Ken Grauer, MD
JANUARY 31, 2023
The ECG in Figure-1 was obtained from an older woman. She presented with shortness of breath. The patient was known to have cancer. QUESTIONS: How would YOU interpret this ECG? Why is every-other-beat changing? Figure-1: ECG obtained from an older woman with shortness of breath. ( To improve visualization — I've digitized the original ECG using PMcardio ).
Dr. Malcolm Kendrick
JANUARY 30, 2023
31st January 2023 With the resignation of Jacinda Ardern, my thoughts were dragged back to Covid once more. Jacinda, as Prime Minster of New Zealand was the ultimate lockdown enforcer. She was feted round the world for her iron will, but I was not a fan, to put it mildly. Whenever I heard her speak, it brought to mind one of my most favourite quotes: ‘Of all tyrannies, a tyranny sincerely exercised for the good of its victims may be the most oppressive.
ECG Cases
JANUARY 31, 2023
The hand is anatomically complex. Having an anatomical-based approach to the assessment of patients who present to the Emergency Department is important to preserve quality of life following a hand injury. Hand injuries are the second most common injury leading to days without work. It is no surprise then that open finger injuries land in the top 10 most common diagnoses that end up in court.
Dr. Smith's ECG Blog
JANUARY 28, 2023
Submitted by anonymous, written by Pendell Meyers. Additional case by Smith. Case 1 A middle aged woman presented with acute chest pain and shortness of breath, unclear time since onset, and likely with episodic symptoms off and on throughout the day. Her vitals were within normal limits. ED1 @1512 What do you think? Meyers : Very clear and specific for acute LAD OMI, with hyperacute T waves in the LAD distribution including leads V2-V6, II, III and aVF.
Open Heart
JANUARY 27, 2023
Background ST elevation myocardial infarction (STEMI) represents a cardiac emergency. Time to diagnosis, identification of culprit lesion, and intervention are important. Inferior STEMI represents a dilemma for cardiologists. The territory can be supplied by the right coronary artery (RCA) or the left circumflex coronary artery (LCx). Diagnostic algorithms have been proposed to predict the culprit artery.
Cardiomatics
JANUARY 23, 2023
Holter ECG analysis available anytime and anywhere, in just 4 clicks. Is it possible? In this series of articles, we have already revealed two major challenges that cardiologists are struggling with in their daily practice. These are the inaccuracy and the time-consuming nature of manual Holter ECG analysis. Now it’s time to uncover the last challenge that we discovered cooperating with hundreds of cardiologists and practitioners from more than 15 countries.
Ken Grauer, MD
JANUARY 26, 2023
The ECG in Figure-1 was obtained from a previously healthy older man — who complained of chest pain and “lightheadedness” while this tracing was recorded. He was not hypotensive. His chest pain had begun the night before. In view of this history — How would YOU interpret the ECG in Figure-1 ? A total of 12 beats are seen in the long lead II rhythm strip.
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Dr. Anish Koka
JANUARY 18, 2023
The open-data movement seeks to liberate the massive amount of data generated in running clinical trials from the grasp of the academic medical-pharmaceutical industrial complex that mostly runs the most important trials responsible for bringing novel therapeutics to market. There are only a few elite academic trialist groups capable of running large trials and there’s ample reason to be suspicious about the nexus that has developed between academia and the pharmaceutical companies that sh
Dr. Smith's ECG Blog
JANUARY 26, 2023
= My Comment by K EN G RAUER, MD ( 1/26 /2023 ): = While reading ECGs — Dr. Smith came across the intriguing tracing shown in Figure-1. No history was available. However, the rhythm is indeed challenging — and illustrates a number of important principles in rhythm interpretation of interest to all emergency care providers. How would YOU interpret the ECG in Figure-1 ?
Open Heart
JANUARY 19, 2023
Objective Postprocedural ischaemic and bleeding risks after transcatheter aortic valve replacement (TAVR) remain a major concern. Nevertheless, no reliable risk models incorporating both possibilities are currently available. We aimed to assess the accuracy of percutaneous coronary intervention (PCI)-derived models and the performance of a recalibrated model that included variables more applicable to TAVR.
Cassling
JANUARY 18, 2023
For many women, undergoing any procedure can leave fear and uncertainty. Especially when it comes to a procedure that your patients may not know much about it. Uterine Fibroid Embolization (UFE) certainly fits the bill. UFE is a minimally invasive surgery that targets fibroids in the uterus, but it still has relatively low adoption among providers, and even fewer patients know about this operation and how it can improve quality of life.
ECG Cases
JANUARY 17, 2023
Dr. Hiren Patel describes the complexities of being a global health practitioner and the skillset that emergency physicians possess giving them the potential to excel in this role on EM Cases' EM GEM blog on Global Emergency Medicine. The post Global EM 2: The Emergency Physician – Global Health’s Missing Piece appeared first on Emergency Medicine Cases.
Wellnest
JANUARY 16, 2023
Depression is a common mental health disorder that affects millions of people worldwide. Feelings of sadness, hopelessness, and a lack of interest in activities characterize it. While the exact cause of depression is unknown, it is thought to be a combination of genetic, biological, environmental, and psychological factors. Recent studies have suggested that there may be a link between depression and heart disease.
Cardiomatics
JANUARY 15, 2023
How to analyze more ECG signals and have more free time. The incidence of cardiovascular disease is growing rapidly. According to WHO , cardiovascular disease is the leading cause of death worldwide. What’s more, an increasing shortage of resources – physicians, as well as nurses – is escalating the vast backlog of cardiac care. As we all know, early diagnosis of such diseases is crucial in order to prevent patients from suffering heart failure or sudden death.
Dr. Smith's ECG Blog
JANUARY 23, 2023
Submitted and written by Megan Lieb, DO with edits by Bracey, Smith, Meyers, and Grauer A 50-ish year old man with ICD presented to the emergency department with substernal chest pain for 3 hours prior to arrival. The screening physician ordered an EKG and noted his ashen appearance and moderate distress. Triage EKG: What do you think? Triage physician interpretation: -sinus bradycardia -lateral ST depressions While there are lateral ST depressions (V5, V6) the deepest ST depressions are in V4.
Open Heart
JANUARY 12, 2023
Background Coronary artery vasospasm is an abnormal spasm of coronary arteries that cause transient or complete occlusion without exertion. It causes stable angina to ACS. However, this can be prevented by calcium channel blockers (CCBs) which suppress Ca 2+ influx into the vascular muscle cells. Nevertheless, several CCBs adverse effects are harmful for these patients.
Dr. Malcolm Kendrick
JANUARY 12, 2023
12th January 2023 Taking a small detour for the moment, I thought I would try and look at bit more closely at corruption. How do you define it? What is it? I believe if you are going to defeat something, you first need to understand what it is. Know thine enemy, as they say. I began by looking up the word corruption in a dictionary, which defined it thus: Corruption: ‘dishonest or fraudulent conduct by those in power, typically involving bribery.
ECG Cases
JANUARY 17, 2023
In this ECG Cases blog we look at 9 patients with possible transient STEMI and discuss pitfalls and pearls in ECG interpretation and management. The post ECG Cases 39 – Transient STEMI Pitfalls and Pearls appeared first on Emergency Medicine Cases.
Cassling
JANUARY 10, 2023
UPDATE: The penalty phase of the Centers for Medicare & Medicaid Appropriate Use Criteria (AUC) program has been suspended until further notice. A major goal of the AUC is to help providers order the most appropriate test for their patients by using a Clinical Decision Support Mechanism (CDSM). The Centers for Medicare & Medicaid Services (CMS) will use data collected from the program to identify outlier ordering professionals who will then be required to secure prior authorization.
HCM Beat
JANUARY 7, 2023
Sudden cardiac arrest (SCA) has had a moment in the public eye this week. Damar Hamlin's misfortune shined a public light on the grim reality that we as HCM patients live with every day: the possibility we could suffer an SCA at any moment without warning.
Dr. Smith's ECG Blog
JANUARY 21, 2023
Case submitted and written by Dr. Mazen El-Baba and Dr. Evelyn Dell, with edits from Jesse McLaren EMS brought a John Doe, in his 30s, who was found in an urban forest near a homeless encampment on a cool fall day. There were no signs of trauma on scene or on the patient. EMS reported an initial GCS of 8 with pupils equal and reactive. The patient had a witnessed generalized tonic-clonic seizure leading to GCS 4.
MIBHS
JANUARY 4, 2023
The heart is the symbol of love, affection, and intimacy for many. However, not everyone knows much about the actual the heart’s structure. What is the difference between a valve and a chamber? What are the major arteries and veins? If you don’t know the answers to these questions, then this is blog is going to answer all of your questions about the heart’s structure.
Cardiomatics
JANUARY 5, 2023
An increasing workload, stress, and a huge feeling of responsibility for patients’ lives. Sound familiar? Manual ECG analysis is a traditional and widely used method for Holter ECG examination. The results of such analysis mainly depend on the knowledge, skills, and vigilance of the doctor carrying it out. However, cardiologists and other healthcare professionals are exposed to a lot of stress and time pressure, which can sometimes lead to unintentional mistakes.
ECG Cases
JANUARY 17, 2023
In this Part 2 of our 3-part Journal Jam series on Laceration Management we dive into the evidence for the choice of material to close lacerations. Which is best for which kind of laceration? Surgical skin glue? Wound adhesive strips? Surgical staples? Absorbable sutures? Nonabsorbable sutures? The post JJ 22 Laceration Repair – Glue vs Strips vs Staples vs Sutures appeared first on Emergency Medicine Cases.
Open Heart
JANUARY 3, 2023
Background Angiographic parameters can facilitate the risk stratification of coronary lesions but remain insufficient in the prediction of future myocardial infarction (MI). AIMS We compared the ability of humans, angiographic parameters and deep learning (DL) to predict the lesion that would be responsible for a future MI in a population of patients with non-significant CAD at baseline.
Society of Thoracic Surgeons - Adult Cardiac
JANUARY 19, 2023
News “Now that They’re Adults”: New STS Risk Model Factors Unique Needs of Congenital Heart Surgery Patients eacevedo Thu, 01/19/2023 - 10:07 3 min read
Dr. Smith's ECG Blog
JANUARY 17, 2023
A 60 year old with chest pain presented to the ED. Here is his first ECG: What do you think? It looks bizarre, doesn't it? There are lots of ST-T abnormalities, but they just don't look recognizable. Whenever you see a bizarre ECG, look at leads I, II, and III. See if one of them does NOT look bizarre. In this case, lead I does not look bizarre, but all other leads do.
Society of Thoracic Surgeons - Critical Care
JANUARY 21, 2023
News “This Should Never Be an Arranged Marriage” — Surgeon + Intensivist eacevedo Sat, 01/21/2023 - 23:47 3 min read
AMS Cardiology
JANUARY 21, 2023
We all want to be heart-healthy and ensuring our cholesterol levels are in the normal range is one of the most critical steps. High cholesterol can increase your risk of severe conditions like heart disease and heart attacks. Medications can improve your cholesterol but if you’re already on them, several simple lifestyle changes can be incorporated into your routine to help lower your levels.
ECG Cases
JANUARY 2, 2023
Understanding why ETCO2 is recommended in cardiac arrest with Swami, practical steps to organ donation in the ED with Dr. Andrew Healy, using your hospital food court to treat paraphimosis, rectal prolapse and food bolus obstruction with Dr. Sarah Foohey, QI Corner with Dr. Tahara Bhate, 4 Medicolegal Myths with Dr. Jennifer C. Tang on this month's EM Quick Hits podcast.
Open Heart
JANUARY 27, 2023
Introduction HIV and cardiovascular disease (CVD) are the two main causes of death in Kenya with hypertension as CVD’s leading risk factor and HIV infection a risk factor for hypertension. We qualitatively evaluated the feasibility of integrated HIV and hypertension screening at Kenyatta National Hospital. Methods We conducted two focus group discussions (FGDs) in November 2020 (female FGD: n=7; male FGD: n=8) to elicit facilitators, barriers and viability of integrated diagnosis and manag
Society of Thoracic Surgeons - Adult Cardiac
JANUARY 9, 2023
News First Multi-Variable Pedimacs Analysis Paves Way for Improved Care for Children with VADs eacevedo Mon, 01/09/2023 - 11:37 2 min read
Dr. Smith's ECG Blog
JANUARY 15, 2023
I was reading ECGs on the system and came across this one. There is minimal STE in II, III, with an inverted T-wave in aVL. There is a very flat ST segment in V2, with 0.5 mm of STD, highly suspicious for posterior OMI. We showed in this paper that ANY amount of STD maximal in V1-V4 (especially in V2) in a patient with chest symptoms is posterior OMI until proven otherwise I knew that if this is a patient with chest discomfort, that it is an infero-posterior OMI.
HCM Beat
JANUARY 12, 2023
TMZ is reporting that singer Lisa Marie Presley, daughter of Elvis, suffered a cardiac arrest at her home and is now at a local hospital.
Society of Thoracic Surgeons - Critical Care
JANUARY 20, 2023
News Surgeon or Intensivist: Who’s Taking Charge in the ICU?
ECG Cases
JANUARY 2, 2023
Based on a blend of number of listens, feedback from listeners, website visits and my personal faves, here is EM Cases Top 10 of 2022. The post Top 10 of 2022 – EM Cases Podcasts & Blogs Highlights of the Year appeared first on Emergency Medicine Cases.
Open Heart
JANUARY 11, 2023
Objectives To evaluate bare-metal Optimus and polytetrafluoroethylene (PTFE)-covered Optimus-CVS balloon-expandable, cobalt–chromium, hybrid cell–designed stents in congenital heart disease (CHD) interventions. Methods Retrospective multicentre review of patients with CHD receiving Optimus stents. Stent mechanical behaviour, clinical indications and outcomes were assessed.
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