Pathophysiology of narrow complex dilated cardiomyopathy insight derived from the velocity equation: velocity = distance/time.

The pathophysiology of narrow complex dilated cardiomyopathy is not defined, so therapeutic options are limited. By utilising the velocity equation, the pathophysiology of narrow complex cardiomyopathy allows above normal conduction propagation velocities. There are two pathophysiological theories that allow above normal conduction velocities and failure to capture the myocardium: (1)insulating fibres of the conduction system extending beyond the apex and (2) reduction of axon branching.

"Observational Medicine" should be replaced by "Real Science".

Science is defined by fundamental principles that can be modeled to explain observations and predict new findings. Clinical trials have not achieved this status. The trials generate new observations and lack the ability to predict future outcomes.

Applying laws of biology to diabetes with emphasis on metabolic syndrome.

The listed laws of biology will be applied to diabetes mellitus and metabolic syndrome. (1) Biology must be consistent with the fundamental laws of physics and chemistry. (2) Life, as opposed to non-living, exhibits negative entropy (known as syntropy), capable of creating order out of chaos.

Should we establish a new protocol for the treatment of peripartum myocardial infarction?

Peripartum myocardial infarction is a rare event that is associated with high mortality rates. The differential diagnosis includes coronary artery dissection, coronary artery thrombosis, vascular spasm, and stenosis. Our evaluation of 2 cases over a 5-year time period has led to a hypothesis that peripartum myocardial infarction is an immune-mediated event secondary to coronary endothelial sensitization by fetal antigen.

Mycotic pseudoaneurysm of the aortic arch with purulent pericardial effusion.

A 67-year-old woman presented with dyspnea on exertion and a diminished left radial pulse in comparison with the right. She had signs and symptoms of cardiac tamponade. A computed tomographic (CT) angiogram of the chest revealed an aortic arch pseudoaneurysm along the lesser curvature and a large pericardial effusion with the density of blood.

Enhanced external counterpulsation is a regenerative therapy.

Enhanced external counterpulsation (EECP) is used for the treatment of severe angina and heart failure in patients who are not candidates for revascularization. The clinical benefits of EECP extend well beyond the time period of any hemodynamic effects, but the cause of this prolonged effect is not understood. The prolonged clinical benefits suggest EECP could be a regenerative therapy.

Relation of atmospheric pressure changes and the occurrences of acute myocardial infarction and stroke.

Previous studies have demonstrated variation in vascular events with respect to season and time of day. Changes in barometric pressure display daily and seasonal variations and could modulate the occurrence of vascular events. The objective of this study was to determine whether a relation exists between changes in barometric pressure and occurrence of stroke or acute myocardial infarction (AMI).

Intestinal obstruction mimicking acute myocardial infarction.

A 64-year-old woman presented at our institution with abdominal pain. An electrocardiogram suggested the possibility of acute anteroseptal myocardial infarction. Her medical history included esophageal reconstruction with use of a jejunal conduit in the anterior mediastinum.