ANSNM 2017 CT Coronary Calcium Hobart Tasmania

Talk on the prognostic value of a CT coronary calcium score of zero.
The Paul Orr Award Presentation

Presenting our research on CT coronary calcium in Vienna May 7th

Santa Claus Florida Christmas 2016

Santa handing out presents Christmas Eve with Lauren

                                                    Christmas with the Family in Florida

A 38 year old peripartum female presents to the ED with severe chest pain due to aortic dissection

38-year-old Maori woman normally fit and well. Presents day 6 post-vaginal delivery with:

–chest pain (since delivery)

–shortness of breath

–nausea

–lightheadedness  
Vaginal delivery difficult – episiotomy, Ventouse-assisted, PPH 600 mL Hypertensive in pregnancy

CTPA: no PE, but pericardial effusion, ascites, and R pleural effusion of unclear cause

Echo: marked dilatation of ascending aorta, mild-mod aortic insufficiency, pericardial effusion

CTA:
Aortic intimal flaps (red arrows) initially reported as “ulceration” After rediscussion with radiology, diagnosed as type A dissection involving ascending aorta

Pregnancy alone is independent risk factor for dissection

•Hypertension

•Hyperdynamic, hypervolaemic state

•Hormonal effects on vasculature

•Gravid uterus compressing descending aorta and iliac arteries -> increased stress/pressures in upper aorta

 Dissections occur in third trimester or in peripartum period

Mortality if untreated in a dissection of the ascending aorta.

–33% of patients die within the first 24 hours

–50% die within 48 hours

–Undiagnosed ascending aortic dissection has two-week mortality of 75%

One of the great saves of my career as a clinical cardiologist! Kia Ora from the land of the long white cloud.

Hospital Rounds Internship Year 1978 A Pharm.D Returns to Round With Me After 38 Years!

I first met Bobby Curtis 38 years ago in Kansas City at the University of Missouri in July of 1978. I was a green 26 year old medical intern. Bobby was assigned to my team as our Pharm.D to make clinical rounds and advise us on drug dosage and drug interactions. We soon became good friends and have remained so to this day. Bobby has recently retired and decided to visit me in New Zealand and I thought it would be great if we could make rounds together one last time. I called Anthea our current clinical Pharmacist who advises me on drug dosage and drug interactions and asked what she thought. As always Anthea was very positive and enthusiastic."I would love to show him around"! So (after the necessary paper work was filled out) at 8am on Thursday October 27, 2016  38 years from our first rounds Bobby, Anthea and I made Cardiology rounds with the house staff !

                                       Bobby, myself and Anthea in the Coronary Care Unit

ASNC 2016 Boca Raton,Florida

Paul Orr Research Award 2016 Christchurch NZ