2022 and Echocardiogram - Cardiovascular Update

FDA Clears First AI to Aid Heart Failure Detection During Routine Check-ups

DAIC

APRIL 3, 2024

doi: 10.1136/bmjhci-2022-100718 FDA 510(k) Summary, K233409 Bachtiger, P., for detection of LVEF below 40%, 84.8% sensitivity, and 69.5% specificity when deployed on over 1,050 patients across multiple real-world settings. BMJ Health & Care Informatics, 30:e100718.

Heart Failure

Heart Failure Cardiomyopathy Hospital AFIB

Peak oxygen consumption by smartwatches compared with cardiopulmonary exercise test in complex congenital heart disease

Heart BMJ

FEBRUARY 12, 2024

Results 48 patients (71% with a Fontan circulation, 42% females, mean age 33±9 years) underwent two CPETs between May 2018 and May 2022 with echocardiograms performed within 6 months of each CPET. Apple Watch was the predominant smartwatch used (79%).

Congenital Heart Disease

Congenital Heart Disease Exercise Congenital Heart Disease

Ultromics Announces Partnership to Expedite Development of Echo AI Algorithm for Early Detection of Cardiac Amyloidosis

DAIC

JANUARY 15, 2024

The algorithm uses deep learning to analyse routine ultrasound scans of the heart ( echocardiograms ) to detect disease that often goes undetected during standard assessments.

Ultrasound

Ultrasound Coronary Artery Disease Innovation Heart Failure

Artificial Intelligence methods for Improved Detection of undiagnosed Heart Failure with Preserved Ejection Fraction (HFpEF)

European Journal of Heart Failure

DECEMBER 28, 2023

Methods In a retrospective cohort study, we used an NLP pipeline applied to the Electronic Health Record (EHR) to identify patients with a clinical diagnosis of HF between 2010-2022. Of 3727 consecutive patients with HF and LVEF ≥ 50% on echocardiogram, only 8.3% Results were validated in a second, independent centre.

Preserved Ejection Fraction

Preserved Ejection Fraction Heart Failure Echocardiogram Article

Imaging Biomarkers and Prevalence of Complex Aortic Plaque in Cryptogenic Stroke: A Systematic Review

Journal of the American Heart Association

NOVEMBER 28, 2023

BackgroundComplex aortic plaque (CAP) is a potential embolic source in patients with cryptogenic stroke (CS).

Plaque

Plaque Biomarkers Aortic Stroke

VF arrest at home, no memory of chest pain. Angiography non-diagnostic. Does this patient need an ICD? You need all the ECGs to know for sure.

Dr. Smith's ECG Blog

JUNE 23, 2024

Echocardiogram showed LVEF 66% with normal wall motion and normal diastolic function. The above said — it may prove insightful to take another look at the Wellens' Syndrome case instantly recognized by Dr. Smith in the August 12, 2022 post in Dr. Smith’s ECG Blog. Lesions less than 70% are generally considered to be non-flow limiting.

Chest Pain

Chest Pain Cardiac Arrest Sudden Cardiac Death Stents

A teenager involved in a motor vehicle collision with abnormal ECG

Dr. Smith's ECG Blog

FEBRUARY 6, 2024

Hopefully a repeat echocardiogram will be performed outpatient. Retrieved July 2, 2022, from [link] Moyé, D. Retrieved July 2, 2022, from [link] Sybrandy, K. I've copied KEY points from My Comment in the August 6, 2022 post in Dr. Smith's ECG Blog — regarding the answer to this question. No cardiac MRI was done.

Tachycardia

Tachycardia Dysrhythmia Atrial Fibrillation Bradycardia

"The dye don't lie".except when it does. Angiogram Negative, or is it?

Dr. Smith's ECG Blog

SEPTEMBER 9, 2024

The patient was thought to have low likelihood of ACS, and cardiology recommended repeat troponin, urine drug testing, and echocardiogram. Bedside echocardiogram showed hypokinesis of the mid to distal anterior wall and apex. Initial hscTnI was 10 ng/L (ref. <14). There was no recommendation for repeat ECG.

Plaque

Plaque Stents Stent Chest Pain

Posterior leads can give false reassurance

Dr. Smith's ECG Blog

SEPTEMBER 21, 2022

Echocardiogram: The estimated left ventricular ejection fraction is 34% Regional wall motion abnormality-lateral, akinetic. The February 10, 2022 post in Dr. Smith's ECG Blog — My Comment ( at the bottom of the page ) illustrates the Mirror Test in a case with posterior reperfusion waves ( ie, tall anterior T waves ).

Chest Pain

Chest Pain Blog Ischemia STEMI

Italy’s Pioneering Push for Telemedicine. Supported by AI

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.

COVID-19

COVID-19 Hospital Outpatient Innovation

See OMI vs. STEMI philosophy in action

Dr. Smith's ECG Blog

DECEMBER 22, 2022

He visited an outpatient clinic for it and an echocardiogram and exercise stress test was normal. In the meantime, cardiology consultant sees the patient and performs a bedside echocardiogram which revealed no major wall motion abnormalities. He has 40 packs-year of smoking history. He denies taking any medication. doi: 10.5543/tkda.2021.21026.

STEMI

STEMI Chest Pain Myocardial Infarction Electrocardiogram

A woman in her 50s with multiple episodes of syncope

Dr. Smith's ECG Blog

JUNE 27, 2024

The echocardiogram showed a normal EF without any abnormalities. I suspect there is LA-RA Lead Reversal ( See My Comment in the August 17, 2022 post of Dr. Smith's ECG Blog for review of the effects of LA-RA reversal ). Troponins were all negative. There was no apparent reversible cause found for the worsening heart block.

Blog

Blog Pacemaker Bradycardia Tachycardia

A 40-something presented after attempted prehospital resuscitation with persistent Ventricular Fibrillation

Dr. Smith's ECG Blog

JULY 14, 2023

Formal Echocardiogram: Normal left ventricular size and wall thickness. As I emphasized in My Comment at the bottom of the page in the October 10, 2022 post in Dr. Smith's ECG Blog — Interpretation of a post-resuscitation ECG can be extremely challenging. First — Some thoughts on the post -resuscitation ECG.

Cardiac Arrest

Cardiac Arrest Chest Pain Defibrillator Atrial Flutter

A 90-something with acute stroke. She has no chest symptoms. What is the diagnosis?

Dr. Smith's ECG Blog

NOVEMBER 11, 2023

The diagnosis was a bit hard to find in the chart, and the echocardiogram did only stated "assymetric hypertrophy." Re ECG recognition of SA Block — See My Comment at the bottom of the page in the May 25, 2022 post — as well as my comment in the Addendum of the August 30, 2023 post.

Stroke

Stroke Strokes Chest Pain Cardiomyopathy

Pretransplant cardiac stress testing and transplant wait time in kidney transplantation candidates

Open Heart

SEPTEMBER 13, 2024

Methods This is a retrospective cohort study of 22 687 end-stage renal disease patients from 2011 to 2022, within an integrated health system. times higher rate of stress echocardiogram (RR 6.51, 95% CI 5.65 Compared with dialysis patients, transplant patients had a 5.6 to 5.92), a 6.5 to 0.58).

Transplant

Transplant Echocardiogram Cardiovascular Disease

This ECG was interpreted as completely NORMAL by the computer: What about it is THE critical finding??

Dr. Smith's ECG Blog

FEBRUARY 4, 2022

Formal Echocardiogram: The estimated left ventricular ejection fraction is 58 %. 2022 Jan;51:384-387. A DDENDUM ( 2/8/2022 ): Dr. Mario Parrinello , an esteemed cardiology colleague of ours from Cremona, Italy — wrote the following comment regarding today’s post on the EKG Club. Left ventricular hypertrophy concentric.

Chest Pain

Chest Pain STEMI Article Myocardial Infarction

A man in his 40s with acute chest pain. What do you think?

Dr. Smith's ECG Blog

SEPTEMBER 29, 2023

The emergent echocardiogram showed normal EF, no WMA, and normal valve function. Unfortunately, this fooled the Emergency Physician and Cardiologist into an emergent angiogram for perceived "inferior STEMI." The angiogram showed completely normal coronary arteries. They rhythm returned to sinus reportedly after metoprolol IV was given.

Chest Pain

Chest Pain Tachycardia STEMI Blog

A Middle Aged Male diagnosed with Gastroesophageal Reflux

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.

Chest Pain

Chest Pain Bradycardia Blog Critical Care

90 year old with acute chest and epigastric pain, and diffuse ST depression with reciprocal STE in aVR: activate the cath lab?

Dr. Smith's ECG Blog

NOVEMBER 4, 2022

See this case: what do you think the echocardiogram shows in this case? Routine STEMI activation in STE-aVR for emergent revascularization is not warranted, although urgent, rather than emergent, catheterization appears to be important. == MY Comment, by K EN G RAUER, MD ( 11/4 /2022 ): == Our thanks to Drs.

Ischemia

Ischemia STEMI Stenosis Coronary Artery Disease

Occlusion myocardial infarction is a clinical diagnosis

Dr. Smith's ECG Blog

DECEMBER 11, 2023

Her contrast enhanced echocardiogram is shown below in the parasternal short axis view. 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. Clin Cardiol [Internet].

Myocardial Infarction

Myocardial Infarction Chest Pain STEMI Blood Pressure

What Lies Beneath

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.

Tachycardia

Tachycardia Cardiomyopathy Electrophysiology ICU

The latest CDC paper on vaccine myocarditis is NOT reassuring

Dr. Anish Koka

SEPTEMBER 24, 2022

This latest data dump did not arrive soon enough to affect the ACIP committee’s recommendations but should serve to chill the ambition of exuberant, overconfident bureaucrats still seeking to mandate vaccines in the fall of 2022. That work is far from complete. Anish Koka is a cardiologist.

COVID-19

COVID-19 Hospital Chest Pain Quality of Life

Noisy, low amplitude ECG in a patient with chest pain

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 October 21, 2022 post — for " artifactual VT". This confirms the suspicion of prior anterior OMI. The thrombus is circled below in red.

Chest Pain

Chest Pain Blog Critical Care Arrhythmia

Opiate overdose, without chest pain or shortness of breath. Cognitive dissonance.

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." Precordial Swirl in ECG #1: As discussed in the October 15, 2022 post in Dr. Smith's ECG Blog — Drs. It does not radiate.

Chest Pain

Chest Pain Coronary Artery Bypass Graft Pericarditis Blog

Back to basics: what is this rhythm? What are your options for treating this patient?

Dr. Smith's ECG Blog

OCTOBER 25, 2022

She had an echocardiogram which was normal. She was prescribed oral diltiazem to prevent recurrence and was discharged. == MY Comment, by K EN G RAUER, MD ( 10/25 /2022 ): == Today’s blog post reviews the important topic of how to approach the patient who presents with palpitations from an SVT ( S upra V entricular T achycardia ) rhythm.

Tachycardia

Tachycardia Atrial Flutter Dysrhythmia Ablation

A young patient with diminishing pain with a subtle but diagnostic ECG.

Dr. Smith's ECG Blog

DECEMBER 18, 2022

Next day echocardiogram showed inferolateral hypokinesia with an EF of %45-50. On echocardiogram you will not see a "posterior" hypokinesia (will see "inferolateral") and, as in this case, LCx may not give the blood supply of basal inferior segment (formerly called "posterior"). 2022 Mar-Apr;71:44-46. Epub 2022 Jan 31.

Myocardial Infarction

Myocardial Infarction Chest Pain Blog Echocardiogram

"Non-STEMI" is a worthless term.

Dr. Smith's ECG Blog

OCTOBER 30, 2023

So the artery had completely spontaneously reperfused prior to intervention; the duration of occlusion was perhaps 2 hours The troponin peaked at 60,000 ng/L (a very large infarction) Formal bubble contrast echocardiogram --The estimated left ventricular ejection fraction is 46%. Regional wall motion abnormality-inferior.

STEMI

STEMI Heart Failure Stents Stent

An anxious approach to a benign arrhythmia in Holter recording

Dr. S. Venkatesan MD

MARCH 19, 2024

He had his echocardiogram done already and was normal. 2022 Jan 5;11(1):279. I don’t know, whether a single blocked P could by any way a concealed Wenke -Bach. I didn’t have calipers to measure the PR accurately though. The baseline heart rate was around a vago-genic 60/mt, that was comforting. J Clin Med.

Arrhythmia

Arrhythmia Sudden Cardiac Death Electrophysiology Cardiomyopathy

New Study Finds Early Coronary Disease, Impaired Heart Function in Asymptomatic People with HIV

DAIC

APRIL 4, 2024

Approximately 39 million people were living with HIV at the end of 2022, according to the World Health Organization (WHO). All underwent MRI to measure coronary vessel wall thickness and an echocardiogram to assess left ventricular function. million lives so far.

Coronary Artery Disease

Coronary Artery Disease Cardiovascular Disease Cardiothoracic Sudden Cardiac Death

A man in his 70s with weakness and syncope

Dr. Smith's ECG Blog

JULY 22, 2023

Formal echocardiogram showed normal EF, no wall motion abnormalities, no pericardial effusion. The patient proceeded to cath where all coronaries were described as normal with no evidence of any CAD, spasm, or any other abnormality. No more troponins were done. He was found to be influenza positive. 1849 after cath: Brugada pattern is gone!

Chest Pain

Chest Pain Heart Rhythm Sudden Cardiac Death Dysrhythmia

Three prehospital ECGs in patients with chest pain

Dr. Smith's ECG Blog

AUGUST 6, 2024

Elevated troponins prompted an echocardiogram — which revealed an apical wall motion abnormality (WMA). Patient #1 in today's post did not get expert ECG interpretation. Despite active CP — cath lab activation was deferred and this patient was transported to a local hospital without PCI capability.

Chest Pain

Chest Pain Ischemia Pericarditis Tachycardia

Upon arrival to the emergency department, a senior emergency physician looked at the ECG and said "Nothing too exciting."

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.

Plaque

Plaque Chest Pain Thrombosis Stenosis

Patient in Single Vehicle Crash: What is this ST Elevation, with Peak Troponin of 6500 ng/L?

Dr. Smith's ECG Blog

NOVEMBER 25, 2022

An echocardiogram was done. Blunt Trauma in a Child 40-something male in a head-on Motor Vehicle Collision and Splenic Injury == MY Comment, by K EN G RAUER, MD ( 10/10 /2022 ): == Highly interesting post by Dr. Smith regarding a 30-something male with multiple injuries from a motor vehicle accident. Is there also Brugada?

Arrhythmia

Arrhythmia Blog Chest Pain Cardiac Arrest

FDA Clears First AI to Aid Heart Failure Detection During Routine Check-ups

Peak oxygen consumption by smartwatches compared with cardiopulmonary exercise test in complex congenital heart disease

Ultromics Announces Partnership to Expedite Development of Echo AI Algorithm for Early Detection of Cardiac Amyloidosis

Artificial Intelligence methods for Improved Detection of undiagnosed Heart Failure with Preserved Ejection Fraction (HFpEF)

Imaging Biomarkers and Prevalence of Complex Aortic Plaque in Cryptogenic Stroke: A Systematic Review

VF arrest at home, no memory of chest pain. Angiography non-diagnostic. Does this patient need an ICD? You need all the ECGs to know for sure.

A teenager involved in a motor vehicle collision with abnormal ECG

"The dye don't lie".except when it does. Angiogram Negative, or is it?

Posterior leads can give false reassurance

Italy’s Pioneering Push for Telemedicine. Supported by AI

See OMI vs. STEMI philosophy in action

A woman in her 50s with multiple episodes of syncope

A 40-something presented after attempted prehospital resuscitation with persistent Ventricular Fibrillation

A 90-something with acute stroke. She has no chest symptoms. What is the diagnosis?

Pretransplant cardiac stress testing and transplant wait time in kidney transplantation candidates

This ECG was interpreted as completely NORMAL by the computer: What about it is THE critical finding??

A man in his 40s with acute chest pain. What do you think?

A Middle Aged Male diagnosed with Gastroesophageal Reflux

90 year old with acute chest and epigastric pain, and diffuse ST depression with reciprocal STE in aVR: activate the cath lab?

Occlusion myocardial infarction is a clinical diagnosis

What Lies Beneath

The latest CDC paper on vaccine myocarditis is NOT reassuring

Noisy, low amplitude ECG in a patient with chest pain

Opiate overdose, without chest pain or shortness of breath. Cognitive dissonance.

Back to basics: what is this rhythm? What are your options for treating this patient?

A young patient with diminishing pain with a subtle but diagnostic ECG.

"Non-STEMI" is a worthless term.

An anxious approach to a benign arrhythmia in Holter recording

New Study Finds Early Coronary Disease, Impaired Heart Function in Asymptomatic People with HIV

A man in his 70s with weakness and syncope

Three prehospital ECGs in patients with chest pain

Upon arrival to the emergency department, a senior emergency physician looked at the ECG and said "Nothing too exciting."

Patient in Single Vehicle Crash: What is this ST Elevation, with Peak Troponin of 6500 ng/L?

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