May, 2024

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ECG Blog #432 — "Should I Shock this Patient?"

Ken Grauer, MD

I was sent the ECG in Figure-1 — without the benefit of any history. Is this VT? What is the 1st thing — that YOU would do? Figure-1: I was sent this ECG without any history. Is this VT? MY Thoughts on Today’s CASE: As tempting as it might be to reach for the defibrillator on seeing the ECG shown in Figure-1 — My initial reaction was different. At 1st glance , my impression from seeing ECG #1 — was that the rhythm is very fast and irregular — with a highly variable QRS morphology — and, without

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Dementia Mortality Tied to Olive Oil Consumption

Med Page Today

(MedPage Today) -- Higher olive oil intake was associated with a lower risk of dementia-related mortality, a prospective study of 90,000 healthcare professionals showed. Eating at least 7 g of olive oil daily -- about a half tablespoon --.

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Don't Miss a Beat: Semaglutide and the Future of Kidney Disease, with Brendon Neuen, MBBS, PhD

HCPLive

Brendon Neuen, MBBS, PhD, joins the podcast to discuss the latest updates in nephrology, including the landmark FLOW trial.

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Heart healthy behaviors may help reverse rapid cell aging

American Heart News - Heart News

Research Highlights: The benefits gained from better heart health may be related to a process involved in the aging of the body and its cells, researchers found in a study of more than 5,000 adults with a mean age of 56 years. People with rapid cell.

Research 132
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Study finds fat cells influence heart health in Chagas disease

Medical Xpress - Cardiology

Jyothi Nagajyothi, Ph.D. and her laboratory at the Hackensack Meridian Center for Discovery and Innovation (CDI) have identified what may be the main mechanism for how chronic Chagas disease, a parasitic infection affecting millions of people worldwide, can cause irreversible and potentially fatal heart damage.

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Transcutaneous Pacing: Part 2

EMS 12-Lead

TCP in the ROSC Patient: False Electrical Capture at 75mA Josh Kimbrell, NRP @joshkimbre Judah Kreinbrook, EMT-P @JMedic2JDoc This is the second installment of a blog series showing how transcutaneous pacing (TCP) can be difficult and how you can improve your skills. We will be using redacted information from different cases where paramedics attempted TCP in the field.

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ECG Blog #430 — Just a Regular LBBB ECG?

Ken Grauer, MD

The ECG in Figure-1 — was obtained from an older man who had just completed dialysis — and , is now complaining of abdominal discomfort that radiates to his chest. The consultant interpreted this tracing as “LBBB” ( L eft B undle B ranch B lock ) — but not indicative of anything acute. QUESTIONS: Do you agree with the consultant’s interpretation? How would YOU approach this case?

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More Trending

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Evaluating Safety of Novel LDL Management Mechanism

HCPLive

Deepak Bhatt, MD, MPH, MBA, reviews the efficacy and safety data of inclisiran, highlighting its long-term effects and noting that injection site reactions are among the most prominent adverse reactions associated with this medication.

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Brief anger may impair blood vessel function

American Heart News - Heart News

Research Highlights: When adults became angry after remembering past experiences, the function of cells lining the blood vessels was negatively impaired, which may restrict blood flow. Previous research has found that this may increase the risk of.

Research 133
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An undergraduate who is an EKG tech sees something. The computer calls it completely normal. How about the physicians?

Dr. Smith's ECG Blog

This was sent by an undergraduate (not yet in medical school, but applying now) who works as an ED technician (records all EKGs, helps with procedures, takes vital signs) and who reads this blog regularly. Edited by Smith He also sent me this great case. A 63 year old man with a history of hypertension, hyperlipidemia, prediabetes, and a family history of CAD developed chest pain, shortness of breath, and diaphoresis after consuming a large meal at noon.

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New Treatment in Pipeline for Patients with Hypertrophic Cardiomyopathy

DAIC

Getty Images milla1cf Tue, 05/14/2024 - 13:00 May 14, 2024 — One of the most common genetic heart diseases worldwide, hypertrophic cardiomyopathy (HCM) causes the walls of the left ventricle to become thick and stiff. In about 70 percent of cases, patients with HCM experience obstruction to blood flow, which increases pressures in the heart and can lead to chest pain, shortness of breath and reduced exercise capacity.

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ECG Blog #431 — My New ECG-Rhythm Podcasts!

Ken Grauer, MD

I recently recorded a series of 4 podcasts regarding KEY concepts in ECG interpretation. Easy LINKS — tinyurl.com/KG-ECG-Podcasts — [link] — Other ECG Audio PEARLS I previously made for my ECG Blog can be found in the right column of each page on this blog just below this icon — under, "ECG Audio PEARLS". My New E CG P odcasts ( 5/28/2024 ): These podcasts are part of the Mayo Clinic Cardiovascular CME Podcasts Series ( "Making Waves" ) — hosted by Dr.

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Some Patients Suffered Psychiatric Issues After Ozempic Initiation

Med Page Today

(MedPage Today) -- NEW YORK CITY -- Some patients who newly started a GLP-1 receptor agonist quickly developed psychiatric symptoms, a few case reports detailed here. One case involved a female, age 42, with a history of bipolar I disorder.

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The mechanosensory channel PIEZO1 functions upstream of angiopoietin/TIE/FOXO1 signaling in lymphatic development

Journal of Clinical Investigation - Cardiology

Lymphedema is a debilitating disease with no effective cure and affects an estimated 250 million individuals worldwide. Prior studies have identified mutations in piezo-type mechanosensitive ion channel component 1 (PIEZO1), angiopoietin 2 (ANGPT2), and tyrosine kinase with Ig-like and EGF-like domains 1 (TIE1) in patients with primary lymphedema. Here, we identified crosstalk between these molecules and showed that activation of the mechanosensory channel PIEZO1 in lymphatic endothelial cells (

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Significant gaps between science of obesity and the care patients receive

American Heart News - Heart News

Statement Highlights: More than 40% of adults in the United States live with obesity, and the percentage of people living with obesity continues to increase dramatically. While experts have learned a great deal about the causes of obesity and.

Obesity 128
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Wide complex tachycardia, resistant to cardioversion. Some fascinating features here.

Dr. Smith's ECG Blog

An elderly dialysis patient presented with chest pain. She has poor LV function. Previous echo 4 months ago (confirmed with ED bedside echo): The estimated left ventricular ejection fraction is 30%. Severely decreased LV function. Regional wall motion abnormality-inferior, inferolateral, septum, anterolateral, anterior and apex, lateral. Here is her ECG: Regular Wide Complex Tachycardia.

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Jason Busse, DC, PhD: Do Cannabis, Opioids have a Role in Chronic Pain Management?

HCPLive

Jason Busse, DC, PhD, highlights the modest benefits of opioids and therapeutic cannabis in managing chronic pain.

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How are asthma and heart health linked?

Medical Xpress - Cardiology

Although the heart and lungs are neighbors in your chest, people may think of them as separate entities with unrelated problems.

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Young-Onset Dementia Tied to Preeclampsia

Med Page Today

(MedPage Today) -- Preeclampsia raised the risk of young-onset dementia, a prospective study of nearly 2 million women in France showed. Compared with pregnancies without hypertensive disorders, preeclampsia more than doubled the risk of dementia.

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Ep 195 Management of Subarachnoid Hemorrhage

ECG Cases

Once the diagnosis of nontraumatic subarachnoid hemorrhage (SAH) has been made, our job is not done. Mortality in SAH patients can be up to 30% even without neurological deficit. Paying attention to the time-sensitive details of ED management of SAH patients can have a significant impact on their outcome. In this second part of our 2-part podcast series on subarachnoid hemorrhage with Dr.

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Insulin sensitivity estimates and their longitudinal association with coronary artery disease in type 1 diabetes. Does it matter?

Cardiovascular Diabetology

Insulin resistance and chronic kidney disease are both associated with increased coronary artery disease risk. Many formulae estimating glucose disposal rate in type 1 diabetes infer insulin sensitivity from c.

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Chest pain: Are these really "Nonspecific ST-T wave abnormalities", as the cardiologist interpretation states?

Dr. Smith's ECG Blog

Written by Jesse McLaren, with a very few edits by Smith A 60-year-old presented with chest pain. The ECG did not meet STEMI criteria, and the final cardiology interpretation was “ST and T wave abnormality, consider anterior ischemia”. But are there any other signs of Occlusion MI? There’s only minimal ST elevation in III, which does not meet STEMI criteria of 1mm in two contiguous leads.

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New postpartum care recommendations target CVD risk

American Heart News - Heart News

DALLAS, May 16, 2024 — Pregnancy-related deaths in the U.S. have risen 140% over the past three decades and cardiovascular disease is the leading cause.[1] Despite existing medical guidance on pregnancy and cardiovascular health, current trends in health.

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Night-time heat significantly increases the risk of stroke

Science Daily - Stroke

Researchers show that nocturnal heat significantly increases the risk of stroke. The findings can contribute to the development of preventive measures: With them, the population can better protect themselves against the risks of climate change with increasingly frequent hot nights. In addition, knowledge of the consequences of hot nights can improve patient care.

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Alzheimer's Biomarkers Linked With Plasma Leptin Levels

Med Page Today

(MedPage Today) -- Plasma leptin levels were linked with Alzheimer's disease PET pathology in cognitively unimpaired older adults, a longitudinal cohort study in Korea showed. Over 2 years, lower baseline plasma leptin was associated with a greater.

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Paul Appelbaum, MD: What to Warn Patients When Prescribing Psychedelics in the Future

HCPLive

In an interview, Paul Appelbaum, MD, discussed issues clinicians will need to bring up to their patients if the FDA approves a psychedelic-assisted therapy.

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RNF4 sustains Myc-driven tumorigenesis by facilitating DNA replication

Journal of Clinical Investigation - Cardiology

The mammalian SUMO-targeted E3 ubiquitin ligase Rnf4 has been reported to act as a regulator of DNA repair, but the importance of RNF4 as a tumor suppressor has not been tested. Using a conditional-knockout mouse model, we deleted Rnf4 in the B cell lineage to test the importance of RNF4 for growth of somatic cells. Although Rnf4–conditional-knockout B cells exhibited substantial genomic instability, Rnf4 deletion caused no increase in tumor susceptibility.

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A young man with palpitations.

Dr. Smith's ECG Blog

A 30-something presented with chest pain, palpitations, and SOB. He has had similar symptoms for 4 years, but has never been evaluated. Here is his presenting ECG, which was sent to me real time, along with the 2nd ECG below: Regular Narrow Fast without P-waves. PSVT. It is very difficult to tell if this is: 1) AVNRT or 2) orthodromic AVRT (Orthodromic AVRT = WPW with orthograde conduction down the AV node and retrograde up an accessory pathway) See Ken Grauer's discussion below in differentiati

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Documentary Led by HonorHealth Research Institute Focuses on Injuries to Doctors and Nurses Working in Cardiology

DAIC

milla1cf Tue, 05/07/2024 - 12:54 May 7, 2024 — HonorHealth Research Institute ’s David G. Rizik , M.D., narrates and is a co-producer of a documentary focused on radiation and orthopedic injuries suffered by doctors and nurses who work in cardiac catheterization laboratories where they apply the very latest non-surgical technologies to treat the world’s leading cause of death, heart disease.

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Singing repairs the language network of the brain after a cerebrovascular accident

Science Daily - Stroke

Singing rehabilitates speech production in post-stroke aphasia. Researchers investigated the rehabilitative effect of singing on the brain.

Research 117
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Brain Risks Drop When Diet Includes More Minimally Processed Foods

Med Page Today

(MedPage Today) -- A diet high in ultra-processed foods upped the risk of cognitive impairment or stroke, data from the prospective REGARDS study showed. However, risk of either cognitive decline or stroke fell for people who had higher intake.

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Lenard A. Adler, MD: “Symptoms of ADHD Need to Go Back to Childhood”

HCPLive

In an interview with Adler at APA 2024, he also explained how adults with ADHD may present additional symptoms not noted on the DSM when they have comorbidities.

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Challenges and opportunities in patients with adult congenital heart disease, a narrative review

Frontiers in Cardiovascular Medicine

Adult congenital heart disease Pregnancy Transition of care Challenges heart failure.

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Do you need to be a trained health care professional to diagnose subtle OMI on the ECG?

Dr. Smith's ECG Blog

An undergraduate (not yet in medical school) who works as an ED technician (records all EKGs, helps with procedures, takes vital signs) and who reads this blog regularly arrived at work and happened to glance down and see this previously recorded ECG on a table in the ED. It was recorded at 0530: What do you think? The young ED tech immediately suspected LAD OMI.

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The alanyl-tRNA synthetase AARS1 moonlights as a lactyltransferase to promote YAP signaling in gastric cancer

Journal of Clinical Investigation - Cardiology

Lactylation has been recently identified as a new type of posttranslational modification occurring widely on lysine residues of both histone and nonhistone proteins. The acetyltransferase p300 is thought to mediate protein lactylation, yet the cellular concentration of the proposed lactyl-donor, lactyl-coenzyme A, is about 1,000 times lower than that of acetyl-CoA, raising the question of whether p300 is a genuine lactyltransferase.

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America’s CKM Syndrome Problem

CardiacWire

A new JAMA study revealed that a shocking 90% of US adults are at risk of developing cardiovascular-kidney-metabolic (CKM) syndrome, underscoring the need for preventative action before we face a wave of CKM-related heart disease. Officially published by the AHA six months ago, CKM syndrome defines the connections and risks associated with obesity, type 2 diabetes, chronic kidney disease, and cardiovascular disease.

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Kids With Hypertension May Have Twice the Risk of Cardiac Events

Med Page Today

(MedPage Today) -- Children diagnosed with hypertension had a higher associated long-term risk of major adverse cardiac events (MACE) compared with matched controls without the condition, according to a Canadian population-based, retrospective.