Tag Archives: Heart failure

Health

Women left behind | the Mirage news | Instant News


Women left the treatment to get a heart beat back in rhythm

A new study has revealed significant gender gap for the treatment of atrial fibrillation (AF), a common heart rhythm disorder, which, according to forecasts, will increase by 60 percent over the next 15 years and dramatically increases the risk of stroke and death.

Research headed Professor Peter KistlerThe head of clinical electrophysiology at the Baker Institute and Alfred hospital, and his graduate student Dr. Hari Sugumar showed that a potential cure for AF — known as catheter ablation — it is much less effective for women than men.

“Although AF is more common in men, women constitute a large proportion of people with ‘persistent’ AF, those who experience prolonged symptoms despite treatment or other treatments,” said Professor Kistler.

“A woman’s life is in danger, and we must do better to treat them. There is not a new product developed for the AF for more than 30 years. Most research and development went into catheter ablation. But the success of these procedures sits about 60 to 70 percent, and our research shows that figure is even lower for women with persistent AF.”

People with AF have a three times increased risk of heart failure and five times more likely to suffer from stroke than those without AF.

Research Professor Kistler at published recently in the journal heart rhythm looked at 281 patients — 30% of women and 70% men who received more than one procedure is cardiac ablation to treat AF.

He found that while 57 percent of men in the group were free from atrial fibrillation at subsequent, only 38 percent of women.

The data also showed that pulmonary vein reconnection is a key marker in the treatment — were much less likely in women, and the number of the connected pulmonary veins were significantly smaller in women than in men.

“We need to shift our priorities with a focus on AF as a predominantly male condition, to examine gender differences in mechanisms and gap treatment,” said Professor Kistler.

Professor Kistler just got the funding from Department of cardiometabolic health Bakerrecently established Medical school in Melbourne to support trials of new treatments for ablation and check to see if it can generate the best results.

Cardiac ablation works by scarring or destroying tissue in the heart that triggers or supports abnormal heart rhythm. It is typically used to help people with arrhythmias when the medication is not working as it should be or produce negative side effects.

“We want to improve the success of this procedure and developed a new method that aims to a large area in the left center of the atrium. This is a more laborious procedure, but we hope to show that it could produce more successful for patients,” said Professor Kistler.

In CAPLA randomized controlled trial will monitor approximately 400 patients with AF, half of which receive regular ablation procedure, the other half who get what the team of Professor Kistler offers a new gold standard. Then participants are provided with the latest technology mobile ECG, so that researchers can intensively monitor the heart rhythm for several months after the procedure.

The trial will be conducted at the international level, in five different places in the state of Victoria, and sites in Canberra, Adelaide, the UK and Canada over the next two years.

Professor Kistler said there were huge advantages in the management of judicial process within the framework of the new partnership between the Baker Institute and the University of Melbourne.

“This is a multidisciplinary oriented research, and look at the results in a wide demographic requires broad group of patients and professionals around the world,” he said.

Public Release/. View in full here.

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Health

AHA Statement Regarding Cardiovascular Health of Pregnant Women | Instant News


In an effort to increase the spectrum of care for mothers across the US, the American Heart Association (AHA) ‘s latest scientific statement responded cardiovascular considerations when caring for pregnant patient.

That statement, which was published in Indonesian Circulation, detailed guidelines and recommendations for cardiovascular care for women before, after and during pregnancy.

“Cardiovascular disease is a leading cause of pregnancy-related deaths and is increasing, perhaps because women have babies at an older age and are more likely to have pre-existing heart disease or risk factors for heart disease,” said Laxmi Mehta, MD, chairman of the group of authors for the statement that, and professor of medicine and director of preventative cardiology and women’s cardiovascular health at The Ohio State University’s Wexner Medical Center, in a statement.

Written by Mehta and a group of 9 colleagues, this 22-page document represents the work of the AHA Council on Clinical Cardiology, the Board for Arteriosclerosis, Thrombosis and Vascular Biology, the Cardiovascular and Stroke Nursing Council, and the Stroke Board. In an effort to guide doctors, the statement outlines the impact of pregnancy on women’s cardiovascular and overall health – as well as recommendations on how to treat women with a variety of conditions.

Among the initial highlights of the document include part of the physiological changes that occur during pregnancy and how it impacts the body’s interactions with certain classes of drugs, including antihypertensive and antithrombotic agents. The document also stresses the need for pre-pregnancy counseling and multidisciplinary care teams to reduce maternal cardiovascular and obstetric risks and fetal risk during potential pregnancies.

The statement also includes recommendations for treatment if the patient suffers from many different cardiovascular conditions during pregnancy. Conditions of note included in this document are hypercholesterolemia, ischemic heart disease, cardiomyopathy, arrhythmias, valvular heart disease, and aortic disease. The document also refers to treatment for patients suffering from deep vein thrombosis, pulmonary embolism, and cerebrovascular disease.

“For each of these heart conditions, pregnancy can have an impact on care because there are limitations in treatment management and invasive procedures given the potential risk of the fetus … Women must understand the risk of the fetus and the risks to their own health posed by the heart condition before becoming pregnant, “Mehta explained, in the statement above.

Also included in this document is the emphasis on lifestyle modification, delivery time, and postpartum follow-up.

A foundation in the prevention of almost all cardiovascular conditions, the scientific statement reviews data suggesting that exercise and proper diet can provide dividends for maternal health – showing data showing regular exercise can improve health and prevent preeclampsia.

“The role of a healthy lifestyle during pregnancy – whether a woman has a cardiovascular condition or not – cannot be stressed enough,” Mehta said.

With regard to delivery times, the authors stress the importance of consulting with patients and understanding the risks and potential benefits associated with the timing and various modes of delivery. For postpartum follow-up, the authors highlight the need for discussion around contraception before discharge and identify which patients should receive fourth trimester follow-up.

This scientific statement, “Cardiovascular Considerations in Caring for Pregnant Patients, “Published in Circulation.

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Italy

Cardiac Arrested Outside Hospital Soar During COVID-19 in Italy | Instant News


Editor’s note: Find the latest COVID-19 news and guides in Medscape Coronavirus Resource Center.

Cardiac arrest outside the hospital increased 58% during the peak of the COVID-19 outbreak in the Lombardy region of Italy, compared to the same period last year, a new analysis shows.

During the first 40 days of the outbreak which began February 21, four provinces in northern Italy reported 362 cases of cardiac arrest outside the hospital and 229 during the same period in 2019.

The increase in these provinces varied in magnitude from 18% in Mantua, where there were 1688 confirmed COVID-19 cases, to 187% in Lodi, which had 2,166 COVID-19 cases. Cremona Province, which has the highest number of COVID-19 cases in 3869, experienced an increase in cardiac arrest 143% outside the hospital.

The mortality rate in the field is 14.9 percentage points higher in 2020 than in 2019 among patients where resuscitation was attempted by emergency medical services (EMS), Enrico Baldi, MD, University of Pavia, Italy, and colleagues reported in the April 29 letter at Journal of New England Medicine.

“Patients’ gender and age are similar in the 2020 and 2019 periods, but by 2020, the incidence of cardiac arrest outside the hospital for medical reasons is 6.5 percentage points higher, the incidence outside of cardiac arrest at home is 7.3 points “percentages are higher, and the incidence of cardiac arrest without witnesses is 11.3 points higher,” the authors wrote.

Patients also tend to accept pulmonary resuscitation from observers in 2020 vs 2019 (-15.6 percentage points) and more likely to die before reaching the hospital when resuscitation is attempted by EMS (+14.9 percentage points).

Among all patients, mortality rates in the field increased by 11.4 percentage points during the outbreak, from 77.3% in 2019 to 88.7% in 2020.

The cumulative incidence of cardiac arrest outside the hospital in 2020 is “strongly related” to the cumulative incidence of COVID-19 (Spearman’s rank correlation coefficient, 0.87; 95% confidence interval, 0.83 – 0.91) and spikes in cases ” followed by the passage of time from the COVID-19 outbreak, “the researchers noted.

A total of 103 patients, who were arrested outside the hospital and diagnosed with or suspected of having COVID-19, “accounted for 77.4% of the increase in cardiac arrest cases outside the hospital observed in these provinces in 2020,” the investigator notes.

As a pandemic has occurred, hospitals and doctors throughout the US too voicing concern about decreasing the number of patients that come with myocardial infarction (MI) or stroke.

Nearly a third of Americans (29%) report delaying or avoiding medical treatment for fear of contracting COVID-19, according to new polls released April 28 from the American College of Emergency Physicians (ACEP) and Morning Consult, a global data research company.

Although many emergency departments report a decrease in patient volume, 74% of respondents say they are worried about hospital waiting times and overcrowding. Another 59% expressed concern about being rejected from hospitals or doctor’s offices.

At the same time, the survey found strong support for emergency physicians and 73% of respondents said they were worried about over-stressing the health system.

The decline in the number of Americans seeking treatment for MI and stroke nationally has prompted eight professional societies – including the ACEP, the American Heart Association, and the Association of Black Cardiologists – to recently issue joint statement urge those who experience symptoms to call 911 and seek treatment for this life-threatening event.

The authors do not disclose relevant financial relationships.

N Engl J Med. Published April 29, 2020. Letter

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Switzerland

ESC Guidance on CVD Diagnosis, Management in the Middle of COVID-19 | Instant News


Editor’s note: Find the latest COVID-19 news and guides in Medscape Coronavirus Resource Center.

The European Society of Cardiology (ESC) has issued guidance on the diagnosis and management of cardiovascular disease during the COVID-19 pandemic.

“Patient with cardiovascular risk factors and established cardiovascular disease represent a vulnerable population when suffering from COVID-19, and patients with heart injuries in the context of COVID-19 have an increased risk of morbidity and mortality, “Stephan Windecker, MD, PhD, Swiss Cardiovascular Center, Bern, Switzerland, told Medscape Medical News.

Therefore, ESC gathered a group of experts and doctors with experience in the care of patients with COVID-19 to provide guidance on all aspects of CV care during the COVID-19 pandemic, Windecker explained.

That guidance documentposted on a community website, organized into chapters that summarize “important” information in numbers, tables, and lines of care and provide key points in advance.

It provides information on epidemiology, pathophysiology, strategies for diagnosing SARS-CoV-2, protective measures for health workers and patients, triage system, and diagnosis of cardiovascular conditions in COVID-19 patients.

“Life” Documents Can Change

The management section discusses the path of care in patients with acute and chronic coronary syndromes, heart failurevalvular heart disease, hypertension, pulmonary embolismand arrhythmia.

“It should be noted,” Windecker said, “arithmogenic considerations of the therapeutic agent COVID-19 are also discussed as well as the use of oral anticoagulants. This document concludes with sections that provide useful information for patients with CV disease.”

The document notes that there is currently no evidence-based treatment for COVID-19 infection and experimental treatment may have heart side effects. It is recommended that experimental treatments become part of controlled trials whenever possible.

Windecker emphasized that this document is not a guideline, but a guidance document and does not replace the existing ESC guidelines. The contents also should not interfere with recommendations given by local and national health authorities.

“This document is comprehensive in scope, but only provides a brief overview with initial findings that can change and mature over time with increasing knowledge,” he told Medscape Medical News.

“Therefore, through this live document, we hope to continue to engage with our front-line colleagues and accept contributions, comments and suggestions“that might be considered for future updates,” he said.

Windecker has previously revealed institutional research grants from Abbott, Amgen, Bayer, Bristol Myers-Squibb, Boston Scientific, Biotronic, CSL Behring, Edwards Lifesciences, Medtronic, Polares, and Sinomed.

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Health

VA Hydroxychloroquine Study, Aid Fund | Instant News


Editor’s note: Find the latest COVID-19 news and guides in Medscape Coronavirus Resource Center.

Here are the coronavirus stories you should know about Medscape editors around the world:

VA Hydroxychloroquine study

A retrospective study Veterans Affairs (VA) patients hospitalized with COVID-19 found that hydroxychloroquine treatment, with or without azithromycin, is not associated with a lower risk than needed mechanical ventilation compared to standard supportive care alone. The risk of death from any cause is also higher in the group of patients receiving chloroquine hydroxy.

“Until we have a good prospective randomized trial, it’s hard to know what to do,” said an expert who was not involved with the study. “But this is more evidence that there is no good reason to use it [hydroxychloroquine]. ”

The next round is the COVID-19 Relief Fund

The federal Department of Health and Human Services will begin distributing the second tranche of $ 100 billion in COVID-related Relief Provider Funds as soon as tomorrow, officials said Wednesday. It will also immediately begin the process for hospitals and doctors to be replaced to test and treat uninsured patients.

The new payment cycle will be divided into several ways: $ 20 billion for Medicare and doctor facilities; $ 10 billion to hospitals in COVID-19 hot spots; $ 10 billion for rural health clinics and hospitals; and $ 400 million for Indian Health Services. A total of $ 30 billion was distributed earlier this month, and around $ 27 billion of the $ 100 billion has not been allocated.

Noninvasive ventilation and Respiratory Advice

European physicians with experience treating COVID-19 patients discuss the benefits of CPAP helmets as a method for noninvasive ventilation assistance, the importance of hypercoagulation monitoring, pronation for patients with characteristic disease subtypes, and the need for detailed respiratory physiotherapy protocols. in the European Anesthesiology Society webinar.

At one point, panelists wiped tears when a person cried, remembering the pressure on hospital resources during the wave: “I fully agree with [the] ideas for early intubation when we can’t control the respiratory urge caused by disease. But we can’t do it because we have too many patients. So we have to triage. “

“Great Impersonator” New

When researchers learn more about COVID-19, it’s clear it can be more than just a respiratory disease. It has joined the ranks of other “great imitators” – diseases that can look like almost any condition, Neha Pathak, MD, write for WebMD Health News.

In addition to the more typical respiratory symptoms, reported SARS-CoV-2 can cause conjunctivitis, Loss of taste and smell, muscle aches, fatigue, diarrhea, abdominal pain, loss of appetite, nausea and vomiting, whole body rashes, and areas of swelling and redness in just a few points.

In more severe illnesses, doctors also report heart rhythm problems, heart failure, kidney damage, confusion, headaches, seizures, Guillain-Barré syndrome, and passed out spells, along with new blood sugar control problems.

“This is a disease progression that we have never seen for an infection that I can think of, and I have been doing this for decades,” said an infectious disease specialist.

Remdesivir Data Published Unintentionally

Data from a randomized controlled trial of experimental drug remdesivir Gilead Sciences for patients with severe COVID-19 disease in China were “inadvertently” published on the World Health Organization (WHO) website on Thursday, then transferred, a WHO spokeswoman to STAT News.

The study summary states that remdesivir “was not associated with a difference in time to clinical improvement,” or a difference in the 28-day mortality rate, compared to the patient control group.

The trial ended early due to low registration, according to Gilead officials statement, and is therefore “underpowered to allow statistically meaningful conclusions.” The company expects data from other studies of remdesivir to be available later this month and May.

Reminiscing

As frontline health workers who treat patients with COVID-19, they are committed to difficult and draining jobs and also put themselves at risk of infection. Hundreds of people have died worldwide.

Medscape has published a warning list to commemorate them. We will continue to update this list if needed. Please help us make sure this list is complete by sending names by age, profession, or specialization, and location through this form.

Ellie Kincaid is managing editor of the Medscape association. He has previously written about health care for Forbes, that Wall Street Journal, and Natural Medicine.

For other news, follow Medscape at Facebook, Indonesia, Instagram, and Youtube and follow Ellie Kincaid on Twitter @ellie_kincaid.

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