Index to the Cardiology PowerPoint Shows at Zunis

(Click a link to go to the Index Group for that topic.)

1. Atrial Fibrillation

2. Atrial Fibrillation – Grand Rounds Version

3. Troponin

4. EKG Monitoring for Hospitalized Patients

5. Acute Coronary Syndrome

6. Cardiology Update 2003

Atrial Fibrillation (Click this link to go to the Slide Show)

01. Atrial Fibrillation/ Cell Death

02. Initiation Of Atrial Fib By A Rapid Pulmonary Vein Focus

03. Electrophysiology of Ventricular Fibrillation

04. Atrial Fibrillation: Risk Factors

05. Afib: Heart Rate and LV EF after Diltiazem

06. Critically Ill Pts: Afib Management

07. ER Rx of Afib: Diltiazem vs Metoprolol

08. Amiodarone For Conversion of New Afib

09. Diltiazem for Afib: iv-to-oral transition

10. Ibutilide vs Amiodarone for Afib

11. Amiodarone Given Prophylactically With Heart Surgery (PAPABEAR Study) – Efficacy

12. Amiodarone Given Prophylactically With Heart Surgery (PAPABEAR Study) – Hazards

13. Afib Management After Cardiac Surgery

14. Cardioversion: Versed Anesthesia – Method

15. Cardioversion: Versed Anesthesia – Results

16. Afib Recurrence vs Antiarrhythmic Used

17. Warfarin vs ASA+Plavix in Afib

18. Warfarin Initiation in the Elderly

19. Warfarin: Managing High INR or Bleeding

Troponin (Click this link to go to the Slide Show)

01. One cc of Blood

02. 1cc though 1 capillary

03. Troponin Overview

04. Relative size of myocardial proteins

05. Cardiac Marker Release

06. Marker Sensitivity (gm)

07. Head of a pin weight

08. MI Redefined

09. Pop Quiz: Tpn Samples

10. London Marathon/Jaffe

11. Pop Quiz: High Risks?

12. Higgins’ Tpn Title Page

13. Troponin Causes: Part 1

14. Troponin Causes: Part 2

15. Emotional Cardiomyopathy

16. Outcome: ER-Tpn-Cath

17. Risk of Tpn Levels

18. 6-mo. Outcome vs Tpn

19. Atherosclerotic Plaques Are Common

20. What Category of Narrowing Produces the Greatest Hazard? Mild.

21. A.Fib & RVR – Tpn

22. Outcome of #22

23. Pop Quiz: Peds & Tpn

24. Peds Sepsis & Tpn 1

25. Tpn: Cell Death vs Leak

26. Peds Sepsis & Tpn 2

27. Peds: Tpn & Chemo

28. Pop Quiz: Rhabdo & Tpn

29. Troponin and Trauma

30. Pop Quiz: Drug OD & Tpn

31. Rhabdo/Drugs & Tpn

32. Pop Quiz: CHF & Tpn

33. CHF Chronic and Troponin

34. CHF Acute & Troponin 1

35. CHF-ADHERE-Troponin

36. CHF-Acute & Troponin 2

37. Mechanism of Tpn in CHF

38. Definition:

39. Pop Quiz: STEMI

40. STEMI – EKG – IMI

41. ST Elevation – Causes

42. Time and Infarction Size

43. Time, Mortality and Infarction Size

44. Angioplasty vs. Thrombolysis for Acute ST-Elevation MI

45. Pop Quiz: NSTEMI – Cath?

46. EKG with ST depression

47. NSTEMI Rx Options

48. NSTEMI Roundtable

49. State Bird of Oklahoma?

50. Smoking: OK vs US

51. Oklahoma’s Poor Health

52. Lecture Summary

53. Sunset? Green Ray

54. Galileo Probe Photo

EKG Monitoring For Hospitalized Patients (Click this link to go to the Slide Show)

01. EKG Monitoring For Hospitalized Patients: Techniques and Rationale

02. How StatView Works

03. How StatView Works-2

04. How GE CIC Works

05. CIC – Step 1

06. CIC – Step 2

07. CIC – Step 3

08. CIC – Step 4

09. CIC - Atrial Fibrillation Analysis – Part 1

10. CIC - Atrial Fibrillation Analysis – Part 2

11. Potemkin Village

12. ACC Practice Guidelines

13. 1993 Post-PCI EKG Monitoring

14. 1995: Telemetry – Non-ICU

15. 1997: Chest Pain, Monitor Techs

16. 1998: Response Time, Value of Monitoring

17. 2000: Monitoring Saves 2 Lives/10,000 Monitored

18. 2001: 0/1033 Lives Saved By Non-ICU Monitoring

19. 2002: Most R/O MI Patients Are Low-Risk, Patients Are Monitored Too Long

20. 2004: No Benefit of Monitoring Low-Risk Pts

21. 2002: Effect of Use of Goldman’s Rule on Admits

22. 2002: Goldman’s Rule for Chest Pain in ER (LBBB mod.)

23. 2004: ACS Diagnosis: LDS Hospital – Salt Lake City

24. 2004: ACS Management: LDS Hospital – Salt Lake City

25. 2006: Cardiac arrest in-hospital: Usually not VT/VF

26. 2002: Physicians Overestimate Cardiac Risk

27. 1975: The Hanging of Crepe and Pascal’s Wager

Acute Coronary Syndrome (Click this link to go to the Slide Show)

01. Coronary Anatomy

02. Progression of Coronary Artery Disease

03. Inflammatory Markers

04. Dietary differences

05. Caloric Restriction Society (N = 18)

06. Atherosclerotic Plaques Are Common

07. Definition: Acute Coronary Syndrome

08. GRACE Study

09. Mechanism of Thrombus Formation in ACS

10. Emboli From Ruptured Plaque

11. Micro-Emboli and ACS

12. Stagnation Thrombus

13. Endothelial EROSION with a Small Thrombus

14. Plaque RUPTURE Causing Major Thrombosis

15. What Category of Narrowing Produces the Greatest Hazard? Mild.

16. EMT Check List For ACS

17. Sorting Out ST Segment Coving

18. ST Segment Elevation: Normal Variants

19. ST Segment Elevation: Pathologic Variants

20. ST Segment Elevation: PE and Post-DC Shock

21. EKG: Inferior MI

22. EKG: Anterior MI

23. EKG: LBBB

24. EKG: LVH

25. EKG: RV Paced Rhythm

26. EKG: ST Depression

27. Troponin and Pinhead

28. Elevated Troponin Causes (Partial List)

29. London Marathon And Troponin Elevation

30. NTG Response: Diagnostic Significance

31. Risk Stratification In ACS

32. Therapy for ACS

33. Time and Infarction Size

34. Time to Treatment and TPA vs PCI in STEMI

35. Absolute benefit in terms of lives saved per thousand for patients treated with fibrinolytic

therapy for ST elevation or bundle branch block MI

36. Angioplasty vs. Thrombolysis for Acute ST-Elevation MI

37. SENIOR PAMI: 30-day events – All Patients >=70 y.o.

38. SENIOR PAMI: 30-day events in patients aged 70 to 80 years

39. Criteria For Emergency Catheterization In ACS

40. The SHOCK Trial - 1

42. The Shock Trial - 2

43. PCI and 2B3A Inhibitor Use in ACS

Cardiology Update 2003 (Click this link to go to the Slide Show)

01. What We Are Doing Now: NNT = 440

02.The Heart Protection Study, 2002: NNT = 83

03. The Hazard of Small Numbers

04. Principle: Treatment Effects Are Modest

05. Mortality Reduction by Medications in Heart Disease

06. Principle: Treatment Effects Are Modest

07. Lack of Efficacy of Increased Health Care Spending at the End of Life

08. Principle: Qualitative Interactions Are Uncommon, but Quantitative Interactions Are Usual

09. The SHOCK Trial

10. The SHOCK Trial

11. The SHOCK Trial

12. The SHOCK Trial

13. The SHOCK Trial

14. Principle: Unintended Targets Are Common

15. HERS Trial

16. HERS: CHD Death and Nonfatal MI

17. HRT to Protect the Heart?

18. Natural Estrogens?

19. Alternative medicine: a recipe for disaster

20. Principle: Most Beneficial Therapies Do Not Save Money, but They are Incrementally Cost-

Effective

21. Principle: Applying the Results of Clinical Trials Is Beneficial

22. The Heart Protection Study

23. The Heart Protection Study

24. The Heart Protection Study

25. The Heart Protection Study

26. The Heart Protection Study

27. Folate Is Not Perfect, Either

28. The Heart Protection Study

29. The Heart Protection Study

30. Statin Rx: Muscle Pain With Normal CPK

31. Statin Rx: Course After Myopathy

32. The Heart Protection Study

33. The Heart Protection Study

33a.The Statins May Have Similar Effects

34. Wrong Again! The AFFIRM Trial

35. AFFIRM: Inclusion criteria

36. AFFIRM: Adverse Outcomes

37. Treatment Success: Comparisons at 1 year

38. AFFIRM: Mortality results

39. AFFIRM: Caveats

40. Less Is More: ALLHAT

41. Less Is More: ALLHAT

42. Less Is More: ALLHAT

43. Less Is More: ALLHAT

44. Less Is More: ALLHAT

45. Less Is More: ALLHAT

46. We Have No Idea What We’re Looking At

47. Interpreting Troponin-I Values

48. Troponin and the Head of a Pin

49. Time Course of Marker Release After MI

50. Reported Cases of Elevated Tpn-I

51. Non-MI Causes of Elevated Troponin

52. Clues to a False-Positive Troponin-I

53. Nitro: Not Such A Big Help After All

54. Response of Chest Pain in the E.R. to NTG: Brooke Army Hospital - 223 Patients (retrospective)

55. Response of Chest Pain in the E.R. to NTG: Johns Hopkins Hospital - 459 Patients (prospective)