Ken Grauer, MD

JULY 29, 2023

The ECG in Figure-1 was obtained from an 18-year old woman — who moments before been resuscitated from out-of-hospital cardiac arrest. QUESTIONS: In light of the above clinical history. How would YOU interpret her post-resuscitation ECG? Does this ECG in Figure-1 provide clue(s) to the etiology of this patient's cardiac arrest? Figure-1: The initial ECG in today's case — obtained following resuscitation from cardiac arrest of an 18-year old woman.

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Blog Cardiac Arrest Cardiomyopathy Hospital 148

ECG Guru

JULY 24, 2023

This is a "classic" ECG of very good quality for you to use in a classroom setting. The Patient: A 57-year-old man who complains of a sudden onset of "sharp" chest pain while on a long bike ride. The pain does not radiate, and nothing makes it worse or better. He is pale, cool, and diaphoretic. His medical history is unknown. The ECG: This ECG could be considered "classic" for an inferior wall ST elevation M.I. caused by occlusion of the right coronary artery.

Chest Pain 98

Chest Pain STEMI Ischemia Outcomes 98

Cassling

JULY 21, 2023

‘Elder’ describes a senior authority figure who is highly respected and valued for their wisdom. Cassling is lucky to have many whose leadership and service help us strengthen community healthcare, but one aptly named Regional Service Manager (RSM) truly takes things to another level: Tim Elder.

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Blog 98

Dr. Smith's ECG Blog

JULY 17, 2023

A young man presented with weakness and fever. His pulse was 186. An ECG was recorded: What do you think? There is a regular narrow complex tachycardia. Thus, it is supraventricular tachycardia. It is important to remember that SVT includes Sinus Tachycardia! That is why I like to call re-entrant SVT "Paroxysmal" SVT, or PSVT). The sinus node is "supraventricular" and in young people it can beat VERY fast.

Tachycardia 90

Tachycardia Atrial Flutter Blog Exercise 90

ECG Cases

JULY 18, 2023

On this month's EM Quick Hits podcast David Carr on differential diagnosis of normal unenhanced CT renal colic, Leeor Sommer on recognition and management of perichondritis and auricular abscess, Suzanne Schuh on IV magnesium sulphate for pediatric asthma, Jess McLaren on Occlusion MI ECG interpretation requiring cath lab activation and Justin Morgenstern on update on steroids for pneumonia.

Pediatrics 89

Pediatrics Chest Pain Atrial Fibrillation STEMI 89

Science Daily - Stroke

JULY 6, 2023

Unprocessed red meat and whole grains can be included or left out of a healthy diet, according to a study conducted in 80 countries across all inhabited continents. Diets emphasizing fruit, vegetables, dairy (mainly whole-fat), nuts, legumes and fish were linked with a lower risk of cardiovascular disease (CVD) and premature death in all world regions.

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Diet Cardiovascular Disease Outcomes 91

Ken Grauer, MD

JULY 22, 2023

The ECG in Figure-1 was obtained from an elderly man with a history of coronary disease — who contacted EMS for "burning" chest discomfort that woke him at 3am. Unlike his "usual" anginal episodes — this chest discomfort was not relieved by NTG. Some amount of time passed at home — during which his chest discomfort persisted The patient was hemodynamically stable at the time he was seen by EMS, when ECG #1 was recorded.

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Blog Chest Pain STEMI AFIB 78

Cassling

JULY 10, 2023

The ASRT Foundation, the philanthropic arm of the American Society of Radiologic Technologists, has announced the recipients of the two $4,000 scholarships, awarded to healthcare professionals continuing their medical imaging and radiation therapy education and expanding their credentials.

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Radiologic Technologist Education 68

Dr. Smith's ECG Blog

JULY 14, 2023

A 40-something with persistent Ventricular Fibrillation presented after attempted prehospital resuscitation A 40-something with no previous cardiac history presented to the ED in persistent Ventricular Fibrillation after attempted prehospital resuscitation. He underwent further standard resuscitation EXCEPT that we applied the Inspiratory Threshold Device ( ResQPod ) AND applied Dual Sequential Defibrillation (this simply means we applied 2 sets of pads, had 2 defib machines, and defibrillated w

Cardiac Arrest 89

Cardiac Arrest Chest Pain Defibrillator Atrial Flutter 89

Learning + Leading

JULY 27, 2023

The pharmacy technician shortage is a significant challenge facing the healthcare industry. It is putting a strain on pharmacists, pharmacy operations and patient care delivery.

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Patient Care 52

Science Daily - Stroke

JULY 5, 2023

Neuroscientists say the brain's auditory lexicon, a catalog of verbal language, is actually located in the front of the primary auditory cortex, not in back of it -- a finding that upends a century-long understanding of this area of the brain. The new understanding matters because it may impact recovery and rehabilitation following a brain injury such as a stroke.

Stroke 67

Stroke Strokes 67

Ken Grauer, MD

JULY 15, 2023

The ECG in Figure-1 was obtained from a previously healthy middle-aged man — who while performing his regular exercise routine, developed "slight" chest discomfort and "palpitations". These symptoms persisted for over an hour, which led the patient to contact EMS. Surprisingly — he was hemodynamically stable with minimal discomfort at the time his initial ECG in Figure-1 was recorded.

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Blog Coronary Angiogram Cardiomyopathy Ischemia 78

ECG Guru

JULY 30, 2023

Complex ECGs like this one have to be approached systematically. Firstly, we can see a normal sinus rhythm. A is the first beat of a wide complex tachycardia. This must be a ventricular tachycardia. Although there is a P-wave before the first beat of the tachycardia, it is not premature. Therefore, there is no SVT with aberrant conduction. The first beat of the tachycardia looks different from the subsequent beats because there is a fusion beat present.

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Tachycardia 98

CTVS

JULY 31, 2023

At CTVS, our team of board-certified thoracic surgeons routinely perform a procedure known as a thoracic sympathectomy to treat hyperhidrosis, or excessive sweating. During this surgery, part of the sympathetic chain of nerves that runs along the spine is carefully severed to halt signals that trigger the sweat glands.

Arrhythmia 52

Arrhythmia Pacemaker 52

Dr. Smith's ECG Blog

JULY 12, 2023

I come in early for every shift to read the ECGs on the system that have not yet been "confirmed". I came across this one: The computer calls is: "SINUS RHYTHM. NORMAL ECG" What do you think? Be VERY careful when the computer calls the ECG "Normal". I saw the inferior ST depression (which is reciprocal to subtle STE in aVL) and the subtle ST depression in precordial leads and thought: "If this patient came in with chest pain, then it is an acute OMI.

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Chest Pain Blog Stent Stents 74

Heart Sisters

JULY 30, 2023

Doctors, next time you’re seeing a freshly-diagnosed heart patient for a follow-up appointment, please remember that we’re far more than just a major organ that’s undergone a procedure.

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Heart Attack Heart attacks Heart Disease 52

EMS 12-Lead

JULY 30, 2023

David Didlake, FF/EMT-P, AG-ACNP @DidlakeDW An elder female presented to the ED with worsening shortness of breath. She was known to have a history of poorly controlled COPD, AFib, and multivessel coronary disease. Specific to the latter, she was previously deemed not appropriate for CABG (complex rationale) with preference for optimized medical management, instead.

Atrial Fibrillation 52

Atrial Fibrillation AFIB Pharmacology Echocardiogram 52

Ken Grauer, MD

JULY 9, 2023

The ECG in Figure-1 was obtained from a 60-year old woman — who presented to the ED ( E mergency D epartment ) for “palpitations”. Her vital signs were normal at the time this triage ECG was recorded. Blood was drawn , and the patient was promptly placed in a room to be seen — but on entering, the ED physician found her unresponsive in cardiac arrest.

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Blog Cardiac Arrest Pulmonary AFIB 78

ECG Guru

JULY 31, 2023

Broad complex tachycardia in a 78-year-old patient with coronary heart disease (CHD) and an old inferior myocardial infarction. Why is this a ventricular tachycardia (VT) and not a supraventricular tachycardia (SVT) with aberrant conduction? Broad complex tachycardia is generally about 80% likely to be ventricular in origin. However, in a patient with CHD and a history of myocardial infarction, this likelihood increases to about 90%.

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Tachycardia Myocardial Infarction Heart Disease 52

Open Heart

JULY 28, 2023

Purpose The purpose of this meta-analysis is to compare the magnitude of the changes in left ventricular ejection fraction (LVEF) and cardiac magnetic resonance (CMR) relaxometry techniques soon after the completion of anthracycline therapy. Anthracyclines are associated with myocardial functional and morphological changes. LVEF is currently used to identify the functional changes.

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Dr. Smith's ECG Blog

JULY 22, 2023

Written by Pendell Meyers A man in his 70s with no cardiac history presented with acute weakness, syncope, and fever. He denied chest pain or shortness of breath. An ECG was performed in the ED at 1554: Original image unavailable, this is the only recorded scanned ECG available. See below for PM Cardio digitized version of this. PM Cardio digitized version.

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Chest Pain Heart Rhythm Sudden Cardiac Death Dysrhythmia 70

Learning + Leading

JULY 28, 2023

T he success of your Medical Assistant (MA) program depends on the quality of the learning solutions and certification partner. A reputable partner offering Nationally accredited certifications can have a profound impact on the program.

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Certification 52

Medical Xpress - ECG

JULY 26, 2023

A new deep learning application provides an automated screening method for left ventricular (LV) systolic dysfunction. The condition substantially reduces the pumping capacity of the heart and is associated with frequent hospitalizations and a twofold risk of premature death. LV dysfunction is preventable with timely detection and initiation of medications.

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Innovation Hospital 52

GEMMS

JULY 25, 2023

Cardiology is an evolving field, and staying ahead with the latest technological advancements is paramount in delivering efficient, top-notch care. Embracing and implementing cutting-edge technologies allows cardiologists to provide the highest quality care and stay at the forefront of medical advancements. Electronic Health Record (EHR) software has revolutionized the way cardiology clinics and healthcare facilities manage patient data, streamline workflows, and improve overall practice efficie

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Cardiovascular Imaging Technology Innovation Patient Care 52

ECG Guru

JULY 30, 2023

The Patient: This ECG is from a 63-year-old man who complained of epigastric pain for three hours. The pain was sudden in onset, burning in nature, and accompanied by nausea and palpitations. The patient is a heavy smoker, diabetic and hypertensive with a long history of non-compliance to his medications. He was given crushed aspirin, loaded with clopidogrel and heparin, given high-intensity statins, and rushed to the cath lab.

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Ischemia Hypertension Diabetes 52

Cardiometabolic Health Congress

JULY 25, 2023

Dr. Salvatore Carbone is professor in the Department of Kinesiology & Health Sciences, College of Humanities & Sciences at the Virginia Commonwealth University. Can you please explain the concept of an obesity paradox? Salvatore Carbone, PhD: First, I’d like to point out that obesity is a major risk factor for cardiometabolic disease. There are significant data that show that if you have obesity, you have a high risk of developing coronary heart disease, heart failure, type 2 diabetes (T

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Obesity BMI Heart Failure Cardiovascular Disease 52

Dr. Smith's ECG Blog

JULY 30, 2023

Written by Pendell Meyers A woman in her 50s presented with acute chest pain and lightheadedness since the past several hours. Here is her triage ECG during active symptoms: What do you think? The ED physician read this as "Normal sinus rhythm. LVH. Marked ST abnormality, possible anterior subendocardial injury." Smith : I suspect this was a confirmation of the conventional computer interpretation.

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Chest Pain Ischemia STEMI Arrhythmia 52

Learning + Leading

JULY 25, 2023

As a health sciences educator, you know how important it is to align your program with the latest industry trends and developments. By keeping up with industry advancements, you can provide the most relevant and up-to-date information to best prepare your students for their future as medical assistants.

Education 52

Education 52

EMS 12-Lead

JULY 24, 2023

David Didlake Acute Care Nurse Practitioner Firefighter / Paramedic (ret) @DidlakeDW Expert commentary and peer review by Dr. Steve Smith [link] @smithECGBlog A 57 y/o Female with PMHx HTN, HLD, DM, and current use of tobacco products, presented to the ED with chest discomfort. She described it as tightness, centralized, and associated with both dyspnea and diaphoresis.

Angina 52

Angina Ischemia Coronary Angiogram Stenosis 52

CTVS

JULY 25, 2023

It’s been more than five years since CTVS was the first practice in Central Texas to pioneer use of the GORE® TAG® Thoracic Branch Endoprosthesis (TBE) in a pivotal research study for treating aortic disease. More recently, our own board-certified cardiothoracic and vascular surgeons Dr. Mark Felger and Dr.

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Aortic Innovation Cardiothoracic Research 52

ECG Guru

JULY 26, 2023

This is the ECG of an 81-year-old man with hypertension. Currently, he has no complaints: no palpitations, no shortness of breath, no syncope, no chest pain. The rhythm is irregular, but all P-waves have the same shape. There is a non-respiratory sinus arrhythmia present, which is essentially the minimal variant of a sick sinus syndrome. There are no consequences for the patient resulting from this diagnosis.

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Arrhythmia Chest Pain Hypertension 52

Open Heart

JULY 24, 2023

Introduction Current guideline recommend functional imaging for myocardial ischaemia if coronary CT angiography (CTA) has shown coronary artery disease (CAD) of uncertain functional significance. However, diagnostic accuracy of selective myocardial perfusion imaging after coronary CTA is currently unclear. The Danish study of Non-Invasive testing in Coronary Artery Disease 3 trial is designed to evaluate head to head the diagnostic accuracy of myocardial perfusion imaging with positron emission

Coronary Artery Disease 52

Coronary Artery Disease Angina Article Research 52

Dr. Smith's ECG Blog

JULY 27, 2023

This 29 year old African American patient was found down, unconscious, not breathing and was given 2 mg of intranasal naloxone by a bystander. He then received bag-valve-mask ventilations for several minutes until he became responsive. He had a prehospital ECG that was worrisome to the medics, so they called me to see him at the door. On arrival to the ED, the patient was diaphoretic, tachycardic. and had dilated pupils.

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Tachycardia Ischemia Cardiac Arrest Echocardiogram 52

Dr. Anish Koka

JULY 23, 2023

Most have gotten used to egregiously bad coverage of current events that fills the pages of today’s New York Times, but even by their now very low standards a recent telling of a story about peripheral artery disease was very bad. The scintillating allegation by Katie Thomas, Jessica Silver-Greenberg and Robert Gebeloff is that “medical device makers are bankrolling doctors to perform artery clearing procedures that can lead to amputations” The reporters go on to tell a story a

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Vascular Care Outpatient Peripheral Arterial Disease Stents 52

Wellnest

JULY 18, 2023

Introduction Electrocardiogram has been crucial in diagnosing and monitoring cardiovascular health for over a century. Since its discovery in the early 20th century, it has undergone significant advancements, revolutionizing cardiology. Here, we will delve into the fascinating evolution of ECG technology, exploring its origins, key milestones, and modern applications.

Electrocardiogram 52

Electrocardiogram Technology Innovation Heart Rhythm 52

Vector Remote

JULY 18, 2023

Using Alert Prioritization to Maximize Cardiac Remote Patient Monitoring Outcomes The amount of data shared by cardiac remote monitoring systems is vast — without alert prioritization help, it can be too much data for an already-busy clinic to easily process. In a study following the transmission volume produced by 26,000 remotely monitored device patients, only about 40% of transmissions were actionable , whereas the rest were routine summaries.

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Outcomes Patient Care Defibrillator Tachycardia 52

ECG Guru

JULY 26, 2023

ST-elevation V2/V3, why? The patient never had chest pain, echocardiography inconspicious. History of several syncopal episodes. But, there is something wrong with the ECG. We observe a sinus rhythm ECG, at first glance, there are ST-elevations in leads V2-V4. No ST-depressions are visible. Upon closer examination, a prominent T-wave is noted, starting immediately after the QRS complex.

Chest Pain 52

Chest Pain 52