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General Internal Medicine

Preventive Cardiology   

Questions discussed in this category

Is there a role for routine stress testing in intermediate-high risk CAD patients with a significantly elevated coronary calcium score who are otherwise asymptomatic?
1 Answer available
Do you recommend starting a statin in patients above 75 years old with diabetes but no known ASCVD?
3 Answers available
Should CT coronary calcium score be avoided in dialysis patients in light of presumed high prevalence of CAC in this population?
3 Answers available
What should the LDL target be in patients with prediabetes and high lipoprotein (a) with family history of coronary artery disease?
6 Answers available
What is your preferred, first-line class of anti-anginals for MINOCA with proven epicardial coronary vasospasm?
1 Answer available
How do you counsel patients with metabolic syndrome who decline statin therapy and have low coronary calcium scores regarding their long-term CVD risk?
3 Answers available
For patients over 70 with elevated ASCVD risk but no prior cardiovascular events, do you ever recommend continuing or initiating low-dose aspirin?
Aspirin Use to Prevent Cardiovascular Disease: Preventive Medication
1 Answer available
How do you integrate HIV (+) serostatus into a patient's ASCVD if they would not otherwise qualify for a statin either for primary or secondary prophylaxis?
As seen in this published work: Craig Beavers, Alice K. Pau, David Glidden, et al. Statin Therapy as Primary Prevention for Persons With HIV: A S...
1 Answer available
How often do you recommend performing an advanced lipid panel for monitoring of lipid lowering therapy?
4 Answers available
How do you approach the management of aortic stenosis in an elderly, frail patient with multiple comorbidities who is symptomatic but considered high risk for surgical aortic valve replacement?
3 Answers available
What is your typical approach to the use of beta blockers in the setting of recent cocaine use amongst patients presenting with cocaine-related MI, arrhythmias, or new-onset heart failure?
If these patients were already prescribed non-selective beta blockers outpatient, do you recommend withholding these medications in the acute phase?&n...
2 Answers available
When would you consider long-term cardiac monitoring to look for atrial fibrillation in patients with mitral stenosis given their baseline elevated risk for atrial fibrillation and thrombosis?
2 Answers available
How should we approach the recommendation of intermittent fasting for weight loss in patients with pre-existing cardiovascular conditions, given the observed association of increased CV mortality with eating durations of less than 8 hrs?
Chen & Zhong, AHA/ASA Journals 2024
2 Answers available
What is your preferred choice of anticoagulant (VKA vs. DOAC) in patients with an LV thrombus and apical infarct? 
Would you extend length of time for anticoagulation if the apex remained akinetic on surveillance TTEs? 
2 Answers available
What are alternate approaches to medical therapy and/or interventions to consider in patients with refractory, severe coronary vasospasm despite short-acting nitrates, calcium channel blockers, L-arginine, and clonidine?
6 Answers available
Would the diagnostic yield for ABIs or peripheral arterial duplex doppler in a patient with metal rods in both legs be similar or acceptable in comparison to those tests in a patient without metal rods? 
1 Answer available
Would you consider opting for beta blocker withdrawal to improve exercise capacity in patients with heart failure with preserved ejection fraction and chronotropic incompetence?
2 Answers available
For patients with hypertension who have normal filling pressures following right cardiac catheterization, can hypertension still be attributed to volume overload?
2 Answers available
Should we be more cautious with the use of GLP 1 R agonist therapy in patients with Type 1 diabetes mellitus and obesity given the increased risk of cardiovascular disease with high body weight variability?
Prattichizzo et al., PMID 39468384
1 Answer available
Is there a specific INR cut-off value that would prompt you to consider administering vitamin K for patients with mechanical valves requiring urgent non-cardiac surgery and if so, what would be your starting dose?
1 Answer available
With the recent trials such as SELECT and STEP-HFpEF demonstrating benefits of GLP1-agonists in terms of CV risk reduction and improved exercise function, have you begun to incorporate this class of medications into routine CV health maintenance for patients with HFpEF and/or pre-existing CAD?
2 Answers available
What are some potential etiologies to consider for isolated, mildly elevated BNP levels with normal TTE findings in an asymptomatic, elderly patient? 
3 Answers available
What is your approach to counseling a patient with stable but severe multivessel coronary disease if the patient does not wish to undergo bypass surgery? 
And when would you consider referral for staged/complex PCI instead? 
1 Answer available
Should colchicine be considered in patients with ischemic heart disease and persistently elevated hsCRP despite statin and aspirin therapy and appropriate physical activity?
0 Answers available
Given that there are a fair number of myocarditis cases without a troponin elevation, how do you clinically approach the diagnosis of myocarditis?
1 Answer available
Which class(es) of antihypertensives do you recommend for first-line therapy for hypertension in severe aortic stenosis?
1 Answer available
Would you start ASA and/or statin therapy on an asymptomatic patient noted to have incidental pathologic Q waves on EKG, assuming no prior history of ischemic heart disease?
Would you consider further imaging like coronary calcium scoring or coronary CTA to further risk stratify them?
1 Answer available
Do you recommend noninvasive testing or coronary angiography as the initial test for pre-kidney transplant evaluation of an asymptomatic patient older than 50 years of age with ESKD secondary to diabetic nephropathy and no known history of CAD?
1 Answer available
Is it sufficient to maintain patients with atrial fibrillation and established PAD on a DOAC or VKA alone, or is there an additional benefit to adding an antiplatelet agent for CVD benefit?
If so, would you prefer a P2Y12i over low-dose aspirin? 
1 Answer available
When would it be reasonable to consider enhanced external counter-pulsation therapy in patients with refractory angina despite maximally tolerated anti-anginal therapy?
4 Answers available
What is your preferred rate control agent for atrial fibrillation with rapid ventricular rate, and why?
1 Answer available
Would you empirically elective to anticoagulate patients with a remote (i.e. >10 year) history of paroxysmal atrial fibrillation presenting with newly diagnosed CVA, presumed cardioembolic in etiology, without any documented recurrence of AF?
3 Answers available


Papers discussed in this category

J Am Coll Cardiol, 2019 Jan 28
2019 AHA/ACC/HRS Focused Update of the 2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society.
Stroke, 2019-06
Perioperative/Postoperative Atrial Fibrillation and Risk of Subsequent Stroke and/or Mortality.
Journal of cardiovascular imaging, 2018 Jun 22
Antihypertensive Treatment in Severe Aortic Stenosis.
Clinical medicine & research, 2013-12
The role of enhanced external counter pulsation therapy in clinical practice.
Lancet (London, England), 2015 Jul 15
Small bites versus large bites for closure of abdominal midline incisions (STITCH): a double-blind, multicentre, randomised controlled trial.
The New England journal of medicine, 2020 Mar 30
Initial Invasive or Conservative Strategy for Stable Coronary Disease.
Clinical cardiology, 2020 Feb 19
Beta-blockers withdrawal in patients with heart failure with preserved ejection fraction and chronotropic incompetence: Effect on functional capacity rationale and study design of a prospective, randomized, controlled trial (The Preserve-HR trial).
PloS one, 2023 Nov 16
Effects of beta-blocker withdrawal in patients with heart failure with preserved ejection fraction: A protocol for systematic review and meta-analysis.
JACC. Cardiovascular interventions, 2014-07
Futility, benefit, and transcatheter aortic valve replacement.
The New England journal of medicine, 2010 Sep 22
Transcatheter aortic-valve implantation for aortic stenosis in patients who cannot undergo surgery.
JACC. Cardiovascular interventions, 2020 Feb 12
Balloon Aortic Valvuloplasty as a Bridge to Aortic Valve Replacement: A Contemporary Nationwide Perspective.
Circulation research, 2020 Jun 18
Population-Based Screening for Atrial Fibrillation.
Journal of the American College of Cardiology, 2024 Aug 29
Effect of Screening for Undiagnosed Atrial Fibrillation on Stroke Prevention.
The New England journal of medicine, 2023 Nov 11
Semaglutide and Cardiovascular Outcomes in Obesity without Diabetes.
The New England journal of medicine, 2022 Apr 21
Calorie Restriction with or without Time-Restricted Eating in Weight Loss.
The lancet. Healthy longevity, 2024 Apr 05
Effects of 3 months of 10-h per-day time-restricted eating and 3 months of follow-up on bodyweight and cardiometabolic health in Danish individuals at high risk of type 2 diabetes: the RESET single-centre, parallel, superiority, open-label, randomised controlled trial.
Diabetes & metabolic syndrome, 2024 Feb 05
Does early time-restricted eating reduce body weight and preserve fat-free mass in adults? A systematic review and meta-analysis of randomized controlled trials.
Journal of clinical lipidology, 2022 Sep 11
Assessment and management of statin-associated muscle symptoms (SAMS): A clinical perspective from the National Lipid Association.
AIDS (London, England), 2025 May 23
Risks for sudden cardiac and undetermined cause of death among people with HIV in the REPRIEVE primary cardiovascular prevention trial.
Journal of the American College of Cardiology, 2022 Mar 01
Independent Association of Lipoprotein(a) and Coronary Artery Calcification With Atherosclerotic Cardiovascular Risk.

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