazil Where obviously The YEARBOOK SCENARIO. The president has called this a little flu. He's been going to massive rallies against social distancing. Right he has he has done this at a level that that perhaps We had a huge spike in the past twenty four hours. I don't know if you just saw these numbers. They just came out ten thousand five hundred and three known new infections. No I should emphasize in just twenty four hours in Brazil. I mean it's huge surge. What is the significance? Here I in terms of it's clearly not control there and there's very little effort to control. It was obviously cautionary tale. A very ominous cautionary tale. Both scenarios been a president who has a denied the significance of the undoubted the significance of the corona virus. He's gone to a rally and has shake the hand hands of protesters. He's called the virus a little flu and that resonates through the population. Look what we know. Works is mitigation strategies. Such a stay at home and social distancing and when people start to move away from that the virus spread and you see you seeing that happen in Brazil now. We need to think about that as we start to open up the United States economy. We need to. We need to use it. As an example of what happens if we lessen our guard and we open too quickly or imprudently dot Reiner thank you

George Washington University H Brazil United States President Trump New York Dr. Jonathan Reiner George W Bush FLU Acute Myocardial Infarction New York City Appendicitis Cardiac Cath Lab White House CDC
"cath lab" Discussed on Cardionerds

Cardionerds

04:03 min | 1 year ago

"cath lab" Discussed on Cardionerds

"Michael in fortune indeed the majority of patients we see are type. Two non stemming events the patient described today with an se segment elevation at my is somewhat atypical in our most recent and DEMOC with covert nineteen. There's a another potential mechanism of Michael Injury. The source corona virus to virus of binds to humid injured tense in converting enzyme two receptor which is highly expressed in the respiratory tract in as well as the heart in itself out seven percent of current covet a nineteen patients admitted to the hospital at positive components and about one in four patients who are critically. Oh what cove. In nineteen will have positive proponent ovations. I wanted to sort of Digress. A Little Bit. Since you brought up cove in nineteen and the proponent elevation. I know you recently completed a stint in the C. C. You when you see the proponent elevation how were you distinguishing between acute coronary syndrome and another possible reason like Myocarditis in these patients? Oh that's a great question. Renew one of the challenges and Asians infected and non infected is distinguishing Mike Coral injury from my coralline fortune. And so we're certainly looking for beyond the enzyme elevation evidence of Schema via symptoms he. Cg Wall motion add the Molly at would let us define this. As a micro and fortune nonetheless. The prognosis whether it's injury or micro fortune both adds significantly to the disease process in an adverse way M. I usually present differently in these patients or is it. Is there a difference in the severity. The presentation depends on the context in my experience and in the Lurch. Mr Does present differently so in contrast the primary reason a patient comes to the corner carrying with acute my com fortune. These patients arrived at the hospital with their viral syndrome. And then through evaluation either worsening shortness of breath E C g changes are full motion. Add the molly gives us a hint. That the Horta's involved with this Processes well and so we have to have a very high index of suspicion particularly in patients the elderly those with pre existing corners easing multiple risk. Factors at this. Is that risk population in that? The heart may ultimately be involved in the process. And you said at n stem is usually the more common presentation compared to stem. -I absolutely soon In the literature and in Randy Johnson study. He didn't ninety percent of patients will have anonymously segment. Elevation of that is sorry guys. This is I may have been quiet so far. But I've just been so mesmerized by this discussion and I have to say house specialises for me. Dark Schulman running with you and learning from you remains a among my favorite memories from residency. And it's a it's so awesome. Learn from you again right. Now when we're talking about the Michael Injury in the within the context of a viral infection jetting is relevant for influence and cove. Ed How are you teasing out in? Acs Presentation from Microsoft is. Can you walk us through your steps in terms of are there differences in the clinical history or proponent trend or ekg? And I asked. Because ideally we would try to minimize trips to imaging testing or the Cath lab to try to prevent exposure to healthcare workers. Just so in the Kovic. Nineteen Pandemic News Ben to patterns of Michael Injury Pattern is a progressive rise in proponent associated with other inflammatory Markers d diner Feridan. I'll six in that likely reflects Cited kind storm of that of shoe patients..

Michael Injury Horta Molly Michael Michael Injury Pattern acute coronary syndrome respiratory tract viral syndrome Cath lab Mike Coral Kovic Microsoft Dark Schulman Randy Johnson Mr
"cath lab" Discussed on Newsradio 700 WLW

Newsradio 700 WLW

08:44 min | 1 year ago

"cath lab" Discussed on Newsradio 700 WLW

"Was lying face up on a cath lab with a fabulous cardiologists beaches child looking down at me saying got to put some steps in your body it was not above pleasant experience to say the less but here I am ten years later and I I'd might have been able to avoid that if I ate chili peppers regularly because here now is a new study the checkout carried out in Italy where chili is a common ingredient and the study compared the risk of death among twenty three thousand people some of whom a chilly some of whom did not and it found out that participants who ate chili peppers their chance of death by stroke was cut in half is this is chili pepper our chili peppers the new modern day miracle medicine standing by talking about this is somebody's probably eating chili peppers even as we speak she is doctor Aaron Donald's in good guesser this program passionate about preventive medicine and standing by on the acute hearing centers dot com hotline and Dr Donald said how are you on this glorious Monday I'm hearing great ten are you ready for Christmas I'm ready for Christmas but I'm stopping by the store on the way home to get some hot chili peppers now this this yeah sounds too good to be true doctor Donald I hate to burst your bubble I worry that it it possibly could be to get the B. trail so it's an interesting study from Chile peppers have something called capsaicin in them when I if you're with her have heard that word before because it popped up a few times finance linking to being like appetite increased burning other really get things for us so I'm certainly all on board for people eating chili peppers and plenty of fresh vegetables Betty that made me wonder if it included in the FAQ that trail it is because it doesn't necessarily replace exercise and eating properly and other things I mean it's not like you can sit around your couch eating Cheetos all day and then pop a few chili peppers and everything's going to be okay right you're exactly right and that study was done with a large number of people like you mentioned over twenty two thousand but the good thing for the people involved in the study but that the tough thing about analyzing the earth about less than two percent of the people actually died of a heart attack or stroke so the actual number analyze when you know whether the chili peppers help them or not it is very well politically you look at less than two percent of that number and if you analyze it the old people eat chili peppers are not the actual number is pretty small when you look at it that way thing is you know these studies which is nothing nothing negative about this is that the you traction bodies are what we call observational beating they don't really change anything or or pine to these people are limit anything else should their diet or lifestyle well you know did you eat chili peppers or not and it does and the people who are eating a lot of fresh chili peppers are probably doing things like eating a lot of fresh vegetables probably other lifestyle choices like you mentioned why so it doesn't really tell us hi this to happen so this thing called capsaicin which is in Chile peppers doesn't exist in other foods or do you have to eat chili peppers to get that in your blood stream it's a lot of things that have a fight so think of it with with things that are right so it is in a lot of pepper and I'm not know honestly there are a lot of health benefits if they have a lot of different vitamins and anti oxidants really any friends vegetable that had the bright color to it I would recommend it that would certainly Dougherty hardball yeah so any oxidants in caps Asian so it's kind of like and exfoliation for the inside of the body right yeah you definitely can think about it that way when our body breaks down our our future energy for our cells which happens every single time we each put something called free radicals oxidative stress target at the debris or the extent energy left over after you give birth and she will be in the anti oxidants capture that energy into it that way so it really does help clean up our well we got a lot of free radicals loose here in Cincinnati so maybe that that has something to do with that I don't know on the right doctor and Donald soon preventive medicine and well this is what she's all about okay well you know what's you know what's happening and it started last week and it is going to continue on through January first they're going to be get all these family gatherings or with friends or whatever or maybe you're going out to eat I don't know what you might do but you there there is going to be an inordinate amount of food and it's not just like thanksgiving words one day it's Christmas Eve and Christmas day it's the day after Christmas it's new year's eve it's new year's day and we're just going to be you know dated with all of these dining options and we're probably all not going to do what we should do now I'm not asking you to be a dietary Scrooge here doctor Donaldson but I mean what how should we approach throwing food down our throats here in the next seven to eight days what should we do you know it's a tough thing and it's going to depend I you know I heard you it before you came on saying that the closure can your shipping your anniversary from your I want to say that's that's amazing to hear I'm so glad you're doing so well you're not alone it is that time of year that the thing that pop up more frequently this technical holiday heart and drown and I used to work in the hospital and and we see a lot of that I think the point you started it people are sleeping the toppling their strat they're probably drinking alcohol not to say you were but they're not quite as hydrated it is really a perfect storm which I would I would say the people that you're in and a lot of people know who they are if you're not quite in that healthier category we don't have quite as much room for error to quote totally go off the wagon here with all your other health practices keep that in mind you know one thing I tell my patients maybe have like a lot of water and a healthy snack before you go to the holiday parties or family get together so you're not tempted to have quite so much before you get there Hey don't look at that and and enjoy time with your family yeah it's not a good another like a good glass of metamucil before you go out to eat you know those you know and then there's nothing else you could throw down your throat but I I you know I'm glad that we had a chance to talk your doctor because I was going to stop by and get some you know some Carolina reapers or something on the way home but we're really all I have to do is eat you know nice colored vegetables which probably is better for my innards anyway the doctor does you have you have a very very happy holiday and we will visit down the road thank you so much well you take care there she is she knows best but it does say here I mean I'm not making this this stuff up I can't make things up on a local radio host it was a study that was done among twenty three thousand people and these people their health status and eating habits were monitored over eight years and researchers found that the risk of dying from a heart attack was forty percent lower among those among those eating chili peppers at least four times a week not every day it's not report times a week and death from stroke was more than have so I'm gonna continue to eat healthy but you know what I'm probably gonna throw some chili peppers down my throat because as they say in life you can always be that sure all right straight ahead are you enrolled have you been diagnosed with something that scares you are you afraid that that may be you the end is near because you'll have been on the internet search doing a Google trying to self diagnose well number one stay off the internets and stay tuned it continues after the news on seven hundred W. L. W. weather affecting travel this holiday weekend I Matt Rees seven hundred WLW dot com winter weather hitting parts of the country out west drivers stranded for hours southern California pounded with heavy rain and snow at one point forcing parts of two inner space to shut down airlines already.

"cath lab" Discussed on KFI AM 640

KFI AM 640

03:40 min | 2 years ago

"cath lab" Discussed on KFI AM 640

"When someone has chest pain or any number of symptoms that could be associated with a heart attack absolutely the standard of care everyone needs to know this is to seek emergency medical attention call nine one one or a present to an emergency room at that point an EKG of the heart will be done and it's based on those EKG finding as it is not uncommon for a patient to be brought to the cath lab where that those card every arteries called the cath lab the catheter laughing cafeteria right to the cath lab cath lab half Latino yellow. going to see what's going on I think they shorten it because time is of the essence I mean time is they say that the fire department has to get to you within six minutes if you stop breathing. anything over six minutes call up your next call is the fourth lawn. but anything below under six minutes they have a shot at saving up. lab where that those coronary arteries are then explored if a blockage is found it is absolutely an indication for stent placement in a stand is basically just kind of an opening of that artery the setting of an acute heart attack is one of several indications for stand placement there are others such as unstable angina or even stable and shin but in a in an abrupt kind of circumstance like this obviously acute heart attack is one I am on the what we call the differential all right so could have been a heart attack but it could not it also could have been something else but as you said at the top so that we don't know enough information yet whether that was the case here which is a good reminder right but how how do you gauge how serious this is to hear a lot about students being put in patient as you said with the with the hospital getting his heart work done I called Sears as you said with the when they are found to have some of the symptoms Bernie Sanders we know always physician just a few years ago put out a statement that he had no history of heart disease no have high blood pressure yeah well now he does. yes now he he got now he has a history of heart I can't imagine being on the road for as long as he's on the road his diet is all that hot yeah he's a milkshake you know burger guy and he's not you know vegan sitting. and he's older and he seems like he's just a you know a casual guy with his cholesterol and. not really that you know he doesn't run around that does look like a guy's cycling all the time what's interesting is that this week he was supposed to be at U. S. C. with our buddy Alex Michaelson all right is that called off called off. yeah that's horrible they were going to do that kind of a. candidate forum with thirty Sanders is going to start a whole other horrible we that's a that's a kiss of death that Alex Michael slow wow what's going on with you well you're very bad a heart attack this one guy I don't know Amanda missed on high alert on standby alert. Alex Michael said is next to talk about whether what now it now you're getting all my podcasts guests mixed up for twelve months if you come in. is he. I thought so I don't know if he was calling or if he's got a normally he's here by now I don't have my my cell phone with me left at home maybe he's been calling he normally text me okay Melissa I will talk to for its next on KFI AM six forty heard everywhere on the I heart radio.

Alex Michael KFI Melissa I six minutes twelve months
"cath lab" Discussed on News Radio 810 WGY

News Radio 810 WGY

06:55 min | 2 years ago

"cath lab" Discussed on News Radio 810 WGY

"Back. To Mayo Clinic Radio, I'm Dr Tom jibes. I mean, we are talking. With mayo clinic interventional cardiologist, Dr Peter Pollock director of structural heart disease. At the mayo clinic in Florida a Payton for Ayman ov- alley or PF. Oh is a hole in the heart. That didn't close the way it should after birth PF. Oh occurs in about twenty five percent of the normal population the whole never completely closes. But most people with a condition don't even know they have it. So Dr Pollock, but we are all born with a hole in her heart. Yes, we are the PF oh is really more of a flat than a whole. And we all have this before we're born. And let me explain why we have before we're born we can't breathe in a fluid filled bag amniotic sac. So our lungs aren't doing the same kind of work. They're doing once we're born we get all of our oxygenated blood from mom through the placenta. So it's coming down the umbilical cord coming into our what's now our belly button. So. Coming up from underneath the heart and the heart as it's developed is designed to take that flow of oxygenated blood from underneath the heart and deflected at the thin wall that separates the two top chambers. So the right atrium receives what's normally Venus blood. But in this case is richly oxygenated blood from underneath the heart, and there's a little rigid tissue called the station region. It deflects that oxygen rich blood from through the wall between the two chambers which grow from either side kind of overlap, and so there's a flat between them and this constant flow of blood holding that flap open over to the left side, which is supposed to be the oxygen rich side, and where it can get pumped out to the body. Now when we're born we cry, and if we don't cry they kind of stimulate the kid to make them cry because they've got to fill their lungs with Aaron expand their lungs for the first time, and we cut the umbilical cord, and when we cut the umbilical cord all sudden, there's a lot less flow blood coming to the right side of the heart because that flows no longer. There. And now we've expanded the lungs a lot of blood flow goes to the long so the pressure with all that blood going to the lungs the pressure on the rights of the heart drops in comparison to left and that flap and seals, but it seals in most people. Now, you've got to think that twenty five percent of the world population about two billion people. And statistically that means someone in this room. Has it PF? Oh, and that is a lot of people that means twenty five percent of people with any condition are likely to have a PF. Oh and most people walking around. Don't know you can't hear it on exam doesn't cause any problem normally. So the vast majority of people is just there doesn't require anything. Besides reassurance. If it's found and hasn't caused a problem, but it is a potential source for problems if something goes through that potential connection. So if that flap opens if if the pressure on the right side of the heart is ever higher than the less, for example, if you cough gag wretch bear down that can push temporarily the pressure on the right side, the hard to be higher, and then bump that flap open. So that if something such as Venus blood, or if there are little bits of cloud, and that Venus blood they could transit through the PF. Oh and get over to the arterial side the left side with. They can go to anywhere in the body and causes stroke, for example. Yes. So we call that paradox. Embolism if a a small bit of clot moves from the right side through the PF, oh to the left side, if it goes to the brain, we call, the struggle plugs, up a blood vessels and causes injury to brain tissue. It could go to anywhere in the body though, these tend to be smaller size clots, and so most noticeable place for a smaller size clout to go would be the brain. And how do you figure out that it was a problem? But that the PF oh was the source of the disease that is the real challenge. And so our approach here male clinic is very collaborative what we advocate for is that you work with an analogy. So we have these heart brain clinics where folks like me cardiologists work hand in hand with a stroke neurologist of aspirin or artists to really evaluate patients and figure out was the PF. Oh, an incidental finding an. Innocent bystander or was it a potential culprit was this really likely to be a stroke that was caused by paradox. Does doing device closure of the PF? Oh is that going to decrease the risk of a recurrence stroke? Can't do anything about the stroke that happened. But can we reduce the likelihood that this patient with a PF? Oh is going to have a second or third event. And how do you do that? We create kind of a sandwich. There are two different kinds of devices. What they both work mentally the same way. There's a disk that is placed on the left. Atrial side a disc that opens on the right atrial side, and they close with that flap of tissue in the middle, and they hold it closed the body grows over the both of the discs on either side. It stays with you. It's permanently part of the heart. And this is done in the cath lab. It's a procedure with very high success rate is very low complication rate patients, stay overnight tend to go home the next day. And then we monitor afterwards. So you don't have to open up the heart to fix the defect. Now, this is done with catheters in the cath lab. Patients are kind of sleepy but not all the way asleep after breathe on their own incredible. You do it through a catheter that you snake up through the groin, and you can close at defect the real challenge. With PF owes identifying the right patient because it's so common. I think you have to do a diligent evaluation and a collaborative evaluation with neurology to figure out which are the patients that are most likely to benefit from closure. Twenty five percent of people might have this the things that you described that can cause problems are pretty routine or mundane things that seems kind of alarming is this something that people could or should go get tested should. I know if I haven't PF, oh in case something like that happens to me. I would say no, I think we don't screen for something. That's so common. Now, I do think that people especially younger, folks, if they've had a stroke. They should you should look to see whether they have a PF. Oh, but you should also look to make sure that it isn't due to anything else. Now a word about aging. It's interesting because you have this before your whole life. You've had it since before you were born. But we know that closure of PF Ohs is less likely to be helpful in preventing recurrent events as you get older because every other cause for stroke. Gets more common. So atrial fibrillation is more common atherosclerosis in the order. In the karate in the cerebrovascular. They get more common, hypertension as a cost for stroke gets more common. So all of those other causes of stroke, get more communist, get older. And so the benefit is really limited to folks who are younger than.

PF mayo clinic Mayo Clinic Radio right atrium Dr Peter Pollock Dr Pollock Dr Tom cath lab director Florida Payton aspirin Embolism Aaron twenty five percent Twenty five percent
"cath lab" Discussed on Pat Gray Unleashed

Pat Gray Unleashed

01:54 min | 3 years ago

"cath lab" Discussed on Pat Gray Unleashed

"Yeah. Directly a surge. In fact, I hate to say this out loud. But I haven't seen any insurance Bill any hospital bills nothing. Really nobody came for me to for amber to fill out any pay again. Paper were nothing the whole weekend at this hospital. Nothing. That's crazy. Amazing. And I know did somebody pass universal healthcare. And we don't know about this so pay for like, I'm paying for your -mergency room. I'd like to say, thank you. Wow. That's amazing. So, you know, I'm sure I'm sure that they'll drop off a suitcase full of paperwork as they think. So. Heard anything only eight hundred twenty five thousand dollars. I mean, that's because it was ICU. Two days lab. I mean, it was direct the heart surgeon on call right there. I mean, and the lady I do remember one lady in the cath lab saying putting her hand on my shoulder saying, we just gave me some Fenton, all and stuff that's been in the news lately. And I I remember just give it to remember. Thinking if I could talk right now, and lift my hand, I would strangle I don't care. Push fix it. Eight inches on me. Yeah. Yeah. When I was in the hospital last year for the kidney situation, and it was in the just unbelievable searing pain. Just all you want him to do is stop. I don't care if it kills me. I won't be feeling the pain yet me the Benton in massive doses. Q I know when I tried to chop my hand off the lady came into give me a tetanus shot. She says this is going to hurt quite a bit pointing at my arm where she's going to give me the the injection. I'm like, holy get my hands like nuts. This is hurting right now. All.

tetanus Benton eight hundred twenty five thou Eight inches Two days
"cath lab" Discussed on Pat Gray Unleashed

Pat Gray Unleashed

01:54 min | 3 years ago

"cath lab" Discussed on Pat Gray Unleashed

"Yeah. Directly a surge. In fact, I hate to say this out loud. But I haven't seen any insurance Bill any hospital bills nothing. Really nobody came for me to for amber to fill out any pay again. Paper were nothing the whole weekend at this hospital. Nothing. That's crazy. Amazing. And I know did somebody pass universal healthcare. And we don't know about this so pay for like, I'm paying for your -mergency room. I'd like to say, thank you. Wow. That's amazing. So, you know, I'm sure I'm sure that they'll drop off a suitcase full of paperwork as they think. So. Heard anything only eight hundred twenty five thousand dollars. I mean, that's because it was ICU. Two days lab. I mean, it was direct the heart surgeon on call right there. I mean, and the lady I do remember one lady in the cath lab saying putting her hand on my shoulder saying, we just gave me some Fenton, all and stuff that's been in the news lately. And I I remember just give it to remember. Thinking if I could talk right now, and lift my hand, I would strangle I don't care. Push fix it. Eight inches on me. Yeah. Yeah. When I was in the hospital last year for the kidney situation, and it was in the just unbelievable searing pain. Just all you want him to do is stop. I don't care if it kills me. I won't be feeling the pain yet me the Benton in massive doses. Q I know when I tried to chop my hand off the lady came into give me a tetanus shot. She says this is going to hurt quite a bit pointing at my arm where she's going to give me the the injection. I'm like, holy get my hands like nuts. This is hurting right now. All.

tetanus Benton eight hundred twenty five thou Eight inches Two days