Ken Grauer, MD
MARCH 29, 2023
The ECG in Figure-1 is from a man in his 30s — who overall has been healthy, except for a history of "intermittent palpitations" that he has had since childhood. Episodes typically last less than 2 minutes — but this time, he presented to the ED ( E mergency D epartment ) because of ongoing symptoms lasting a number of hours. The patient consumed alcohol at a party the night before.
Open Heart
MARCH 31, 2023
The wide uptake of anterior right thoracotomy (ART) as an approach for aortic valve replacement (AVR) has been limited despite initial reports of its use in 1993. Compared with median sternotomy, and even ministernotomy, ART is considered to be less traumatic to the chest wall and to help facilitate quicker patient recovery. In this statement, a consensus agreement is outlined that describes the potential benefits of the ART AVR.
Heart 2023 Conference
MARCH 31, 2023
We hear a lot about the benefits of intermittent fasting, but a six- time study in JAHA set up that the length of time between the first and last mess had no effect on weight loss. rather, the number and size of refections may be the more important factor. Although intermittent fasting has come a popular weight- loss strategy, strictly designed studies have yet to determine whether confining the mess window can effectively control body weight over the long term.
Dr. Smith's ECG Blog
MARCH 31, 2023
This was sent to me by a friend. It is from a 50-something with chest pain: What do you think? This was marked as "Not a STEMI" by the physicians. It is not a STEMI, but it is diagnostic of an LAD OMI (Occlusion MI). There is subtle ST Elevation in V1-V4 and hyperacute T-waves in V2-V6. There is also subtle but diagnostic INFERIOR ST Elevation, with reciprocal ST Depression in aVL.
Cassling
MARCH 30, 2023
Goats are naturally curious and highly sociable creatures. Perhaps that’s why Jason Schmitt, whose colleagues consider him one of the Greatest of All Time (GOAT), has found so much success as a Cassling Field Service Engineer over the past 20 years. It’s not a bad combination when your career success thrives on troubleshooting and trust.
Vector Remote
MARCH 28, 2023
Cutting Through the Noise: Effective Strategies for Loop Recorder Monitoring Management Are you a cardiology device clinic nurse struggling with the overwhelming amount of data coming from implantable loop recorders (ILRs or “loops”)? You’re not alone. Many of the alerts generated by these devices are not clinically significant and can distract you from focusing on alerts and patients that need your attention.
Ken Grauer, MD
MARCH 23, 2023
The 12-lead ECG and long lead II rhythm strip shown in Figure-1 — was obtained from a previously healthy, elderly woman who collapsed in the hospital parking lot. She underwent cardiopulmonary resuscitation for VT/VFib — with ROSC ( R eturn O f S pontaneous C irculation ) following defibrillation and treatment with Epinephrine and Amiodarone. A series of cardiac arrhythmias were seen during the course of her resuscitation — including the interesting arrhythmia shown in the long lead II of Figure
Cardiovascular Update brings together the best content for cardiovascular medicine professionals from the widest variety of industry thought leaders.
GEMMS
MARCH 28, 2023
An EHR system is more than just a platform to store patient information digitally. It can convert that data into valuable insights, which helps medical practitioners provide better patient care. Highly rated EHR systems remarkably impact operations, patient care, and profits. They provide an essential workflow structure and can be employed to streamline processes, ensure patients get the best care, and bolster your bottom line.
Dr. Smith's ECG Blog
MARCH 30, 2023
= My Comment by K EN G RAUER, MD ( 3/30 /2023 ): = The ECG in Figure-1 was sent to me without the benefit of any history. I thought the rhythm illustrated a number of essential concepts for clinicians dedicated to Emergency Care. Do YOU know what the rhythm is? IF this arrhythmia is puzzling to you — READ ON! I illustrate how to make the diagnosis within less than 15 seconds.
ECG Cases
MARCH 28, 2023
Dr. Nav Sahsi gives us a quick primer on Doctors Without Borders, explains the difference between humanitarian work and development work and describes the motivation, personal skills, education, time commitment and flexibility required for humanitarian work for all those with an interest in Global EM. The post Global EM 3 So you want to be a humanitarian doctor?
Cassling
MARCH 24, 2023
2023 marks the five-year anniversary of the Cassling Leadership Institute. It’s shocking to think about how much has changed in healthcare in that relatively short amount of time. Staffing challenges have only grown fiercer even as managers and directors have to figure out ways to do more with less (less time, less team, less budget). Meanwhile, technology continues to progress at a breakneck pace, and patients and providers alike place more of a premium on experience than ever before.
Ken Grauer, MD
MARCH 18, 2023
The ECG in Figure-1 was obtained from a man in his mid-60s — who presented with new chest pain. Should the cath lab be activated? Figure-1: T he initial ECG in today’s case. Should the cath lab be activated? MY Thoughts on the Initial ECG: The rhythm in ECG #1 — is sinus at ~70/minute. All intervals ( PR, QRS, QTc ) are normal. There is no chamber enlargement.
Open Heart
MARCH 24, 2023
Our perspectives on aortic stenosis (AS) are changing. Evolving from the traditional thought of a passive degenerative disease, developing a greater understanding of the condition’s mechanistic underpinning has shifted the paradigm to an active disease process. This advancement from the ‘wear and tear’ model is a result of the growing economic and health burden of AS, particularly within industrialised countries, prompting further research.
Cardiomatics
MARCH 23, 2023
There is no product without customers What makes a product a perfect fit for its audience and a company a successful player in the market? That’s a key question being asked in most companies, especially those operating in a fast-paced IT startup environment. There are different ways to achieve success: the range of product functionalities/services ; the quality and accuracy of the product; gathering and implementing users’ needs.
Dr. Smith's ECG Blog
MARCH 27, 2023
I was reading ECGs on the system, and saw this one: What do you think? I knew that, if the patient had presented with chest discomfort, that this ECG is diagnostic of inferior posterior OMI, even though it is not a STEMI. However, it is difficult to recognize for an interpreter who is does not have special expertise in OMI ECG diagnosis. We taught an AI system from PM Cardio to recognize patterns of subtle OMI (beware: this version of the app is not available to the public yet).
ECG Cases
MARCH 28, 2023
In this month's EM Quick Hits podcast: Anand Swaminathan on 3-pronged approach to aortic dissection management, Jonathan Wallace on rural practice tips for glue removal and ESP block for renal colic, Sara Gray on everything you need to know about High Flow Nasal Cannula but were afraid to ask, Maria Ivankovic on reducing the duration of antibiotic therapy for uncomplicated common bacterial infections, Tahara Bhate on handover and learner oversight on QI corner and Kerstin De Wit on the ADJUST-UN
GEMMS
MARCH 21, 2023
There are many ways to ensure growth in your cardiology practice without being overworked and increasing your patient load. By updating your inefficient EHR system to one with an integrated billing systems, you could easily increase your revenue. Look to EHR technologies to optimize and automate internal tasks, improving your business operations and management.
Ken Grauer, MD
MARCH 12, 2023
I start today’s case with the ECG shown in Figure-1 — obtained from a 30-something year old man, who presented with palpitations. How would YOU interpret the ECG in Figure-1 ? Treatment? What is unusual about this arrhythmia? = NOTE: The ECG in Figure-1 has been recorded at the usual 25mm/second speed — but with the Cabrera format ( Please see my Editorial Note near the top of the page in ECG Blog #365 for review of the basics of this recording system ). = Figure-1: The initial ECG in today’s ca
Open Heart
MARCH 20, 2023
Objective To identify factors that independently predict the risk of rehospitalisation and death after acute heart failure (AHF) hospital discharge in a real-world setting, considering death without rehospitalisation as a competing event. Methods Single-centre, retrospective, observational study enrolling 394 patients discharged from an index AHF hospitalisation.
EMS 12-Lead
MARCH 19, 2023
David Didlake Acute Care Nurse Practitioner Firefighter / Paramedic (Ret) @DidlakeDW Expert contribution by Dr Robert Herman @RobertHermanMD @PowerfulMedical (Chief Medical Officer) An adult male called 911 for new-onset epigastric burning. Fire/EMS crews found him clammy and uncomfortable. Vital signs were noted to be unremarkable with respect to any hypo-hypertensive crisis, hypoxia, etc.
Dr. Smith's ECG Blog
MARCH 20, 2023
Submitted by Dr. Caio Aguiar from Brazil, written by Pendell Meyers It is immensely rewarding to receive these emails, like I received from Dr. Aguiar last week: "Last year I had a couple of lessons with you while on my internship. I finished my residency of Emergency Medicine and I’m working at a great Emergency Department here in Brazil. Since then, I started looking for OMI EKG findings and not just STEMI.
Heart 2023 Conference
MARCH 17, 2023
Atherosclerosis, also called " hardening of the arteries, " occurs when fat, cholesterol and other substances are deposited in the walls of the arteries. These deposits are called plaques. Over time, these plaques can narrow or completely block arteries and cause problems throughout the body. Atherosclerosis is a common disease. Exercise training and physical exertion are effective styles for lowering the threat of cardiovascular events, still, multitudinous studies have shown that aged and midd
Dr. Malcolm Kendrick
MARCH 17, 2023
17th March 2023 Recently, I was in Phoenix Arizona for a few days to attend the Broken Science Initiative Conference. This organisation was set up by Greg Glassman, who founded CrossFit, and Emily Kaplan, a media expert. The title of the organisation may give you a clue as to its purpose. For my part I gave a presentation on medical research, and where I believe it has gone wrong.
Ken Grauer, MD
MARCH 7, 2023
You are given this ECG to review. No history is provided — except knowing that this patient was seen in the ED ( E mergency D epartment ). QUESTION: Is there a potential problem with this ECG? Figure-1: The initial ECG in today's case. == N OTE : Many of us are charged with reviewing ECGs that have been interpreted by other clinicians — often without the benefit of much ( or any ) history.
Open Heart
MARCH 17, 2023
Background Women’s pregnancy history is associated with incident risk of coronary artery disease with some evidence also suggesting a relevance for prognosis following treatment. Objectives To study the associations between maternal history of preterm delivery, a history of small for gestational age infant, parity and age at first delivery with clinical restenosis after percutaneous coronary intervention (PCI).
Cassling
MARCH 17, 2023
The words “collaborative” and “dedicated” are often used when describing Cassling’s Field Service Engineers, and FSE Dave Evans is no exception. Dave joined Cassling 20 years ago and is known for his commitment to teamwork and knack for getting things done.
Dr. Smith's ECG Blog
MARCH 19, 2023
This ECG was texted to me in real time, but I did not notice the message until about an hour after it came. "50 + yo. Concerning history, known CAD" Recorded 2 hours after pain onset: What do you think? This was my response: "This looks like a worrisome EKG. It looks like an Occlusion MI (OMI), but I am not 100% certain. But by now you must have a repeat ECG.
ECG Cases
MARCH 14, 2023
In this main episode podcast we explore a dozen pitfalls in the assessment and management of acetaminophen poisoning. Dr. Emily Austin and Dr. Margaret Thompson answer questions such as: how is massive acetaminophen overdose a totally different toxidrome compared to non-massive overdose? Which patients are the ones that we are most likely to miss and have poor outcomes?
International Journal of Cardiovascular Sciences
MARCH 13, 2023
The International Journal of Cardiovascular Science (IJCS) is accepting articles for a special thematic issue focusing on cardiometabolic diseases, to be published in September 2023. The term cardiometabolic risk describes the chances that a person has of damaging the cardiovascular system when one or more risk factors appear together. These factors include obesity, dyslipidemia, hypertension, and insulin resistance — also known as metabolic syndrome.
Wellnest
MARCH 12, 2023
A human's health and well-being may suffer significantly after a heart attack. It occurs when blood flow to the coronary arteries is restricted, frequently by a blood clot, which can harm the heart muscle and result in consequences like heart disease or sudden cardiac arrest. However, early intervention and taking precautions to avoid future cardiac issues can improve results and lower the likelihood of complications.
Open Heart
MARCH 16, 2023
Objectives Worldwide, an estimated 10 million adults annually experience significant myocardial injury after non-cardiac surgery. Our aim is to assess whether preoperative and postoperative serum B-type natriuretic peptides levels (BNP) could be used as a predictor of postoperative complications in hypertensive and diabetic patients post non-cardiac surgery.
Heart 2023 Conference
MARCH 11, 2023
Health experts proved that LAUGHTER is good medicine. A good laugh can get 20% more blood flowing through your body. One study found that people's blood flow increased when they watched a funny movie. That's why laughter could be the perfect antidote to stress. When you laugh, the lining of your blood vessel walls relaxes and stretches, says Krasuski.
Dr. Smith's ECG Blog
MARCH 17, 2023
Submitted by anonymous, written by Pendell Meyers A woman in her 50s presented to the Emergency Department with chest pain and shortness of breath that woke her from sleep, with diaphoresis. She had a prior history of "NSTEMI" one month ago, during which she had a coronary angiogram reportedly showing no stenosis in any coronary artery. Her vitals were within normal limits.
Society of Thoracic Surgeons - Allied Health
MARCH 10, 2023
Video 8 in 8 Series: Optimizing Therapy Postoperatively After CABG dkaczmarek Fri, 03/10/2023 - 17:06 For patients to receive the maximal benefit after CABG and reduce the risk of major adverse events, adherence to post-discharge medications is essential. In this episode of the 8 in 8 Series, the presenters examine the data for post-op medication prescribing guidelines, including aspirin, statins, beta blockers, and more.
Vector Remote
MARCH 9, 2023
All About Cardiac Remote Patient Monitoring Software Comprehensive healthcare for rhythm, heart failure, and hypertension requires the ability to monitor a heart’s condition. In response, an increasing number of clinics have chosen to rely on cardiac remote patient monitoring ( RPM ) software. This software is transforming preventative healthcare, as it optimizes clinic management and improves patient care.
Dr. Anish Koka
MARCH 4, 2023
If there was any doubt the academic research enterprise is completely broken, we have an absolute train wreck of a study in one of the many specialty journals of the Journal of the American Medical Association — JAMA Health. I had no idea the journal even existed until today, but I now know to approach the words printed in this journal to the words printed in supermarket tabloids.
Open Heart
MARCH 16, 2023
Objective To present phenotypic characteristics and biomarkers of a family with the rare mutation Thr410Ala of the α-galactosidase A gene (T410A/ GLA ) causing Fabry disease (FD). Methods and results In a woman in her 60s with hypertrophic cardiomyopathy, T410A/ GLA was found in screening for variants in 59 cardiomyopathy-related genes. Her son in his 40s, two granddaughters and two great grandsons carried T410A/ GLA.
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