August, 2023

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ECG Blog #389 — A Quote from Sherlock Holmes

Ken Grauer, MD

The long lead II rhythm strip shown in Figure-1 — was obtained from a previously healthy 30-year old woman, who presented with new abdominal pain. Her vital signs were stable — and she did not have an acute abdomen. QUESTIONS: Is there complete AV block? If not — How would YOU interpret this rhythm? What is unusual about this conduction disturbance?

Blog 148
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Instructors' Collection ECG - Inferior Posterior Wall M.I. In Cabrera Format

ECG Guru

Does something about this ECG look "different" to you? This ECG shows a “classic” presentation of inferior-posterior M.I. when it is caused by a lesion in the right coronary artery (RCA). There are ST elevations in leads II, III, and aVF. Reciprocal ST depression is seen in Leads I and aVL. There is also reciprocal ST depression in Leads V1 – V3.

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Cassling Adds New Role, Hires Brian Bradfield as Chief Operating Officer

Cassling

Bradfield joins a leadership team dedicated to strengthening community healthcare across the country and touching 350 million patient lives by the end of the decade. Omaha, Neb. (August 25, 2023) — Cassling, an imaging and therapeutic technology, services and solutions vendor, welcomes Brian Bradfield as Chief Operating Officer. As COO of Cassling, Brian Bradfield will be responsible for ensuring the organization’s service, operations and strategy are in constant alignment with customers’ needs

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Lecture by Smith: Selected Cases of Occlusion MI (OMI), or not, on the ECG

Dr. Smith's ECG Blog

This may be my best lecture yet. I gave it virtually to the Kaiser group. You can access it also on the "Lectures and Podcasts" link on the Banner above. [link] == MY Comment, by K EN G RAUER, MD ( 8/6 /2023 ): == Brilliant talk by Dr. Smith on the state of the art addressing the “need for OMI — and the fallacy of STEMI”. For skeptics ( including cardiologists ) — Any questions about “Who is Dr.

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ECG Cases 44 ECG Interpretation in Epigastric pain, Vomiting

ECG Cases

In this ECG Cases blog with Dr. Jesse McLaren we interpret 10 ECG cases and explore cardiac, metabolic and GI causes: We consider anginal equivalents, and look for ECG signs of Occlusion MI, including subacute occlusion from delayed presentations. We consider electrolyte disturbances and look for ECG signs of hyperkalemia or hypokalemia/hypomagnesemia, and we consider the differential of diffuse ST depression with reciprocal ST elevation in aVR, and false positive STEMI.

STEMI 82
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Cluster of slightly unhealthy traits linked with earlier heart attack and stroke

Science Daily - Stroke

Middle-aged adults with three or more unhealthy traits including slightly high waist circumference, blood pressure, cholesterol and glucose have heart attacks and strokes two years earlier than their peers, according to new research.

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ECG Blog #392 — Repolarization T Waves?

Ken Grauer, MD

The ECG in Figure-1 was obtained from a man in his 60s — who described the sudden onset of "chest tightness" that began 20 minutes earlier, but who now ( at the time this ECG was recorded ) — was no longer having symptoms. In view of this history — How would YOU interpret this ECG? Should the cath lab be activated? Figure-1: The initial ECG in today's case. ( To improve visualization — I've digitized the original ECG using PMcardio ).

Blog 145

More Trending

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Shawn Pew Puts Customers First as New VP of Service

Cassling

With more than two decades of experience on the Cassling service team, Shawn stands ready to lead the organization in delivering unmatched OEM service and response times on Siemens Healthineers systems while expanding the company’s ability to provide vendor-agnostic service across the Midwest.

Blog 98
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75 year old dialysis patient with nausea, vomiting and lightheadedness

Dr. Smith's ECG Blog

Written by Jesse McLaren A 75 year-old patient with diabetes and end stage renal disease was sent to the ED after dialysis for three days of nausea, vomiting, loose stool, lightheadedness and fatigue. RR18 sat 99% HR 90 BP 90/60, afebrile. Below is the 15 lead ECG. What do you think? There’s normal sinus rhythm, normal conduction, normal axis, normal R wave progression and normal voltages.

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Ep 186 Traumatic Dental Emergencies

ECG Cases

In this part 2 of our 2-part podcast series on dental emergencies we cover traumatic dental emergencies. Dental trauma is common and often associated with facial trauma. In this episode Dr. Chris Nash and Dr. Richard Ngo answer questions like: at what age is it safe to attempt reimplantation of an avulsed tooth in the ED? What are the 3 most time-sensitive dental trauma emergencies?

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Dip and plateau pattern of ventricular pressure tracing in constrictive pericarditis

All About Cardiovascular System and Disorders

Dip and plateau pattern of ventricular pressure tracing in constrictive pericarditis Thickened and stiff pericardium in chronic constrictive pericarditis has poor compliance reducing the distension of cardiac chambers to a limited fixed total volume. Transmission of intrathoracic pressure to the pericardial cavity is also prevented by thickening of the pericardium [1].

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ECG Blog #391 — Asymptomatic but Irregular.

Ken Grauer, MD

This patient was seen in the office — and during his exam, was found to have an “irregular heart beat”. He was not symptomatic with the ECG shown in Figure-1. How would YOU interpret this ECG? As the primary care clinician — What would YOU do? Extra Credit ( which is a HINT to the Answer! ): How many beats are recorded on the ECG in Figure-1 ? Figure-1: The initial ECG in today’s case. ( To improve visualization — I've digitized the original ECG using PMcardio ).

Blog 78
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Ancestral diversity in lipoprotein(a) studies helps address evidence gaps

Open Heart

Introduction The independent and causal cardiovascular disease risk factor lipoprotein(a) (Lp(a)) is elevated in >1.5 billion individuals worldwide, but studies have prioritised European populations. Methods Here, we examined how ancestrally diverse studies could clarify Lp(a)’s genetic architecture, inform efforts examining application of Lp(a) polygenic risk scores (PRS), enable causal inference and identify unexpected Lp(a) phenotypic effects using data from African (n=25 208), East

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Final Result of the Call for Reviewers

International Journal of Cardiovascular Sciences

It is with great pleasure that we announce the list of selected reviewers to contribute to the International Journal of Cardiovascular Science (IJCS). These experts will play a fundamental role in ensuring the quality and scientific rigor of the research published in our journal. The selected names will receive an email with instructions for their registration in the system.

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OMI Pocket Guide

Dr. Smith's ECG Blog

? OMI Pocket Guide The OMI Pocket Guide ( [link] ) is a user-friendly online resource designed to help healthcare professionals learn how to recognize subtle signs of acute coronary occlusion on the ECG which represent occlusion myocardial infarctions (OMI). Learning to recognize OMIs is an important clinical skill because it helps identify the subpopulation of "NSTEMIs" who are likely to be found with total thrombotic occlusion at the time of cardiac catherization.

Blog 73
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Do Statins Cause Diabetes?

Dr. Paddy Barrett

Life would be so much easier if there were binary, yes and no answers to every question that was important to us. But there isn’t. And even for so many of the questions you ‘ think ’ that have clear-cut answers, there actually aren’t. You just think there are. Let me explain. Subscribe now Does speeding cause car crashes? Most of you would agree that the answer here is a clear ‘ yes ’ But it’s not.

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Is My Cardiology EHR Software The Right Choice for My Clinic?

GEMMS

Healthcare technology is an important asset for any clinic or specialty practice. Selecting the proper Electronic Health Record (EHR) software is crucial for specialty clinics, such as Cardiology Clinics. It can significantly impact the efficiency and effectiveness of patient care, making it essential to choose wisely to provide exceptional services and stay ahead in this dynamic industry.

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ECG Blog #390 — No Information Provided.

Ken Grauer, MD

I was sent the ECG in Figure-1 , with a request for my opinion — without the benefit of any history. How would YOU interpret the ECG in Figure-1 ? What might you suspect clinically? Figure-1: The initial ECG in today’s case. ( To improve visualization — I've digitized the original ECG using PMcardio ). MY Thoughts on the ECG in Figure-1: In these days of widespread smart phone availability — transmission of ECGs to request expert opinion is an increasingly used practice, that on many occasions o

Blog 78
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SICK SINUS SYNDROME

ECG Guru

This EKG shows the classic features of sick sinus syndrome. Initially, there is an accelerated atrial rhythm/atrial tachycardia. After a pre-automatic pause of 2609 ms, a ventricular premature beat occurs, followed by a junctional escape rhythm. Pre-automatic pause is a pause after a tachycardia and before an automatic rhythm, like sinus rhythm or, in this case, junctional escape rhythm.

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The BE-ALIVE score: assessing 30-day mortality risk in patients presenting with acute coronary syndromes

Open Heart

Aim To create and validate a simple scoring system for predicting 30-day mortality in patients presenting with acute coronary syndromes (ACS) at their moment of admission. Methods and results 2407 consecutive patients presenting to Harefield Hospital with measured arterial blood gases, from January 2011 to December 2020, were studied to build the training set. 30-day mortality in this group was 17.2%.

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A woman in her 70s with chest pain

Dr. Smith's ECG Blog

Case sent by Logan Stark MD, written by Pendell Meyers A woman in her 70s presented with acute chest pain. It started 10 hours prior to arrival, then had improved, then recently returned. No prior ECG was available. Here is her triage ECG: What do you think? The ECG was sent to me with no information, and I replied "OMI". I sent this ECG to the Queen of Hearts (PMcardio OMI), and here is the verdict: V1 and V2 have abnormal STE, and V2 has a hyperacute T wave.

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Debunking Myths About Cardiac Health and Heart Diseases

Wellnest

Introduction One of the biggest causes of death worldwide continues to be cardiovascular disease. Unfortunately, there are numerous myths and misconceptions surrounding cardiac health that can lead to misinformation and, ultimately, jeopardize our well-being. In this blog, we will unravel some of the most common myths about cardiac health and heart diseases while providing accurate and evidence-based information to promote a healthy lifestyle.

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APOE4 & Cardiovascular Risk

Dr. Paddy Barrett

Being a carrier of the APOE4 gene variant is associated with higher rates of the most common type of dementia, late-onset dementia. There are three primary variants of APOE - APOE2, APOE3 & APOE4. Everyone has two separate copies. One inherited from either parent. As a result, there are six different possible combinations. APOE 2/2, 2/3, 2/4, 3/3, 3/4, 4/4.

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CineECG is the next step

CineECG

Mayo Podcast interview: Gorgels indicates he thinks CineECG is the next step into the development of electrocardiography. In the recent weeks an ECG centered Mayo Clinic podcasts focused on CineECG. Both our co-founder and scientific director Dr. Peter van Dam and the distinguished cardiologist prof. Ton Gorgels were interviewed by dr Anthony Kashou MD of the Mayo Clinic’s ECG segment Making Waves series.

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Convergent Procedure to Treat Atrial Fibrillation

CTVS

It is estimated that more than 12 million people in the United States will have Atrial Fibrillation, or AFib in 2030. It is one of the most commonly diagnosed heart conditions and is characterized by an irregular heartbeat or rhythm, known as arrhythmia. If left untreated, this erratic heartbeat can disrupt blood flow and lead to serious life-threatening issues like stroke or heart failure.

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Association between implanted cardioverter-defibrillators and mortality for patients with left ventricular ejection fraction between 30% and 35%

Open Heart

Background Consensus guidelines support the use of implanted cardioverter-defibrillators (ICD) for primary prevention of sudden cardiac death in patients with either non-ischaemic or ischaemic cardiomyopathy with left ventricular ejection fraction (LVEF) ≤35%. However, evidence from trials for efficacy specifically for patients with LVEF near 35% is weak.

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Podcast CAMP 2023 Tickets on Sale Now

ECG Cases

Podcast CAMP 2023 tickets are on sale now through podcastcamp.org. Podcast CAMP the only online comprehensive course dedicated to medical education podcast production – by podcasters – for podcasters. Whether you’re a beginner or a seasoned pro, this interactive, small-group, hands-on immersive experience with Anton Helman will help you not only sharpen your technical podcasting skills, but give you valuable knowledge, tips and tricks to produce your own high quality educational and impactful po

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90 years man gets a successful Beating Heart Bypass Surgery

Dr. Prateek Bhatnagar

In a very rare surgery, renowned heart surgeon Dr. Prateek Bhatnagar has successfully done a quadruple bypass surgery on a 90 years old man, hailing from Raipur. The bypass surgery was done on the beating heart using total arterial revascularisation. No cuts were made on the legs. The bypass operation was done without open heart surgery, without any cuts on heart and without stopping the heart.

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What I wish I knew back then: “Stop apologizing for needing help!”

Heart Sisters

Before being sent home from the Emergency Department, I apologized for "making a fuss over nothing" to the Emergency staff who had just misdiagnosed my heart attack. Why do women tend to do that?

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New AI model could help screen for heart defect

Medical Xpress - ECG

Investigators from Brigham and Women's Hospital and Keio University in Japan have developed a deep learning artificial intelligence model to screen electrocardiogram (ECG) for signs of atrial septal defects (ASD). This condition can cause heart failure and is underreported due to a lack of symptoms before irreversible complications arise. Their results are published in eClinicalMedicine.

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A Complete Guide to an ECG Machine’s Certifications, Standards & Compliances

Wellnest

Introduction Electrocardiogram (ECG) machines are vital in diagnosing and monitoring various cardiac conditions. As these devices become increasingly integrated into healthcare systems, ensuring machines’ safety, performance, and compliance with regulatory standards becomes paramount. ECG machine certification is crucial in achieving these goals and building trust among healthcare providers and patients.

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Antiplatelet therapy and long-term mortality in patients with myocardial injury after non-cardiac surgery

Open Heart

Backgrounds Myocardial injury after non-cardiac surgery (MINS) has recently been accepted as a common complication associated with increased mortality. However, little is known about the treatment of MINS. The aim of this study was to investigate an association between antiplatelet therapy and long-term mortality after MINS. Methods From 2010 to 2019, patients with MINS, defined as having a peak high-sensitivity troponin I higher than 40 ng/L within 30 days after non-cardiac surgery, were screen

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Welcome Vascular Surgeon Dr. Kofi Quaye

CTVS

Throughout our 65-year history at CTVS, we have always been proud to assemble the most talented team of cardiothoracic and vascular surgeons in Central Texas. We are thrilled to announce the addition of a new member to our team vascular surgeon Dr. Kofi B. Quaye who will begin seeing patients in September. Dr.

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3 Must-Haves of Any Office-Based Lab

Cassling

Are you getting ready to open, or currently operating, an Office-Based Lab (OBL) or Ambulatory Surgery Center (ASC)? When you’re unable to rely on hospital administration or a purchasing manager to oversee the business end of your practice, including purchasing, service contracts, staffing, reimbursement and more, it’s imperative that you keep costs contained while simultaneously investing in equipment that will stand the test of time, supported by a reliable, all-encompassing service contract.

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How To Test For Insulin Resistance

Dr. Paddy Barrett

Insulin resistance is a core risk factor for the three leading causes of death: Cardiovascular Disease Cancer Dementia. Insulin resistance is unlikely to be the primary causal factor for these conditions but is likely to be a major accelerant. Subscribe now Take cardiovascular disease, for example. With no insulin resistance and high APOB (LDL-C), the risk of future heart events increases by about 80%.

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Who Is At Risk for Heart Disease?

AMS Cardiology

Heart disease remains a prevalent and serious health concern that affects millions worldwide. Understanding the risk factors, recognizing the signs and seeking guidance from a cardiologist can play a significant role in preventing and treating this disease. Below, the heart doctors at AMS Cardiology explain who’s at risk and the signs of a cardiovascular problem and highlight why it’s necessary to seek help from a cardiologist for optimal heart health.

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Patient Engaged Research Funding

Conquering CHD

Research Matters. Conquering CHD exists to conquer the most common birth defect. As an organization made up entirely of CHD patients, families, and medical experts, we build knowledge, create visibility, and empower all impacted by congenital heart disease. One way that Conquering CHD achieves our mission is to champion patient engaged research. We do this through advocacy, consultation, collaboration, and direct funding.