The American journal of medicine
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Differentiating patients with type 1 and type 2 myocardial infarction (MI) and acute non-ischemic myocardial injury continues to be a problem for many clinicians. Type 1 MI is the most easily defined. It involves the rise and fall of blood troponin measurements (only falling values if the patient arrives late) with an appropriate clinical observation consistent with myocardial ischemia. ⋯ The clinical scenarios leading to type 2 MI and non-ischemic myocardial injury are, however, often fraught with greater degrees of uncertainty. In addition, therapy for these latter 2 entities is poorly defined. This review will present 3 patient scenarios that should help clinicians understand the difference between these 3 entities as well as possible therapeutic interventions.
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The number of kidney transplant recipients has grown incrementally over the years. These patients have a high comorbidity index and require special attention to immunosuppression management. In addition, this population has an increased risk for cardiovascular events, electrolyte abnormalities, allograft dysfunction, and infectious complications. It is vital for hospitalists and internists to understand the risks and nuances in the care of this increasingly prevalent, but also high-risk, population.