June, 2023

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ECG Blog #384 — Why So Fast?

Ken Grauer, MD

The ECG in Figure-1 was obtained from a young man with a history of rheumatic heart disease — who presented with “palpitations”. He was hemodynamically stable at the time this tracing was recorded. How would YOU interpret the ECG in Figure-1 ? How would you treat the patient? Figure-1: The initial ECG in today’s case. What is the rhythm? How would you treat the patient?

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A man in his 50s with acute chest pain who is lucky to still be alive.

Dr. Smith's ECG Blog

Sent by Magnus Nossen MD, written by Pendell Meyers A man in his 50s, previously healthy, developed acute chest pain. EMS was called, and they recorded the following ECG on scene at 13:16: What do you think? Below is the version standardized by PM Cardio app Meyers interpretation: Findings are specific for posterior (and also likely inferior) wall transmural acute infarction, most likely due to acute coronary occlusion (OMI).

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ECG Cases 43 – ECG Interpretation in Shortness of Breath

ECG Cases

In this ECG Cases blog we look at 10 patients with shortness of breath, and discuss how the ECG can be used to help diagnose cardiac, respiratory and metabolic emergencies. We discover that for STEMI/OMI vs subendocardial ischemia, we should look for STEMI(-)OMI, subacute OMI, and OMI in the presence of LBBB and RBBB, and consider the differential for diffuse ST depression with reciprocal ST elevation in aVR.

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Cassling and Alta Bring Remote Collaboration to Interventional Teams

Cassling

T he two companies have partnered to connect providers in cath labs and operating rooms with advanced software that records cases and makes seamless remote collaboration possible. Omaha, Neb. – June 23, 2023 – Cassling i s now a nationwide strategic sales and service agent for Alta, a healthcare audiovisual platform designed to record, archive, and/or live-stream cases for a variety of clinical purposes.

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Chronic exposure to lead, cadmium and arsenic increases risk of cardiovascular disease

Science Daily - Stroke

Around the world, most people are regularly exposed to low or moderate levels of lead, cadmium and arsenic in the environment, increasing risk of coronary artery disease, stroke and peripheral artery disease, according to a new statement.

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Implementing the 2023 Expert Consensus Statement: A Strategic Roadmap for Device Manufacturer Sales Representatives

Vector Remote

Implementing the 2023 Expert Consensus Statement: A Strategic Roadmap for Device Manufacturer Sales Representatives In the ever-evolving landscape of cardiac device care, keeping pace with guidelines and policies can often seem daunting. To help you navigate this shifting terrain, we’re focusing on the 2023 expert consensus statement by the Heart Rhythm Society, European Heart Rhythm Association, Asia Pacific Heart Rhythm Society, and Latin American Heart Rhythm Society, and its implicatio

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ECG Blog #383 — Is this Coronary Disease?

Ken Grauer, MD

== P lease N OTE : After today — No new ECG Blog posts for 2- to -3 weeks. — I will also not be prompt in replying to emails. == All material on this ECG Blog site remains open! The INDEX tab ( in the upper right of each page ) — has linked Contents, listed by subject. So IF you are looking for ECG material — There is plenty on this web site! IF you scroll down a little on the right-hand column of this blog — You'll see a lot of icons.

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More Trending

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EM Quick Hits 49 Stroke Management Update, Intussusception, 5 Penetrating Trauma Tips, Skin Foreign Body Hack, CT Radiation Risk, Emergency Fund

ECG Cases

On this month's EM Quick HIts podcast: Anand Swaminathan on EVT for large vessel occlusion strokes, Sarah Reid on picking up intussusception, Andrew Petrosoniak on 5 Penetrating Trauma Tips, Peter Toth on using a slit lamp to manage skin foreign body hack, Nour Khatib and Jonathan Wallace on CT Radiation Risk and Matt Poyner on setting up an emergency fund.

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Advanced Imaging Shows Promise for Addressing Radiology Staff Shortages

Cassling

Hospital staffing shortages are a real problem. In fact, last March the American Hospital Association submitted a letter to the U.S. House of Representatives Energy and Commerce Committee that deemed them a "national emergency." The impact of these shortages has affected the gamut of healthcare worker roles -- from physicians and nurses to medical technicians and yes, radiologic technologists.

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Relationship between psychological distress, health behaviours and future reports of hypertension among adults in East Zimbabwe: a cohort study

Open Heart

Introduction Extensive cross-sectional evidence has demonstrated an association between psychological distress (PD) and hypertension. However, evidence on the temporal relationship is limited, especially in low-income and middle-income countries. The role of health risk behaviours including smoking and alcohol consumption in this relationship is also largely unknown.

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3 Use Cases of EHR Software Reporting in Cardiology Clinics

GEMMS

Electronic Health Record (EHR) software has an essential technology tool for cardiology clinics in meeting the ever-changing demands of the healthcare industry. EHRs offer a wide range of benefits, from improving patient care to streamlining administrative tasks and ensuring payment. The reporting features found in a comprehensive cardiology EHR platform can truly improve workflow and increase practice efficiency.

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ECG Blog #382 — What Does the Holter Show?

Ken Grauer, MD

I was sent the Holter monitor tracing in Figure-1 — but without the benefit of any clinical information. QUESTIONS: A total of 9 QRS complexes are seen in the 2 simultaneously-recorded monitoring leads. How would YOU interpret the rhythm in Figure-1 ? How many P waves do you see? Why do the QRS complexes of beats #4 and 5 in the bottom lead look different than the other 7 beats?

Blog 78
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Two ECGs texted to me in the same hour. What would you recommend?

Dr. Smith's ECG Blog

Written by Pendell Meyers Both of these cases were sent to me with no information other than adults with acute chest pain. What would be your response? Case 1: Case 2: What if I told you that Case 1 has an abnormal initial troponin, and Case 2 has a normal initial troponin? Case 1 An elderly male presented with chest pain. His vitals were within normal limits except some mild hypertension.

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Ep 184 Must Know Drug Interactions in Emergency Medicine

ECG Cases

We miss potentially dangerous and even lethal drug interactions in EM more often than we realize. In this main episode EM Cases podcast with Dr. David Juurlink and Dr. Walter Himmel we review the common categories of drugs, the high risk patients and the key drug interactions that we need to know about in Emergency Medicine. The post Ep 184 Must Know Drug Interactions in Emergency Medicine appeared first on Emergency Medicine Cases.

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Top 10 Things to Know about Mental Health & CHD

Conquering CHD

When heart defects are first diagnosed, the heart structure and function get all the attention. However, congenital heart disease (CHD) may have a lifelong impact on your whole being. This includes your mental health. It is important that we make mental health care a normal part of CHD care. As an adult with CHD we urge you to keep these things in mind: 10.

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Continuous long-term heart rate variability and risk assessment in pulmonary hypertension

Open Heart

Objective Current multimodal risk assessment for pulmonary hypertension (PH) has been redefined with a simplified assessment for follow-up in the new European Society of Cardiology/European Respiratory Society (ESC/ERS) guidelines. Follow-up risk assessment parameters include WHO functional class, 6 min walk test and N-terminal pro-brain natriuretic peptide.

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Changing Landscape of Cardiovascular Diagnosis | Google AI

Wellnest

Introduction AI, Artificial Intelligence, Deep Learning Algorithms, cognitive computing- these techniques and terms have been the focus of the scientific community and laymen on the internet, respectively. With its ability to mimic the human’s cognitive process and vast storage capacity, AI has been revolutionizing entire industrial and service sectors.

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Heart Valve Disease Forum 2023

Society of Thoracic Surgeons - Allied Health

Event Heart Valve Disease Forum 2023 kchalko Thu, 06/22/2023 - 15:14 Event dates Sep 15–16, 2023 Location Seoul Dragon City, Seoul, Korea STS is pleased to co-present the Heart Valve Disease Forum (HVDF) with the Korean Society for Thoracic and Cardiovascular Surgery, sharing latest knowledge on the basis, cause, diagnosis, treatment, and future of valve disease.

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A young man with another episode of tachycardia. What is it? And why give adenosine in sinus rhythm?

Dr. Smith's ECG Blog

Written by Bobby Nicholson MD and Pendell Meyers A man in his 30s presented to the ED for evaluation of chest pain and palpitations. He described it as a "jackhammering" sensation, associated with palpitations, diaphoresis, and shortness of breath, and he stated it started soon after consuming an "energy drink" (product/contents unknown). He stated these symptoms were the same as a prior episode which required cardioversion.

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Global EM 4 Climate Change and the Impeding Impact on Emergency Medicine

ECG Cases

With increasing forest fires, heat waves, floods, storms, vector-borne illnesses and heat waves, the emergency department is uniquely positioned to declare sentinel events, advocate on behalf of vulnerable populations and lead by example. Dr. Matt Douglas-Vail explains the need for Increased education on climate change and planetary health, Increased resource allocation in emergency departments for climate-related pathologies and increased disaster planning for climate-related emergencies on thi

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A Parent’s Guide to Traveling with Kids with CHD

Conquering CHD

Every parent wants to take their child on an adventure that creates lasting memories. But when your child has CHD, planning a trip requires extra preparation to ensure their safety and well-being. Before you explore destinations near and far, here are 7 tips to help you navigate the challenges of traveling with kids with CHD, plus 3 tricks from parents like you. 1.

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Digitally enabled acute care for atrial fibrillation: conception, feasibility and early outcomes of an AF virtual ward

Open Heart

Background Atrial fibrillation (AF) represents a growing healthcare challenge, mainly driven by acute hospitalisations. Virtual wards could be the way forward to manage acute AF patients through remote monitoring, especially with the rise in global access to digital telecommunication and the growing acceptance of telemedicine post-COVID-19. Methods An AF virtual ward was implemented as a proof-of-concept care model.

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7 EHR Interoperability Tips for Outpatient Care

GEMMS

In the dynamic realm of outpatient care, healthcare providers frequently encounter the need to exchange crucial patient information and records with fellow medical professionals. Such a demand underscores the importance of seamless and efficient communication among all parties to ensure an optimal healthcare experience for patients. Electronic Health Record (EHR) software facilitates this communication, but ensuring interoperability can sometimes be challenging.

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Academic recognition for CineECG

CineECG

This week a true milestone is achieved for ECG Excellence. We are so proud of Machteld Boonstra being the very first to use CineECG in her public defence of the results of her academic PhD research on CineECG and the use of non-invasive inverse ECG techniques in Cardiomyopathy. Over the past years Machteld has worked in UMCU on delivering both the conceptual, technical and clinical validation of CIneECG and her findings have been published in leading cardiology journals.

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An Intriguing Rhythm: Who Belongs to Whom?

Dr. Smith's ECG Blog

== MY Comment , by K EN G RAUER, MD ( 6/26 /2023 ): == The tracing in Figure-1 was sent to me — without the benefit of any history. How would YOU interpret this tracing? Figure-1: The initial ECG in today's case. ( To improve visualization — I've digitized the original ECG using PMcardio ). MY Initial Thoughts: My attention was immediately drawn to the long lead rhythm strip in Figure-1.

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Latest developments in the Cardiac Healthcare system through AI

Wellnest

India is witnessing a rise in Coronary heart disease (CHD). It has been increasing at an alarming rate of 28.1% since the past two decades as one of the leading causes of mortality. The development has urged us to integrate the latest Artificial Intelligence with the healthcare system, including Cardiac Medicare. By harnessing the power of the latest technology, healthcare providers can enhance diagnostics, treatment planning, and patient care.

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U.S. News Hospital Rankings Are One Piece of the CHD Care Puzzle

Conquering CHD

Where to receive care is one of the most important decisions a family can make. Conquering CHD has a strong commitment to transparency and ensuring patients and families have essential information at their fingertips when they need it to assist them in making the best choice for their family. With the publishing of this year’s U.S. News & World Hospital Report rankings , we remind you this is only one of many tools you can use to have a conversation with your care team and should not be used

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Recurrent myocardial infarction and emergency department visits: a retrospective study on the Stockholm Area Chest Pain Cohort

Open Heart

Background Patients who experience acute myocardial infarction (AMI) are at risk of recurrent AMI. Contemporary data on recurrent AMI and its association with return emergency department (ED) visits for chest pain are needed. Methods This Swedish retrospective cohort study linked patient-level data from six participating hospitals to four national registers to construct the Stockholm Area Chest Pain Cohort (SACPC).

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Cassling's New Website Empowers Imaging Providers

Cassling

Our new website is officially live! The Cassling website has been rebuilt from the ground up to improve your experience. When we launched our new vision for strengthening community healthcare earlier this year, it quickly became clear that we had work to do to convey the full scope of how we can help healthcare providers. That meant we needed to completely rethink our approach to connecting you with solutions to improve patient outcomes and provider experience.

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Highlights from the 2023 STS Coronary Conference

Society of Thoracic Surgeons - Congenital

At the 2023 STS Coronary Conference, focus was on the fundamentals and advanced therapies for coronary artery disease, including medical management, arterial conduits, and minimally invasive surgical revascularization.

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A 40-something male with resolving chest pain and a "Normal ECG" by computer and cardiology overread

Dr. Smith's ECG Blog

A 40-something male presented by ambulance with one hour of chest pain that was improving after sublingual nitroglycerine and 325 mg of aspirin, chewed. Here is his initial ED ECG: What do you think? I read this ECG without any history as reperfusing inferior and posterior OMI due to the Q-wave in lead III with minimal STE and reciprocal ST depression in V2-V4 (which should never be there).

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Call for Reviewers

International Journal of Cardiovascular Sciences

The International Journal of Cardiovascular Science (IJCS) is calling for qualified reviewers to join the Reviewers Board. The electronic application form will be available from June 1, 2023 to August 1, 2023. The result will be announced on September 15, 2023 on the journal’s website. You can see all the details in the notice: Notice – Portuguese Notice – English Notice – Spanish O post Call for Reviewers apareceu primeiro em International Journal of Cardiovascular Scien

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Medications for Congenital Heart Disease: What Every Parent Should Know

Conquering CHD

While this blog post has been reviewed by clinical experts, it does not substitute for personalized advice from your healthcare providers. Be sure to talk to your doctor if you have any questions or concerns. Congenital heart disease is a daunting diagnosis for any parent. But, with the right treatment plan in place, your child can lead a happy and healthy life.

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Drugless and radiographer led: the start of a new era for CT coronary angiography

Open Heart

Objective Since inception CT coronary angiography (CTCA) has required facilitating beta blockers (BB). However, CT technology has improved rapidly as has radiographer and reporter expertise. Using these factors, we instituted a radiographer led cardiac CT service (RLCCTS), without routine BB, which we studied for quality control (QC). Methods RLCCTS started October 2021 using a wide detector array CT system, with 20 min slots.

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Ryan Mahler Goes Above and Beyond for 20 Years

Cassling

At Cassling, it’s our philosophy that superior customer service always comes first. So it’s no surprise to us when our customers have amazing things to say about our Field Service Engineers. But what is surprising is that Cassling FSE Ryan Mahler’s service is so superior that his customer reached out to us to congratulate him on reaching his 20-year anniversary.

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Vaccine myocarditis update from Korea

Dr. Anish Koka

A national study from Korea published in the European Heart Journal sheds important new light on complications related to COVID vaccine related myocarditis. While US public health authorities have been convinced from the very beginning about how safe and effective the new vaccines are, researchers in other countries with far smaller budgets have been testing that theory.

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A young lady with wide complex tachycardia. My first time actually making this diagnosis de novo in real life in the ED!

Dr. Smith's ECG Blog

Written by Pendell Meyers A woman in her 30s with minimal past medical history presented simply stating she was "feeling unwell." Her symptoms started suddenly about 48 hours ago, but had continued to worsen, including epigastric discomfort, nausea, cough, and dyspnea and lightheadedness on exertion. She denied chest pain and denied feeling any palpitations, even during her triage ECG: What do you think?