EMS 12-Lead

APRIL 28, 2022

David Didlake, NRP, APRN, ACNP-BC @DidlakeDW Expert analysis provided by Dr. Ken Grauer [link] @ekgpress EMS is called to the main reception area of a retirement center where an elderly female is found down, unconscious and unresponsive. She has a palpable pulse at the radial arteries, bilaterally, with shallow respirations. This particular facility is situated for independent living, thus no medical providers are on site to provide pertinent details for medical history, medication intake, or re

Tachycardia 52

Tachycardia AFIB Coronary Artery Bypass Graft Arrhythmia 52

Open Heart

APRIL 27, 2022

Objective Group II pulmonary hypertension (PH) can be challenging to distinguish from Group I PH without proceeding to right heart catheterisation (RHC). The diagnostic accuracy of the H2FPEF and OPTICS scores was investigated in Scotland. Methods Patients were included in the study if they were referred to the Scottish Pulmonary Vascular Unit between 2016 and 2020 and subsequently diagnosed with Group II PH or Group I PH which was either idiopathic, heritable or pulmonary veno-occlusive disease

Pulmonary 52

Pulmonary Hypertension 52

The Beat Blog

APRIL 26, 2022

An in-depth look at our business case for SOC 2® compliance. The risks of mishandling user data are increasing constantly. Cyberthreats are growing in sophistication and prevalence every year, and international regulatory bodies are demanding more stringent controls to ensure sensitive information is transmitted, stored, and leveraged in a manner that prevents it from being lost, leaked, adulterated, or misused.

Certification 52

Certification Best Practices Document Blog 52

Heart 2023 Conference

APRIL 26, 2022

Doctors need to now no longer mechanically begin maximum folks that are at excessive chance of coronary heart ailment on an everyday routine of low-dose aspirin, in line with new draft tips via way of means of a U.S. panel of experts. The proposed advice is primarily based totally on mounting proof that the chance of significant facet results some distance outweighs the gain of what becomes as soon as taken into consideration a remarkably reasonably-priced weapon withinside the combat towards co

Heart Attack 52

Heart Attack Heart attacks Cancer Strokes 52

ECG Cases

APRIL 26, 2022

Computer interpretation of the ECG has been called a double-edged sword: when correct, it increases physician accuracy, but when incorrect it increases errors. This is especially problematic in the emergency department, where computer accuracy drops as clinical significance increases—with common errors for arrhythmias and ischemia. Jesse McLaren guides us through 10 cases where the computer interpretation misguides us and how to avoid these pitfalls.

Ischemia 52

Ischemia Arrhythmia STEMI 52

Dr. Smith's ECG Blog

APRIL 24, 2022

Case sent by Magnus Nossen MD, edits by Meyers A previously healthy woman in her 60s presented to an outpatient clinic for palpitations. Vitals were within normal limits other than heart rate. The ECG there reportedly showed an irregular tachycardia, and the patient was immediately referred to the emergency room. Here is her ECG on arrival: There is a wide complex tachycardia that is irregularly irregular (this is difficult to determine at these very high rates).

AFIB 52

AFIB Tachycardia Atrial Fibrillation Blog 52

EMS 12-Lead

APRIL 21, 2022

David Didlake, NRP, APRN, ACNP-BC @DidlakeDW Peer review provided by Dr. Steve Smith @smithECGblog A 55 y/o Male presents to a freestanding urgent care center with chest discomfort, left arm pain, nausea, and diaphoresis. He reports to staff that for the past two months, approximately, he has experienced intermittent dyspnea on exertion when walking the dog, particularly when scaling an incline.

Ischemia 52

Ischemia Myocardial Infarction Blog Coronary Angiogram 52

Cardiomatics

APRIL 19, 2022

This is how to make devices and software location-independent. During the pandemic, many medical workers have been working from home in order to protect themselves and others from infection. Unfortunately, this approach brought with it one major challenge – in most situations, devices and software are located and hosted in hospitals and clinics, not in workers’ homes.

COVID-19 52

COVID-19 Technology Hospital Education 52

Heart 2023 Conference

APRIL 25, 2022

Ambulatory electrocardiography (ECG) lets in for prolonged tracking of arrhythmias in an actual-global setting. This article critiques the presently to be had ambulatory ECG gadgets and their variations in design, function, indications, efficacy, cost, and top-of-the-line use in scientific practice. KEY POINTS Ambulatory ECG tracking is generally used to correlate signs with arrhythmia, verify occult atrial fibrillation, and determine the efficacy of antiarrhythmic therapy.

Arrhythmia 52

Arrhythmia Myocardial Infarction Article Atrial Fibrillation 52

ECG Cases

APRIL 26, 2022

In this episode we discuss how to earn, spend, save and invest wisely and answer questions such as: What is time affluence and how should it guide our financial planning? Why should our goal be financial independence rather than retirement? What are the 4 evidence-based cornerstones for financial planning for happiness? What is the 4% rule for figuring out how much money one needs to be happy?

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Dr. Smith's ECG Blog

APRIL 22, 2022

Written by Jesse McLaren, with comments from Smith and Grauer A 60 year old presented with three weeks of intermittent non-exertional chest pain without associated symptoms. ECG was labeled ‘normal’ by the computer (confirmed by the overreading cardiologist) and the high-sensitivity Troponin I was normal at a value of 11 ng/L (Abbott Alinity assay, where normal is S in V2.

Chest Pain 52

Chest Pain Ischemia Myocardial Infarction Angina 52

EMS 12-Lead

APRIL 14, 2022

David Didlake, NRP, APRN, ACNP-BC This case is provided by C. Madden, Paramedic. Many thanks for sharing! A 48 y/o Male called 911 after experiencing sudden onset chest discomfort while performing yard work. He presented to EMS with extreme pallor, Levine sign, diaphoresis, bilateral arm pain, and an apprehensive sense of doom. Past medical history included HTN, HLD, and MI 10 years prior.

ACE Inhibitor 52

ACE Inhibitor Physiology Chest Pain Academic 52

Open Heart

APRIL 20, 2022

Objectives To describe a cohort of patients with arrhythmogenic left ventricular cardiomyopathy (ALVC), focusing on the spectrum of the clinical presentations. Methods Patients were retrospectively evaluated between January 2012 and June 2020. Diagnosis was based on (1) ≥3 contiguous segments with subepicardial/midwall late gadolinium enhancement in the left ventricle (LV) at cardiac magnetic resonance plus a likely pathogenic/pathogenic arrhythmogenic cardiomyopathy (AC) associated geneti

Cardiomyopathy 52

Cardiomyopathy Chest Pain Sudden Cardiac Death Heart Failure 52

The Beat Blog

APRIL 8, 2022

“Doc, your patient is here,” said one of the clinical staff members. We were closing up for the day when my patient arrived over an hour late. He moved slowly and leaned into his cane as if it would split at any moment, looking exhausted. He sat down apologetically to explain the taxing journey that he had taken to get to the clinic that day—a half mile walk to the bus stop to catch the 106, only to hop off and onto the 44 and then the 52.

Cardiogenic Shock 52

Cardiogenic Shock Blood Pressure Heart attacks Heart Attack 52

Heart 2023 Conference

APRIL 20, 2022

Avocado consumption of at least two servings per week is linked to a lower risk of cardiovascular disease. (Harvard University Heart Letter) A clinical polygenic risk score test for diseases ranging from atrial fibrillation (AFib) to breast cancer was piloted by scientists. (Naturopathic Medicine) According to a subanalysis of a randomised study, low-dose edoxaban (Savaysa) was related with a reduced stroke risk and a negligible increase in bleeding in older Afib patients at high bleeding risk.

Pulmonary 52

Pulmonary Hypertension AFIB COVID-19 52

ECG Cases

APRIL 12, 2022

Tahara Bhate's new QI corner Quick Hits series, Hans Rosenberg & Michael Gottlieb on the evidence around ED diagnosis and management of skin abscesses using PoCUS, Anand Swaminathan on what the oxygen saturation monitor can tell you besides oxygen saturation, Sarah Reid on how to pick up infantile spasms and prevent poor neurologic outcomes, Elisha Targonsky on battle of the ED rate control medications for rapid atrial fibrillation.

Atrial Fibrillation 52

Atrial Fibrillation Outcomes 52

Dr. Smith's ECG Blog

APRIL 8, 2022

Case written and submitted by Brandon Fetterolf MD, edits by Meyers A woman in her early 30s with multiple autoimmune disorders including vasculitis presented with 2-3 hours of mid-left side chest discomfort with radiation to neck and left arm and associated with nausea, diaphoresis and dizziness. Initial ECG on presentation at 1554 (no prior for comparison): What do you think is happening to his 30s woman?

Chest Pain 52

Chest Pain SCAD STEMI Blog 52

EMS 12-Lead

APRIL 8, 2022

David Didlake Firefighter / Paramedic Acute Care Nurse Practitioner @DidlakeDW Peer review by Dr. Stephen Smith @smithECGblog I was reviewing ECG’s in our LifeNet database and happened upon this one without any knowledge of clinical circumstances. Figure 1 Raw findings include Sinus Rhythm, narrow QRS duration, small q-waves in Leads I / aVL / V5 / V6 (which is not entirely atypical), an inverted P-wave in V1 to suggest possible lead malposition, a normal QRS/T angle, and a dispersion of alterna

Myocardial Infarction 52

Myocardial Infarction Coronary Angiogram STEMI Ischemia 52

Open Heart

APRIL 20, 2022

Objective To assess the feasibility, efficacy and safety of performing exercise stress echocardiography (ESE) for the assessment of myocardial ischaemia during the COVID-19 pandemic. Methods and results Baseline data were collected prospectively on 740 consecutive patients (mean age 61.4 years, 56.8% males), referred for a stress echocardiogram (SE), who underwent ESE between July 2020 (immediate post lockdown) and January 2021 according to national safety guidelines, in addition to patients wea

COVID-19 52

COVID-19 Exercise Coronary Artery Disease Echocardiogram 52

JAMA Cardiology

APRIL 30, 2022

This genomic substudy of a randomized clinical trial assesses whether patients with clonal hematopoiesis of intermediate potential have greater cardiovascular event reduction in response to canakinumab.

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Heart 2023 Conference

APRIL 29, 2022

Eating fruit each day can decrease the hazard of coronary heart disorder via way of means of as much as 40%, new studies suggest. A new take a look at that check out extra than 451,680 contributors over seven years requested the organization to document their fruit consumption, whether or not or not it's by no means, monthly, 1-three days in keeping with week, 4-6 days in keeping with week, or daily.

Heart Disease 52

Heart Disease Document Cardiovascular Disease Technology 52

HCM Beat

APRIL 8, 2022

Comprehensive risk assessment combined with shared decision making around the decision to participate in sports seems to be the way of the future, as more fully discussed in the most recent ACC/AHA Guidelines.

Defibrillator 40

Defibrillator Cardiomyopathy Blog 40

Medical Xpress - ECG

APRIL 4, 2022

A simple electrocardiogram (ECG) can pinpoint hospitalized COVID-19 patients at high risk of death who might need intensive management. That's the finding of a study presented at EHRA 2022, a scientific congress of the European Society of Cardiology (ESC). Specifically, the research showed that a prolonged QT interval on the ECG was an independent risk factor for both myocardial injury and one-year mortality.

COVID-19 40

COVID-19 Hospital Electrocardiogram Risk Factors 40

EMS 12-Lead

APRIL 2, 2022

David Didlake Firefighter / Paramedic Acute Care Nurse Practitioner @DidlakeDW Expert commentary provided by Dr. Ken Grauer CASE 1 An 82 y/o Male called 911 for sudden onset dizziness while at rest. Upon arrival he was found alert and oriented, and without gross distress. He denied difficulty breathing, epigastric pain, or chest discomfort. BP 110/67 HR 68 RR 14 (non-labored) SpO2 95 RA Physical exam revealed slight pallor and diaphoresis.

Myocardial Infarction 52

Myocardial Infarction Stent Stents STEMI 52

Open Heart

APRIL 18, 2022

Introduction Intravascular ultrasound (IVUS) improves clinical outcome in patients undergoing percutaneous coronary intervention (PCI) but dedicated prospective studies assessing the safety and efficacy of IVUS guidance during primary PCI are lacking. Methods and analysis The SPECTRUM study is a prospective investigator-initiated single-centre single-arm observational cohort study aiming to enrol 200 patients presenting with ST-segment elevation myocardial infarct undergoing IVUS-guided primary

Ultrasound 52

Ultrasound Myocardial Infarction Cardiovascular Imaging Plaque 52

Dr. Sanjay Gupta

APRIL 4, 2022

We are blessed with 4 heart valves – 2 on the left side which are known as the mitral and aortic valves and 2 on the right side – the tricuspid and pulmonary valves. Sometimes due to a congenital problem, age related changes or even an acquired cause, these valves can start leaking and when they do so to a severe extent, they can adversely impact on a patient’s quality of life as well as their lifespan.

Heart Valves 40

Heart Valves Aortic valve Exercise Quality of Life 40

Open Heart

APRIL 15, 2022

Background Currently, potent P2Y 12 inhibition with the use of prasugrel or ticagrelor is the mainstay of treatment after an acute coronary syndrome (ACS). The 2020 European Society of Cardiology (ESC) Guidelines recommend the use of prasugrel over ticagrelor in patients with non-ST-elevation ACS (NSTE-ACS) intended to receive invasive management (class IIa recommendation), however there are contradictory views regarding this recommendation.

Myocardial Infarction 52

Myocardial Infarction Thrombosis Stent Stents 52

Open Heart

APRIL 11, 2022

Objective This study aimed to evaluate the prognostic value of hyperemic microvascular resistance (HMR) and its relationship with hyperemic stenosis resistance (HSR) index and fractional flow reserve (FFR) in stable coronary artery disease. Methods This is a substudy of the DEFINE-FLOW cohort (NCT02328820), which evaluated the prognosis of lesions (n=456) after combined FFR and coronary flow reserve (CFR) assessment in a prospective, non-blinded, non-randomised, multicentre study in 12 centres i

Coronary Artery Disease 52

Coronary Artery Disease Stenosis 52

Open Heart

APRIL 11, 2022

Background Body iron stores (BISs) have been proposed to be related to the development of cardiovascular diseases. However, results from epidemiological studies are conflicting. Knowledge on the long-term impact of BIS on cardiovascular outcomes in the general population is lacking. Purpose The aim of this study was to explore the relationship between BIS and coronary heart disease (CHD) including death due to CHD.

Heart Disease 52

Heart Disease Outcomes Biomarkers Cardiovascular Disease 52

Open Heart

APRIL 7, 2022

Background Proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9is) are an important but underutilised option to help optimise lipid management. We developed a new service to improve patient access to these medicines in line with National Institute for Health and Care Excellence recommendations. This paper describes the model and provides lipid-lowering results and feedback from the first 100 referred patients.

Innovation 52

Innovation Cholesterol Education 52

Open Heart

APRIL 6, 2022

Objective Patients hospitalised with acute dyspnoea due to acute heart failure (AHF) have a grave prognosis, but the European Society of Cardiology guidelines recommend no system to risk stratify these patients. The prognostic value of combining National Early Warning Score (NEWS) 2 and established cardiac biomarkers is not known. Methods We measured high-sensitivity cardiac troponin T (hs-cTnT) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) and calculated NEWS2 in 314 patients with a

Biomarkers 52

Biomarkers Heart Failure 52

Open Heart

APRIL 6, 2022

Objective This study summarises the diagnostic validity and clinical utility of genetic testing for patients with hypertrophic cardiomyopathy (HCM) and their at-risk relatives. Methods A systematic search was performed in PubMed (MEDLINE), Embase, CINAHL and Cochrane Central Library databases from inception through 2 March 2020. Subgroup and sensitivity analyses were prespecified for individual sarcomere genes, presence/absence of pathogenic variants, paediatric and adult cohorts, family history

Cardiomyopathy 52

Cardiomyopathy Article 52

Open Heart

APRIL 5, 2022

Objective Atrial dilation is known to be a poor prognostic indicator. However, its clinical, functional and prognostic implications have not been thoroughly explored in secondary mitral regurgitation (SMR). We sought to describe the implications of severe atrial dilation (SAD) in SMR. Methods We included all adult patients with severe SMR due to left ventricle dysfunction (with no organic mitral valve disease) who underwent transthoracic echocardiography between January 2012 and March 2021 at ou

Bicuspid/Mitral 52

Bicuspid/Mitral Atrial Fibrillation Diabetes Outcomes 52

Open Heart

APRIL 4, 2022

Objective Given recent data on published diagnostic accuracies, this study sought to determine the most cost-effective diagnostic strategy for detection of significant coronary artery disease (CAD) in stable angina patients using invasive coronary angiography (ICA) and fractional flow reserve (FFR) as the reference standard. Methods A probabilistic decision-analytical model was developed which modelled a cohort of patients with stable angina.

Angina 52

Angina Coronary Artery Disease 52

Open Heart

APRIL 7, 2022

Aims To define the prevalence of non-sustained tachyarrhythmias and bradyarrhythmias in patients with the m.3243A>G mitochondrial genotype and a previously defined, profile, associated with ‘high sudden-death risk’ Methods and results Patients at high risk of sudden death because of combinations of ventricular hypertrophy, mitochondrial encephalopathy, lactic acidosis and stroke-like episodes family phenotype, epilepsy or high mutation load, due to the m.3243A>G mutation, wer

Arrhythmia 40

Arrhythmia ACE Inhibitor Download Tachycardia 40

Open Heart

APRIL 28, 2022

Introduction Coronary artery perforation (CP) is a rare but life-threatening complication of percutaneous coronary intervention (PCI). This study aimed to assess the incidence, management and outcomes of CP over time. Methods A single-centre retrospective cohort study of all PCIs performed between January 2010 and December 2020. Patients with CP were divided into two cohorts (A+B), representing the two halves of the 11-year study.

Angioplasty 52

Angioplasty Outcomes Stent Stents 52

Open Heart

APRIL 6, 2022

Background Poor adherence to guideline recommendations for anticoagulation in patients with acute myocardial infarction (MI) and atrial fibrillation (AF) is previously reported. The aim of the present cohort study was to assess time trends in prescription of anticoagulation therapy in a nationwide registry-based cohort of patients with acute MI and AF.

Myocardial Infarction 52

Myocardial Infarction Atrial Fibrillation Heart Failure Strokes 52