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TEE of a giant LV thrombus as well as other, smaller thrombi in a 51 year-old man who came to the hospital complaining of chest pain. He was subsequently taken to the cardiac cath lab and was found to have clean coronary arteries. Surprisingly, he was clinically stable despite his TEE findings and an EF of 20%.
Debulking is the surgical removal of part of a malignant tumour which cannot be completely excised, so as to enhance the effectiveness of radiation or chemotherapy. It is used only in specific malignancies, as generally partial removal of a tumor is not considered a worthwhile intervention. Ovarian carcinoma and some types of brain tumor are debulked prior to commencing radio- or chemotherapy. It may also be used in the case of slow growth tumors to shift tumor cells from phase of cell cycle to replicative pool.
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Although drug treatment of hypertension is associated with improved survival and decreased vascular complications, drug compliance is a major problem in the control of hypertension. All antihypertensive medications are associated with side effects; thus, it is a physician's responsibility to explain to each patient the side effects of the drugs he prescribes to treat hypertension, and to instill in the patient a sense of necessity for the treatment of hypertension. The choice of antihypertensive drug should be made based on each patient's lifestyle, overall health and ability to tolerate the drug. Ideally, the antihypertensive regimen should be simple, effective, convenient to take and have very few side effects.