September 2021

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Health Lifestyle

Campaign Wants to Spread Awareness of the Risk of High Blood Clot

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It is strange to think how low public awareness about blood clots is when they are among the most common threats to the cardiovascular system. Luckily, there are people trying to change this.
The International Society on Thrombosis and Haemostatis says that one in four deaths across the globe is caused by blood clots. The Centers for Disease Control and Prevention has partnered with the National Blood Clot Alliance to make the public more aware of the issue through a public education campaign called “Stop the Clot, Spread the Word.”
It has been pointed out that there are more people dying from blood clots than AIDS, …

Cardiology

How to Tell Uncontrolled Hypertension and Hypertensive Emergencies Apart

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It is not an uncommon sight to find patients with hypertension presenting to the Emergency Department. Did you know that one in four Canadians is diagnosed with it? Chronic hypertension is also the leading cause of disability-adjusted life expectancy.
Hypertensive Emergencies
Heterogenous acute hypertensive disorders make up hypertensive emergencies. These afflictions require immediate diagnosis and treatment. Using the main guidelines used in the country, we can break down hypertensive emergencies into two groups:

Evidence of worsening or acute end-organ damage
Severe hypertension (dBP > 120-130 …

Cardiology

What is an Electrical Storm in the Emergency Department?

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How is electrical storm managed in the emergency department?
We will discuss how the process goes for those with implantable multi-shock cardioverter-defibrillators, refractory ventricular fibrillation, and polymorphic ventricular tachycardia.
Electrical shock is the occurrence of at least three sustained ventricular fibrillation or ventricular tachycardia in a span of 24 hours. On the other hand, it is defined as three ventricular arrhythmia detections requiring ICD therapies in the same amount of time.
Kindly take note that this is not a comprehensive definition as it does not consider VT that is undetected or slower…

Cardiology

The Three Acute Aortic Syndromes

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Are you familiar with the three acute aortic syndromes? If not, these are three diagnoses that are deemed to be on the same spectrum. They are, therefore, detected and treated in similar ways. They are the following:
Aortic dissection
This condition involves a rip on the intimal layer. Aside from that, it involves a false lumen and either retrograde or anterograde expansion. Among the three, this is the most common type that even accounts for 85-90% of all acute aortic syndromes.
Intramural hematoma
On the other hand, an intramural hematoma is caused by the vasa vasorum rupturing in the media. This …

Thrombosis Research

Thrombolytic Therapy During The Early ‘90s: Part 2

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We have previously discussed three trials from the early ‘90s. This list continues the theme by focusing on other studies conducted around that time.
ATLANTIS A
This trial evaluated the administration of tPA across several time windows from 0-6 hours. The primary result compared proportions of patients with a 4-point or greater improvement at 30 days and at the moment of presentation.
Researchers noted a 15% absolute difference favoring the placebo arm. There were also statistically significant absolute increases in mortality and symptomatic ICH among tPA recipients.
ATLANTIS B
This was an …

Thrombosis Research

Thrombolytic Therapy During The Early ‘90s: Part 1

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The early ‘90s witnessed the rise of thrombolytic RCTs for acute ischemic stroke. This article focuses on the impact of these trials on the development of the tPA time window for acute ischemic stroke treatment.
ECASS-1
The first tPA trial was a double-blinded RCT of acute ischemic stroke sufferers presenting within six hours of the onset of symptoms. Data analysis was conducted through modified intention to treat and intention-to-treat strategies.
There was a clinically relevant improvement in patients who took tPA, but it was not statistically significant. However, the modified analysis saw statistical …

Health Lifestyle

How to Prevent Deep Vein Thrombosis Through Your Diet

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Deep vein thrombosis can affect anyone regardless of age, although some people are at a higher risk than others. It is a relief to hear that this condition is treatable and preventable. One way to keep it at bay is through your diet. These tips will help you ward off DVT:
Drink a Lot Of Water
Dehydration is known to thicken the blood and increase the risk of blood clots. Women need to drink 91 ounces of water a day, while men require 125 ounces on average. There is a good chance that you are drinking enough water when your urine is clear or pale yellow. Darker urine can be an indication that you need to drink more.
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Thrombosis Research

Pregnancy-Adapted YEARS Algorithm for Diagnosis of Suspected Pulmonary Embolism

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Published in the New England Journal of Medicine, this paper by van der Pol LM, et al. studied 510 expecting women to see if an algorithm could diagnose pulmonary embolism without the need for imaging.
The aim of the study is to see if it is an effective alternative to ventilation-perfusion scanning and CT pulmonary angiography. These two traditional tests expose both the pregnant woman and the fetus to radiation.
Researchers evaluated three criteria from the YEARS algorithm. They were the clinical signs of hemoptysis, pulmonary embolism, and deep-vein thrombosis. The D-dimer level was also measured. The team ruled out …

Thrombosis Research

Do I Have To Be Concerned About Deep Vein Thrombosis?

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Frequent fliers are at a higher risk of the potentially fatal condition called deep vein thrombosis or DVT. Below, we have the basic facts that everyone should know about it.
What Is DVT?
Deep vein thrombosis happens when a blood clot forms and obstructs a blood vessel in the body. While it is most commonly seen in the lower leg or thigh, it affects other body parts as well. It might have no visible symptoms, but sufferers sometimes notice swelling, pain, discoloration, and cramps in the affected area.
Who Is At Risk?
The risk of DVT increases if a person remains seated for an extended period of time. …

Thrombosis Research

D-Dimer Vs. CT Pulmonary Angiography In Detection Of Pulmonary Embolism

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There are many nuances that come with a diagnosis of pulmonary embolism. For one thing, this condition affects 25 to 100 people per 100,000. This means that 30,000 Canadians suffer from it on a yearly basis. It is also a potentially fatal affliction.
In fact, it is behind only stroke and heart attack in terms of fatality among cardiovascular diseases. Lastly, survivors have a high risk of pulmonary hypertension in the long run.
It is important to identify it among at-risk patients as soon as possible. There are two primary diagnostic tests used to check for pulmonary embolism: CT Pulmonary Angiography and D-Dimer.
D-…