Angina - CRASH! Medical Review Series

[@realtrickybilly]

I have used your videos to preparing for my Internal medicine exams during specialization. Finished all exams with the highest marks. Thank you Paul Bolin

[@diivaficatiOn]

Thank you so much for these videos. It's so selfless of you to provide us these videos and you don't even charge us. God bless you!

[@anastasiaaa4094]

I am getting ready for my license exam and your videos keep me going everyday. Thank you. From Maldives

[@sruthiganduri]

Really happy to know that you responded and re-uploaded it. Thank you so much Sir..

[@omsohum4000]

Dr.Paul, thank you so much for sharing your knowledge. May God bless you

[@woloabel]

Friday September 30, 2022. Cardiology: Angina (1) Stable Angina will show Dyspnea on Exertion but will be alleviated with Rest And/or Activity Cessation; Dx: 1) Clinical; 2) Laboratory Investigations: 1) Exercise Stress Test or Chemical; 2) Cholesterol Panel, 3) Fasting Glucose, 4) Glycated Hemoglobin Test (aka HbA1C Test or Hemoglobin A1C), 5) Complete Metabolic Panel (CMP); Tx: 1) Platelet Aggregation Inhibitors (PAIs/Anticoagulants)/Salicylates/Salicylate Analgesics Aspirin (or Platelet Aggregation Inhibitors/Thienopyridine Agents, Clopidogrel if Indicated), 2) Beta-adrenergic Blocking Agents or Beta Blocker Propranolol and 3) HMG-CoA Reductase Inhibitors otherwise Statins if Diabetes Mellitus Comorbidity or Dyslipidemia); In 2) Unstable Angina (Acute Coronary Syndrome [ACS]). Dx: 1) Clinical Suspicion based on Risk Factors and Clinical Presentation; 2) EKG Positive is a Necessary Investigation thereafter along with Cardiac Enzymes (CK-MB and Troponins; 3) Stress Test Positive (or Chemical Stress Test: 1) Dobutamine Stress Test using the Beta Adrenergic Agonist/Cardiovascular Agent Dobutamine, an Inotrope, and visualizing on Echocardiogram a Decreased Cardiac Wall Movement is Consider a Positive Test; or the 2) Dipyridamol-Thallium Stress Test is A Nuclear Imaging Test also known as Thallium Scintigraphy. A Positive Test yields a Decreased Thallium Uptake by the Myocytes (Mechanism of Thallium is Potassium Analogizing)); Exercise Stress Testing is Contraindicated for in 1) Bedridden Hospitalized Patients, 2) Morbid Obesity) or 3) In EKG Anomalies (Dysrhythmia or Pacemaker). A Positive Result for Exercise Stress Testing is Defined as 2mm Or More Of ST Depression (Ischemia), or 2) Hypotension, a Drop of Systolic Blood Pressure of 10 mmHg or More while the Patient is Monitored via EKG Until 80% of Maximum Heart Rate (HR) is attained (220-Age of the Subject is the MHR); 4) Angiogram (Extent and Severity of Atherosclerosis/Stenosis) also indicating best Treatment Modality (Coronary Artery Bypass Graft [CABG] Surgery for 3 Vessel Disease or Left Main Artery Disease; or 2) Angioplasty with Stenting for any other Abnormality of Stenosis; Tx/Mx: 1) Anticoagulant Prophylaxis with Aspirin (Thienopyridine Agent Clopidogrel if Aspirin Hypersensitivity Exists), 2) IV or PO Beta Blocker; 3) Nitrates Nitroglycerin (Vasodilatation); 4) Anticoagulants Heparin or Low Molecular Weight Heparin (Enoxaparin) for Mortality Reduction; 5) IV Morphine Sulfate (Analgesic Opioid Agonists) is Warranted for Pain Management. Morphine use For MI is Controversial to say the least; and 6) Surgery. Possible Indications are 1) CABG or 2) Angioplasty With Stenting. Goodness, there is no other best Reason for Prevention of Disease, considering the Most Common Aetiology of Death is Coronary Heart Disease/Heart Attack, than the Pathology of Atherosclerosis. MD Paul Bolin, es geht gut aber alles immer besser kann sein. Heil!

[@orandaxi]

Paul Bolin, you are good man! Thanks for great videos

[@ravipandey9215]

Sir your reviews are very worthy... May God bless you .

[@tnlectures8903]

These are the best best medicine lectures ever! Csn we get the pdf on our emails of these lectures?

[@chariemyd]

currently listening to this im reviewing for the upcoming exam

[@Charlie23488]

Thank you very much Dr. Bolin!

[@Sam_1964]

This is outstanding

[@kolawoleadeniran3220]

Thank you so much for these lectures. They are super awesome.

[@macpere7]

thank you Dr Paul.

[@rukiahodge3849]

I love your videos!! I always struggled with this topic

[@user-cc4kq6hl4c]

Rukia Hodge me too

[@alkuwaiti1858]

Thank you

[@idkwhattonameit8359]

You're amazing, thank you

[@dryohanamwandamd1857]

I love your lectures

[@marissacabrera9684]

thank you so much Paul!!

[@DrDinooshDeLivera]

Thank you so much. Your videos are fantastic.

[@frankjoya4234]

Fantastic lectures for and M4

[@Chiko-sc1gz]

You should prefer cardioselective b-blockers

[@jamie5mauser]

We have the same cholesterol numbers in our venous and arterial system. If cholesterol directly caused athlerosclerosis, why do we not see this disease in veins?

[@wofire1]

Love the videos. Just wanted to comment that the audio for the intro isn't there leading to the audio to be roughly 10 secs off from the slides.

[@DrDinooshDeLivera]

Thank you! Awesome lectures!

[@medicmanal5313]

Would you not consider Diabetes and CKD as risk factors too?

[@akash1yadav5]

Love from the Nepal 🇳🇵

[@luciesujanova957]

Why did I remembered angina as a tonsil infection, not a heart problem. Jez. Iam confused.

[@luciesujanova957]

Like I mean...angina monocytotica, angina leukemica,angina vesiculosa.

[@pwbmd]

Ludwig's angina is an infection of the floor of the mouth. I suppose that's close to the tonsils...

[@dawitteklu7698]

i love you sir. we sure damn cant change our chromoaomes.

[@fernandomarquez5429]

Bisoprolol over propranolol

[@newsgig7597]

God blesslu

[@shimaasobhi9733]

Thank you