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The ECG in Figure-1 — was obtained from an older woman with persistent CP ( C hest P ain ) over the previous day. Her symptoms lessened after Nitroglycerin — so the decision was made not to activate the cath lab. Do YOU agree with this decision? Figure-1: The initial ECG in today's case. MY Thoughts on the ECG in Figure-1: In a patient with CP that had been persistent over the previous day ( until Nitroglycerin was given ) — the initial ECG shown in Figure-1 is extremely worrisome.
(May 10, 2023) Omaha, Nebraska – Cassling, an imaging and therapeutic technology, services and solutions vendor, is launching a new team to expand its industry partnerships and make its vision a reality. The business unit, Growth & Innovation, is tasked with bringing new services and solutions to market to help healthcare organizations solve their imaging pain points, remain viable and keep providers local.
Written by Pendell Meyers A man in his early 40s experienced acute onset chest pain. The chest pain started about 24 hours ago, but there was no detailed information available about whether his pain had come and gone, or what prompted him to be evaluated 24 hours after onset. EMS arrived and recorded this ECG: What do you think? See same ECG below with computer automated interpretation, using the Glasgow ECG algorithm which apparently is used by many different providers and devices Amazing that
VTT Technical Research Centre of Finland has developed a new sustainable electrocardiogram (ECG, also known as EKG) patch that is fully recyclable and made of biomaterials. The device is modular, so electronic components can be easily removed from the disposable patch and used again. The patch itself is made of nanocellulose and printed with carbon conductors and sensing electrodes.
Speaker: Simran Kaur, Co-founder & CEO at Tattva Health Inc.
AI is transforming clinical trials—accelerating drug discovery, optimizing patient recruitment, and improving data analysis. But its impact goes far beyond research. As AI-driven innovation reshapes the clinical trial process, it’s also influencing broader healthcare trends, from personalized medicine to patient outcomes. Join this new webinar featuring Simran Kaur for an insightful discussion on what all of this means for the future of healthcare!
Welcome to Dr. Andreas Roeschl, who is a cardiologist and ECG instructor in Germany. He will have a recurring blog on the Guru, contributing his knowledge about ECG and teaching, along with ECGs from his collection. His ECGs are digitized and beautiful quality for reproduction, and his contributions will be a great asset to any student or teacher of ECG.
In this part 2 of our 2-part series on STIs with Dr. Catherine Varner and Dr. Robyn Shafer we answer such questions as: Why should we care about making the diagnosis of pelvic inflammatory disease (PID) in the ED? What combination of clinical features and lab tests should trigger a presumptive diagnosis and empiric treatment of PID? Which patients with PID require admission to hospital?
The ECG in Figure-1 was obtained from a 60-ish year old man with a history of coronary disease ( including prior CABG ) — who presented to the ED ( E mergency D epartment ) with new CP ( C hest P ain ) of 3 hours duration , diaphoresis and nausea/vomiting. The patient was hypotensive at the time his initial ECG in Figure-1 was obtained. The decision was made not to immediately perform cardiac cath — because there is no ST elevation in Figure-1 — and because the initial troponin was negative.
The ECG in Figure-1 was obtained from a 60-ish year old man with a history of coronary disease ( including prior CABG ) — who presented to the ED ( E mergency D epartment ) with new CP ( C hest P ain ) of 3 hours duration , diaphoresis and nausea/vomiting. The patient was hypotensive at the time his initial ECG in Figure-1 was obtained. The decision was made not to immediately perform cardiac cath — because there is no ST elevation in Figure-1 — and because the initial troponin was negative.
Improving CRT response in heart failure patients is another CineECG feature. Next to the HRS 2023 presentation regarding the added value of CineECG in identifying the origin of atrial ectopic activity ( see our previous blog ) last week’s conference in New Orleans also became a platform for presenting another clinical added value option of CineECG.
A 20-something presented after a huge verapamil overdose in cardiogenic shock. He had been seen at an outside institution and been given 6 g calcium gluconate, KCl, and a norepinephrine drip. The initial K was 3.0 mEq/L and ionized calcium was 5.5 mg/dL (sorry, Europeans, for the weird units) Here was the initial ED ECG: There is a junctional rhythm with retrograde P-waves (see the dip in the T-wave in lead II across the bottom; you can follow that up to all the other leads and see the retrograd
Expert Consensus Statement and Remote Patient Monitoring Guidelines What does the Heart Rhythm Society’s new Expert Consensus Statement say? The Heart Rhythm Society recently unveiled the new 2023 HRS/EHRA/APHRS/LAHRS Expert Consensus Statement on Practical Management of the Remote Device Clinic , marking significant progress since the previous 2015 version, which originally identified remote monitoring as the standard of care for implantable cardiac device clinics.
This ECG comes from a 75 yo man who had 2 syncopes in the past few weeks. The 12-lead-EKG at the family doctor showed an inconspicuous finding. Here you can see a section of the patients Holter ECG. There is a very slow junctional escape rhythm. How can this be recognized?
The Midwest company will begin offering EchoSolv, an artificial intelligence clinical decision support platform designed to help detect severe aortic stenosis, to providers throughout the country. Omaha, Neb. – May 25, 2023 – Cassling has announced a partnership with the goal of benefitting cardiovascular practices throughout the United States.
I was sent the rhythm strip shown in Figure-1 — obtained from telemetry monitoring. I did not know the history. Can YOU explain what happens after beat #4? Figure-1: Multi-lead rhythm strip obtained from telemetry monitoring. MY Thoughts on the Rhythm Strip in Figure-1: The first 4 beats in this 11-beat rhythm strip are sinus — as determined by the presence of regular upright P waves , with a constant PR interval in lead II ( RED arrows in Figure-2 ).
Exiting news regarding the use of CineECG in localizing the origin of atrial ectopic activity. HRS 2023 is a wrap! Over the past 3 days cardiologists from all over the world met in New Orleans to learn and discuss the developments in technology and patient care. As ECG Excellence we are proud our CineECG technology was part of this innovation festival.
A 50-something man presented in shock with severe chest pain. His prehospital ECG was diagnostic of inferior posterior OMI. The patient was in clinical shock with a lactate of 8. BP was 108 systolic (if a cuff pressure can be trusted) but appeared to be maintaining BP only by very high systemic vascular resistance. He appeared gray in color, with cool skin.
Patient Care Depends on Connectivity: How To Engage Patients in their Remote Monitoring Care More than 88% of clinics report that patient connectivity to their remote monitoring devices are a major concern for their cardiac device clinics. Yet, with increasing patient population and ongoing staffing shortages, clinics do not have the resources to dedicate to patient compliance.
This ECG is from an 80-year-old lady who has collapsed or had sycopal episodes several times. The ECG comes from a Holter monitor. She has arterial hypertension and coronary artery disease. The ECG shows a second-degree, Mobitz Type II AV block. In both types of AVB, the PP intervals are usually the same.
Dr. Reynolds and Dr. Mittal, authors of the CAMELOT study, discuss ambulatory cardiac monitoring and retrospective analysis of data from Medicare claims.
The ECG in Figure-1 — was obtained from an older woman with chest pain. How would YOU interpret this tracing? What kind of AV block is present? — OR — Is there no clear evidence of any AV block? 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: This tracing is challenging to interpret because of the changing QRS morphology — and because of the uncertainty regarding atrial activity.
cineecg flow inferior wall infarct In this blog we will address a case of identifying a specific case of a heart infarct, in particular an infarct in the lower part of the heart (Inferior wall infarction ; RCA distal to the RV branch). In an earlier blog we focused on an extensive anterior wall infarction and the ease of using CineECG to read the related ECG.
I received the following text message with these 3 EKGs (providers text me ECGs all day every day; most are false positives; many are subtle true positives): "Hi Steve, here are 3 EKGs for you (my colleague's case). A 67 yo f developed chest pain this morning." EKG #1 Followed 15 minutes by this #2 EKG: Then the patient received aspirin and Dilaudid (hydromorphone, same effect as morphine) and the pain went away and there was this 3rd ECG: Smith comment: hydromorphone will make any pain go away
Blog How Can I Get the Latest, Greatest Tech at My Institution? KCummings Wed, 05/17/2023 - 13:11 Surgeon Image Elisabeth Dexter, MD Scenario: You finished CT surgery residency last June and are the newest assistant professor at Perfect University. You just returned from the STS Annual Meeting and saw the GeeWhiz Gadget in the Exhibitor Hall. You know GeeWhiz will fix all the issues you’ve been having with X procedure at your new institution.
Science has a long history of being subsumed to serve rabid ideologues. Soviet biologist Trofim Lysenko famously rejected the objective reality of Mendelian genetics because it clashed with the Marxist philosophy that the environment, not genetics, was the primary determinant of outcomes. The Soviet party was enamored by Lysenko because his “Science” said that soaking crops in freezing water would educate them to sprout at different times of the year, and even more startlingly, this
Objective To evaluate whether transcatheter or surgical aortic valve replacement (TAVR or SAVR) affects clinical and haemodynamic outcomes in symptomatic patients with moderately-severe aortic stenosis (AS). Methods Echocardiographic evidence of severe AS for enrolment in the Evolut Low Risk trial was based on site-reported measurements. For this post hoc analysis, core laboratory measurements identified patients with symptomatic moderately-severe AS (1.0<aortic valve area (AVA)<1.5 cm 2
In this ECG Cases blog we look at 10 cases of patients with chest pain, including false positive STEMI, false negative STEMI, and other causes to help hone your ECG interpretation skills in time-sensitive cases where those very ECG skills might save a life. The post ECG Cases 42 – Approach to ECG Interpretation in Patients with Chest Pain: OMI, False Positive & Negative STEMI & Other Causes appeared first on Emergency Medicine Cases.
How to Incorporate Remote Patient Monitoring Into Existing Workflows Remote patient monitoring (RPM) is a service under the telemedicine umbrella that uses specialized technology to track patient health data in real time, integrating care updates into clinic workflows as needed. RPM plays an important role in cardiac clinics. The technology allows clinicians and staff to respond to rhythm changes, hypertension or more critical alerts as soon as they happen in order to improve outcomes and stream
An elderly patient had a fall from probable syncope, and could not get up. He complained of weakness and shortness of breath, but no CP. Vital signs were normal. Here is the first ED ECG: COMPUTER INTERPRETATION: Electronic Atrial Pacemaker. Marked ST Elevation, ACUTE MI What do you think? First, the QRS is incredibly wide! You should ask for more history.
Templates are pre-designed forms or protocols that can be customized to meet the specific needs of a clinic or provider. They can improve the speed and accuracy of patient care and billing, leading to better diagnoses, more effective treatment plans, and ultimately better patient health outcomes. It’s no secret that healthcare continues to evolve.
Cassling employee and Executive Assistant, Felicia Vasser, was recently recognized as the recipient of the company’s most esteemed honor, the Bob Cassling Service Excellence Award. Named for the company’s founder, Bob Cassling, the award is presented to an individual who goes above and beyond in exemplifying the organization’s culture and values.
Objective There is a substantial incidence of stroke in patients with atrial fibrillation (AF) not receiving anticoagulation. The reasons for not receiving anticoagulation are generally attributed to clinician’s choice, however, a proportion of AF patients refuse anticoagulation. The aim of our study was to investigate factors associated with patient refusal of anticoagulation and the clinical outcomes in these patients.
In this Part 1 or our two-part podcast series on STIs we discuss a general approach to cervicitis, vulvovaginitis and urethritis, elucidate some key historical features, debate who needs a pelvic exam in the ED, understand who needs what testing, debate self swabs vs physician taken swabs, dig into some specific under-recognized organisms like Mycoplasma Genitalium, figure out who needs what kind of empiric treatment, sexual partner treatment and which discharge instructions are key.
Holter Monitors vs. Loop Recorders: A Comparison Remote cardiac monitoring is an essential tool for diagnosing and managing a variety of heart conditions. It enables healthcare professionals to remotely monitor a patient’s cardiac activity over an extended period, providing valuable data for accurate diagnosis and treatment. Two devices commonly used for monitoring are Holter monitors and loop recorders.
This case was provided by Steven Souchtchenko, a recent graduate of our Hennepin Healthcare EM/IM residency (i.e., a former trainee of mine). Case A 45 yo man with no previous cardiac history presented to an ED not associated with a cath lab. He complained of jaw pain radiating to left shoulder for 6 hours. He stated he had had a brief similar episode the evening prior.
A closer look at how cardiovascular care is changing across the country. Throughout my career, I’ve witnessed a lot of changes in healthcare. One constant over my thirty years of experience is that things do not stay the same. I’ve worked with hospitals, provider groups and payers – trying to help drive the right type of access, care, and value across the healthcare continuum.
If you follow Cassling online or interact with our team regularly, you might have noticed a few changes over the last couple months. As our customers’ needs have grown, so too have the requests for Cassling to evolve, to rise to the occasion and solve imaging’s most pressing challenges. We’ve embraced this call for help and launched a strategy to bring new services and solutions to market, with a goal of impacting 350 million patient lives by the year 2030.
Objective Postmarketing observational studies report that a substantial percentage of patients with atrial fibrillation (AF) receive a reduced non-vitamin K antagonist oral anticoagulant (NOAC) dose without a clear indication. Recently, increasing evidence has become available to explore the clinical consequences of such off-label reduced dosing (OLRD).
This secondary analysis of the HOST-EXAM randomized clinical trial evaluates clopidogrel vs aspirin for long-term maintenance after percutaneous coronary intervention in patients with diabetes.
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