Pharmacogenetics are central to genetic testing in cardiovascular medicine. As different patients metabolize drugs differently, medication prescription should be tailored to patients specific needs. By doing so maximizing benefits to a particular individual can be expected, while minimizing risk. The most well-known use for this kind of genetic testing comes from oncology, where chemotherapy or…
Ulcers can generally be divided into arterial, venous, neuropathic and atypical. Treatment depends on ulcer type. In some patients, chronic venous insufficiency leads to skin breakdown. Obviously, these are venous ulcers. Healing often takes many weeks, and involves patience and expert wound care. How to Diagnose Venous Ulcers To make the diagnosis, combine clinical appearance,…
It is well known that elevated total cholesterol raises cardiovascular risk. This is especially true in younger adults. It is also most true when other cardiovascular risk factors are present. HDL and cardiovascular disease are also related. The higher the HDL, the lower cardiovascular disease risk. From this stems the logic that raising HDL cholesterol…
Renal vein thrombosis is a relatively rare entity. It is most commonly described in the context of nephrotic syndrome and renal cell carcinoma. There is very little literature about to guide us, thus the treatment of this condition is not very well established. Presentation Many patients are asymptomatic at first. But flank pain and hematuria…
Saphenous vein thrombosis is easily diagnosed but poses a therapeutic dilemma for clinicians. For some patients watchful waiting, warm compresses and NSAIDs are enough. But consider anticoagulation in highly symptomatic patients, when clot is extensive and when clot is near the deep system. Is Saphenous Vein Thrombosis Superficial or Deep? The venous system can be…
Inferior vena cava filters are being inserted very commonly. Acceptable indications for IVC filters are venous thromboembolism without possibility for anticoagulation. However, retained IVC filters tend to cause complications. Examples of IVC filter related complications include filter thrombosis, migration and perforation, among others. Of course, IVC filter retrieval is not always necessary. But still, IVC…
A key insight into the etiology of a leg ulcer can be garnered from observing the ulcer’s distribution. The three most typical ulcers that are seen in clinical practice are of arterial, venous and neuropathic etiologies. Arterial ulcers typically arise on the toe tips, heels and anterior shins. Venous ulcers usually arise at the gaiter…
Pseudoaneurysm thrombin injection is a reasonable treatment option for most groin pseudoaneurysms. Usually, after the injection pseudoaneurysm will close and not reopen. Of course, there are other options. These include watchful waiting, ultrasound guided compression and surgical ligation. Usually, the procedure is accomplished at the bedside and even in an outpatient setting. Having a proper…
A groin pseudoaneurysm is a common complication of femoral catheterization. A pseudoaneurysm is a hematoma that remains in communication with the arterial lumen. In other words, it is a contained rupture of the vessel. Pseudoaneurysms most commonly arise from the common femoral artery, external iliac artery or superficial femoral artery. They typically occur after sheath removal as…
Here we go again. Four years have come and gone and the London Olympics are about to kick off in a few short hours. The 2012 London Olympics will bring together athletes from all over the world to compete. Some will leave with a bag full of medals and the adulation of their countrymen, while…
