Bradycardia and Diabetes - Cardiovascular Update

Abstract 4145609: The Cardiac Conundrum of Cannabis: A Case of Junctional Bradycardia Triggered by Cannabis Use

Circulation

NOVEMBER 11, 2024

Electrocardiogram (ECG) and telemetry revealed junctional bradycardia with heart rate in 30s and sinus pauses (5-7 seconds). He was admitted for further workup of bradycardia. His home medications included metoprolol succinate 25mg daily which was held given bradycardia. Initial laboratory analysis was unremarkable.

Bradycardia

Bradycardia Coronary Artery Disease Kidney Disease Outpatient

Emergency transvenous temporary pacing during rotational atherectomy

Frontiers in Cardiovascular Medicine

DECEMBER 13, 2023

Background Rotational atherectomy (RA) during percutaneous coronary intervention may cause transient bradycardia or a higher-degree heart block. Traditionally, some operators use prophylactic transvenous pacing wire (TPW) to avoid haemodynamic complications associated with bradycardia. No patients underwent prophylactic TPW insertion.

Bradycardia

Bradycardia Diabetes Hospital

Abstract 4134483: How succesfully can we presribe the 'four pillars' of medications for patients with heart failure with reduced LV systolic function?

Circulation

NOVEMBER 11, 2024

Reasons for not prescibing or discontinuing were: CKD 6, severe aortic stenosis 5, asthma 3, symptomatic bradycardia 5, hypotension 3, type1 diabetes 2, syncope 1, Raynauds 1, patient choice 8 and 6 patients died before all appropriate medications could be initiated. In 10 cases no clinical reason could be identified.It

Heart Failure

Heart Failure Outpatient Bradycardia Nursing

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Orchestra BioMed Announces Initiation of BACKBEAT Pivotal Study of AVIM Therapy in Hypertensive Pacemaker Patients

DAIC

JANUARY 19, 2024

Our collaboration with Orchestra BioMed will explore how cardiac pacing can go beyond management of bradycardia and conduction disease to treat hypertension as well,” said Robert C. Kowal, M.D., vice president and general manager of Cardiac Pacing Therapies within the Medtronic Cardiac Rhythm Management operating unit.

Pacemaker

Pacemaker Hypertension Blood Pressure Kidney Disease

Physiology Friday #228: Identifying Sleep Patterns that Influence Chronic Disease Risk

Physiologically Speaking

JULY 26, 2024

We talk about the ketogenic diet as a metabolic therapy for type 1 diabetes. Dozens if not hundreds of (albeit observational) studies have linked a short sleep duration to a number of health conditions including type 2 diabetes and cardiovascular disease. Welcome to the Physiology Friday newsletter.

Chronic Disease

Chronic Disease Physiology Atrial Flutter Atrial Fibrillation

See what happens when a left main thrombus evolves from subtotal occlusion to total occlusion.

Dr. Smith's ECG Blog

OCTOBER 20, 2024

Written by Magnus Nossen The patient in today's case is a male in his 70s with hypertension and type II diabetes mellitus. As per Dr. Nossen — today's initial ECG ( LEFT tracing in Figure-2 ) shows sinus bradycardia with QRS widening due to bifascicular block ( RBBB/LAHB ). The syncope lasted about 2-3 minutes according to his wife.

Cardiogenic Shock

Cardiogenic Shock Ischemia Chest Pain Cardiac Arrest

Three normal high sensitivity troponins over 4 hours with a "normal ECG"

Dr. Smith's ECG Blog

JANUARY 5, 2024

Written by Willy Frick A 46 year old man with a history of type 2 diabetes mellitus presented to urgent care with complaint of "chest burning." The ECG shows sinus bradycardia but is otherwise normal. The documentation does not describe any additional details of the history. The following ECG was obtained. ECG 1 What do you think?

Angina

Angina Plaque Document Stents

Syncope and Block

EMS 12-Lead

JUNE 1, 2022

In isolation, however, syncope does not hold significant weight for OMI – as opposed to something like crushing chest discomfort, for example – although stereotypical ACS might become blurry in both the elderly and diabetic populations. This is important because we must rely on the ECG to further elucidate the story when the patient cannot.

Heart Failure

Heart Failure Myocardial Infarction Bradycardia Chest Pain

Distractions

EMS 12-Lead

MARCH 19, 2023

He denied any known medical history, specifically: coronary artery disease, hypertension, dyslipidemia, diabetes, heart failure, myocardial infarction, or any prior PCI/stent. Breath sounds were clear in all lung fields. No appreciable skin pallor. He reported to be a social drinker, but used tobacco products daily.

Myocardial Infarction

Myocardial Infarction STEMI Coronary Angiogram Coronary Artery Disease

Is this ECG diagnostic of coronary occlusion? Also: Inferior de Winter's T-waves on prehospital ECG??

Dr. Smith's ECG Blog

JANUARY 28, 2018

He has a history of known CAD, diabetes, and dyslipidemia. Here is his previous ECG: This was my interpretation of the first ECG: Sinus bradycardia with less than 1mm ST elevation in V4-V6, elevated compared to the previous ECG, suggestive of lateral MI. By pure clinical appearance, he looked like the textbook patient with acute MI.

Pericarditis

Pericarditis Ischemia STEMI Chest Pain

Wide complex tachycardia and hypotension in a 50-something with h/o cardiomyopathy -- what is it?

Dr. Smith's ECG Blog

JUNE 23, 2023

A 50-something male with unspecified history of cardiomyopathy presented in diabetic ketoacidosis (without significant hyperkalemia) with a wide complex tachycardia and hypotension. The patient later settled into sinus bradycardia. Bedside echo showed "mildly reduced" LV EF. Here is the ED ECG: What do you think? It is regular.

Tachycardia

Tachycardia Cardiomyopathy Arrhythmia Diabetes

Diffuse ST depression, and ST elevation in aVR. Left main, right?

Dr. Smith's ECG Blog

MARCH 2, 2019

Biphasic T-waves in a Middle-Aged Male with Vomiting Diabetic Ketoacidosis: is there hypokalemia? In my experience, Ive seen U waves not only with low K+/low Mg++ but also in patients with bradycardia, LVH, and sometimes in normal subjects. You probably think it is left main. Are These Wellens' Waves?? ST depression: is it ischemia?

Sickle Cell Disease

Sickle Cell Disease Ischemia Dysrhythmia Chest Pain

Potassium 6.2 with narrow QRS: any indication for calcium?

Dr. Smith's ECG Blog

FEBRUARY 10, 2025

Written by Jesse McLaren An 80 year old patient with diabetes/hypertension/ cirrhosis had a recent increase in candesartan for their hypertension, and was also on spirolactone and nadolol. Theres no prior ECG to compare - but the bradycardia, prolonged PR and peaked T waves could all be from hyperkalemia. Take away 1.

Bradycardia

Bradycardia Cardiac Arrest Hypertension ICU

Abstract 4145609: The Cardiac Conundrum of Cannabis: A Case of Junctional Bradycardia Triggered by Cannabis Use

Emergency transvenous temporary pacing during rotational atherectomy

Abstract 4134483: How succesfully can we presribe the 'four pillars' of medications for patients with heart failure with reduced LV systolic function?

Webinars

Orchestra BioMed Announces Initiation of BACKBEAT Pivotal Study of AVIM Therapy in Hypertensive Pacemaker Patients

Physiology Friday #228: Identifying Sleep Patterns that Influence Chronic Disease Risk

See what happens when a left main thrombus evolves from subtotal occlusion to total occlusion.

Three normal high sensitivity troponins over 4 hours with a "normal ECG"

Syncope and Block

Distractions

Is this ECG diagnostic of coronary occlusion? Also: Inferior de Winter's T-waves on prehospital ECG??

Wide complex tachycardia and hypotension in a 50-something with h/o cardiomyopathy -- what is it?

Diffuse ST depression, and ST elevation in aVR. Left main, right?

Potassium 6.2 with narrow QRS: any indication for calcium?

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