2020–2021 BCSC Basic and Clinical Science Course™
1 Update on General Medicine
Chapter 5: Acquired Heart Disease
Highlights
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Atherosclerotic coronary heart disease (CHD) remains by far the leading killer in the United States and around the world.
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Primary prevention of CHD at a public health level requires lifestyle changes, including reduced intake of saturated fat and cholesterol, increased physical activity, and weight control.
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Smoking remains the number-one preventable risk factor worldwide for vascular disease, which includes CHD, cerebrovascular disease, and peripheral vascular disease.
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Randomized trials suggest that, regardless of cholesterol level, any patient at significant risk for vascular events should be prescribed a statin.
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Primary percutaneous coronary intervention (PCI) performed by experienced operators is superior to thrombolysis for the treatment of acute myocardial infarction (MI).
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Stenting with either a bare-metal stent or a drug-eluting stent is useful for managing patients with acute MI and for preventing MI in selected patients. It requires a postprocedural period of dual antiplatelet therapy (DAT).
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Prophylactic implantable cardioverter-defibrillators (ICDs) are indicated for patients who have survived a cardiac arrest or an episode of hemodynamically unstable ventricular tachycardia. ICDs are also indicated for severe left ventricular dysfunction after MI.
Excerpted from BCSC 2020-2021 series: Section 1 - Update on General Medicine. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.