Ken Grauer, MD
FEBRUARY 28, 2023
The ECG and long lead II rhythm strip in Figure-1 — was obtained from a COVID positive patient with persistent tachycardia not responding to Diltiazem. How would YOU interpret this tracing? How to manage the patient? Figure-1: The initial ECG — obtained from a patient with persistent tachycardia. ( To improve visualization — I've digitized the original ECG using PMcardio ).
Wellnest
FEBRUARY 28, 2023
It's challenging to exaggerate how crucial the heart is to good health. The heart drives the circulatory system, ensuring that all the body's organs and tissues receive the oxygen they require. This is done by circulating blood throughout the body. Unfortunately, heart disease ranks among the world's major causes of illness and demise. There is growing awareness of the risks of inadequate sleep for heart health, even though it is already well established that variables, including a poor diet, li
ECG Cases
FEBRUARY 28, 2023
ED recognition and management of some commonly missed or mismanaged hand inuries including finger tip avulsions and amputations, nailbed injuries, PIP dislocations, metacarpal fractures, hand tendon lacerations, Stener lesions, Seymour fractures, mallet fingers, jersey fingers, skier's thumb, Bennet fractures and Rolando fractures with masters Dr. Arun Sayal and Dr.
Dr. Smith's ECG Blog
FEBRUARY 27, 2023
I was reading EKGs on the system and came across this one: What do you think? This is diagnostic of hyperkalemia. HyperK can result in all sorts of pseudoSTEMI or pseudoOMI patterns, including ST elevation, ST depression, and large T-waves. These T-waves are tall but have a narrow base and a corresponding flat ST segment (see lead V4). Also, there are no definite P-waves and this is another result of hyperkalemia.
Heart 2023 Conference
FEBRUARY 24, 2023
The plant Andrographis is native to South Asian nations like India and Sri Lanka. Medicine is made from underground stems and leaves. Andrographis is frequently used to treat and prevent influenza (colds and flu). Despite the fact that this claim is unproven, some individuals assert that Andrographis halted the Indian flu epidemic of 1919. Andrographis is also used to treat a wide range of other problems.
Open Heart
FEBRUARY 23, 2023
Background Long COVID is associated with multiple symptoms and impairment in multiple organs. Cross-sectional studies have reported cardiac impairment to varying degrees by varying methodologies. Using cardiac MR (CMR), we investigated a 12-month trajectory of abnormalities in Long COVID. Objectives To investigate cardiac abnormalities 1-year post-SARS-CoV-2 infection.
Ken Grauer, MD
FEBRUARY 24, 2023
The ECG in Figure-1 was obtained from a previously healthy 30-ish year old man — who presented to medical attention for vasovagal syncope. Based on this initial ECG — the patient was transferred to a PCI-capable center: Do YOU agree with the need for transfer? Hospital evaluation for this patient was negative for an acute coronary syndrome ( ie, CT coronary angiogram was normal — troponin was not elevated — and Echo was negative, with no sign of pericardial effusion ).
Cardiovascular Update brings together the best content for cardiovascular medicine professionals from the widest variety of industry thought leaders.
ECG Cases
FEBRUARY 28, 2023
Dr. Jesse McLaren on when to consider Spontaneous Coronary Artery Dissection (SCAD), which patients are at risk for reocclusion, and the challenges of diagnosing SCAD in patients who have nonischemic ECGs despite silent occlusion, occlusions perfused by collaterals, or from non-occlusive MI on this ECG Cases. The post ECG Cases 40 – Approach to Spontaneous Coronary Artery Dissection (SCAD) appeared first on Emergency Medicine Cases.
Dr. Smith's ECG Blog
FEBRUARY 23, 2023
Case submitted by Magnus Nossen MD, written by Pendell Meyers A previously healthy man in his 40s presented to the ED with epigastric abdominal pain off and on for several days. Vitals were within normal limits. It is unclear whether he had active pain at the time of the first ECG: What do you think? Here is PM Cardio's Queen of Hearts interpretation (AI ECG interpretation trained by Meyers, Smith, and PM Cardio team using thousands of cases and their outcomes): The output number ranges from 0 t
Heart 2023 Conference
FEBRUARY 25, 2023
It is very important to secure your heart. Healthy Heart = Healthy You The stylish thing you can do to ameliorate heart health is to produce a good life plan that's designed to strengthen your cardiovascular system. A good plan can start with the 6 simple ways below. 1) Add Physical Activity to Your Day A good way to start strengthening your heart is sculpturing out 75 twinkles or further per week of vigorous aerobic exertion or 150 minutes or further per week of moderate-intensity aerobic exert
Open Heart
FEBRUARY 23, 2023
Background We investigated the associations of healthcare worker status with multisystem illness trajectory in hospitalised post-COVID-19 individuals. Methods and results One hundred and sixty-eight patients were evaluated 28–60 days after the last episode of hospital care. Thirty-six (21%) were healthcare workers. Compared with non-healthcare workers, healthcare workers were of similar age (51.3 (8.7) years vs 55.0 (12.4) years; p=0.09) more often women (26 (72%) vs 48 (38%); p<0.01)
Ken Grauer, MD
FEBRUARY 18, 2023
T he ECG in Figure-1 was obtained from a 60ish year old man on arrival to the ED ( E mergency D epartment ). The presenting complaint was chest pain — and the patient collapsed soon after arrival in the ED. QUESTION: A cardiologist interpreted the rhythm in Figure-1 as VT ( V entricular T achycardia ). Do YOU agree with this cardiologist ? Figure-1: The initial ECG in today's case — obtained from a 60ish year old man who collapsed in the ED shortly after this tracing was recorded. ( To improve v
Cassling
FEBRUARY 17, 2023
At the beginning of this year, a reimbursement cut came into effect that went largely under the radar, despite many providers still utilizing the system in question. For the past few years, providers of outpatient Medicare-eligible X-rays conducted on a computed radiography system experienced a payment reduction of 7% on each exam. But on January 1, 2023, that penalty actually jumped up even higher, to 10%.
ECG Cases
FEBRUARY 14, 2023
Is low dose diltiazem as effective and safer than standard dose diltiazem for rate control in patients with atrial fibrillation with rapid ventricular response? Dr. Rohit Mohindra and Dr. Shelley McLeod critically appraise the latest study on diltiazem dosing and deliver a research methodology hot take on this month's EM Cases Journal Club. The post Journal Club 2 – Diltiazem Dosing in Atrial Fibrillation with Rapid Ventricular Response appeared first on Emergency Medicine Cases.
Dr. Anish Koka
FEBRUARY 13, 2023
The COVID19/vaccine myocarditis debate continues in large part because our public health institutions are grossly mischaracterizing the risks and benefits of vaccines to young people. A snapshot of what the establishment says as it relates to the particular area of concern: college vaccine mandates: Dr. Arthur Reingold, an epidemiology professor at UC-Berkeley, notes that UC also requires immunizations for measles and chickenpox, and people still are dying from COVID at rates that exceed those f
Heart 2023 Conference
FEBRUARY 20, 2023
Heart Complaint is the No. 1 killer of women , causing 1 in 3 deaths each time. Recently, about 44 of all women fete heart complaints as their leading cause of death. It’s important to know your family history and treat them properly to reduce heart failure and protect your heart. Utmost cardiac and stroke events can be prevented through education and life changes, including living a more active life, eating smart, and managing blood pressure.
Open Heart
FEBRUARY 16, 2023
Severe coronary artery calcification is one of the greatest challenges in attaining success in percutaneous coronary intervention, limiting acute and long-term results. In many cases, plaque preparation is a critical prerequisite for delivery of devices across calcific stenoses and also to achieve adequate luminal dimensions. Recent advances in intracoronary imaging and adjunctive technologies now allow the operator to select the most appropriate strategy in each individual case.
Ken Grauer, MD
FEBRUARY 13, 2023
The ECG in Figure-1 was obtained from an older woman — who presented with chest pain and palpitations over the previous hour. She had a history of hypertension, and was on medication for this — but she was otherwise healthy. BP = 140/90 mm Hg in association with the rhythm in Figure-1. How would YOU interpret the rhythm in Figure-1 ? Is this Ventricular Bigeminy?
Dr. Smith's ECG Blog
FEBRUARY 13, 2023
Written by Jesse McLaren Two 70 year olds had acute chest pain with nausea and shortness of breath, and called paramedics. Who needs the cath lab? (photocopy of prehospital ECGs digitized by PMcardio) ECG #1 (top): there’s normal sinus rhythm, normal conduction, normal axis, normal R wave progression, and normal voltages. There’s inferior ST depression which is reciprocal to subtle lateral convex ST elevation, and the precordial T waves are subtly hyperacute – all concerning for STEMI(-)OMI of p
ECG Cases
FEBRUARY 14, 2023
In this Part 3 of our 3-part podcast series on management of lacerations Dr. Haley Cochrane joins Anton and Justin to explore laceration aftercare and the evidence for keeping wounds dry or wet, wound dressings, topical antibiotics, prophylactic oral antibiotics, Vitamin E oil, aloe vera cream and UV protection with regards to cosmetic outcomes and infection rates.
Wellnest
FEBRUARY 10, 2023
Are you tired of being bound to a stationary ECG machine? Are you ready to upgrade to a solution that suits your on-the-go lifestyle? Portable ECG devices are appropriate for usage in a wide range of settings since they are small, lightweight, and conveniently carried in comparison to traditional ECG machines, which are heavy and usually stationary.
Heart 2023 Conference
FEBRUARY 12, 2023
A recent investigation on the relationship between egg consumption and heart health was published in the Nutrients journal. According to the study, eating one to three eggs each week reduces cardiovascular disease risk by 60%. In fact, the study discovered that people who consume four to seven eggs a week have a 75% decreased risk of acquiring cardiovascular disease.
Open Heart
FEBRUARY 14, 2023
Background High-risk cardiovascular disease (CVD) prevalence in pregnant patients is increasing. Management of this complex population is not well studied, and little guidance is available regarding labour and delivery planning for optimal outcomes. Objective We aimed to describe the process for and outcomes of our centre’s experience with the main operating room (OR) caesarean deliveries for patients with high-risk CVD, including procedural and postpartum considerations.
Ken Grauer, MD
FEBRUARY 8, 2023
A 14-year old boy was forced to do numerous squats as a “punishment”. He woke up the next day with severe pain in his legs — and presented to the ED ( E mergency D epartment ). Renal function and serum electrolytes were normal — but CK was markedly elevated , leading to a diagnosis of Rhabdomyolysis. Cardiac monitoring revealed a series of interesting ( albeit asymptomatic ) rhythms, 2 of which are shown below in Figure-1.
Dr. Smith's ECG Blog
FEBRUARY 10, 2023
I came across this ECG while reading ECGs for Cardiologs in order to train the Cardiologs Deep Convolutional Neural Network. I don't have any clinical information or any other associated ECGs on this case, but wanted to post it here because it is interesting and it is pathognomonic. What is it? This is a proximal LAD Occlusion. First, there are hyperacute T-waves in V2-V4.
ECG Cases
FEBRUARY 14, 2023
In this EM Quick Hits podcast: Justin Hensley and Aaron Billin on Wilderness Medicine, Elisha Targonsky on Bowel Prep Hyponatremia, Brit Long on Non-Convulsive Status Epilepticus, Andrew Petrosoniak on Morel Lavallee Lesions, Jesse McLaren on Pacemaker ECGs and Matt Poyner on paying off loans vs investing. The post EM Quick Hits 46 – Wilderness Medicine, Bowel Prep Hyponatremia, Non-Convulsive Status Epilepticus, Morel Lavallee Lesions, Pacemaker ECGs, Loans vs Investing appeared first on
Cassling
FEBRUARY 10, 2023
Interventional cardiologists have unique needs. The highly specialized nature of cardiology is such that you need special equipment and software to do your best work and improve clinical workflows, staff experience and, ultimately, patient outcomes. A new era of interventional cardiology is here, and with it comes new technologies designed from the ground up to meet the specific clinical burden of cardiology.
Dr. Anish Koka
FEBRUARY 6, 2023
One of the hallmarks of the last two years has been the distance that frequently exists between published research and reality. I’m a cardiologist, and the first disconnect that became glaringly obvious very quickly was the impact COVID was having on the heart. As I walked through COVID rooms in the Spring of 2020 trying to hold my breath, I waited for a COVID cardiac tsunami.
Open Heart
FEBRUARY 9, 2023
Objective Ideal cardiovascular health (CVH) was developed to promote CVH as a key component of primordial prevention. Mobile short message service (SMS) is useful for improving health behaviours. We aim to test the effectiveness of SMS intervention in women to improve CVH. Methods In a single-blinded, randomised, controlled study, 620 women, aged 35–70 years, without cardiovascular disease, were enrolled in SMS intervention versus no SMS.
Ken Grauer, MD
FEBRUARY 4, 2023
The ECG in Figure-1 is from a middle-aged man — who had just received thrombolytic therapy for presumed acute infarction. No other history available. QUESTIONS: How would YOU interpret this ECG? How certain are you of your answer? Figure-1: ECG obtained from a middle-aged man following thrombolytic therapy. ( To improve visualization — I've digitized the original ECG using PMcardio ).
Dr. Smith's ECG Blog
FEBRUARY 6, 2023
Sent by anonymous, written by Pendell Meyers A man in his 60s presented with acute chest pain with diaphoresis. He had received aspirin and nitroglycerin by EMS, with some improvement. His vitals were within normal limits. Here is his triage ECG: 2045: What do you think? The ECG is subtle, but diagnostic of infero-posterior OMI. The QRS is normal, yet in aVL the normal upright small QRS complex is followed by in appropriately large-volume T wave inversion, which is reciprocal to the T waves in l
ECG Cases
FEBRUARY 8, 2023
If you missed The EM Cases Summit '23, no worries, we've got you covered! All the main stage talks of both the 2023 and 2021 Summits are now available for video streaming, on your own time, for a limited time only thru emcasessummit.com. Plus you get the 2023 and 2021 eBooks summarizing the talks as a bonus. New EM Cases swag too. The post EM Cases Summit Video Streaming Package Now Available appeared first on Emergency Medicine Cases.
Cassling
FEBRUARY 2, 2023
When you invest in medical imaging equipment from Cassling and Siemens Healthineers, we work closely with you to ensure your purchase helps you make a positive impact on patient outcomes in your community. Part of that commitment involves making sure your systems are delivered on time and within scope of your construction project, with no surprises that could delay or impede your ability to deliver exceptional care.
Dr. Sanjay Gupta
FEBRUARY 1, 2023
A lot of people have contacted me and asked me as to how to safely stop Beta blockers and therefore I thought I would do a quick blog on this subject. I would like to stress that you should only alter the dosage or stop Beta-blocker usage with the explicit consent of your usual healthcare provider as they will know about your unique clinical situation and all I am doing in this vlog is just giving general information.
Open Heart
FEBRUARY 7, 2023
Objective The onset of new conduction abnormalities requiring permanent pacemaker implantation (PPI) after transcatheter aortic valve implantation (TAVI) is still a relevant adverse event. The main objective of this registry was to identify modifiable procedural risk factors for an improved outcome (lower rate of PPI) after TAVI in patients at high risk of PPI.
The Beat Blog
FEBRUARY 27, 2023
In this ongoing interview series, we’ll be talking to leading clinicians, tech leaders, and entrepreneurs about their life, careers and professional experiences in the fields of heart care, cardiology and heart health as a whole. Heartbeat in Conversation interviews are conducted by Heartbeat’s very own VP of Marketing, David Mait. This past month we spoke to Heartbeat Staff Cardiologist, Edward “Ted” Gibbons.
Dr. Smith's ECG Blog
FEBRUARY 4, 2023
This was posted a few years ago. I'm highlighting it again, with comments from Ken Grauer below. This was sent to me by Jason Winter. @JasonWinterECG This is a 36 yo m with h/o TBI and epilepsy. He had a seizure this morning and rolled out of bed unable to get up. There were no injuries and no chest pain and he appeared well. He complained of 3 days of diarrhea and abdominal pain.
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