Cleveland Clinic Journal of Medicine

  • Which test for CAD should be used in patients with left bundle branch block?
    Bo Xu, MBBS (Hons), Paul Cremer, MD, Wael Jaber, MD, Stuart Moir, MBBS, PhD, Serge C. Harb, MD and L. Leonardo Rodriguez, MD
    Cleveland Clinic Journal of Medicine March 2018, 85 (3) 224-230; DOI: https://doi.org/10.3949/ccjm.85a.17051

    CT angiography is the fi rst-line test in those under 65; for older patients there are SPECT and dobutamine echocardiography.

  • Acute cardiorenal syndrome: Mechanisms and clinical implications
    Acute cardiorenal syndrome: Mechanisms and clinical implications
    Guramrinder S. Thind, MD, Mark Loehrke, MD, FACP and Jeffrey L. Wilt, MD, FACP, FCCP
    Cleveland Clinic Journal of Medicine March 2018, 85 (3) 231-239; DOI: https://doi.org/10.3949/ccjm.85a.17019

    Volume overload is central to its pathogenesis, and accurate assessment of volume status is critical.

  • Hemodynamically, the kidney is at the heart of cardiorenal syndrome
    Justin L. Grodin, MD, MPH
    Cleveland Clinic Journal of Medicine March 2018, 85 (3) 240-242; DOI: https://doi.org/10.3949/ccjm.85a.17126

    In heart failure, the heart and the kidneys share a rocky relationship.

  • Paraneoplastic acral vascular syndrome
    Satish Maharaj, MBBS, Simone Chang, MBBS, Karan Seegobin, MBBS and Carmen Isache, MD
    Cleveland Clinic Journal of Medicine February 2018, 85 (2) 101-102; DOI: https://doi.org/10.3949/ccjm.85a.17007

    The patient presented with a painful blue great toe, abdominal pain, and unintentional weight loss.

  • PCI for stable angina: A missed opportunity for shared decision-making
    PCI for stable angina: A missed opportunity for shared decision-making
    Michael B. Rothberg, MD, MPH
    Cleveland Clinic Journal of Medicine February 2018, 85 (2) 105-121; DOI: https://doi.org/10.3949/ccjm.85gr.17004

    Patients mistakenly believe that PCI saves lives. They need clear information to give informed consent.

  • Having the COURAGE to include PCI in shared decision-making for stable angina
    Umesh N. Khot, MD
    Cleveland Clinic Journal of Medicine February 2018, 85 (2) 124-127; DOI: https://doi.org/10.3949/ccjm.85a.17113

    In a select group, a PCI-first strategy does not reduce the risk of death, but it does relieve angina sooner.

  • Medication management in older adults
    Luke D. Kim, MD, FACP, CMD, Kenneth Koncilja, MD and Craig Nielsen, MD, FACP
    Cleveland Clinic Journal of Medicine February 2018, 85 (2) 129-135; DOI: https://doi.org/10.3949/ccjm.85a.16109

    Some drugs may become unnecessary or even dangerous as the patient ages. Periodic medication review is needed.

  • Finding balance: Optimizing medication prescribing in older patients
    Kelly C. Sponsler, MD and Amanda S. Mixon, MD, MS, MSPH, FHM
    Cleveland Clinic Journal of Medicine February 2018, 85 (2) 136-137; DOI: https://doi.org/10.3949/ccjm.85a.17087

    More than one-third of older adults in the United States take 5 or more medications. Consider deprescribing.

  • Kidney transplant: New opportunities and challenges
    Joshua Augustine, MD
    Cleveland Clinic Journal of Medicine February 2018, 85 (2) 138-144; DOI: https://doi.org/10.3949/ccjm.85gr.18001

    Kidney transplant improves survival and long-term outcomes in patients with renal failure.

  • A 75-year-old with abdominal pain, hypoxia, and weak pulses in the left leg
    Maya Serhal, MD, Natalie Evans, MD, RPVI and Heather L. Gornik, MD, RVT, RPVI
    Cleveland Clinic Journal of Medicine February 2018, 85 (2) 145-154; DOI: https://doi.org/10.3949/ccjm.85a.16069

    Workup revealed the patient had both arterial and venous thrombosis. What was the cause?

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