Can medical managment save a patient with cardiogenic shock ?

CCU’S can also save  patients with cardiogenic shock
Many of us would say ” never” or some may say “rarely” but in reality the answer is “yes it can ” slightly lower than  Primary PCI . One could save atleast  few  lives every month by  intensive medical  management alone (Inotrope, vasodilator,pacing if needed ) in any coronary care unit.
So the message [...]

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Can primary neural pain originate from heart ?

Are we missing an entity called Primary cardiac neuralgia ?
Unexplained chestpain even after elaborate investigation is a very common clinical cardiac problem. Cardiac neural plexus has a complex network with mainly autonomic network ,with somatic projections. Neural dysfunction could occur in any organ which has rich neural network.Diabetes is the classical example of cardiac autonomic [...]

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If aortic dissection is the most painful clinical condition why coronary dissection is least painful?

Thousands of dissections happen in cath labs  all over the world every day  very rarely it is painful . the answer is not clear. Both have rich vasa nervorum. Aortic dissection  involves media and smooth muscle . Coronary dissection may also be a  equally painful  , probably we are not recognising it ! or we [...]

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Is plaque fissure or rupture painful ?

Plaque fissure ,rupture and subsequent thrombois is the hallmark of acute coronary syndrome . Are these events painful ? We always attribute any chest pain in an ACS patient to ischemia of myocardium.Is that always true? Coronary artery also has a rich vasa nervorum that could be activated by plaque disruption.
Why  we need an answer [...]

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