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In a large observational study, people already on statins before being admitted with COVID-19 had lower in-hospital mortality.
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It’s not an all-or-nothing situation, with experts agreeing that there are times when use of CMR makes sense.
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New AHA stats reveal entrenched problems as well as key racial and ethnic disparities. COVID-19 can only make things worse.
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New AHA stats reveal entrenched problems as well as key racial and ethnic disparities. COVID-19 can only make things worse.
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Like others before, two new studies suggest that myocarditis is rare but microclots are not, supporting a role for anticoagulation.
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UK study results offer a grim warning for hospitals facing surging COVID-19 admissions, and for patients leery of seeking help.
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A roundup of published autopsy data and a comparison of tissue samples provide some reassurance for clinicians.
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Nurses and techs are quitting permanent jobs for lucrative traveling contracts, leaving hospitals and cath labs scrambling.
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Along with BRACE CORONA, there are now two RCTs showing no impact on outcomes when maintaining ACE inhibitors and ARBs.
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Two studies reveal the pandemic’s impact on CV mortality in the US and a global drop in diagnostics that could spell future trouble.
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Editors grappled with study volume and quality but wanted to publish something—ANYTHING—on the virus’s CV effects.
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An EAPCI document offers advice on how to prioritize procedures and do them safely as the pandemic moves past its first wave.
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The median density of web-like neutrophil extracellular traps in STEMI patients was tripled versus in noninfected controls.
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The biggest challenge “was facing the unknown and getting comfortable with uncertainty,” said Anna Bortnick.
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Cardiologists and other clinicians are lining up for shots and spreading the word to patients that their turn will come soon.
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Countries worldwide reported steep drops in cardiac admissions during the pandemic. A new study mulls the mortality impact.
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COVID-19, divisive politics, racism, and eroding faith in science—on a range of hot topics, physicians are speaking out.
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Researchers note that there are a number of randomized trials ongoing, but to date, the evidence supports benefit, not harm.
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The study, focused on the earliest months of the pandemic, spotlights risk factors and drug regimens that may play a role.
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The pandemic revealed that research doesn’t have to be the lumbering creature it’s been and can be more agile and efficient.
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The researchers hope lessons can be learned by shedding light on the lack of support, stress, and economic concerns felt by staff.
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For all the grief and loss it’s caused, the pandemic may trigger some needed shifts and shine a light in the shadows.
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An Italian multicenter registry showed no difference in survival based on alterations in immunosuppressive therapy.
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Prognosis is poor for those with CV risk factors/comorbidities, but complications like PE and DVT are less frequent than expected.
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Better public messaging is needed for young adults unaware that youth can’t protect against severe COVID-19 if their BMI is high.
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Outcomes were similar across racial/ethnic groups, indicating disparities must be addressed upstream from the hospital.
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Some anticipate a more coordinated response to the pandemic and a change in tone under the new administration.
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Recommendations zero in on supporting ongoing heart failure trials and strengthening the “trial ecosystem” for the future.
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With an eye toward the second wave, experts urge public health campaigns to ease patients’ fear of going to the hospital.
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An expert is skeptical of the signal given the lack of control group in the small series, saying you’ll find things if you go looking.
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The findings from 277 autopsies refute some early concerns, but don’t rule out other heart effects of the virus, pushing up troponin.
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Monday, November 2 | FEATURE
The pandemic is reviving debate around universal ECG screening, but recommendations remain focused on more-targeted testing.
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One expert cautions that data from the pandemic’s first-wave may not reflect the current state of treatment.
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A range of cardiovascular therapies have been tested in COVID-19, but small trial sizes and duplicate efforts are limiting progress.
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More than a third had a major thrombotic complication despite 90% getting prophylactic anticoagulation, a new report shows.
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Transthoracic echo, particularly point-of-care devices, should not be overlooked in patients with suspected cardiac involvement
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Separate studies highlight underlying mechanisms through which the SARS-CoV-2 virus may cause heart and lung damage.
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It remains unclear, however, whether the risk is all that high in the first place when adequate PPE is used.
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Contingency plans are needed to curb mortality rates from conditions untreated during the next wave of the pandemic.
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Deaths exceeded 40% in registry patients with valvular heart disease who fall ill. Swift treatment—with caveats—cuts the risk.
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Public health messaging should reassure patients they needn’t be scared to go to the hospital, a COVID-ACS researcher says.
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The director of one PERT said they had three times as many activations in March/April than the previous years.
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A new review discusses shared CV risks, vaccine development, and a plan to redeploy flu trials in the COVID-19 battle.
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Two experts urge caution with the results, but suggest dialing back liberal use of therapeutic anticoagulation unless in an RCT.
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More studies will be needed to understand what the white blood cells are doing and whether they pose long-term risk.
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Though lower than in other parts of the US, thrombosis rates still were elevated at two Cleveland Clinic sites.
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The mortality rate of slightly below 40% is good news compared with earlier reports, researchers say.
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Four procedures have volume requirements for Medicare reimbursement. CMS won’t enforce them during the pandemic.
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A nationwide survey affirms plunging numbers of PCIs and TAVRs seen in other studies, but adds some personal insights, too.
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Media coverage of several small CMR studies has led to an uptick in unwarranted CMR requests, says Venkatesh Murthy.
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The small series will fuel the contentious debate over the lasting cardiac effects, but everyone agrees: more data are needed.
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Separate studies showed how hypertension among infected patients influences adverse outcomes.
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In a population under age 35, 20% required ICU care, 10% were put on ventilators, and approximately 3% died.
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Disentangling COVID-19 from CV risk factors when cardiac events occur is tricky. The bottom line is looking for and treating the risk.
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To move forward, treatment strategies should have set protocols and be prospectively tested, one expert stressed.
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The pandemic era saw looser standards in some major journals, but some evidence is better than none, say researchers.
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The study is observational, but it sets the stage for larger anticoagulation RCTs to come, including FREEDOM COVID-19.
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Treatment was delayed, but the proportion of patients receiving “effective reperfusion” remained stable over time.
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MIS-C and an adult myocarditis-like syndrome are likely on a shared spectrum of CV complications, researchers say.
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It’s much too soon to be excited, say experts, who caution that only randomized trials will provide definitive results.
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In one of the larger series to date, severe obesity was particularly lethal in men and younger patients.
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The virus or its treatments may disrupt heart rhythm, but the immune response and its targets likely deserve the most scrutiny.
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Severe strokes, some due to the virus itself, surged, while fear drove many patients to avoid seeking hospital care.
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Retrospective US data confirm trends seen elsewhere but offer additional, unique insights into patients and outcomes.
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CAC is a “freebie” you get when the lungs are imaged, Harvey Hecht points out. Might as well put the information to use.
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Two-thirds of patients in the small postmortem series had evidence of active virus in cardiac tissue, but questions remain.
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A series of middle-aged patients followed more than 2 months after diagnosis showed that most had abnormal results on CMR.
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Wednesday, July 29 | FEATURE
Cardiology groups large and small used different tactics to keep afloat and continue patient care. The future remains unclear.
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It’s not just the sickest people requiring ICU care who are at risk, according to NYC data.
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Using the appropriate test can aid diagnosis but also lead to changes in management that may improve patient outcomes.
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A small study of patients treated early in the pandemic shows poor outcomes when leg symptoms are involved.
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Autopsy analysis shows that myocarditis isn’t the only cause of MI in the absence of occlusive disease.
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Three case reports describe adults whose symptoms, including conjunctivitis and rashes, echo the rare pediatric presentation.
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Available data support the administration of early, therapeutic anticoagulation in this population, experts say.
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Monday, July 20 | FEATURE
Cardiac complications in COVID-19 have thwarted acute care. Now physicians are asking what this portends down the road.
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After PCI, the mean LVEF is lower in COVID-19 cases, and investigators saw a signal toward higher mortality.
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RECOVERY investigators stress the steroid should be used when the disease is dominated by “immunopathological elements.”
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Out-of-hospital cardiac arrests and related deaths spiked while ACS admissions fell, offering lessons for areas yet to surge.
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Whether COVID-19 adds risk by virtue of being a comorbidity or due to direct effects is unknown. A global registry offers clues.
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Whether COVID-19 adds risk by virtue of being a comorbidity or due to direct effects is unknown. A global registry offers clues.
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A new review documents the extrapulmonary ramifications of COVID-19, including its heavy effect on the kidneys and heart.
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Doctors should be on the lookout for Takotsubo, researchers say, noting that high stress levels are endemic at this time.
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When measured at presentation, cardiac troponin levels can be used to risk-stratify infected patients, says Allan Jaffe.
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Now-familiar themes again emerged in the 78-patient series with data from Iraq, Italy, Lithuania, and Spain.
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Monday, June 29 | PCR e-Course 2020
Out-of-hospital arrests doubled or tripled in cities with major outbreaks and missing STEMIs, making it tricky to confirm cause.
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Megakaryocytes were found in all hearts on autopsy in the small study, a rare find that may aid in exposing the virus’ mechanism.
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Depending on the severity of COVID-19, further cardiac testing may be warranted to prevent myocarditis-linked sudden death.
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Dexamethasone is “inexpensive, on the shelf, and can be used immediately to save lives,” says a RECOVERY researcher.
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One journal’s call for cases drew more than 500 submissions that highlighted SARS-CoV-2’s extensive CV effects.
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The disproportionate distribution of disease is not surprising, say experts, given the historic injustices faced by people of color.
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A BMJ editorial notes obesity is a modifiable risk factor for COVID-19, calling for reformulation of processed foods and a ban on ads.
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Patients deemed low risk after primary PCI can safely skip the ICU, an appealing option when resources are strained.
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The data confirm earlier reports and show that these patients are at an increased risk of dying in the hospital.
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One author warns they may be seeing just the “tip of the iceberg” and suggests monitoring those with even mild disease.
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To gain patient trust again in hospitals, Barbara Casadei said testing and isolating COVID-19 patients will be paramount.
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One of the major questions to answer will be the optimal anticoagulation strategy in patients with COVID-19, say experts.
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Observed mortality was highest in those not on antihypertensive meds, with no signal of harm for RAAS inhibitors.
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The risk is small, but study investigators emphasize the need for potent antiplatelet therapies in high-risk patients with COVID-19.
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The NEJM-published study further muddies the path for this drug amid yesterday’s retraction of the dubious-data Lancet paper.
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Friday, June 5 | FEATURE
Physician burnout was already a concern, but now with COVID-19, experts stress the need to address the well-being of staff.
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The company that owns the data set wouldn’t surrender it in full, throwing the veracity of the studies’ findings into question.
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Tuesday, June 2 | FEATURE
ECMO, most often venovenous, may help in otherwise healthy, younger patients. What happens long term remains unclear.
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A group of scientists is asking for the numbers to be made public and externally validated. A Lancet study investigator responds.
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Physicians latched quickly onto hopes that antimalarial drugs could help, but weren’t swayed by ACE inhibitor/ARB theories.
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Two large analyses reinforce the view that the antimalarial medications raise the risk of death and arrhythmia.
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The still-forming picture suggests significantly more new-vessel growth in the lung than would be expected from a typical flu.
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There’s more to learn about the mechanisms of stroke in COVID-19 patients, as well as the impact of stay-at-home orders.
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In China, the virus was largely contracted from within the hospital, while community acquisition was likely in Holland.
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As data come in from big hospital networks and across countries, physicians are urging health administrators to learn the lessons.
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About one-third of polled program directors and current fellows said training should somehow be extended.
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Physicians are still learning about the newly identified multisystem inflammatory syndrome in children (MIS-C).
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It remains to be seen whether the drugs increase the likelihood of infection or whether they may in fact be helpful treatments.
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Wednesday, May 20 | FEATURE
President Trump says he’s taking it daily, but three new studies and an ACP warning say hydroxychloroquine is of little benefit.
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Compared with survivors, those who died were more likely to have elevated troponins as well as comorbidities.
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Wednesday, May 20 | FEATURE
A new era for telemedicine, rebuilding patient trust, and an increase in efficiency of care were common themes.
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The prospective study from the US hot spot also shows a high rate of multiple organ failure, including severe kidney disease.
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In Bergamo province, investigators report a 30-fold increase in severe Kawasaki, diagnosed according to accepted criteria.
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Schools, teams, competitive athletes, and dedicated amateurs are starting to ask clinicians how they can get back in the game.
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Tuesday, May 12 | FEATURE
Working off the backlog of elective CV cases put on hold for the last 8 weeks will be more of a marathon than a sprint, say docs.
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The data support the idea that some patients may need anticoagulation to prevent pulmonary embolism.
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Friday, May 8 | FEATURE
In some cases, large strokes are the first presentation of COVID-19 in younger patients, but numbers are lacking and uncertainty abounds.
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Some physicians report an uptick in cases, but the size of the problem needs more study.
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Mount Sinai physicians found lower mortality with systemic anticoagulation and plan to dig deeper.
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Two pediatric cardiologists are convinced this is “something to be aware of,” with one urging echocardiographic follow-up.
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RAAS inhibitors also do lead not to more-severe COVID-19, providing reassurances for patients treated with the drugs.
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The finding supports anecdotal reports of STEMI mimics but not a role for fibrinolysis during the pandemic, one researcher says.
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RVLS outdid other echo parameters in Wuhan-based patients but needs further study, particularly in other populations.
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Investigators believe theirs are the first published data showing high numbers of at-home cardiac arrests amid the pandemic.
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The IV drug has a “clear-cut, significant, positive effect on diminishing the time to recovery,” says Anthony Fauci.
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A French series is putting PE in the spotlight, but the optimal anticoagulation strategy remains unknown.
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Wednesday, April 29 | FEATURE
Globally, cardiologists are seeing VSDs, papillary ruptures, and other complications rarely seen in the primary PCI era.
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When telemetry beds are scarce, these monitors rapidly detect issues and also minimize contact with infectious patients.
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Social isolation doesn’t just mean Netflix on the couch, say prevention experts, who stress the importance of daily exercise.
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Two retrospective studies from China found no link to higher mortality, with one even suggesting lower death risk.
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Thursday, April 23 | FEATURE
How the immune response tips so radically off-balance is unclear, but research, some drawing on recent CVD trials, ploughs on.
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A new review explores the higher risk of thrombotic disease with this coronavirus, how to prevent and treat it, plus research gaps.
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Tuesday, April 21 | FEATURE
Obesity is the latest theory du jour for why some SARS-CoV-2 infections take a deadlier course, particularly in the young.
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Better testing and culturally targeted PSAs are needed in the short term; on the other side, societal fixes will be critical.
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Friday, April 17 | FEATURE
Business as usual may not be possible, and overwhelmed hospitals may consider lytic-based pathways, a group says.
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Friday, April 17 | FEATURE
Some say COVID-19 might pave the way for more robotic procedures, but proof they cut disease transmission is lacking.
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Thursday, April 16 | FEATURE
Trading catheters for central lines, many fellows are stepping into roles they’d never imagined, while programs adapt.
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Although the majority did not require hospitalization, severe disease and death were reported across age groups.
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Eight societies came together to offer tips on how healthcare providers can protect themselves while helping their patients.
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Tuesday, April 14 | FEATURE
Some US hospitals have asked doctors over a certain age to work from home, but surge situations may mean all hands on deck.
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Which TAVR can be deferred, which MV should be repaired? Advice from ACC, SCAI, and the heart of the US pandemic.
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Their suggestions include an increased use of POCUS, greater scrutiny of orders, and a hiatus for hands-on training.
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Numbers from nine US hospitals largely echo the drop seen in Spain. Understanding the consequences is key, experts say.
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Expert's say there's no better time than now to keep preventative CV care going and forge a new path for outpatient cardiac rehab.
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Half of patients who died during a 10-day stretch in January had hypertension.
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Tuesday, April 7 | FEATURE
RCTs are paused or slowing to a trickle. Researchers predict data gaps, less funding, and new priorities when the pandemic ends
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Hydroxychloroquine, chloroquine, and azithromycin all prolong QT interval. The next step is studying if their benefit exceeds risk.
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Thursday, April 2 | FEATURE
Fear of infection is likely the biggest driver, but as other theories circulate, cardiologists are bracing for the fallout.
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Friday, March 27 | FEATURE
Different hospital policies as to who should wear a mask—and when—pit a shaky evidence base against a supply chain shortage.
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The new, detailed guidance does not amount to “hard and fast rules.” SCAI says hospitals need to make case-by-case decisions
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Experts stress there is not enough evidence to suggest these medications can worsen COVID-19 morbidity and mortality.
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Wuhan researchers have published details on 416 hospitalized patients, but treatment pathways remain unclear.
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The experience of Chinese physicians is leading the way for others around the world as the pandemic explodes in the US.
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Tuesday, March 24 | FEATURE
From FaceTime to old-fashioned telephone visits, healthcare workers are turning to virtual means to conduct clinical care.
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Friday, March 20 | FEATURE
“You wouldn’t send a soldier into war without a gun or body armor,” one doctor says. Hard-hit areas offer some tips.
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Be prepared, experts urge. Much is still unknown about how the novel coronavirus will affect day-to-day and emergency CVD care.
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(UPDATED) More research is needed, but for now, there’s no evidence that background use of the agents harms or helps in COVID-19.
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Within hours of the ACC’s announcement, the European Heart Rhythm Association 2020 also announced their meeting was off.
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It’s a wise move, Mamas Mamas says, both for the health of the attendees and for the patients they care for back home.
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One piece of advice is to not overlook classic symptoms and presentation of acute MI in the context of the COVID-19 virus.
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China Interventional Therapeutics 2020, slated for April, has been canceled, but little impact is anticipated for other conferences.
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ON RECORD
Shelley Wood explores the potential for lingering cardiac damage after SARS-CoV-2 with Elena Arbelo and Khurram Nasir.
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TOPICAL DISCUSSION
Christine Chung, Susheel Kodali, Jacob Mishell, Tamim Nazif, and Mark Reisman discuss COVID-19's impact on structural heart programs: triaging patients, ensuring safety, and how to restart a practice that has been put on hold.
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ON RECORD
Shelley Wood hears from Gennaro Sardella, Ghada Mikhail, and Javier Escaned about STEMI patients delayed by COVID-19 and those that didn't come at all.
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TOPICAL DISCUSSION
Michael Borger, Juan Granada, Mamas Mamas, Thomas Modine, Goran Olivecrona, and Holger Thiele discuss the impact of social isolation and outcomes in the EU during the COVID-19 era.
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TOPICAL DISCUSSION
Christine Chung, Susheel Kodali, Jacob Mishell, Tamim Nazif, and Mark Reisman discuss COVID-19's impact on structural heart programs: triaging patients, ensuring safety, and how to restart a practice that has been put on hold.
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ON RECORD
Shelley Wood hears about symptoms, self-management, and takeaways from Gennaro Giustino, Isaac George, Azeem Latib, and Jordan Safirstein.
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WEBCAST
How has the cath lab adapted to perform interventional and surgical procedures in high-risk or COVID19+ patients? This three part webcast addresses current challenges and recommendations with perspectives from the Chinese Society of Cardiology.
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WEBCAST
Mamas Mamas, Jay Mohan, Purvi Parwani, Nosheen Reza, Juan Granada, Sarah Hudson, Sahil Parikh, Martha Gulati, & Danielle Belardo discuss the impact of COVID-19 on cardiology fellowship programs from redeployment to adapting education and training.
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WEBCAST
Drs. Juan Granada, Martha Gulati, Ajay Kirtane, Mamas Mamas, and Christ White discuss lessons learned and applicability from China’s approach to managing COVID-19.
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WEBCAST
Juan Granada, Azeem Latib, Mamas Mamas, and Federico Pappalardo discuss hospital preparedness and management protocols as well as pulmonary care for the non-pulmonary specialist in this special edition webcast on COVID-19.
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WEBCAST
Roxana Mehran, Ajay Kirtane, and Gennaro Giustino discuss the latest data on cardiac injury and COVID-19.
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ROX HEART RADIO
Roxana Mehran hears from Robert Bonow, Filippo Crea, and Valentin Fuster on how COVID-19 has impacted cardiology journals.
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ROX HEART RADIO
Roxana Mehran discusses COVID-19 and inflammation with Sanjit Jolly, Peter Libby, and Jean-Claude Tardif.
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ROX HEART RADIO
What’s worked so far? What hasn’t? Roxana Mehran hears from Ron Blankstein and Asif Qasim.
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HEART SOUNDS
This month: a cardiac MRI study of COVID-19, MIs in EXCEL, the pandemic's indelible mark on cardiology, and more.
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ROX HEART RADIO
Roxana Mehran explores the pandemic's lessons for telehealth with Ami Bhatt, Andrew Freeman, and Niraj Varma.
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HEART SOUNDS
This month, Julia Grapsa and Mary Norine Walsh describe the many ways COVID-19 affects the heart.
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HEART SOUNDS
This month, Barbara Casadei describes how the UK is emerging from COVID-19.
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ROX HEART RADIO
As part of a special series on female physicians, Roxana Mehran speaks with Amreen Dinani about her experiences with COVID-19 in New York City.
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ROX HEART RADIO
Roxana Mehran talks with Ladan Golestaneh. caring for patients in the Bronx.
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ROX HEART RADIO
Today, Roxana Mehran hears COVID-19 news from Leila Hosseinian, based in Chicago, IL.
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HEART SOUNDS
In the COVID-19 era, older and younger physicians, telehealth, RCTs, obesity, and inflammation
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ROX HEART RADIO
Today, Roxana Mehran hears from Miguel Martillo in New York City
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ROX HEART RADIO
In this episode, Roxana Mehran takes on physician wellness in COVID-19 with Laxmi Mehta and Benjamin Salter.
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ROX HEART RADIO
Today, Roxana Mehran discusses PPE in COVID-19 with George Dangas and Ajay Kirtane.
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ROX HEART RADIO
Roxana Mehran speaks with Giulio Stefanini and Gennaro Giustino about the latest developments related to COVID-19.
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HEART SOUNDS
This month features an in-depth conversation on COVID-19 with Alaide Chieffo, MD.
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EDITOR'S CORNER
AHA late breakers dominated the list this month, along with a farewell to Anthony Gershlick and our COVID-19 Daily Dispatch.
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EDITOR'S CORNER
Most of the top stories stemmed from TCT Connect, but a PCI vs surgery analysis and the COVID-19 Daily Dispatch took top spots.
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EDITOR'S CORNER
Half of TCTMD’s top stories this month are from the virtual ESC Congress, but topping the list was the Daily COVID-19 Dispatch.
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EDITOR'S CORNER
Affirmative action and cannabis use took the top slots alongside more-typical cardiology news on hot topics like DAPT.
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EDITOR'S CORNER
Heart damage in COVID-19, MIS-C in adults, perennial hot topics in interventional cardiology, and our Daily Dispatch dominate.
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EDITOR'S CORNER
COVID-19’s unusual manifestations, risk factors, and possible treatments dominate the top stories on TCTMD this month.
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EDITOR'S CORNER
For the second month a row, all of our top 10 stories address some angle of the COVID-19 pandemic.
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EDITOR'S CORNER
Missing MIs, inflammation, thrombosis, safe echo, junior and senior physicians, clinical trials, and more, all related to COVID-19.
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EDITOR'S CORNER
As COVID-19 cases go global, a picture is emerging as to its CV impact and how cardiologists in hard-hit regions are coping.
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OFF SCRIPT
The coronavirus has led to cancelled meetings and hospitals barring physician travel, offering a glimpse of the future of medical education.
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This program is sponsored by the Cardiovascular Research Foundation and supported through an unrestricted grant from Edwards Lifesciences. The Cardiovascular Research Foundation ensures that its programs are educational and meet the needs of the target audience. This program was developed without influence from commercial supporters.