Ken Grauer, MD
NOVEMBER 10, 2023
== — CLICK HERE — for a V ideo presentation of this case! Below are slides used in my video presentation. For full discussion of this case — See ECG Blog #220 — == The long lead II rhythm strip shown in Figure-1 was obtained from an 51-year-old man who presented to the ED ( Emergency Department ) with "palpitations" that began 1 hour earlier. HOW would you interpret this tracing?
Science Daily - Stroke
NOVEMBER 30, 2023
Researchers have succeeded in restoring lost brain function in mouse models of stroke using small molecules that in the future could potentially be developed into a stroke recovery therapy.
Dr. Smith's ECG Blog
NOVEMBER 29, 2023
Written by Pendell Meyers Two adult patients in their 50s called EMS for acute chest pain that started within the last hour. Both were awake and alert with normal vital signs. Both cases had an EMS ECG that was transmitted to the ED physician asking "should we activate the cath lab?" What do you think? Here they are: Patient 1, ECG1: Zoll computer algorithm stated: " STEMI , Anterior Infarct" Patient 2, ECG1: Zoll computer algorithm stated: "ST elevation, probably benign early repolarization.
ECG Cases
NOVEMBER 28, 2023
On this month's EM Quick Hits podcast: Anand Swaminathan on update to ED management of postpartum hemorrhage, Nour Khatib on serotonin syndrome and its mimics, Katie Lin on an approach to recognition and management of severe TBI and brain herniation syndromes, Hans Rosenberg on the ED management of ulcerative colitis, Heather Cary on pediatric c-spine immobilization controversies and techniques, Navpreet Sahsi on the difference between humanitarian and development work The post EM Quick Hits 53
Med Page Today
NOVEMBER 30, 2023
(MedPage Today) -- Giving unstable brain-dead heart donors intravenous levothyroxine did not lead to more hearts being transplanted, a randomized trial showed. In hemodynamically unstable potential donors, administering the thyroid hormone supplement.
American Heart News - Heart News
NOVEMBER 30, 2023
DALLAS and WASHINGTON (Nov. 30, 2023) — The American Heart Association (AHA) and the American College of Cardiology (ACC), along with several other leading medical associations, have issued a new guideline for preventing and optimally managing atrial.
Ken Grauer, MD
NOVEMBER 25, 2023
== CLICK HERE — for a V ideo presentation of this case! ( 19:40 min. ) Below are slides used in my video presentation. For full discussion of this case — See ECG Blog #191 — == The 2-lead rhythm strip shown in Figure-1 was obtained from an elderly woman who presented to the ED following a syncopal episode. On the basis of this rhythm strip — she was diagnosed as being in complete AV Block.
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Dr. Smith's ECG Blog
NOVEMBER 17, 2023
I was texted this ECG just as I was getting into bed. It is of an elderly woman who complained of shortness of breath and had a recent stent placed. I was told that the Queen of Hearts had called it OMI with high confidence. What do you think? Ken (below) is appropriately worried about pulmonary embolism from the ECG. What I had not told him before he made that judgement is that the patient also had ultrasound B-lines of pulmonary edema.
ECG Cases
NOVEMBER 7, 2023
You diagnose uncomplicated appendicitis in the ED. The on call General Surgery team wants to wait until the next morning to perform an appendectomy. Is your patient at risk for appendiceal perforation with a delay to surgery? Dr. Rohit Mohindra and Dr. Shelley McLeod analyze the latest RCT that attempts to answer this question, the PERFECT study, on this EM Cases Journal Club.
Science Daily - Heart Disease
NOVEMBER 9, 2023
Allergic responses to common foods such as dairy and peanuts can increase the risk for heart disease and cardiovascular death as much or more than smoking, new research suggests. And these dangerous allergic responses can strike both people with food allergies and those with no obvious allergy symptoms.
American Heart News - Heart News
NOVEMBER 29, 2023
Research Highlights: People diagnosed with coronary heart disease had a significantly increased risk of developing dementia later in life, according to an analysis of data for more than 430,000 people from the UK Biobank. Participants who had.
Ken Grauer, MD
NOVEMBER 4, 2023
You are told that the patient next door is in the regular SVT ( S upra V entricular T achycardia ) rhythm shown in Figure-1. QUESTIONS: Is the rhythm AVNRT or AVRT? Is Adenosine likely to convert this rhythm? Figure-1: How would YOU interpret this ECG? MY Thoughts on the ECG in Figure-1: When faced with a challenging cardiac arrhythmia — It is a "luxury" to have access to a long lead rhythm strip containing 3 simultaneously -recorded leads.
ECG Guru
NOVEMBER 11, 2023
This interesting case was provided by Dr. Bojana Uzelac, Emergency Medicine physician. We are paraphrasing a translation of her comments here. The patient is a 50-year-old complaining of chest pain. The ECG shows a rare occurrence – an isolated POSTERIOR WALL MI (PWMI). Note that leads V1 through V4 show the usual signs of posterior wall MI. We see ST segment depression, which represents a reciprocal view of the ST elevation present on the posterior wall of the left ventricle.
Dr. Smith's ECG Blog
NOVEMBER 14, 2023
In the last post, we saw how important old ECGs are in assessing the current ECG in a patient without atypical presentation (in this previous case, the patient had no chest pain, and the apparent inferior OMI did not have reciprocal ST depression in lead aVL). Here is that last post: A 90-something with acute stroke. She has no chest symptoms. What is the diagnosis?
Cassling
NOVEMBER 2, 2023
It’s one of the best weeks of the year – National Radiologic Technologist Week! Cassling’s annual commemoration of Rad Tech Week has taken place for 14 years, and for good reason, this week is an opportunity to stop and appreciate the hard work technologists, physicians, support teams and other healthcare workers put forth to ensure a compassionate, high-quality patient experience.
ECG Cases
NOVEMBER 7, 2023
Key principles and approach to management of both non-massive and massive hemoptysis with Dr. Scott Weingart and Dr. Bourke Tillmann, who answer questions such as: What are the factors to consider in the decision to intubate patients with massive hemoptysis? How can one reliably distinguish hemoptysis from pseudohemoptysis? What is the evidence for tranexamic acid in patients with hemoptysis?
Science Daily - Heart Disease
NOVEMBER 9, 2023
Replacing sitting with as little as a few minutes of moderate exercise a day tangibly improves heart health, according to new research.
Ken Grauer, MD
NOVEMBER 18, 2023
== — CLICK HERE — for a V ideo presentation of this case! ( 15 minutes ) Below are slides used in my video presentation. For full discussion of this case — See ECG Blog #344 — == How would YOU interpret the lead II rhythm strip shown in Figure-1 ? Is the rhythm Mobitz I or Mobitz II 2nd-degree AV Block? Or — Is it “ something else ”? Figure-1: How would YOU interpret this lead II rhythm strip?
JAMA Cardiology
NOVEMBER 30, 2023
This secondary analysis of a randomized clinical trial assesses whether myocardial viability testing identifies patients with ischemic left ventricular dysfunction who benefit from percutaneous coronary intervention.
Dr. Smith's ECG Blog
NOVEMBER 22, 2023
To learn more about Occlusion MI, join us in this Free Webinar on November 27 12 noon US Central Time: Sign up at this link: [link] Infection and DKA, then sudden dyspnea while in the ED A 63 year old male with a PMH of CAD and peripheral vascular disease from type 1 DM presented to clinic and was found to have a very high blood sugar and so was sent to the emergency department.
Cassling
NOVEMBER 17, 2023
With so many technological advancements happening across all of healthcare, it’s easy to lose sight of the incredible evolution happening to one of the cornerstones of the hospital imaging experience: MRI. 2024 will continue to see a number of improvements to the MRI patient experience, the workflows of imaging teams and the systems that are crucial to ensuring the image is of the highest quality necessary to aid in a successful diagnosis.
Circulation
NOVEMBER 29, 2023
Circulation, Ahead of Print. AimThe “2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation” provides recommendations to guide clinicians in the treatment of patients with atrial fibrillation.MethodsA comprehensive literature search was conducted from May 12, 2022, to November 3, 2022, encompassing studies, reviews, and other evidence conducted on human subjects that were published in English from PubMed, EMBASE, the Cochrane Library, the Agency for Healthcare Re
Science Daily - Heart Disease
NOVEMBER 13, 2023
Researchers have discovered the mechanism by which cholesterol in our diet is absorbed into our cells. This discovery opens up new opportunities for therapeutic intervention to control cholesterol uptake that could complement other therapies and potentially save lives.
The New England Journal of Medicine
NOVEMBER 29, 2023
Wearable DHT has reached an inflection point between fanciful descriptions and practical applications. The editors announce a series of articles focusing on the clinical applications of wearable DHT.
Stroke Journal
NOVEMBER 30, 2023
Stroke, Ahead of Print. BACKGROUND:Stroke survivors with impaired balance and motor function tend to have relatively poor functional outcomes. The cerebellum and primary motor cortex (M1) have been suggested as targets for neuromodulation of balance and motor recovery after stroke. This study aimed to compare the efficacy and safety of intermittent theta-burst stimulation (iTBS) to the cerebellum or M1 on balance and motor recovery in patients with stroke.METHODS:In this randomized, double-blind
Dr. Smith's ECG Blog
NOVEMBER 15, 2023
A 70-something female with no previous cardiac history presented with acute chest pain. She awoke from sleep last night around 4:45 AM (3 hours prior to arrival) with pain that originated in her mid back. She stated the pain was achy/crampy. Over the course of the next hour, this pain turned into a pressure in her chest. She said this was midsternal and felt like a tightness.
Journal of Cardiovascular Electrophysiology
NOVEMBER 29, 2023
Abstract Left ventricular assist device (LVAD) implantation is an established treatment for patients with advanced heart failure refractory to medical therapy. However, the incidence of ventricular arrhythmias (VAs) is high in this population, both in the acute and delayed phases after implantation. About one-third of patients implanted with an LVAD will experience sustained VAs, predisposing these patients to worse outcomes and complicating patient management.
Circulation
NOVEMBER 29, 2023
Circulation, Ahead of Print. BACKGROUND:Cholesterol efflux capacity (CEC) predicts cardiovascular disease independently of high-density lipoprotein (HDL) cholesterol levels. Isolated small HDL particles are potent promoters of macrophage CEC by the ABCA1 (ATP-binding cassette transporter A1) pathway, but the underlying mechanisms are unclear.METHODS:We used model system studies of reconstituted HDL and plasma from control and lecithin-cholesterol acyltransferase (LCAT)–deficient subjects to inve
Science Daily - Heart Disease
NOVEMBER 13, 2023
Nearly everyone can lower their blood pressure, even people currently on blood pressure-reducing drugs, by lowering their sodium intake, reports a new study. It found 70-75% of all people, regardless of whether they are already on blood pressure medications or not, are likely to see a reduction in their blood pressure if they lower the sodium in their diet.
European Journal of Heart Failure
NOVEMBER 29, 2023
ABSTRACT Aims Heart failure outcomes remain poor despite advances in therapy. The European Society of Cardiology Heart Failure III Registry (ESC HF III Registry) aims to characterize HF clinical features and outcomes and to assess implementation of guideline-recommended therapy in Europe and other ESC affiliated countries. Methods Between 1 November 2018 and 31 December 2020, 10 162 patients with chronic or acute/worsening HF with reduced, mildly reduced, or preserved ejection fraction were enro
Cassling
NOVEMBER 10, 2023
Breast cancer is the second most common cancer among women in the United States. Currently, it accounts for nearly 30% of all new female cancers each year. For 2023, the American Cancer Society estimated that 297,790 new cases of invasive breast cancer would be diagnosed and about 43,700 women would die from breast cancer. Despite the high number of diagnoses, the death rate from breast cancer has been decreasing steadily in the US since 1989.
Dr. Smith's ECG Blog
NOVEMBER 5, 2023
By Magnus Nossen, edits by Grauer and Smith The patient is a 70-something female with DMII, HTN and an extensive prior history of coronary artery disease and myocardial infarctions. She's had multiple PCI procedures. She also has sick sinus syndrome (SSS) and intermittent high grade AV block for which she had a dual chamber pacemaker implanted. On the day of presentation she complained of typical chest pain, and stated it feels like prior MI.
Journal of the American Heart Association
NOVEMBER 29, 2023
Journal of the American Heart Association, Volume 12, Issue 23 , December 5, 2023. BackgroundThe association of age at coronary heart disease (CHD) onset with incident dementia remains unexplored. This study aimed to examine whether younger onset age of CHD is associated with a higher risk of incident dementia.Methods and ResultsData were obtained from the UK Biobank.
Stroke Journal
NOVEMBER 28, 2023
Stroke, Ahead of Print. BACKGROUND:Dental caries is a highly prevalent disease worldwide. In the United States, untreated dental caries is present in >1 in 5 adults. The objective of this study was to determine the relationship between dental caries and incident ischemic stroke, coronary heart disease (CHD) events, and death.METHODS:The dental cohort (n=6351) of the ARIC study (Atherosclerosis Risk in Communities) was followed for incident ischemic stroke, CHD event, and all-cause mortali
JAMA Cardiology
NOVEMBER 30, 2023
This cross-sectional study measures the association of lipoprotein(a) concentrations in pairs of first- and second-degree relatives of participants in the UK Biobank with high lipoprotein(a) levels.
Becker's Hospital Review - Cardiology
NOVEMBER 30, 2023
Sacramento, Calif.-based Sutter Health has taken part in testing and researching a headset designed to help emergency technicians better identify large vessel occlusion ischemic strokes prior to patients arriving at the hospital.
Science Daily - Heart Disease
NOVEMBER 28, 2023
Heart disease kills 18 million people each year, but the development of new therapies faces a bottleneck: no physiological model of the entire human heart exists -- so far. A new multi-chamber organoid that mirrors the heart's intricate structure enables scientists to advance screening platforms for drug development, toxicology studies, and understanding heart development.
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