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Using 3D ultrasound to improve monitoring of dangerous aneurysms

Medical Xpress - Cardiology

During her doctoral research, Esther Maas investigated the use of new ultrasound techniques to image dangerous aortic aneurysms for patient-specific care.

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Utilization and Outcomes Associated With Intravascular Ultrasound during Abdominal and Thoracic Endovascular Aortic Interventions in the United States in the Contemporary Era (2016–2023)

Circulation: Cardiovascular Interventions

Inverse probability weighting was used to assess the impact of IVUS on a composite outcome of repeat aortic intervention or death. Circulation: Cardiovascular Interventions, Ahead of Print. Cox regression was used to estimate weighted hazard ratios.RESULTS:A total of 136 540 patients underwent TEVAR and EVAR, of which 9.8% (13 364) used IVUS.

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Subacute AnteroSeptal STEMI, With Persistent ST elevation and Upright T-waves

Dr. Smith's ECG Blog

An intra-aortic balloon pump was placed, and the patient was taken for immediate surgical repair but did not survive. If detected early by ultrasound, the patient can be saved. Additionally , these patients have a high incidence of LV aneurysm with mural thrombus. 3) Oliva et al. (4)

STEMI 52
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A teenager with chest pain, a troponin below the limit of detection, and "benign early repolarization"

Dr. Smith's ECG Blog

CT angiogram chest: no aortic dissection or pulmonary embolism. Repeat CT angio chest (not CT coronary, unclear what protocol) showed possible LAD aneurysm and thrombus. Beware a negative Bedside ultrasound. No further troponins were measured. Serial chest xrays: progressive bilateral pulmonary edema. Pericarditis?

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PseudoSTEMI and True ST elevation in Right Bundle Branch Block (RBBB). Don't miss case 4 at the bottom.

Dr. Smith's ECG Blog

An elderly patient with a ruptured abdominal aortic aneurysm: Formal ECG Interpretation (final read in the chart!) : "Inferior ST elevation, lead III, with reciprocal ST depression in aVL." A bedside ultrasound was done by the emergency physician, using Speckle Tracking. What do you think?

STEMI 40
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POCUS Cases 10 Limitations, Pitfalls and Accuracy of POCUS for Ruptured AAA

ECG Cases

Rob Simard discusses one of the most important uses of POCUS in the ED, and that is for AAA. He reviews the literature on the accuracy of POCUS for AAA as well as demonstrates the limitations and the common pitfalls in this POCUS Cases video.

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Emergency Department Syncope Workup: After H and P, ECG is the Only Test Required for Every Patient.

Dr. Smith's ECG Blog

Look for Vascular Etiology -- think of these while doing H and P: --Bleeding: ruptured AAA, GI bleed, ruptured ectopic pregnancy, other spontaneous bleed such as mesenteric aneurysms. Aortic Dissection, Valvular (especially Aortic Stenosis), Tamponade. heart auscultation (aortic stenosis); c. orthostatic vitals b.