Primary care
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The link between elevated LDL-C, low HDL-C, elevated triglycerides, and an increased risk for cardiovascular disease has solidified over the past decades. Concomitantly, the number of agents to treat dyslipidemia proliferated in clinical trials, proving or refuting their clinical efficacy. ⋯ Recently, there has been an explosion in emerging therapeutics for the primary and secondary prevention of cardiovascular disease through the control of dyslipidemia. This article reviews standard, new, and emerging treatments for hyperlipidemia.
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In 2019, before the COVID-19 pandemic, cardiovascular disease (CVD) was the leading cause of death. Since 2020, the pandemic has had far-reaching effects on the landscape of health care including CVD prevention and management. ⋯ This article reviews the effects of the SARS-CoV-2 virus and the accompanying pandemic on CVD risk factor prevention and management in the United States. Potential solutions are also proposed for these patients.
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More people are living with congenital heart disease (CHD) because many children now survive to adulthood with advances in medical and surgical treatments. Patients with CHD have ongoing complex health-care needs in the various life stages of infancy, childhood, adolescence, and adulthood. Primary care providers should collaborate with pediatric specialists to provide ongoing care for people living with CHD and to create smooth transitions of care.
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Pericarditis typically presents with classic symptoms of acute sharp, retrosternal, and pleuritic chest pain. It can have several different underlying causes including viral, bacterial, and autoimmune etiologies. The mainstays of pericarditis treatment are nonsteroidal anti-inflammatory drugs and colchicine with glucocorticoids or other immunosuppressive drugs used for refractory cases and relapse. ⋯ Pericarditis and myocarditis associated with vaccine have been extremely rare before coronavirus disease 2019 (COVID-19). There is a small increase of incidence after COVID-19 messenger ribonucleic acid vaccine, but the relative risk for pericarditis and myocarditis due to severe acute respiratory syndrome coronavirus 2 infection is much higher. Therefore, vaccination against COVID-19 is currently recommended for everyone aged 6 years and older.
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Infectious endocarditis (IE) is a universally fatal condition if left unmanaged, requiring urgent evaluation and treatment. Fever, new heart murmur, vegetations found by echocardiogram, and bacteremia are the most common symptoms and findings. ⋯ Staphylococci, Streptococci, and Enterococci are common pathogens, necessitating bactericidal antimicrobial therapy. Importantly, up to 50% of patients with IE will require cardiothoracic surgical intervention.