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Old 08-25-2019, 06:08 AM
 
Location: Maryland
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Quote:
Originally Posted by guidoLaMoto View Post
Mechanism of heart attack--> oxidative stress on arterial lining (intima) causes cracks. Cracks are "healed" by activating the fibrinogen system which forms a net of fibrin and that net collects white cells, cholesterol etc to form a scar. That scar is "hardening of the artery." As the coronary artery narrows, it has more trouble delivering oxygen to the cardiac muscle as exercise increases the demand for the oxygen--> that gives you an episode of angina....You don't actually have a heart attack until the sharp edges of the plaque causes the sudden closure of the artery with a blood clot. Then zero oxygen can be delivered down stream and the muscle dies (infarction)….If you get to the ER in time, they can inject drugs that dissolves the clot and restore circulation hopefully before too much damage is done.

Only about half of people who suffer an MI have complaints at the time-- crushing chest pain or nausea are most common, although only jaw or arm pain are present in some. The other half have "silent MI." Unusual fatigue or SOB or no complaint at all. More common in diabetics.


BTW--ACE inhibitors like lisinopril are excellent BP meds but also have effects on the chemistry of the arterial intima, reducing the risk of damage. They are recommended for diabetics even without hi bp to help delay renal problems, but then low bp can be a side effect.
That’s interesting info about Lisinopril, didn’t know that. That reminds me of a researcher I got to know at the NIH (she’s now at U. Pittsburgh). I worked with her developing a machine, cobbled together from several existing components. She called it Episcopic Fluorescence Image Capture, or EFIC for short. There are a number of them around but it never caught on commercially.

Anyway, it produced an image similar to an MRI but at microscopic resolution based autofluorescence of the tissue. The final image was also 3D, so she could rotate the entire mouse heart for example and take optical slices of it along pretty much any plane. She said she noticed things in 3D she would never have noticed just looking at usual 2D images. She created a number of developmental atlases of the mouse and human heart. About the time we parted ways, she made an interesting comment about a serendipitous observation. She noticed the pattern of fluorescence was variable in the cardiac arteries and that the pattern closely followed locations where plaque tended to form in cardiovascular disease. I don’t know whether she ever followed up on it but I thought at the time that it was very interesting.

http://apps.devbio.pitt.edu/mouseatlas/About/AboutEFIC

Her more recent machines have used a confocal scan head to reduce deep autofluorescence since the aniline dye used in paraffin embedding matrix in the early work had its own set of problems.

Last edited by LesLucid; 08-25-2019 at 06:19 AM..
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Old 08-25-2019, 11:05 AM
 
Location: The Driftless Area, WI
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Very interesting. Thanks. I just looked it up: https://embryology.med.unsw.edu.au/e..._Image_Capture


It appears to be a way of imaging specimens prepared in the usual way for microscopic viewing-- imbed in wax-- but no need to destroy the specimen by submitting it to the microtome.


It probably hasn't caught on in medical pathology because ca dx is still based on seeing abnormal mitoses visually. Nobody has (yet) defined ca cells based on differential fluorescence.


I always wondered, did Edison invent the record or the record player first?
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Old 08-26-2019, 06:47 AM
 
Location: Maryland
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Actually it is, unfortunately, a destructive process, it’s main disadvantage to MRI for example. The potential for using immunofluorescence in addition to the autofluorescence normally used is a big advantage however.

The merits of this approach however were probably best indicated when agreement was made to sacrifice specimens from the Kyoto embryo collection to the procedure. That is not something done lightly. This was started when she was still at the NIH and someone from Japan came over to monitor the work. IIRC, all the sections produced from the human embryos were collected and saved, unlike the animal model tissues.

Last edited by LesLucid; 08-26-2019 at 06:56 AM..
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Old 08-27-2019, 08:29 PM
 
Location: Florida
3,128 posts, read 2,226,610 times
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Quote:
Originally Posted by LesLucid View Post
I’m curious about other’s experiences. To keep it brief, I’m considered a risk for heart disease. My dad, both grand dads and most uncles all died in the mid-fifties of heart disease. My blood cholesterol level and ratio has always been bad and so have my triglycerides. I’ve had multiple stress tests of various types, echocardiograms, carotid neck ultrasounds, etc. Most of those tests started because I was, eventually, diagnosed with a “non-pathological ST depression” detected when I went into the emergency room for a different matter. They threw me cardiac intensive care overnight. None of the tests have revealed any problem worth treating right now by anything other than medication.

Despite all this stuff going on, I have not, to my knowledge, ever had any obvious symptoms of heart disease. I’m curious whether others here have had something hit them out of the blue, even when their doctors have told them there is no concern at the moment. I’m going to be 72 soon and I’m honestly surprised I’m still here given my family history. I feel like this is what’s going to get me some day, just sort of wondering whether it’s likely to be sudden and unexpected.
Almost a year to the day when I had a stress test and my doctor said I had the heart of a 16 year old, I had a widow maker heart attack. Like you, my dad, his brothers, and other male relatives all died of heart disease in their 50’s. I’m now 64 and 19 years post open heart and looking forward to at least another 20 years!!
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Old 08-28-2019, 09:32 AM
 
Location: Maryland
2,269 posts, read 1,618,705 times
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Quote:
Originally Posted by Ron61 View Post
Almost a year to the day when I had a stress test and my doctor said I had the heart of a 16 year old, I had a widow maker heart attack. Like you, my dad, his brothers, and other male relatives all died of heart disease in their 50’s. I’m now 64 and 19 years post open heart and looking forward to at least another 20 years!!
Wow, glad you made it. So I take it you had no serious warning signs, the stress test was part of a physical or just because of family history?
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