There is a population who is at the highest risk of having major cardiovascular events, i.e. a non fatal stroke or a fatal MI. Usually they already have had a prior cardiovascular event. Atherosclerosis has damaged the patient’s vessels. This means there is evidence of prior heart damage or vascular damage. Remember that evidence of…
Tag: family medicine
Anticholinergic poisoning
The following illustration reviews the famous mnemonic that helps to remember some of the feature signs and symptoms of anticholinergic poisoning. It’s important to remember that there are over 600 medications usually prescribed by physicians and over-the-counter that have anticholinergic components. These include antihistaminics, bronchodilators and psychotropics. Elderly population is in special risk due to…
Pericardial disease: 2015 ESC guidelines / Pericarditis, diagnóstico según la ESC, 2015.
The following illustration summarizes both clinical presentation and diagnostic procedure and criteria of pericardial disease, as well as one of the worst complications: constriction and arrest (due to obstructive shock). Remember the following: you will start suspecting it after seeing, listening and talking to your patient. You will use ECG, bio-markers and imaging to confirm…
Atrial fibrillation and increased stroke risk / Fibrilación auricular y riesgo elevado de ictus.
Atrial fibrillation is the most common arrhythmia. As sinus rhythm fails and an irregular pace is established, turbulence in atria increases the risk of thrombus formation, embolism and ischemic stroke. It also increases the risk of tachyarrhythmia, altering end diastolic volume, causing heart failure. In order to prevent stroke, depending on certain risk factors and…
“Do not do” and “Do” recomendations in the elderly patient.
From SEMFYC’s “Recomendaciones no hacer y hacer en el anciano” (https://www.semfyc.es/biblioteca/recomendaciones-no-hacer-y-hacer-en-el-anciano/) The following illustration is a summary of some of things we must be aware of when treating and prescribing medication for an elderly patient. Different chronic conditions present, lots of medication and higher risk for adverse effects, much more sensibility and less glomerular filtrate,…
Thrombotic microangiopathy and hemolytic anemia:
It’s all about damage of endothelium of small vessels (micro-angio-pathy). This will cause red blood cells to “crash into” inflamed walls, break (hemolytic anemia) and trigger clot formation (thrombotic). Anemia will cause hypoxemia and then thrombosis leads to reduced and impaired blood flow, tissue hypoxia, infarction and a suggestive clinical picture: petechiae, purpura, pain, organ…
