Dr. Smith's ECG Blog

OCTOBER 15, 2024

See this case, where a patient with BTWI morphology and dramatic EKG changes within minutes is diagnosed with myocarditis: [link] com/2019/07/what-does-this- ecg-with-significant-st.html EKG 3 also has a saddleback morphology in V2, which is only rarely due to OMI. Still, such dramatic changes cannot be overlooked.

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Chest Pain STEMI Echocardiogram Stent 116

Journal of Cardiovascular Electrophysiology

NOVEMBER 17, 2023

Methods A retrospective study was conducted on 468 patients who underwent ablation for CTI dependent typical AFL at a single institution between 2010 and 2019. Echocardiographic data were analyzed at baseline before ablation, and at early follow-up within 1-year postablation.

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Cardiomatics

JUNE 6, 2024

For instance, the average waiting time for an echocardiogram at Turin’s Molinette Hospital was 31 days in 2016 and an even longer 53 days for a Holter ECG. Prior to the new regulation, getting a consultation with a cardiologist or getting a needed diagnostic cardiology test often involved long waiting times.

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Dr. Smith's ECG Blog

JANUARY 1, 2024

A rapid echocardiogram was performed, revealing an ejection fraction of 20% with thinning of the anterior-apical walls. Although the patient reported experiencing mild pressure-like chest pain, there was suspicion among clinicians that this might be indicative of an older change. The initial troponin T level was measured at 30 ng/L.

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Tachycardia Blog Ischemia Heart Failure 112

Dr. Smith's ECG Blog

AUGUST 6, 2024

Elevated troponins prompted an echocardiogram — which revealed an apical wall motion abnormality (WMA). We have addresssed this issue on a number of occasions ( See My Comment in the April 25, 2023 — July 21, 2019 — December 10, 2019 — and January 10, 2020 posts). Patient #1 in today's post did not get expert ECG interpretation.

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Dr. Smith's ECG Blog

OCTOBER 12, 2024

Echocardiogram was obtained and showed mild LVH without regional wall motion abnormality. Rather than loss of both a J wave and S wave — there is a "slur" ( J-point equivalent ) in lead V2 of ECG #2 ( See My Comment in the November 14, 2019 post for illustration of T-QRS-D ). ng/mL and 0.10 ng/mL before returning to 0.05

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Dr. Smith's ECG Blog

OCTOBER 24, 2019

Troponins, echocardiogram An echocardiogram showed inferobasilar hypokinesis, further supporting a diagnosis of regional ischemia , likely of the area supplied by the RCA. JACC 2019 Sep 10;74(10):1290-1300. The biphasic T wave is consistent with recent reperfusion of an occluded coronary artery supplying the inferior region.

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Dr. Smith's ECG Blog

JANUARY 15, 2024

While awaiting transfer to the cath lab, STAT echocardiogram was performed and showed LVEF 30-35%, as well as anterior, inferior, and apical hypokinesis, and apical thrombus. The September 27, 2019 post — for the Rowlands & Moore article with the above-noted formulas for recognizing the “culprit” extremity.

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Dr. Smith's ECG Blog

NOVEMBER 4, 2022

See this case: what do you think the echocardiogram shows in this case? Am J Med 2019, 132(5):622-630. Now there is a paper published in 2019 that proves the point beyond doubt, though makes it clear that this pattern is associated with very high mortality. American Journal of Medicine 132(5):622-630; May 2019.

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Dr. Smith's ECG Blog

DECEMBER 13, 2019

The next morning the patient went for his routine echocardiogram, where the operator noticed a dilated aortic root at 5.47 That said — I illustrate HOW this RATIO is arrived at in Figure-2 , which I have adapted from the 3/16/2019 post in Life-In-The-Fast-Lane. Troponins gradually trended down from 0.19

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Pericarditis Chest Pain Aortic Blog 52

EMS 12-Lead

AUGUST 22, 2022

Indeed, bedside Echocardiogram revealed severe left ventricular impairment of Takotsubo cardiomyopathy. Surawicz and Knilans report that intense catecholamine surge, or severe maladjustment of the autonomic nervous system, can manifest “cerebral T waves” in the absence of an acute intracranial process. potassium) were within normal parameter.

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Dr. Smith's ECG Blog

JULY 21, 2019

Get an emergent contrast echocardiogram. QTc's were 330 ms and 373 ms This is what I texted back: These look like they are a very pronounced case of Benign T-wave Inversion. I do not think this is acute occlusion myocardial infarction (OMI). These are reasons why it does not look like OMI: 1. flat ST segment in V4 2. huge R-wave in V4 3.

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Chest Pain Myocardial Infarction Pericarditis Angina 52

Dr. Smith's ECG Blog

SEPTEMBER 21, 2022

Echocardiogram: The estimated left ventricular ejection fraction is 34% Regional wall motion abnormality-lateral, akinetic. She went to the cath lab and had a 100% Obtuse Marginal Occlusion (supplying the lateral and posterior wall) with TIMI-0 flow. A massive acute OMI.

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Chest Pain Blog Ischemia STEMI 52

GEMMS

JANUARY 2, 2024

Athena was developed in 2019 to create a partner network to improve the care continuum. The award-winning medical FHIR API even offers healthcare app developers the opportunity to create more solutions. Athena Cardiology EHR (Athenahealth) Another top contender for cardiology EHR is Athena Cardiology EHR.

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Document Patient Care Private Practice Reimbursement 52

Dr. Sanjay Gupta

DECEMBER 19, 2022

Another way of imaging the heart is via a transesophageal echocardiogram. References: Mendirichaga et al, Evaluation of Cryptogenic stroke; American College of Cardiology 2019 The post Cryptogenic Stroke appeared first on Dr Sanjay Gupta Cardiologist.

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Dr. Smith's ECG Blog

FEBRUARY 4, 2022

Formal Echocardiogram: The estimated left ventricular ejection fraction is 58 %. We wrote this Editorial in the Journal of Electrocardiology in 2019. Because it reperfused on its own and because we intervened before it could re-occlude. Left ventricular hypertrophy concentric. Litell JM, Meyers HP, Smith SW.

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Dr. Smith's ECG Blog

SEPTEMBER 30, 2019

Unfortunately there is no echocardiogram accessible because the patient checked himself out of the hospital in order to get back to his home state before it could be completed. Slow TIMI 2 initially with brisk flow status post percutaneous coronary intervention with 18mm drug-eluting stent. To our knowledge, the patient did well.

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Dr. Smith's ECG Blog

SEPTEMBER 7, 2020

I have ordered an echocardiogram which will be done today, after that patient can be discharged to home with follow-up in 2 to 3 months." Not all forms of idiopathic VT are predictable based on their ECG appearance ( Anderson et al, 2019 ). The echo was normal. Learning points 1.

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Dr. Smith's ECG Blog

JANUARY 30, 2019

A formal echocardiogram was completed the next day and again showed a normal ejection fraction without any focal wall motion abnormalities to suggest CAD. Cardiology was consulted and they agreed that the EKG had an atypical morphology for STEMI and did not activate the cath lab. Heart Rhythm, 15(9): 1394-1401. [7]

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Dr. Smith's ECG Blog

NOVEMBER 25, 2022

An echocardiogram was done. Kazmi et al have reported on a case in which chest trauma was transiently associated with development of a Brugada-1 ECG pattern ( J Am Coll Cardiol 73 [9-Supp-1], 2019 ). Is there also Brugada? Here is the result: The estimated left ventricular ejection fraction is 50 %. Right ventricular prominence.

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Dr. Smith's ECG Blog

APRIL 15, 2020

Echocardiogram: Estimated left ventricular ejection fraction, lower limits of normal; 45-50%. M Y T HOUGHTS : I have previously reviewed my Systematic Approach to Rhythm Interpretation ( See My Comment in the October 16, 2019 post ). Tele Monitor: Normal sinus rhythm throughout, no ectopic atrial or ventricular beats.

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Dr. Smith's ECG Blog

NOVEMBER 1, 2022

After discussing all of the above with ED staff, we have made a decision to get stat echocardiogram and assess overall LV function and wall motion abnormalities and defer cath lab activation at the time." For more on T-QRS-D — Please see My Comment at the bottom of the page in the November 14, 2019 post in Dr. Smith's ECG Blog ).

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Chest Pain Coronary Artery Bypass Graft Pericarditis Blog 52

Dr. Smith's ECG Blog

APRIL 3, 2019

When I heard she had not undergone immediate angiogram, my first question was, "Did she die?" == Comment by K EN G RAUER, MD ( 4/3/2019 ): == Insightful case presented by Dr. Smith — of an elderly woman with acute LAD OMI. Anyone can die of LAD occlusion, but especially the very elderly and especially if they are not reperfused.

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Dr. Smith's ECG Blog

NOVEMBER 30, 2022

Here is the cath report: Echocardiogram: There is severe hypokinesis of entire LV apex and apical segment of all the walls. Hospital Course The patient was taken emergently to the cath lab which did not reveal any significant coronary artery disease, but she was noted to have reduced EF consistent with Takotsubo cardiomyopathy.

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Dr. Smith's ECG Blog

MARCH 6, 2020

Later, he underwent a formal echocardiogram: Very severe left ventricular enlargement (LVED diameter 7.4 E CG # 2 in Figure-1 is from the October 16, 2019 post on Dr. Smith’s Blog. I review my S ystematic A pproach to Rhythm Interpretation in detail in My Comment to the October 16, 2019 post on Dr. Smith’s ECG Blog.

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Dr. Smith's ECG Blog

FEBRUARY 16, 2025

Despite apparently hearing the above history together with two diagnostic ECGs and a troponin compatible with OMI, the cardiologist thought the ECG represented pericarditis and recommended echocardiogram. Echocardiogram was finally performed five hours after the first diagnostic ECG. This far out, the benefit of PCI is very attenuated.

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