h******u
发帖数: 602 | 1 Acute coronary syndrome includes unstable angina and MI, NOT stable angina.
MI include NSTEMI and STEMI.
Both unstable angina and NSTEMI present with ST depression on ECG, but
cardiac enzymes are normal in unstable angina and elevated in NSTEMI.
Thrombolytic therapy is beneficial in patients with STEMI, but is not
effective in UA or NSTEMI and may be harmful!
Percutaneous coronary intervention can be used in all acute coronary
syndrome, I believe. |
|
w*******d
发帖数: 7 | 2 我正在准备CCS，发现有些病例的处理才写到一半，时间才过7分钟左右，那个最后5分
钟医嘱就跳出来了，比如UNSTABLE ANGINA 病例，才写到给HEPARIN，后面的ICU还没有
送，最后5分钟医嘱就出来了，是怎么回事？急求指导。下周考。 |
|
t*******n
发帖数: 224 | 3 那个unstable angina的病例，我刚刚练了一遍，我可以一直写到最后。不知你那边软
件出了什么问题，不行的话记住顺序就行了。 其它的病例，我有几个稍稍提前了一点
结束，但都是在做完重要的事情以后，我估计没有什么大问题。我也下个星期考，和你
握握手。：-） |
|
y******7
发帖数: 17 | 4 The following is what I collected when I was a student doing capstone in a
local hospital. Not sure if it is useful.
Lidocaine topical is a amide-type local anesthetic. for production of
topical anesthesia, relief of pain associated with postherpetic neuralgia,
reduction of gagging during dental procedures, prevention and control of
urethral pain, anesthetic lubricant for endotracheal intubation, and relief
of hemorrhoidal pain.
Polyethylene glycol(Miralax) is a nonabsorbed solution used to trea... 阅读全帖 |
|
w**********9
发帖数: 242 | 5 Because his father appears to have no myocardiac infarction, but angina is
for sure. the most common is stable angina; of course, unstable angina is
also possible. but, unstable angina is very dangerous, 50% will progress to
myocardiac infarction. His father appears not in that urgent situation.
angina? |
|
b*h
发帖数: 637 | 6 我把我爸爸的药都抄下来了。需要说明的是这些药是从至少两个不同医生那里开的。因
为在国内每次看病有不一定能再挂到同一个大夫的号。 出了冠状动脉痉挛引起的心绞
痛，我爸还有前列腺增生，所以也在吃控制前列腺增生的药。 他现在每天吃一下4种药：
1） Aspirion Enteric-coated tables 阿斯匹林肠溶片
2）Amlodipine Besylate Tables 5mg 洛活喜
治疗前列腺增生的：
3） Prostat Tables 70／4 mg： （普适泰片：良性前列腺增生）
4） Doxazosin Mesylate Extended Release Tables 4mg: Symptomatic treatment of
begin prostatic hyperiplasia & Hypertension（甲磺酸多沙唑嗪缓释片：良性前列
腺增生对症治疗；高血压）
另外，以下是有不同大夫給开的药，这些药现在都没有吃。原因是不知道哪些该吃，哪
些可以不吃. 也不是很清楚这些药的用法比如哪些是急救药，哪些是每天都要吃的。
因为在国内看病，每个病人只有两三分钟，有很多... 阅读全帖 |
|
g*2
发帖数: 658 | 7 刚刚把堆积了几个星期的nejm翻看了一下，居然在11月底的那期case discussion就是
讲得这个病
http://www.nejm.org/doi/full/10.1056/NEJMcpc1103565
Case 36-2011 — A 93-Year-Old Woman with Shortness of Breath and Chest Pain
Presentation of Case
Dr. Pooja Agrawal (Emergency Medicine): A 93-year-old woman was seen in the
emergency department at this hospital because of chest pain and shortness of
breath.
The patient had been in her usual state of health, with hypertension and
chronic renal insufficiency, until the morning of admission, wh... 阅读全帖 |
|
发帖数: 1 | 8 11 月13日 终于找到另一股在我家害我的势力
昨天，这些人折腾了一天，白天，晚上皮啦啦，也不知道谁把谁杀了，谁把谁带走了。
反正我先生和孩子被绑架了，就不知道是不是已经遇害了。我本来是打算睡觉的，但他
们头上，地下装电磁波攻击器，让我几乎窒息。虽然我没倒下，但其实他们在我身上扎
的毒针已经蔓延，我能感觉到我的呼吸有窒息的感觉。我想我对他们已经非常仁慈了，
但他们不依不饶地攻击我，欲置我于死地，让我非常生气，特别是肆意伤害我家里的人
，绑架我先生和孩子，而且有许许多多无辜的生命毁于他们之手，有必要把他们曝光。
当然我还没分析这里边是那几个人具体攻击我，伤害我的，但他们显然都是一伙的。鉴
于他们伤害我的头部，胸部 和胃部，我就把这几部分的医生都曝光，受害者慢慢去调
查，追查他们吧。
Cleveland Clinic, Website: my.clevelandclinic.org
Call 855. REFER. 123 or 855.733.3712
Lung Cancer
Results: 57 Doctors
PREV123NEXT
Results per page:
Dav... 阅读全帖 |
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w**********9
发帖数: 242 | 9 STABLE OR UNSTABLE ANGINA are medical terms doctors use to describe the
nature of chest pain.
stable angina: chest pain usually occuring with exercise or labor.
Underlying pathology: coronary atherosclerosis.
unstable angina: recurrent episodes of progressingly increasing chest pain
on minimal effort or at rest that is no longer reliefed by nitroglycerin.
Underlying pathology: coronary thrombosis with or without atherosclerosis. |
|
l*h
发帖数: 4124 | 10 there are quite some possible causes for angina without severe coronary
blockage:
1. coronary spasm (Prinzmetal's). occurs more often in young people, esp.
young women. in older people with this, most also have moderate coronary
blockage.
2. abnormal origin of coronary arteries.
3. microvascular angina.
4. Inflammation, infection, anemia, hypertension ... can also cause or
contribute to angina.
the information you provided is still sketchy, so cannot rule any one of
these out yet. |
|
l*h
发帖数: 4124 | 11 there are quite some possible causes for angina without severe coronary
blockage:
1. coronary spasm (Prinzmetal's). occurs more often in young people, esp.
young women. in older people with this, most also have moderate coronary
blockage.
2. abnormal origin of coronary arteries.
3. microvascular angina.
4. Inflammation, infection, anemia, hypertension ... can also cause or
contribute to angina.
the information you provided is still sketchy, so cannot rule any one of
these out yet. |
|
W*******n
发帖数: 4140 | 12 为现实历史，我一定要顽强地清醒地活着For Current History, I Must Stubbornly
and Consciously Live
王利民 by Wang, Limin
2019年8月18日 Aug. 18, 2019
我于2018年1月16日在B.Q.Wide Auto Body Parts Supply, Inc. (109-35 178th St,
Jamaica, NY 11433)所遭受的从被人故意破损的八英尺梯子上跌落的脑、脊工伤愈发严
重，其后经历工伤诊疗、工伤理赔经历诸多被阴暗操作，最近的社安残疾申请已显现龌
龊端倪。最近的这个八月的某些天，从该工伤开始的心绞痛极度剧烈，让我直接再次面
临死亡，这种心绞痛不是因为心脏本身，而是因为脑、脊受伤。我的个人经历和感受是
，几乎没有国家政权、机构、保险、雇主、个人在乎我的死活，反而可以明目张胆地黑
白颠倒。本来从一开始就是被合谋被预谋的谋害谋杀案，我向他们要生命、赔偿和正义
，是否显得我自己非常荒唐愚蠢？还是以我的荒唐愚蠢来揭示这个假冒伪劣毒世界的真
实人吃人面目？我没有资格证要求系统改变？
On Jan... 阅读全帖 |
|
g*****j
发帖数: 1211 | 13 Honestly, it is dangerous to play with 倍他乐克 yourself. Adding 硝苯地平
is even more dangerous.
If your father is never symptomatic during the day, especially when
exercising, it is unlikely stable angina. Unstable angina is unlikely
such short-lived and goes away when standing up every time. Shortness of
breath at night, you should consider sleep apnea, congestive heart
failure, neither of which should use 倍他乐克. Arrhythmia is also common,
which may or may not use 倍他乐克.
Things that you can do is |
|
g*****j
发帖数: 1211 | 14 It does not sound like typical angina pain (heart undergoing lack of oxygen)
. If you can reproduce the pain by pressing on your back, it likely comes
from muscle, tendon or bones, which is likely benign. If you cannot
reproduce it and pain persists, especially associated with breathing, you
should have it checked out immediately. Even though it may not be angina,
it can be still be serious problems. |
|
w**********9
发帖数: 242 | 15 because "心电图说缺氧量其实不大" and they want to move to shanghai.
My point is not to distinguish the stable and unstable angina from this
particular patient. My point is when to consider using PTCA in the patient
population with angina. |
|
l*h
发帖数: 4124 | 16 angina can lead to decreased cardiac output and then decreased cardiac and
brain perfusion, which can result in myocardial infarction and stroke. this
is a vicious cycle and need to be intervened early.
your dad's "unconsciousness" could be a part of his angina as explained
above (decrease blood supply to the brain) but we are not certain. it should
be checked out by his physician.
for patient and family's emergency response, it's more than CPR, but rather
should be directed to the patient's con... 阅读全帖 |
|
l*h
发帖数: 4124 | 17 you have done a lot of research yourself and your understanding is correct
for almost all the things you mentioned.
he should be thoroughly evaluated by a cardiologist first. some findings may
need further evaluation by other specialists.
for potential stenting of bypass surgery, he will need imaging studies to
determine how constricted his arteries are. in some patients, CT angiogram
or MR angiogram will suffice. they are basically non-invasive. others will
need standard angiogram.
for aspirin,... 阅读全帖 |
|
l*h
发帖数: 4124 | 18 should let the doctor ask him some questions to make sure it's angina. some
other pains can be mistaken as angina. a doctor with a curious mind and
systemic approach is very important. |
|
l*h
发帖数: 4124 | 19 angina can lead to decreased cardiac output and then decreased cardiac and
brain perfusion, which can result in myocardial infarction and stroke. this
is a vicious cycle and need to be intervened early.
your dad's "unconsciousness" could be a part of his angina as explained
above (decrease blood supply to the brain) but we are not certain. it should
be checked out by his physician.
for patient and family's emergency response, it's more than CPR, but rather
should be directed to the patient's con... 阅读全帖 |
|
l*h
发帖数: 4124 | 20 you have done a lot of research yourself and your understanding is correct
for almost all the things you mentioned.
he should be thoroughly evaluated by a cardiologist first. some findings may
need further evaluation by other specialists.
for potential stenting of bypass surgery, he will need imaging studies to
determine how constricted his arteries are. in some patients, CT angiogram
or MR angiogram will suffice. they are basically non-invasive. others will
need standard angiogram.
for aspirin,... 阅读全帖 |
|
l*h
发帖数: 4124 | 21 should let the doctor ask him some questions to make sure it's angina. some
other pains can be mistaken as angina. a doctor with a curious mind and
systemic approach is very important. |
|
z***a
发帖数: 8436 | 22 七妹，我不是学医的。我以前也是正宗的理科女，后来改的，呵呵。你要对我专业有兴
趣我们下来
再聊。对你爸爸用的几种药我给你些信息吧。
1. thiamazole:是我上个回帖里提到的两种主要治疗甲亢的药之一。PTU相比更安全，
孕妇首选。两种药引起肝毒比较少见。还是那个问题，你爸爸甲亢是原发还是激发，是原发应
该做手术。碘同位素治疗是美国这边最常做的，你问问你们那边的医院。
2. digoxin：这个药用来治疗心衰已经非常非常过时了，因为此药毒副作用极大。10年
前在美国这个药用得相当普遍，但现在用得非常少。除非心衰非常严重。在beta blocker and
calcium channel blocker都作用不好，再加spirolactone都不行的时候才考虑加
digoxin。而且digoxin的剂量非常讲究，需要病人经常去医院monitor. 而你爸爸的心
衰治疗没有上述所有的治疗就直接只用digoxin，是非常得不偿失的做法。你要敢兴趣你自
己可以查一下相关的资料。
3. Isosorbite: 治疗angina（心绞痛）的。放松心脏冠状血脉，治疗和防止心脏供血
不足。你爸爸... 阅读全帖 |
|
M********3
发帖数: 269 | 23 牛贴！ 顶！！！
why ST depression in stable angina, however ST elevation in prinzmetal's
variant angina? |
|
s**********8
发帖数: 25265 | 24 http://en.wikipedia.org/wiki/Balloon_angioplasty
Angioplasty
From Wikipedia, the free encyclopedia (Redirected from Balloon angioplasty)
Jump to: navigation, search
Angioplasty
Intervention
Balloon angioplasty.
ICD-9-CM 00.6, 36.0 39.50
MeSH D017130
Angioplasty is the technique of mechanically widening a narrowed or
obstructed blood vessel, typically as a result of atherosclerosis. An empty
and collapsed balloon on a guide wire, known as a balloon catheter, is
passed into the narrowed locations... 阅读全帖 |
|
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o***s
发帖数: 42149 | 26 老外蹬着三轮送孩子上学,成了一道风景。
从9月份起，不断有网友发帖，称每天早上在南京珠江路都能看到一件“奇事”：一对老外夫妇，骑三轮车送两小宝上学，男士骑三轮车，两小宝在后面叽叽喳喳，女士骑另一辆很老式的自行车跟在后面。更多目击者跟帖表示，画面太有爱，所见者无不倾心。网友们还描述了三轮车里两个超级可爱的洋娃娃，并大赞这个老外家庭清新朴实的生活方式，进而进行了教育理念的讨论。
一个老外怎么会骑三轮车呢？这对老外不论寒暑都用三轮车载孩子吗？他们国家的父母送孩子上学与我们这边“有四轮就不用两轮”的方式有什么区别吗？这与教育理念又有关系吗？为了一睹网友口中三轮车里的“小天使”，也为了解答诸多问题，记者昨日早晨7点来到帖中所说的珠江路金鹰天地门口“蹲点”。
网帖热议
一辆三轮载着两个洋娃娃 这个画面太有爱啦！
“不知道有没有姑娘一起看到，一个男老外骑三轮车，两小宝在后面叽叽喳喳，女的骑另一辆很老式的自行车跟在后面，”网友“八月的前奏”激动地发帖。“我想他们肯定不是很穷困买不起电动车的人！”发帖人的语气中却难掩惊讶，以至于每句话结尾用三个感叹号都好像不足以表达她当时的心情。
接下来的讨论却更是热火... 阅读全帖 |
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b********n
发帖数: 38600 | 27 http://www.globalpost.com/dispatch/news/politics/140904/does-th
Look at that face. You're suddenly a bit more serene, a bit more contented
than you were a minute ago, aren't you? Maybe you're remembering the year —
was it 2002? 2003? — when you gave every single one of your friends and
family a copy of "The Art of Happiness" for Christmas.
On the other hand, if you're the president, prime minister, or foreign
secretary of any country in the world, then this face is giving you serious
angina righ... 阅读全帖 |
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r*******g
发帖数: 5495 | 28 Selected Differential Diagnosis of Abdominal Pain
Pain location Possible diagnoses
Right upper quadrant Biliary: cholecystitis, cholelithiasis, cholangitis
Colonic: colitis, diverticulitis
Hepatic: abscess, hepatitis, mass
Pulmonary: pneumonia, embolus
Renal: nephrolithiasis, pyelonephritis
... 阅读全帖 |
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|
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m*********7
发帖数: 5207 | 31 “The medication Sun received containing trimetazidine was for a heart
muscle condition known as angina pectoris, which loosely translates from the
Latin as “strangling feeling of the chest”, and can cause chest pain and
palpitations.”
“THE HEART CONDITION IS REAL
Last year Sun’s medical condition came back to haunt him, with heart
palpitations and chest pains forcing his last-minute withdrawal from the
1500m freestyle final at the 2015 World Championships in Kazan, Russia.
Italy’s Gregorio Paltr... 阅读全帖 |
|
|
w******l
发帖数: 1400 | 33 确实不好，副作用：
Cardiovascular: Angina, arrhythmia (ventricular), chest pain, flushing,
palpitation, sinus tachycardia, tachycardia (supraventricular), vasodilation
Central nervous system: Agitation, delirium, dizziness, hallucinations,
headache, insomnia, irritability, psychosis, restlessness
Dermatologic: Urticaria
Gastrointestinal: Esophageal sphincter tone decreased, gastritis
Neuromuscular & skeletal: Fasciculations
Ocular: Intraocular pressure increased (>180 mg caffeine), miosis
Renal: Diuresis... 阅读全帖 |
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k*******3
发帖数: 918 | 34 The fairy, in particular to Dafa disciples or Dafa disciples, Li Hongzhi
repeatedly said to his disciples, "ye are gods". Ordinary people, not
ordinary people practicing Falun gong. In fact, according to Lee, "wheel",
this is very wrong. "How can a deity called ordinary doctor?" Although want
to emphasize "the immortal can not be called ordinary doctor", but with "
preset or subtext deity is ill". But Li Hongzhi is not recognized "the
immortal also sick", he said: "the real man practicing law, t... 阅读全帖 |
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f******I
发帖数: 769 | 35
aspirin is a must,
for other non-prescribed things, maybe coenzyme Q10 if you really are into
it, but it's kind of expensive though, bought one from costco last week, was
20 dollars for 90 tabs of 150mg each or something like that,
i was always told that flaxeed oil is better than fish oil,
i think vitamin E is out of window for now due to recent studies,
if he has angina while climbing steps, these herbal stuff probably wouldn't
help, need cardiac stress test, aggressively lower bp and cholest |
|
f******I
发帖数: 769 | 36
for coronary disease, ideally you'd like to have an angiogram to look at the
anatomy and degree of disease,
if that's a problem, then for medical management, you start by minimzing all
the risk factors including smoking, high blood pressure, diabetes, high
cholesterol, appropriate exercise regimen would help,
medication wise, start from aspirin, beta blockers mostly used are
metoprolol and coreg, nitrates for angina symptoms, statins for cholesterol(
lower it as much as possible),
supplement wi |
|
f******I
发帖数: 769 | 37
your age, sex, any medical condition, whether you smoke or not, would help
to make a guesstimate,
you could have mild underlying reactive airway disease such as asthma,
triggered by seasonal allergy, or could be angina equivalent, |
|
f******I
发帖数: 769 | 38
beta blocker, used for BP control and coronary disease,
long acting nitrate, used for angina, sometimes for heart failure and bp
control as well, avoid taking viagra with it together, |
|
f******I
发帖数: 769 | 39
with her age and coronary history, as well as hypertension, she has good set
up for having atrial fibrillation, but without evidence, can't say for sure,
i assume 波利维 is plavix, 倍他洛克 is some sort of beta blocker, and 阿司匹
林 is aspirin, and 硝酸甘油 is sublingual nitroglycerin, not sure what is 合
心爽 though,
i'd think she also needs to have her cholesterol looked at, and to keep LDL
as low as possible,
if she continues to have angina, she might need to have another left heart
cath to make sure the ste |
|
l*******n
发帖数: 68 | 40 If you are old, male and have diabetes, hypertension, hyperlipidemia,
smoking history, you may have angina (chest pain), especially if the chest
pain is related to activity and exertion. you need to see your primary
physician. |
|
g***r
发帖数: 285 | 41
depends on what medication is she taking and how often she has angina like
symptoms,
normally flying even transcontinental flight should not be that much of
stress to the heart, you probably should worry more about what if she
developed anything serious AFTER she arrived to the states, |
|
g***r
发帖数: 285 | 42
胸闷 could still very well be angina, chest pain does not necessarily have
to be "pain", could be feeling of pressure, heaviness, and such, especially
in female patients the presentation is often atypical,
not sure what insurance, commercial insurance is often expensive and won't
cover pre-existing condition, |
|
g***r
发帖数: 285 | 43
05mg
below is all the side effects i can find for synthroid,
Cardiovascular: Angina, arrhythmia, blood pressure increased, cardiac arrest
, flushing, heart failure, MI, palpitation, pulse increased, tachycardia
Central nervous system: Anxiety, emotional lability, fatigue, fever,
headache, hyperactivity, insomnia, irritability, nervousness, pseudotumor
cerebri (children), seizure (rare)
Dermatologic: Alopecia
Endocrine & metabolic: Fertility impaired, menstrual irregularities
Gastrointestinal: A |
|
c********e
发帖数: 496 | 44 premature contraction is common and noncritical, as long as it occurs not
too often (less than 5 per min) and single origin.
For premature contraction, ECHO is of no use, neither is angiogram (suppose
there is no angina), what regular EKG can tell is limited, but can rule out
something. Holter is what your father need for the premature contraction. |
|
c********e
发帖数: 496 | 45 several questions before I can come up with some suggestions.
1. normal range of the Liver function test panel.
2. GGT is specific for alcoholic cirrhosis, is she alcoholic?
3. has she ever been tested for PT and PPT?
4. why wanna stent implantation? MI or angina?
5. why pace maker? any bradycardia?
6. any other disease concurrently?
7. any meds?
8. family history, travel history,
9, could you describe what the ultrasonic showed?
10. any other chemical or imaging test done lately? |
|
w**********9
发帖数: 242 | 46 his father may have stable angina, if it is, when to consider ptca ?
should he be first observed with asprin, beta-blocker, nitroglycerin and to
lower lipid ? because ptca has high chance to re-blocking and form thrombi,
what patients to consider to do it ? what kind of stress test and angiogram indicate a revasculization a must ? |
|
c********e
发帖数: 496 | 47 You are right, Conservative medical control is preferred in the Tx of Stable
angina, while many cases receive PTCA and stent implantation for commercial
reasons in cardiology.
Roughly for unstable and MI, PTCA is indicated for most cases. |
|
l*h
发帖数: 4124 | 48 where did s/he give enough information to make you think it's stable angina?
to
,
angiogram indicate a revasculization a must ? |
|
c*****e
发帖数: 36 | 49 怎么判断是不是stable angina啊？这些的名词的对应中文是什么?
to |
|
s*****l
发帖数: 263 | 50 Angina pectoris showing of chest discomfort with some referred pain of over
10 min, not relieved by nitrates,slowed down walking pace by >50%. Elevation
of ST segment and suspected MI from IHD.HR rises from ~62bpm to~96, now back to ~70 bpm with recovery of exercise ablility after supernatural experience.
BTW: Partly because of this, I have to give up my nearly-prepared USMLE step 1. |
|
