Is heart failure over-diagnosed?
A common problem in elderly men, obstructive uropathy, can look a lot like heart failure.
When pulmonary edema is present, heart failure is often the "scapegoat" says Melissa Walton-Shirley, MD in a commentary on Medscape. Approaching heart failure with "an air of skepticism" might help.
I've seen a handful of obstructive uropathy cases masquerading as heart failure in elderly men in recent years. I shudder to think how many times I've missed it. I suspect that it's not just men who suffer. Some of our female patients with "diastolic dysfunction" and overflow incontinence seem to suffer from backpressure that finds its way into the pulmonary vasculature.
Melissa Walton-Shirley, MD
Read more on Medscape.
NYU Langone tests new transcatheter device.
A principal center in the investigational clinical trial for the new Medtronic CoreValve™ Evolut™ PRO TAVR System, NYU Langone Medical Center is once again at the forefront of innovation in TAVR.
Last week, NYU Langone became the first center in the world to implant the new heart valve for TAVR in a patient with severe aortic stenosis.
The new Evolut™ PRO TAVR system retains key advantages of the previous Evolut™ R model, being both recapturable and repositionable, but adds an outer skirt layer which may further improve paravalvular leakage around the implant.
"This new technology represents an innovative advancement on an already-approved device that we hope with more study will become a new option for patients with severe aortic stenosis who are at extremely high risk for surgery," says Matthew R. Williams, MD in a recent press release.
Studies Support Use of High-Sensitivity Troponin Test for MI Rule-Out in One Hour
Last year, ACVP Blog reported on a new strategy to rule-out acute myocardial infarction within one hour using the high-sensitivity cardiac troponin T 1-hour algorithm on blood samples.
"...Accelerated diagnostic protocols that incorporate hsTn can facilitate earlier triage while maintaining an acceptable NPV," writes David Morrow, MD in an accompanying editorial.