Dr. Smith's ECG Blog

SEPTEMBER 25, 2024

Regular readers of this ECG Blog will be well familiar with many of these points. Nevertheless, cases like the one presented today — illustrate the continued need for review of these points that are KEY to attaining a good outcome. Doing so in today’s case might have expedited recognizing the need for cardiac cath by more than a day!

Chest Pain 119

Chest Pain Blog Hospital Tachycardia 119

Cardiometabolic Health Congress

OCTOBER 18, 2024

In this week’s CMHC Pulse Blog Post, Virend K. Somers, MD, PhD , a consultant in cardiovascular medicine from the Mayo Clinic, discusses how sleep impacts both cardiovascular and metabolic outcomes. Prioritizing sleep health isn’t just about improving rest—it’s about enhancing overall cardiovascular outcomes.

Blood Pressure 97

Blood Pressure Diabetes Blog Obesity 97

Dr. Smith's ECG Blog

MARCH 14, 2024

Written by Jesse McLaren Three patients presented with acute chest pain and ECGs that were labeled by the computer as completely normal, and which was confirmed by the final cardiology interpretation (which is blinded to patient outcome) also as completely normal. The reliability of these ECGs should be based on patient outcome.

Chest Pain 118

Chest Pain STEMI Outcomes Electrocardiogram 118

Dr. Smith's ECG Blog

DECEMBER 27, 2023

Brief aside: "Early repolarization" is a frequently proclaimed and poorly understood electrocardiographic phenomenon which mostly serves to reassure clinicians that not all ST elevations are ischemic (something readers of this blog know well). It relies on an 1 mm cut point, which this blog does not favor as an approach to ECG.

Chest Pain 129

Chest Pain Myocardial Infarction Blog Stent 129

GEMMS

NOVEMBER 11, 2024

This transition reflects a growing focus on prioritizing patient outcomes over the volume of services provided. By emphasizing healthcare efficiency and improved outcomes, value-based care is transforming the way cardiology practices deliver patient care, especially when addressing chronic conditions common in cardiac patients.

Technology 59

Technology Patient Care Education Quality of Life 59

Cassling

MARCH 14, 2025

Heres a look at how AI ultrasound and other tech innovations are helping cardiologists work faster while driving better outcomes for patients. At the same time, the growing prevalence of complex cardiovascular conditions means assessing more nuanced, multifaceted presentations of heart disease.

Ultrasound 52

Ultrasound Innovation Heart Disease Outcomes 52

Dr. Smith's ECG Blog

DECEMBER 22, 2023

The patient has active chest pain, so if these are abnormally large T-waves This link shows 13 blog posts of Posterior Reperfusion T-waves. Is she seeing anterior hyperacute T-waves, or does she see Posterior Reperfusion T-waves?

Chest Pain 115

Chest Pain Bradycardia Blog Electrocardiogram 115

Dr. Smith's ECG Blog

NOVEMBER 14, 2023

Outcome: All 4 serial hs troponin I, out to 6 hours, were undetectable. As is often emphasized on Dr. Smith's ECG Blog — the evolution of an acute OMI is not necessarily static — but may be "dynamic". Formal Echo on this visit after ruling out by troponins: Normal estimated left ventricular ejection fraction; 66%.

Chest Pain 115

Chest Pain Blog Thrombosis Hospital 115

Dr. Smith's ECG Blog

MAY 23, 2023

This is because until recently — computerized programs have been based on STEMI -criteria — which as we have shown, will miss an estimated 25-30% of acute coronary occlusions ( See My Comment in the July 31, 2020 post in Dr. Smith's ECG Blog ). Am J Emerg Med. 2022 Jan;51:384-387. doi: 10.1016/j.ajem.2021.11.023. 2021.11.023.

Chest Pain 98

Chest Pain STEMI Blog Stent 98

Dr. Smith's ECG Blog

NOVEMBER 29, 2023

Queen of hearts interpretations: Patient 1, ECG1: Patient 2, ECG1: Patient 1 Clinical Course and Outcome: The EM physician did not see that the S wave voltage has been truncated and squared off at 10 mm, thereby greatly limiting the assessment of proportionality. He diagnosed anterior "STEMI" and activated the cath lab. But he did well.

STEMI 124

STEMI Chest Pain Blog Pericarditis 124

Cassling

OCTOBER 7, 2022

When providers don’t take the time to center the care and communication around their patient, it can lead to poor health outcomes. Patients are thrown into an unfamiliar environment with minimal knowledge and lack the confidence to ask the questions they want to, leaving them feeling overwhelmed and lost.

Outcomes 52

Outcomes Hospital Patient Care Blog 52

Dr. Smith's ECG Blog

AUGUST 2, 2024

Readers of this blog can easily appreciate the hyperacute T waves in the precordium, clearest in V1-V4. the investigators reviewed outcomes in 118 patients presenting with NSTEMI. We've highlighted a considerable number of acute RV MI cases in Dr. Smith's ECG Blog ( See the October 7, 2019 and May 10, 2024 posts , to name just two ).

STEMI 118

STEMI Ischemia Blog Chest Pain 118

Dr. Smith's ECG Blog

DECEMBER 13, 2023

Outcome: 100% LAD Occlusion Here the Queen explains why: The dark blue tells us that she is looking especially at the QRS in V3 and the T-wave in V2 and V3. Not OMI, and we (Pendell and I) always take proportionality into account. So we taught the Queen on cases with very low voltage that were OMI.

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Blog Chest Pain Cardiac Arrest Hemorrhage 122

Society of Thoracic Surgeons - Early Career

APRIL 29, 2024

Blog Building a Practice in the Community KCummings Mon, 04/29/2024 - 12:35 Medical Student Resident / Fellow “Jack of all trades, master of none, though oftentimes better than a master of one.” Know your strengths, ensure safe outcomes, and set short-term and long-term goals. You may be eager to do it all.

Cardiothoracic 64

Cardiothoracic Inpatient Blog Outpatient 64

MIBHS

JANUARY 31, 2025

This blog explores the ways wearable technology can help track heart health, the advantages it offers, and how it contributes to better outcomes for those requiring surgical intervention. The Role of Wearable Technology in Heart Health Wearable tech is designed to monitor physiological data and provide actionable insights to users.

Heart Rhythm 52

Heart Rhythm Technology AFIB Exercise 52

Dr. Smith's ECG Blog

MARCH 30, 2014

My most talented blog readers are paramedics because they have to put themselves on the line every time they activate the cath lab. Outcome and Analysis: ECG 1 is diagnostic of inferior and right ventricular MI. The minute this medical student saw the first ECG, he knew the diagnosis without any further information.

Outcomes 52

Outcomes Cardiogenic Shock STEMI Chest Pain 52

Dr. Smith's ECG Blog

MARCH 27, 2025

Cardiology: delayed cath = Non-STEMI Heres the interventional cardiology note describing the ECGs, management and outcome: He has had transitory peak T-waves, ST-segment elevation, and biphasic T-waves during recurrences of pain. Troponin rose to 12,000 before cath. This morning, he was also found to have a rising troponin.

STEMI 79

STEMI Chest Pain Pericarditis Ischemia 79

Dr. Smith's ECG Blog

APRIL 22, 2024

Available from: [link] In this study, the major outcomes were the same for both groups, but of 70 patients in the delayed group, 4 required emergent intervention for sudden re-occlusion. See My Comment in the April 17, 2022 post of Dr. Smith's ECG Blog for review on how to recognize too-high placement of the V1,V2 electrodes ).

Chest Pain 117

Chest Pain Myocardial Infarction Anatomy Angina 117

GEMMS

JULY 17, 2024

This blog proposes Gemms EHR as one strategic move to achieve this balance, empowering clinic managers and cardiologists to take charge of their clinic’s success. Improved Medical Outcomes Enhanced Patient Care : Using advanced medical practices and technologies to improve patient outcomes.

Best Practices 52

Best Practices Patient Care Blog Outcomes 52

GEMMS

APRIL 3, 2025

For cardiology practices, choosing the right patient engagement platform is vital for improving outcomes, optimizing workflow, and maintaining a competitive edge. Integrating patient-centric tools creates an environment where patients are more likely to engage actively with their care, leading to better outcomes.

Technology 52

Technology Patient Care Education Innovation 52

Society of Thoracic Surgeons - Technology

MARCH 2, 2022

Blog Introducing New Technology to an Institution jbagley Wed, 03/02/2022 - 11:15 Innovation and new technology are essential to the progress of any specialty. Within cardiothoracic surgery, the development of cardiopulmonary bypass in the 1950s was critical for shaping our field with new operations and improved patient outcomes.

Technology 52

Technology Blog Cardiothoracic Outcomes 52

Dr. Smith's ECG Blog

JULY 14, 2023

Non-randomized trials show better outcomes (neurologic survival) using this device; see this article in Resuscitation: Head and Thorax Elevation during cardiopulmonary resuscitation using circulatory adjuncts is associated with improved survival. Finally, head-up CPR (which was not used here), makes for better resuscitation.

Cardiac Arrest 98

Cardiac Arrest Chest Pain Defibrillator Atrial Flutter 98

ADN Center of Excellence

MARCH 13, 2024

In this blog, we'll focus at how continuing medical education is more than simply a professional requirement; it's also a catalyst for good change, altering healthcare throughout the world. Enhancing Patient Outcomes: Continuous learning has a direct influence on patient outcomes.

Education 59

Education Innovation Best Practices Patient Care 59

Dr. Smith's ECG Blog

JANUARY 29, 2024

Tell me the outcome! As we've discussed on mutiple posts in Dr. Smith's ECG Blog — Brugada Phenocopy is not uncommon in association with other underlying conditions, including infarction ( See My Comment at the bottom of the page in the July 22, 2023 post , among many other posts ). My answer: --Tough one! --But

Chest Pain 96

Chest Pain STEMI Blog Outcomes 96

Society of Thoracic Surgeons - Early Career

SEPTEMBER 19, 2024

Blog Managing Relationships with Patients KCummings Thu, 09/19/2024 - 10:19 Medical Student Resident / Fellow Early career cardiothoracic surgeons have many important relationships that need to be managed and developed. Whether it’s an inpatient or outpatient setting, your approach will lead to a similar outcome.

Blog 59

Blog Cardiothoracic Outpatient Inpatient 59

Dr. Smith's ECG Blog

AUGUST 19, 2023

Contemporary trends and outcomes in patients with ST-segment elevation myocardial infarction and end-stage renal disease on dialysis: insights from the National Inpatient Sample. Problem #5: There apparently was dependence on posterior leads for the diagnosis of posterior infarction.

Chest Pain 98

Chest Pain STEMI Myocardial Infarction Blog 98

Society of Thoracic Surgeons - Early Career

MARCH 15, 2024

Blog The Cost of Changing Jobs KCummings Fri, 03/15/2024 - 14:08 Resident / Fellow Surgeon At some point in their career, nearly every cardiothoracic surgeon will grapple with the decision of whether to remain in their current position or seek opportunities elsewhere. Additionally, being aware of the human bias to resist change is crucial.

Cardiothoracic 69

Cardiothoracic Blog Quality of Life Education 69

Society of Thoracic Surgeons - Early Career

OCTOBER 3, 2024

Blog Giving Credit Matters. Recognizing Actions Not Just Outcomes Providing credit to others can come in a range of venues, and it’s important to remember that credit should be offered for actions, not outcomes. Thank people loudly in the operating room for things they’ve done well (not just the outcomes).

Blog 52

Blog Outcomes Research Nursing 52

ADN Center of Excellence

JANUARY 25, 2024

In today's blog, we'll explore the transformative impact of technology on medical education and why continuous learning is crucial for every doctor's success. As a result, doctors must adapt to these changes to provide the best possible outcomes for their patients.

Technology 59

Technology Education Innovation Patient Care 59

ADN Center of Excellence

MARCH 13, 2024

In this blog, we'll focus at how continuing medical education is more than simply a professional requirement; it's also a catalyst for good change, altering healthcare throughout the world. Enhancing Patient Outcomes: Continuous learning has a direct influence on patient outcomes.

Education 52

Education Innovation Best Practices Patient Care 52

Cassling

DECEMBER 14, 2023

We continue to be amazed by the imaging teams around the country who commit so much of themselves to improving patient outcomes. What a year it’s been!

Technology 98

Technology Innovation Ultrasound Article 98

Society of Thoracic Surgeons - Early Career

NOVEMBER 2, 2023

Blog What Surgeons Need to Know About Engaging Consultants KCummings Thu, 11/02/2023 - 14:43 All Members Image Dr. Melanie Edwards In the increasingly complex world of medicine, it is difficult to maintain a high level of expertise in every disease process. Would the clinical outcome be adversely affected?

Patient Care 52

Patient Care Blog Inpatient Outcomes 52

GEMMS

AUGUST 29, 2024

These technologies are not just reshaping but also empowering how cardiology practices manage operations, deliver care, and enhance patient outcomes. These technologies are reshaping how cardiology practices manage operations, deliver care, and enhance patient outcomes.

Technology 52

Technology Patient Care Outcomes Coronary Artery Disease 52

Dr. Smith's ECG Blog

AUGUST 14, 2024

Similar to the prognostic implications of Mobitz I AV block — SA Wenckebach is not necessarily pathologic, and not necessarily associated with adverse outcome. In contrast — true Type II SA Exit Block ( like the Mobitz II form of AV block ) — is much more likely to be associated with adverse outcome and potential need for cardiac pacing. (

Arrhythmia 110

Arrhythmia Pacemaker Outcomes Blog 110

Dr. Smith's ECG Blog

JANUARY 27, 2024

Fortunately they spontaneously reperfused, or else they could have had a worse outcome, but deferring all ‘normal’ ECGs will perpetuate delayed diagnosis and reperfusion for STEMI(-)OMI. This 4% is underestimation because it only included patients admitted as STEMI not those admitted as NSTEMI like the case above.

Chest Pain 116

Chest Pain STEMI Aneurysm Stent 116

ADN Center of Excellence

OCTOBER 26, 2023

In this blog, we'll explore a key topic in Colon and Rectum Surgery, offering valuable insights that will enhance your understanding and skills. Enhanced Patient Outcomes: Minimally invasive procedures often result in shorter hospital stays, reduced postoperative pain, and quicker recovery times. www.adncenterofexcellence.com

Education 52

Education Best Practices Webinar Interventional Cardiology 52

Conquering CHD

DECEMBER 19, 2023

Welcome to our latest blog update, where we delve into the significant contributions of the Centers for Disease Control and Prevention (CDC) and the National Center on Birth Defects and Developmental Disabilities (NCBDD) in the realm of Congenital Heart Disease (CHD).

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Congenital Quality of Life Public Health Education 52