Sat.Jul 15, 2023 - Fri.Jul 21, 2023

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Cassling's Tim Elder Celebrates 20 Years of Service

Cassling

‘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.

Blog 98
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A young man with tachycardia. Should We Try Adenosine?

Dr. Smith's ECG Blog

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.

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ECG Blog #386 — OMI or Something Else?

Ken Grauer, MD

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.

Blog 78
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EM Quick Hits 50 Normal Unenhanced CT Renal Colic DDx, Perichondritis, Magnesium in Pediatric Asthma, Steroids for Pneumonia, OMI Cath Lab Activation

ECG Cases

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.

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Prognosis of light chain amyloidosis: a multivariable analysis for survival prediction in patients with cardiac involvement proven by endomyocardial biopsy

Open Heart

Background Cardiac involvement is a main determinant of mortality in light chain (AL) amyloidosis but data on survival of patients with cardiac AL amyloidosis proven by endomyocardial biopsy (EMB) are sparse. Methods This study analysed clinical, laboratory, electrocardiography and echocardiographic parameters for their prognostic value in the assessment of patients with AL amyloidosis and cardiac involvement.

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Unveiling the Evolution of ECG

Wellnest

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.

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Using Alert Prioritization to Maximize Cardiac Remote Patient Monitoring Outcomes

Vector Remote

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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Journal Club 4 PoCUS or X-ray for Distal Forearm Fractures

ECG Cases

You are working the ambulatory section of your ED and evaluating a 6-year boy with a possible distal radius injury. He lives with autism spectrum disorder and is uncomfortable in X-ray rooms, and you wonder if there is a role for PoCUS to help exclude a fracture. With expert clinical commentary by Dr. Arun Sayal and Research Methodology Hot Take by Dr.

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Systematic review of the incidence and clinical risk predictors of atrial fibrillation and permanent pacemaker implantation for bradycardia in Fabry disease

Open Heart

Introduction Fabry disease (FD) is an X-linked lysosomal storage disorder caused by enzyme deficiency, leading to glycosphingolipid accumulation. Cardiac accumulation triggers local tissue injury, electrical instability and arrhythmia. Bradyarrhythmia and atrial fibrillation (AF) incidence are reported in up to 16% and 13%, respectively. Objective We conducted a systematic review evaluating AF burden and bradycardia requiring permanent pacemaker (PPM) implantation and report any predictive risk

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Reviewing the all-in-pod heart health segment

Dr. Anish Koka

The All-in podcast is a fairly popular show that features successful silicon valley investors commenting about everything worth commenting on from politics to health. The group has good chemistry and interesting insights that breaks the mold of the usual tribal politics that controls legacy media analysis of current events. Last week, the podcast touched on a topic I spend a fair amount of time on : Cardiology.

Plaque 52
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Healthy Summer Foods to Consume for a Healthy Heart

AMS Cardiology

With summer in full swing, we get a bountiful array of healthy summer foods that are not only delicious but are also helpful for your cardiovascular system. Incorporating fresh, nutritious foods into your diet can help support a healthy heart. But what do those include? During the summer, fruits and vegetables are always first on the list! Berries Galore Berries are the crown jewels of summer foods , bursting with antioxidants, vitamins, and fiber that promote heart health.

Diet 52
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A pragmatic approach for the detection of post-ablation atrial fibrillation recurrence

Medical Xpress - ECG

Symptom-driven electrocardiogram (ECG) recording plays a significant role in the detection of post-ablation atrial fibrillation recurrence (AFR). However, making timely medical contact whenever symptoms occur may not be practical. The authors of an article published in Cardiovascular Innovations and Applications deployed a deep learning (DL)-based handheld device to facilitate symptom-driven monitoring.

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Cardiovascular and renal multimorbidity increase risk of atrial fibrillation in the PREVEND cohort

Open Heart

Objective Atrial fibrillation (AF) is a condition that occurs in the presence of comorbidities. With the accumulation of comorbidities (multimorbidity), some combinations may more often occur together than others. Information on the impact of clustering of these on incident AF is sparse. We aimed to investigate clustering of cardiovascular and renal comorbidities and study the association between comorbidity clusters and incident AF.

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Cardiac rehabilitation reduces risk of death years after heart surgery, still underutilized

Science Daily - Stroke

People who participate in cardiac rehabilitation have a decreased risk of death years after surgery, with a trend towards better outcomes in patients who attend more sessions, a study finds. Just over half of patients attended a single session of cardiac rehabilitation, and only 12% of those patients completed all 36 sessions. This occurred despite health systems referring patients to the program 94% of the time, suggesting referral alone is not sufficient to ensure participation.

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The First 60 Minutes of a Heart Attack: The Golden Hour

Wellnest

Have you wondered what causes a heart attack? Three coronary arteries supply blood to the heart. When one of these arteries becomes completely blocked by a blood clot, it results in a heart attack, also known as MI (Myocardial infarction). The accumulation of cholesterol, foam cells, fibrous tissue, and calcium mainly causes the narrowing of coronary arteries.

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Predictors of worse outcome after postponing non-emergency cardiac interventions during the COVID-19 pandemic

Open Heart

Objective Deferral of non-emergency cardiac procedures is associated with increased early emergency cardiovascular hospitalisation. This study aimed to identify predictors of worse clinical outcome after deferral of non-emergency cardiovascular interventions. Methods This observational case-control study included consecutive patients whose non-emergency cardiac intervention has been postponed during COVID-19-related lockdown between 19 March and 30 April 2020 (n=193).

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Artificial intelligence-assisted interpretation of systolic function by echocardiogram

Open Heart

Objective Precise and reliable echocardiographic assessment of left ventricular ejection fraction (LVEF) is needed for clinical decision-making. Recently, artificial intelligence (AI) models have been developed to estimate LVEF accurately. The aim of this study was to evaluate whether an AI model could estimate an expert read of LVEF and reduce the interinstitutional variability of level 1 readers with the AI-LVEF displayed on the echocardiographic screen.

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COVID-19 in congenital heart disease (COaCHeD) study

Open Heart

Background COVID-19 has caused significant worldwide morbidity and mortality. Congenital heart disease (CHD) is likely to increase vulnerability and understanding the predictors of adverse outcomes is key to optimising care. Objective Ascertain the impact of COVID-19 on people with CHD and define risk factors for adverse outcomes. Methods Multicentre UK study undertaken 1 March 2020–30 June 2021 during the COVID-19 pandemic.

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Report highlights public health impact of serious harms from diagnostic error in US

Science Daily - Stroke

Improving diagnosis in health care is a moral, professional and public health imperative, according to the U.S. National Academy of Medicine. However, little is known about the full scope of harms related to medical misdiagnosis -- current estimates range widely. Using novel methods, a team sought to derive what is believed to be the first rigorous national estimate of permanent disability and death from diagnostic error.

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Prognostic utility of N-terminal pro B-type natriuretic peptide ratio in mixed aortic valve disease

Open Heart

Objective We aimed to assess the incremental prognostic value of N-terminal-pro-B-type natriuretic peptide (Nt-proBNP) for risk stratification in mixed aortic valve disease (MAVD) patients. Methods We included 556 (73±12 years, 37% women) consecutive patients with at least a moderate aortic stenosis (AS) or aortic regurgitation (AR) lesion with a concomitant AS or AR of any severity in whom Nt-proBNP was measured and expressed as its ratio (measured Nt-proBNP divided by the upper limit of n

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Association between exercise load, resting heart rate, and maximum heart rate and risk of future ST-segment elevation myocardial infarction (STEMI)

Open Heart

Objective This study aimed to examine the association between exercise workload, resting heart rate (RHR), maximum heart rate and the risk of developing ST-segment elevation myocardial infarction (STEMI). Methods The study included all participants from the UK Biobank who had undergone submaximal exercise stress testing. Patients with a history of STEMI were excluded.