December, 2022

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Researchers achieve contactless electrocardiogram monitoring

Medical Xpress - ECG

Recently, a team led by Prof. Chen Yan and researcher Sun Qibin from the University of Science and Technology of China (USTC) achieved contactless electrocardiogram (ECG) monitoring through a millimeter-wave radar system. Their work was published in IEEE Transactions on Mobile Computing and reported by IEEE Spectrum.

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Digital vs Analog ECG Machine - Which one is the right choice for you.

Wellnest

Electrocardiography (ECG) is a diagnostic tool that measures the heart's electrical activity. It is commonly used to diagnose heart attacks, arrhythmias, and other heart conditions. An ECG machine consists of electrodes placed on the patient's chest, arms, and legs, which record the heart's electrical activity and display it on a screen. There are two main types of ECG machines: digital and analog.

Article 52
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A Deep Dive into Aortic Valve Replacement

MIBHS

A normal functioning aortic valve has three leaflets, usually referred to as cusps, and is positioned at the end of the left ventricle. This valve is the main pump that delivers oxygenated blood to the entire body. An aortic valve replacement is required if someone suffers from Aortic Valve Stenosis or Aortic Valve Insufficiency. These two issues can cause a significant number of problems and can be life-threatening.

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Role of platelet function testing in acute coronary syndromes: a meta-analysis

Open Heart

Objective This meta-analysis aimed to evaluate whether using platelet function testing (PFT) in acute coronary syndromes (ACS) to personalise antiplatelet therapy including a P2Y 12 antagonist offers any clinical benefits to indicate incorporation into routine practice. Methods A search was conducted on five databases for randomised controlled trials (RCTs) conducted between 1 January 2000 and 17 July 2022, which included an ADP-specific platelet function assays and P2Y 12 antagonists as part of

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30-something woman with a HEART score of zero, EDACS of 2, computer "Normal" ECG, and initial troponin < Limit of Detection

Dr. Smith's ECG Blog

I was working in triage very late when a 30 yo previously completely healthy woman walked in with 30 minutes of central chest pressure. This ECG was recorded: The computer called it "Normal" except for "Possible right ventricular conduction delay" What do you think? I immediately recognized an inferior-posterior-lateral OMI. There are hyperacute T-waves in II, III, and aVF.

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Recap: Top Imaging News and Insights of 2022

Cassling

In 2022, a few key trends stuck out when reviewing Cassling's most popular articles. The latest technology advances were top of mind, as was patient experience, staffing, and more. In this recap, check out the Top 10 articles of the year to discover what had the imaging world abuzz in 2022.

Article 52
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Advances in detection of erratic heart rhythm

Medical Xpress - ECG

New research supported by the euCanSHare and HealthyCloud projects has revealed that a model combining ECG features and cardiac imaging-derived radiomics data improves the detection of AF in women. The study was published in the journal Scientific Reports.

More Trending

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WTBS 28 I’m OK, How Are You? How can we innovate our way out of this crisis in EM and cope until we do?

ECG Cases

In this month's Waiting to Be Seen blog Dr. Howard Ovens outlines challenges, innovations and coping strategies in the EM Crisis. The post WTBS 28 I’m OK, How Are You? How can we innovate our way out of this crisis in EM and cope until we do? appeared first on Emergency Medicine Cases.

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Incremental value of mineralocorticoid receptor antagonists in patients with heart failure with reduced ejection fraction treated with sacubitril/valsartan

Open Heart

Aims We investigated the incremental advantage in terms of N-terminal pro-B-type natriuretic peptide (NT-proBNP) reduction in patients affected by heart failure with reduced ejection fraction (HFrEF) treated with sacubitril/valsartan (S/V) and mineralocorticoid receptor antagonists (MRA) versus patients treated with S/V only. Methods Consecutive adult patients with a left ventricular ejection fraction (LVEF) of ≤40% who were followed in our outpatient clinic from January 2016 to December 2

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See OMI vs. STEMI philosophy in action

Dr. Smith's ECG Blog

by Emre Aslanger Dr. Aslanger is our newest editorial member. He is an interventional cardiologist in Turkey. Dr. Aslanger is also the author of the DIFFOCULT study: Emre K. Aslanger , a, ⁎ Özlem Yıldırımtürk , b Barış Şimşek , c Emrah Bozbeyoğlu , c Mustafa Aytek Şimşek , a Can Yücel Karabay , b Stephen W. Smith , d and Muzaffer Değertekin a DIFOCCULT: DIagnostic accuracy oF electrocardiogram for acute coronary OCClUsion resuLTing in myocardial infarction.

STEMI 52
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Cryptogenic Stroke

Dr. Sanjay Gupta

Today’s video is on the subject of stroke and in particular cryptogenic strokes. A stroke is often a devastating occurrence for several reasons: A stroke can be life threatening and stroke is widely recognised as a leading cause of death worldwide A stroke can be disabling and can destroy a person’s quality of life A stroke can recur and cause more damage/death the next time.

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RSNA 2022 Highlights the Brave New World of Imaging

Cassling

Every year, the leading minds in imaging gather for the annual Radiological Society of North America meeting in Chicago. It was the event’s second year in person since the start of the COVID-19 pandemic, and attendee numbers are quickly ticking back up now that more and more people have grown comfortable with travel. Healthcare leaders from around the world descended upon McCormick Place to share new research and knowledge and learn about the latest innovations taking the imaging world by storm.

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What Causes Pulse Deficit?

MIBHS

When you are enjoying an athletic activity, you will notice your heart beats faster than when you are just resting and reading a book. When you exercise, your body may need three to four times your average cardiac output. This happens because your muscles need more oxygen when you exert energy. So what causes pulse deficit, and what is it? Pulse deficit is when one finds a difference in count between heartbeat and peripheral pulse.

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ECG Cases 38 – ECG Interpretation in Cocaine Chest Pain

ECG Cases

Dr. Jesse McLaren discusses some key aspects of cocaine chest pain ECG interpretation in this month's blog including: Patients with cocaine-associated chest pain require benzodiazepines +/- nitroglycerine for symptom relief, aspirin and ECG to look for signs of occlusion and reperfusion. In patients with chest pain + ST elevation, consider false positive STEMI including early repolarization, LVH and Brugada-pattern.

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Nutraceutical activation of Sirt1: a review

Open Heart

The deacetylase sirtuin 1 (Sirt1), activated by calorie restriction and fasting, exerts several complementary effects on cellular function that are favourable to healthspan; it is often thought of as an ‘anti-aging’ enzyme. Practical measures which might boost Sirt1 activity are therefore of considerable interest. A number of nutraceuticals have potential in this regard.

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Right Bundle Branch Block and Posterior OMI????

Dr. Smith's ECG Blog

This 39 year old patient presents with syncope. What do you think? There appears to be RBBB with excessively discordant ST depression (2-2.5 mm) in V2 and V3, suggestive of RBBB with posterior OMI Whenever you see abnormal ST-T (ST elevation, ST depression, hyperacute T-waves), you MUST look at the entire ECG (rhythm, rate, P-waves, intervals, and QRS) to see if there is some abnormality among these which can explain the ST-T.

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MINOCA : When a heart attack is not a heart attack

Dr. Sanjay Gupta

The term MINOCA stands for Myocardial infarction with non-obstructive coronary arteries. I’ll try and explain this a bit better by using a case study. A 50-year-old lady was admitted to my hospital with crushing chest tightness. She had an ECG which suggested changes in keeping with a lack of blood getting to the heart. She had a blood test to measure Troponin.

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Shaping the Future of Urology Cancer Care

Cassling

One of the great joys of my role is getting to see the impact a new imaging system can have on a healthcare provider and, ultimately, their patients. In fact, the most rewarding experiences are when we get to see the profound personal effect providers have on their patients. Sometimes that means watching the installation of the facility’s first MRI that will enable them to provide access to their population on a daily basis rather than rely on a once-per-week mobile solution.

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Keep These Heart-Healthy Goals in Mind For Your New Year’s Resolutions

AMS Cardiology

Now is the opportune time to reflect on your year and start visualizing goals and resoluti ons for the new year. As we quickly approach the start of 2023, it’s a great time to reevaluate and refocus our minds on taking good care of ourselves, particularly our heart health. According to the American Heart Association, heart disease is the leading cause of death in men and women in the United States claiming over 650,000 individuals yearly.

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Ep 177 Bronchiolitis – Diagnostic Challenges and Management Pitfalls

ECG Cases

In this main episode podcast Anton discusses with world expert and bronchiolitis researcher Dr. Suzanne Schuh, the challenges of the diagnosis and management of bronchiolitis during a time of crisis in pediatric emergency medicine and offers some evidence-based solutions to improving outcomes while minimizing valuable resources, as part of our 'Best of University of Toronto EM' series.

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Imaging and haemodynamic parameters associated with clinical outcomes following isolated tricuspid valve surgery

Open Heart

Introduction Isolated tricuspid valve surgery (TVS) may be associated with high morbidity and mortality. The aim of this study was to investigate the association of preoperative imaging and haemodynamic data derived from echocardiography (ECHO), cardiac magnetic resonance (CMR) and right heart catheterisation (RHC) with postoperative outcomes following TVS.

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A man in his 50s with acute chest pain and LVH

Dr. Smith's ECG Blog

Sent by Drew Williams, written by Pendell Meyers A man in his 50s with history of hypertension was standing at the bus stop when he developed sudden onset severe pressure-like chest pain radiating to his neck and right arm, associated with dyspnea, diaphoresis, and presyncope. EMS arrived and administered aspirin and nitroglycerin. He reported several weeks of intermittent chest pain similar to the active pain, worsening over the past 2-3 days, some of them as long as an hour, but all spontaneou

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The three things that can go wrong with the heart

Dr. Sanjay Gupta

At first glance, the subject of heart disease can seem exceptionally complex – consisting of several different conditions, medical jargon and very scary sounding terminology. However when we really examine heart disease closely there are in general mainly 3 things that can go wrong with the heart and cause harm and if we know this then we are able to firstly understand the different conditions better but also get our head around why certain tests are done and what they tell us.

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Applications Being Accepted for 2023-24 Bob Cassling Memorial Scholarships

Cassling

The scholarship, which honors the late founder of Cassling, provides financial support to rural healthcare professionals seeking a degree or certification in the imaging or radiation therapy fields. Higher education has never been more important for a diagnostic imaging professional’s career. This year, Cassling is again providing scholarships to current and aspiring imaging professionals to help them achieve a successful career and provide high-quality care for their communities.

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Cleaning out the Augean Stables – Part II

Dr. Malcolm Kendrick

10th December 2022 [The Federal Aviation Authority (FAA), the Food and Drugs Administration, compare and contrast]. A while back I began to write a blog called. ‘ We need a couple of plane crashes. ’ Which may sound a little harsh. But the point I was hoping to make is that plane crashes make front page news around the world. They are highly visible, and terribly frightening.

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Journal Jam 21 Laceration Management – Does Timing of Closure, Irrigation, Gloves Type, Eversion Matter?

ECG Cases

In this Journal Jam podcast Anton and Justin welcome special guest Dr. Haley Cochrane. We dive deep into the evidence for timing of closure and infection rate, fluid choice, volume and pressure of irrigation of lacerations, glove type and infection rate, how eversion of wound edges effects cosmetic outcomes and much more. You might be surprised to discover that the evidence for many things we do for lacerations that are considered "standard of care", is either weak or non-existent.

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CMR feature tracking in patients with dilated cardiomyopathy: patterns of myocardial strain and focal fibrosis

Open Heart

Background There is a paucity of data on cardiovascular magnetic resonance feature tracking (CMR-FT) in patients with dilated cardiomyopathy (DCM). We aimed at describing global and segmental myocardial strain patterns and a potential association with the presence of focal myocardial scarring in DCM patients by CMR-FT. Methods Thirty-nine patients with DCM and reduced left ventricular (LV) ejection fraction (mean 21±8%) underwent CMR including standard cine steady-state free precession (SSF

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On its way from occlusion to reperfusion (or vice versa), the ECG can be normal or near normal

Dr. Smith's ECG Blog

Written by Pendell Meyers I was reading ECGs in a database (without any clinical information) when I came to this one: What do you think? Seeing only this ECG with no context, I thought this ECG was within normal limits. The upright and large T wave in V1 is unusual, but if it were hyperacute, I did not see reciprocal findings in V6 which would be concerning for LAD OMI pattern (we call that "precordial swirl").

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Pericarditis

Dr. Sanjay Gupta

Pericarditis refers to inflammation of the pericardium The pericardium is a sac within which the heart sits. This sac has 2 layers- known as the visceral and parietal layers separated by a potential space which contains about 10-50mls of fluid. Acute inflammation of this sac is known as acute pericarditis. If the inflammation spreads to the surface of the heart itself, it is termed myopericarditis.

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Jardiance for HCM Patients?

HCM Beat

A recent study found that patients with non-obstructive hypertrophic cardiomyopathy and diabetes showed significant improvements to BNP and diastolic heart function from a class of drug used to lower blood sugar known as a sodium glucose co-transponder 2 inhibitor (SGLT2).

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Drug regulation – How does it work?

Dr. Malcolm Kendrick

31st December 2022 Before laying into the drug regulators, and their inexorable move towards the dark side, I thought I should try to explain a bit more about who decides what drugs should be used, and for what conditions. Yes, I know, for most people this appears simple. The Federal Drugs Administration (FDA), in the US, or the European Medicines Agency (EMA), for the European Union, approve drugs for use in human beings, and that’s pretty much that.

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EMC Journal Club 1 – Does Treating Fever Make A Difference?

ECG Cases

In this first EMC Journal Club (where we take the "boring" out of journal clubs and deliver clear, concise, practical practice changing critical appraisal knowledge based on an Emergency Medicine journal article that may have passed your radar - not too detailed and not too brief), Dr. Rohit Mohindra, an Emergency Physician at North York General in Toronto and SREMI researcher works his critical appraisal magic on the article "Fever therapy in febrile adults: systematic review with meta-analyses

Article 52
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Novel approach to artefact detection and the definition of normal ranges of segmental strain and strain-rate values

Open Heart

Aims Strain artefacts are known to hamper the correct interpretation of segmental strain and strain-rate (S/SR). Defining the normal ranges of myocardial segmental deformation is important in clinical studies and routine echocardiographic practice. In order to define artefact-free normal ranges for segmental longitudinal S/SR parameters, we investigated the extent to which different types of artefacts and their segmental localisation in the three different myocardial layers created a bias in the

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Syncope, hypotension, vomiting and diaphoresis in a 60-something male with Diabetes and Hypertension

Dr. Smith's ECG Blog

I was texted this ECG by one of my partners, with the following history: A 60-something male with diabetes and HTN presented with syncope. Per EMS report, the patient had a syncopal episode at work. On medics arrival, patient noted to be pale and diaphoretic, SBPs 60-80s, complaining of nausea and had one episode of emesis en route, possible hematemesis.

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The Great Medication Lottery

Dr. Sanjay Gupta

A lady in her 60s recently consulted me. She was extremely concerned because she was facing a dilemma and she did not know what to do. Basically she had been to see her GP and because her cholesterol was found to be a little on the higher side, she was being strongly advised by her GP to take a Statin. My patient did not want to take Statins. Her argument was that she had never had a problem with her heart, did not have a family history of heart disease and therefore did not want to take medicat

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HCM Impact on Mental Health

HCM Beat

A recent study found that HCM is associated with mental health disorders. Mental health is an important issue which should not be overlooked by medical providers treating HCM patients.

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12 Channel ECG Machine V/S Other Types of ECG Machines

Wellnest

Introduction An electrocardiogram machine is used to monitor cardiac rhythms by placing different sensors of electrodes on the body that measure the heart's electrical impulses. ECG machine detects irregular cardiac rhythms and any sign of blocked arteries in the heart. Many ECG machines are available in the market, each with different features and price ranges.