Open Heart

APRIL 20, 2022

Methods Patients were retrospectively evaluated between January 2012 and June 2020. Twenty-one (41%) had normal echocardiogram, 13 (25%) a hypokinetic non-dilated cardiomyopathy (HNDC) and 17 (33%) a dilated cardiomyopathy (DCM). Significant right ventricular involvement was an exclusion criterion.

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Cardiomyopathy Chest Pain Sudden Cardiac Death Heart Failure 52

Heart BMJ

NOVEMBER 27, 2023

Methods The Outcomes Registry for Cardiac Conditions in Athletes was a nationwide prospective multicentre observational cohort study that captured testing and outcomes data from 45 institutions (September 2020–June 2021). Athletes with an ECG and transthoracic echocardiogram (TTE) and no pre-existing conditions were included.

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COVID-19 Sudden Cardiac Death Aortic Atrial Fibrillation 52

Open Heart

AUGUST 25, 2023

Methods Patients with lowest LVEF between 30% and 35% without an ICD prior to the lowest-LVEF echo (defined as ‘time zero’) were identified by querying echocardiography data from 28 November 2001 to 9 July 2020 at the Massachusetts General Hospital linked to ICD treatment status. vs 65.4%, p<0.0001), more often white (87.5%

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Defibrillator Sudden Cardiac Death Myocardial Infarction Echocardiogram 52

Circulation

NOVEMBER 11, 2024

A retrospective chart review was performed on 41 patients with COVID-19 on ECMO between March and October 2020. Twenty-two patients had transthoracic echocardiograms (TTE) completed while on ECMO (VV-ECMO = 19, VA-ECMO = 3). Echocardiograms (echo) were obtained pre-cannulation, during ECMO, and post-ECMO decannulation.

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COVID-19 Laboratory Biomarkers Echocardiogram 40

Dr. Smith's ECG Blog

OCTOBER 15, 2024

Additionally, a bedside echocardiogram showed no wall motion abnormality and normal LV function. A formal echocardiogram for patient 2 showed normal LV size, wall thickness, and global systolic function. The two cases were considered: Patient 1 was recognized by the ED provider and the cardiologist as having resolved “STEMI”.

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Chest Pain STEMI Echocardiogram Stents 116

Frontiers in Cardiovascular Medicine

FEBRUARY 11, 2025

Two groups of patients' age, gender, diabetes duration, merge disease, echocardiogram and blood biochemical indexes, had no statistical difference (P>0.05). There were no significant differences in the number of coronary artery lesions, treatment regimens, cardiovascular and hypoglycemic drugs between the two groups (P>0.05).

Myocardial Infarction 52

Myocardial Infarction Diabetes Heart Failure Laboratory 52

Journal of Cardiovascular Electrophysiology

DECEMBER 17, 2024

Methods Patients from a large US hospital system undergoing combined LAAO and left-atrial CA from 8/2020 to 2/2024 were retrospectively analyzed and compared to a control group undergoing LAAO alone. vs. 4.5%, p =0.96) on transesophageal echocardiogram did not differ. vs. 2.1%, p =0.72) and minor (27.8%

Ablation 40

Ablation Arrhythmia Thrombosis Echocardiogram 40

Dr. Smith's ECG Blog

SEPTEMBER 29, 2023

The emergent echocardiogram showed normal EF, no WMA, and normal valve function. Alternatively — Today's regular SVT rhythm could be the much less common "fast-slow" form of AVNRT ( as I illustrate with laddergram in Figure-3 of My Comment in the March 6, 2020 post ). The angiogram showed completely normal coronary arteries.

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Chest Pain Tachycardia STEMI Blog 130

Circulation

NOVEMBER 11, 2024

from March 2020 to October 2021. Patients were included if they had: 1) acute COVID-19 infection confirmed by RT-PCR and 2) a transthoracic echocardiogram (TTE) performed during their hospitalization. Adult patients were identified by hospitalizations using ICD-10 code U07.1

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COVID-19 Echocardiogram Hospital Circulation 40

Journal of Cardiovascular Electrophysiology

MARCH 3, 2024

Methods We retrospectively screened 2009 patients who underwent pacemaker implantation from 2010 to 2020 in seven institutions. The paced QRS recorded immediately after implantation was analyzed.

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Cardiomyopathy Pacemaker Heart Rhythm Atrial Fibrillation 40

Ken Grauer, MD

JANUARY 13, 2024

HCM is an "umbrella term" applied to the presence of LVH in the absence of "abnormal cardiac loading conditions" ( Hughes et al — JAHA 9:e015294, 2020 ). Cardiac cath showed normal coronary arteries.

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Cardiomatics

JUNE 6, 2024

years, which has recovered well following a large decline due to COVID in 2020. 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. In terms of healthcare spending, Italy allocates about 9.4%

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Dr. Smith's ECG Blog

JULY 14, 2023

Formal Echocardiogram: Normal left ventricular size and wall thickness. For more on the application of this Trace-down; Copy-over technique with Shark Fin ST segment deviations — See My Comment in the May 19, 2020 post in Dr. Smith's ECG Blog. Moderately decreased left ventricular systolic function with an estimated EF of 36%.

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Cardiac Arrest Chest Pain Defibrillator Atrial Flutter 98

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. See My Comment at the bottom of the page in the May 19, 2020 post in Dr. Smith's Blog ). 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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Chest Pain Ischemia Pericarditis Tachycardia 104

Dr. Smith's ECG Blog

JUNE 11, 2024

Formal echocardiogram: Systolic function is at the lower limits of normal. To add to this complexity ( as per My Comment in the August 22, 2020 post in Dr. Smith's ECG Blog ) — the ST-T wave appearance in repolarization variants may be dynamic ! This is a significant loss of myocardium and ejection fraction.

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Chest Pain STEMI Blog Exercise 113

Dr. S. Venkatesan MD

MARCH 19, 2024

He had his echocardiogram done already and was normal. The 2020 “Padua Criteria” for Diagnosis and Phenotype Characterization of Arrhythmogenic Cardiomyopathy in Clinical Practice. I don’t know, whether a single blocked P could by any way a concealed Wenke -Bach. What does the guidelines say ? J Clin Med.

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Arrhythmia Sudden Cardiac Death Electrophysiology Cardiomyopathy 52

Dr. Smith's ECG Blog

DECEMBER 19, 2023

His echocardiogram showed normal wall motion. To paraphrase Dr. Smith's comments in the May 19, 2020 post : — Non-obstructive coronary disease does not ne cessarily imply no plaque rupture with thrombus. The patient did well afterward without any recurrence of symptoms. There are no further EKGs or troponin measurements.

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Plaque Angina Blog Stents 127

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

Dr. Smith's ECG Blog

DECEMBER 11, 2023

Her contrast enhanced echocardiogram is shown below in the parasternal short axis view. Academic Emergency Medicine 27(S1): S220; May 2020. After returning from lab repeat troponin was 20,380 ng/L, and later that evening it peaked at 29,571 ng/L before trending down. The patient suffered a large infarct. Abstract 556.

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Myocardial Infarction Chest Pain STEMI Blood Pressure 123

Dr. Smith's ECG Blog

OCTOBER 2, 2021

He underwent formal echocardiogram several days later, which confirmed the findings of anterior, and apical wall motion abnormalities. Smith comment: this patient might have been sent home because of the poor sensitivity of this Point of Care (POC) assay. Do NOT use them. ng/mL when they stopped ordering further troponins. 1] Wereski, R.,

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Chest Pain Ultrasound STEMI Myocardial Infarction 52

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 November 10, 2020 post — for PTA. The October 17, 2020 post — for a 70-year old woman with " Artifactual VT ". The thrombus is circled below in red.

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Chest Pain Blog Arrhythmia Critical Care 64

Dr. Smith's ECG Blog

JULY 16, 2022

Here is the post PCI EKG: And a few hours after that: The post PCI echocardiogram showed: Normal estimated left ventricular ejection fraction, 57%. This is a large OMI that has Zero ST Elevation but can be diagnosed by ECG features other than ST Elevation!! Regional wall motion abnormality-mid to basal inferior wall.

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Dr. Smith's ECG Blog

JULY 27, 2023

hours ECG: Not much change hs troponin I peaks at 500 ng/L 8 hours Next morning Urine drug screen: Amphetamine, Methamphetamine, Fentanyl, Fentanyl metabolite Formal Bubble Contrast Echocardiogram: Indications for Study: Silent Ischemia. SUMMARY Normal left ventricular cavity size. Normal estimated left ventricular ejection fraction.

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Tachycardia Ischemia Cardiac Arrest Echocardiogram 52

Dr. Smith's ECG Blog

OCTOBER 25, 2022

She had an echocardiogram which was normal. Some General Thoughts on SVTs: I’ve previously reviewed in detail an approach to the regular SVT ( Please see My Comment — at the bottom of the page in the March 6, 2020 post in Dr. Smith’s ECG Blog ).

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Tachycardia Atrial Flutter Dysrhythmia Ablation 52

Dr. Smith's ECG Blog

APRIL 15, 2020

Echocardiogram: Estimated left ventricular ejection fraction, lower limits of normal; 45-50%. IF interested in more on the topic of fragmentation — See My Comment in the January 31, 2020 post. Tele Monitor: Normal sinus rhythm throughout, no ectopic atrial or ventricular beats. Regional wall motion abnormality-inferolateral.

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Tachycardia Nursing Heart Disease Dysrhythmia 52

Dr. Anish Koka

SEPTEMBER 24, 2022

The vaccine efficacy data for the original data was from thousands of patients and I certainly felt given the devastation wreaked on many of my patients in 2020 that the vaccines were the best chance of avoiding morbidity and mortality.

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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. Smith on this blog ( Simply search for Brugada Syndrome! ).

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Heart Rhythm Sudden Cardiac Death Arrhythmia STEMI 52

Dr. Smith's ECG Blog

SEPTEMBER 29, 2018

This is a case written by Dan Lee (One of our fantastic Hennepin Residents, class of 2020 ) edits by Smith A 60 something-year-old man with a history of ESRD, LVH and prior CABG presented after an episode of hypotension during his hemodialysis, run followed by a syncopal episode which caused his run to be terminated early.

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Chest Pain Myocardial Infarction Cardiac Arrest Ischemia 52

Dr. Smith's ECG Blog

JANUARY 28, 2023

Echocardiogram: EF 50%, akinesis of mid-apical anteroseptal, inferior, and inferoseptal myocardium. Next morning: Slight evidence of reperfusion (or just completion) with terminal T wave inversion in many leads. QS waves from V2-V5 consistent with LV aneurysm morphology. Normal RV, no valve stenosis or regurgitation.

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STEMI Chest Pain Stents Stent 52

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." On the other hand, stable EKG over an hour in the setting of ongoing acute coronary syndrome is again unusual.

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Chest Pain Coronary Artery Bypass Graft Pericarditis Blog 52

Dr. Smith's ECG Blog

FEBRUARY 6, 2020

Next day, a stress echo was done: The exercise stress echocardiogram is normal. Normal estimated left ventricular ejection fraction improved with stress. No wall motion abnormality at rest. No wall motion abnormality with stress. The stress electrocardiogram is non-diagnostic. The patient did not report angina with stress.

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Chest Pain Ischemia Angina Electrocardiogram 40

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." The echo was normal. Learning points 1. In this regular wide complex tachycardia , since the rhythm converted w adenosine, it is almost certainly SVT w aberrancy, which can be either: A.

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Tachycardia Heart Disease Dysrhythmia Ablation 52

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. For review of ECG findings expected with Takotsubo Cardiomyopathy — Please see My Comment at the bottom of the page in the March 25, 2020 post in Dr. Smith's ECG Blog ). ng/mL by 4th generation and older assays.)

Plaque 52

Plaque Chest Pain Thrombosis Stenosis 52

Dr. Anish Koka

FEBRUARY 20, 2023

It is relevant to note here that as a physician active clinically in both the inpatient and outpatient arenas, I am an eyewitness to the severe toll COVID19 took on my patients in the Spring or 2020. He has had COVID twice, first in September of 2020, and his second time in January of 2023. The pain resolved a few weeks later.

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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 Figure-4: I’ve postulated a laddergram for ECG #3 in Today’s Case ( For more on the use of laddergrams — See My Comment in the February 20, 2020 post ). The patient was given furosemide and admitted to the hospital.

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Heart Failure Tachycardia Atrial Flutter Cardiomyopathy 52

Dr. S. Venkatesan MD

FEBRUARY 4, 2025

She needs an echocardiogram to rule out any subclinical myocardial disease. Echocardiogram is a must. 2020 Aug;43(8):827-833. 2020 Aug;43(8):827-833. Epub 2020 Apr 7. (Rarely, neuro-adrenergic-emotional signals from brainstem can tilt the ST segment like this. Have seen a HCM variants like this ).TMT Reference 1.

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