Trends, outcomes, and management of acute myocardial infarction in patients with chronic viral hepatitis.

Objectives: There is a paucity of data on the management and outcomes of chronic viral hepatitis (CVH) patients [including chronic hepatitis B (CHB) and chronic hepatitis C (CHC)] presenting with acute myocardial infarction (AMI).

Methods: We utilized the National Inpatient Sample database (2001-2019) and studied the management and outcomes of CVH patients with AMI and stratified them by subtypes of CVH. The adjusted odds ratio (aOR) of adverse outcomes in CVH groups were compared to no-CVH groups using multivariable logistic regression.

Acute eosinophilic myocarditis mimicking myocardial infarction.

Eosinophilic myocarditis is characterized by progressive myocardial damage that results in heart failure and death. Herein, we present the case of a 54-year-old man who presented with symptoms of acute myocardial infarction. Normal coronary angiographic results and the presence of elevated levels of peripheral-blood eosinophilia prompted an endomyocardial biopsy that revealed acute eosinophilic myocarditis.

Low high-density lipoprotein cholesterol is associated with impaired endothelial function in Asian Indians.

This study was designed to assess the relationship between plasma lipid levels and endothelial function in Asian Indians without cardiovascular risk factors living in the United States. While traditional risk factors do not account for the increased incidence of coronary heart disease (CHD) in Asian Indians, low high-density lipoprotein (HDL) cholesterol, elevated triglycerides, elevated lipoprotein (a), and insulin resistance are consistently found in Asian Indians with CHD. Endothelial function was measured in 86 healthy Asian Indians (mean age 33 years) free of cardiac risk factors with LDL levels<160 mg/dL.

Fingernail clubbing and chromonychia associated with the use of angiotensin II receptor blockers.

Fingernail clubbing and discoloration frequently indicate serious pulmonary, cardiovascular, and gastrointestinal pathologies. A 76-year-old Caucasian man developed clubbing of the fingernails and discoloration of both the fingernails and toenails after 27 days of treatment with the angiotensin II receptor blocker (ARB) losartan 50 mg/day. Even though this therapy was switched to valsartan, the nail changes persisted for another 6 months.

Physician gender and patient care.

Since 1960, there has been a remarkable increase in the number of women graduating from United States medical schools. Concurrent with this increase, a large body of research has emerged on whether patient gender has an impact on disease diagnosis and therapy. From that research, a related question has emerged: Do patients receive different treatment based on the gender of their physician? In this article, we review the current literature regarding the effects of the gender of the primary care physician on patient care.

ACE inhibitor-induced bronchial reactivity in patients with respiratory dysfunction.

Background: Angiotensin-converting enzyme (ACE) inhibitors are often associated with an increased incidence of cough and bronchial responsiveness that may cause further deterioration of patients with impaired pulmonary function.

Objective: To review the available literature on the incidence of cough and bronchial responsiveness associated with ACE-inhibitor therapy in patients with asthma, chronic obstructive pulmonary disease (COPD), and congestive heart failure (CHF).

Data Sources: Literature was accessed through MEDLINE (1985-September 2001).