Trivalley Cardiology Medical Office

Robotic PCI at U of Washington... really cool and tech is only in the room and doctor is behind the console with no radiation or lead aprons

The results of the study, which examined data on 81,714 women ages 50-79, tracked for an average of 11.9 years beginning in the mid-to-late ’90s, may come as a blow to those trying to fend off weight gain by eschewing regular sodas in favor of low-calorie alternatives. Compared to other postmenopausal women who imbibed less than one diet drink a week, regular consumers had a 23 percent enhanced likelihood of any kind of stroke, 31 percent higher chance of a stroke caused by a... blocked artery by far the most common and a 29 percent increased possibility of a heart attack. Their chances of dying from any cause increased by 16 percent. IT IS OBSERVATIONAL SELF REPORTED STUDY. The authors warn that their study only shows an association, not a cause-and-effect correlation, behind high consumption of artificially sweetened beverages whether sodas, fruit juices or other and the increased health risks. https://www.ahajournals.org/doi/10.1161/STROKEAHA.118.023100

Apple Watch 4 with EKG recording ... Finally arrived after long wait for software update... Need to update both iPhone and Apple Watch to most recent software update and then you can record EKG by putting your index finger on Digital Crown and I am impressed so far with fidelity and quality of recording normal sins rhythm and need to see patients’ a fib and other SVT recording to judge further for quality of abnormal recording!

TIME TO QUIT SMOKING (including e-cigarettes) According to the ACC, tobacco use can be characterized as a chronic relapsing substance use disorder, encouraged by nicotine addiction. It is noted that most smokers who attempt to quit experience repeated cycles of abstinence followed by relapse to smoking prior to experiencing long-term abstinence. Current evidence suggests the combination of pharmacotherapy (i.e., nicotine replacement, bupropion, and varenicline) with beh...avioral interventions (i.e., cognitive behavior therapy, motivational interviewing) are most effective for smoking cessation. https://www.acc.org//2018-acc-expert-consensus-decision-pa

VERY LOW CARB DIET and KETOGENIC DIET... Safety concern! https://www.escardio.org//Low-carbohydrate-diets-are-unsaf This study prospectively examined the relationship between low carbohydrate diets, all-cause death, and deaths from coronary heart disease, cerebrovascular disease (including stroke), and cancer in a nationally representative sample of 24,825 participants of the US National Health and Nutrition Examination Survey (NHANES) during 1999 to 2010. Compared to parti...cipants with the highest carbohydrate consumption, those with the lowest intake had a 32% higher risk of all-cause death over an average 6.4-year follow-up. In addition, risks of death from coronary heart disease, cerebrovascular disease, and cancer were increased by 51%, 50%, and 35%, respectively. https://www.health.com/weight-loss/keto-diet-side-effects

IF YOU HAVE ELEVATED TRIGLYCERIDE AND CARDIOVASCULAR DISEASE OR DIABETES,risk of ischemic events, including cardiovascular death, was significantly lower among those who received 2 g of icosapent ethyl twice daily than among those who received placebo. https://www.nejm.org/doi/full/10.1056/NEJMoa1812792?query=RP

DON'T WASTE MONEY ON DIETARY SUPPLEMENT FOR OMEGA 3 AND VIT D......LATEST LARGE STUDY https://www.nejm.org/doi/full/10.1056/NEJMe1814933?query=RP

AMAZING REDUCTION OF CV RISK with Taking EPA ( FISH OIL named Vascepa) in new study https://www.medscape.com/viewarticle/902478

I wonder I should start learning to play golf: I was oncall for last weekend starting Friday Am till Tuesday Am. I was very tired Monday night (OCT 1st) when I went to bed around 12:30 midnight after wrapping up whole weekend rounding and finished EHR notes. I got a direct call to home from ER at 2:00 am that ambulance transmitted prehospital EKG with "STEMI with Code 3" on the way of 45 year old Man. It was very hard to listen to phone since I just fell asleep but have to ...drive immediately to ER to meet him ASAP in ER. When I saw him, he was younger healthy looking gentleman with pale and worried/concerned look with "strong Irish accent". He was definitely very scared since he passed out before arrival and his HR is 39 bpm and low BP. After asking a few questions about his symptoms before quick examination before taking to Cath Lab, he asked me " Do you play golf ?" with very strong Irish accent. I was completely puzzled since we are in the rush to get him to cath lab to get "fastest door to balloon time less than 60 min to open blocked artery". I asked him to repeat the question and then "why did u ask?" He told me we should go for golfing sometime. It put a smile on my face wondering he is trying to calm me down by distracting with different subject or a defense mechanism for himself that he can pull through this. I know and I felt that I have to try my best to get the best outcome . I have been in practice for 18 years after 8 years of post graduate training after medical school and I never seen someone (who had acute heart attack with transient passing out and HR around 39 bpm with low BP in excruciating pain), asked me that kind of question before taken to cath lab. Everything went well and we were able to unblock his completely blocked artery in 50 min door to device time and his color in face is back and he can smile normally. He is ready to go home this noon time (OCT 3rd) after overnight stay since he did very well. His friend visited him in the room and brought a small gift to take home... guess what.... ?

45 year old man with jaw pain, extreme weakness and then passed out before arrival to ER and he demonstrated in ER slow HR about 39 bpm with low BP with following picture

Finally one FDA approved weight loss drug with NO CARDIOVASCULAR Side effects is discovered ... Exciting good news... https://www.nejm.org/doi/full/10.1056/NEJMoa1808721

https://www.nejm.org/doi/full/10.1056/NEJMoa1800389