Dr. Smith's ECG Blog

OCTOBER 18, 2023

Written by Jesse McLaren Four patients presented with chest pain. All initial ECGs were labeled ‘normal’ or ‘otherwise normal’ by the computer interpretation, and below are the ECGs with the final cardiology interpretation. If you were working in a busy emergency department, would you like to be interrupted to interpret these ECGs or can these patients safely wait to be seen because of the normal computer interpretation?

Chest Pain 117

Chest Pain STEMI Electrocardiogram Ischemia 117

ECG Cases

OCTOBER 17, 2023

In this month's EM Quick Hits podcast: Sarah Reid on an approach to Infant Vomiting, Brit Long on Orbital Cellulitis essentials, Justin Morgenstern on the PATCH trial - Prehospital TXA in Trauma, Christina Shenvi on Prevention and Treatment of Delirium, Jason Hines on Procedural Skills Decay, Aaron Billin on Altitude Sickness. The post EM Quick Hits 52 Infant Vomiting, Orbital Cellulitis, Prehospital TXA in Trauma, Prevention and Treatment of Delirium, Procedural Skills Decay, Altitude Sickness

Pediatrics 94

Pediatrics 94

Science Daily - Heart Disease

OCTOBER 17, 2023

A new study looked at 926 polygenic risk scores for 310 diseases. It found that, on average, only 11% of individuals who develop disease are identified, while at the same time 5% of people who do not develop the disease test positive. Unaffected people usually outnumber those affected which results in far more false than true positive predictions.

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Society of Thoracic Surgeons - Early Career

OCTOBER 20, 2023

Webinar Early Career Journey: The Business of Medicine—How to Successfully Transition from Training to Practice kchalko Fri, 10/20/2023 - 14:04 December 7, 2023 Leaders in cardiothoracic surgery will share valuable information about the transition from training to practice from academic, private practice, and hospital perspectives. Topics will include networking with colleagues, conducting a job search, negotiating a contract, and managing personal finances.

Private Practice 52

Private Practice Webinar Academic Cardiothoracic 52

Dr. Smith's ECG Blog

OCTOBER 18, 2023

The patient is a 20 something female. She is healthy with no known cardiac disease. She was admitted to the neurology department due to headache and vomiting. She was found to have a viral CNS infection. A few days into her hospital stay she developed chest discomfort and the following ECG was recorded. What do you think? Why such large T-waves? Are these hyperacute T-waves?

Cardiac Arrest 104

Cardiac Arrest Tachycardia Cardiomyopathy Bradycardia 104

ECG Cases

OCTOBER 17, 2023

In this ECG Cases blog Dr. Jesse McLaren guides us through 10 cases, driving home the points that sepsis is a common cause of rapid Afib and diffuse ST depression with reciprocal ST elevation in aVR, myo/pericarditis is a diagnosis of exclusion, endocarditis or lyme carditis can cause AV block, PE can cause low grade fever and ECG signs of acute RV strain and that fever can unmask Brugada syndrome.

Pericarditis 91

Pericarditis AFIB Blog Atrial Fibrillation 91

Dr. Malcolm Kendrick

OCTOBER 20, 2023

20th October 2023 (With lessons from, and for, all other health services around the world) The Quality and Outcomes Framework The Quality and Outcomes Framework (QOF) was to be the glittering triumph of Evidence Based Medicine. Many of the commonest and most deadly diseases afflicting humanity would be picked up early, then treated. Almost entirely by using medications which had proven benefits.

Heart attacks 52

Heart attacks Heart Attack Blood Pressure ACE Inhibitor 52

Dr. Smith's ECG Blog

OCTOBER 15, 2023

Submitted by anonymous, written by Pendell Meyers I was at triage when this ECG was presented to me. What do you think? Here's what the Queen of Hearts thinks: Note that the Queen has "HIGH" confidence that this is OMI. As noticed by the AI, if the patient presented with chest pain , then even this subtle ECG is diagnostic of OMI. Specifically , this ECG is diagnostic of acute LAD OMI, with hyperacute T waves likely in V3 and V4, very small but abnormal STE in V2-V4 (because of its there is a lo

Chest Pain 101

Chest Pain Cardiomyopathy STEMI Blog 101

Coronary Artery Disease Journal

OCTOBER 18, 2023

Objective We investigated the relationship between using a rotary compression device (RCD) with or without sterile gauze and adverse events in transradial access (TRA) for coronary intervention. Methods In this study involving 933 patients at Yueyang Hospital, we recorded TRA-related adverse events, such as bleeding, forearm hematoma, swollen palms, radial artery occlusion (RAO) and others.

Hemorrhage 52

Hemorrhage Hospital 52

CineECG

OCTOBER 19, 2023

Page 1 shows all the results of the CineECG analyis. Details regarding the results of the ECG waveform comparisons for both the ventricles and atria can be found on pages 2 & 3 for the ventricles and page 4 (atria) The report shows the patient information as contained in the received ECG data set. The gender indication is used to select a normal distribution category which is used in the CineECG analysis process.

Anatomy 52

Anatomy Physiology Electrocardiogram 52

ADN Center of Excellence

OCTOBER 19, 2023

In the fast-paced world of modern medicine, staying at the forefront of innovation is crucial for providing the best patient care. One area that has made significant strides in revolutionizing patient care is the field of minimally invasive techniques. As doctors committed to enhancing patient outcomes, let's delve into how these techniques are changing the landscape of healthcare and improving the overall patient experience.

Patient Care 52

Patient Care Innovation Interventional Cardiology Outcomes 52

Dr. Smith's ECG Blog

OCTOBER 16, 2023

This is a case I posted Saturday, October 14. This ECG was texted to me after the fact with no information. What do you think? This is the ECG that I used for the post. It is high quality screenshot of a pdf: I had said that the Queen said this is Not OMI with low confidence However , the image that had been texted to me and submitted to the Queen was not this one above.

Chest Pain 58

Chest Pain Blog Cardiomyopathy 58

All About Cardiovascular System and Disorders

OCTOBER 19, 2023

Risk of Spontaneous vs Induced Brugada Pattern It is well known that sodium channel blockers can unmask the ECG pattern in Brugada syndrome. A recent systematic review and meta-analysis evaluated the utility of drug challenge in testing for Brugada syndrome. They found that spontaneous type 1 ECG characterized by coved, down sloping ST elevation with T inversion in right precordial leads had 2.4% annual incidence of serious arrhythmic events.

General Cardiology 52

General Cardiology 52

Cassling

OCTOBER 19, 2023

Mobile 1.5T system brings high-quality diagnostic imaging to offsite locations Siemens Healthineers has announced the Food and Drug Administration (FDA) clearance of the MAGNETOM Viato.Mobile , a new 1.5 Tesla (1.5T) magnetic resonance (MR) imaging scanner optimized for mobile use to provide greater flexibility in deploying MR imaging.

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ADN Center of Excellence

OCTOBER 17, 2023

At ADN CoE , we have always been committed to providing top-notch medical training, especially in the realm of interventional cardiology. Our mission has been to equip you with the latest techniques and knowledge to enhance patient care and elevate your medical practice. However, as the landscape of healthcare evolves, so do our aspirations and goals.

Innovation 52

Innovation Quality of Life Webinar Patient Care 52

Cardiomatics

OCTOBER 17, 2023

Now including AV block detection, fast-track analysis, and a new layout We’re excited to unveil some significant updates, news and improved features of Cardiomatics v5 that help medical professionals interpret ECG easily and quickly with the use of high-accuracy AI. World’s 1st MDR Certification for automated ECG analysis using the power of AI Today we share thrilling news for the MedTech community and cardiologists!

Certification 52

Certification Technology 52

All About Cardiovascular System and Disorders

OCTOBER 17, 2023

How Does Fever Precipitate Arrhythmia in Brugada Syndrome? In Brugada syndrome dysfunctional voltage gated sodium channels Na V 1.5 have delayed activation and earlier inactivation. This leads to shortening of action potential duration. There is additional shortening of action potential duration at higher temperatures. This is the proposed mechanism of precipitation of arrhythmias in Brugada syndrome during febrile episodes.

Arrhythmia 52

Arrhythmia General Cardiology 52

MIBHS

OCTOBER 16, 2023

In the realm of cardiac and thoracic surgeries, advancements in surgical techniques have led to the development of minimally invasive approaches that offer several advantages over traditional open-heart procedures. Two of these minimally invasive techniques, minithoracotomy, and ministernotomy, have gained prominence in recent years. Minithoracotomy Vs.

Coronary Artery Bypass Graft 52

Coronary Artery Bypass Graft Open-Heart Surgery Bicuspid/Mitral Aortic valve 52

ADN Center of Excellence

OCTOBER 17, 2023

At ADN CoE , we have always been committed to providing top-notch medical training, especially in the realm of interventional cardiology. Our mission has been to equip you with the latest techniques and knowledge to enhance patient care and elevate your medical practice. However, as the landscape of healthcare evolves, so do our aspirations and goals.

Innovation 52

Innovation Quality of Life Webinar Patient Care 52

CTVS

OCTOBER 16, 2023

According to the CDC, every 40 seconds someone suffers from a stroke in the United States. Unfortunately, nearly every four seconds, someone also dies from one. A stroke occurs when blood flow to the brain is interrupted, causing parts of the body to rapidly weaken and/or stop functioning.

Strokes 52

Strokes Stroke Risk Factors Heart Disease 52

All About Cardiovascular System and Disorders

OCTOBER 16, 2023

Current Role of Digoxin in Heart Failure as Per Guidelines and DIGIT-HF trial of Digitoxin Use of digoxin in heart failure has come down markedly over the past decades due to concerns of toxicity and availability of more effective medications. Concern for toxicity is because of the narrow therapeutic window of digoxin along with interactions with other cardiovascular drugs and in those with renal dysfunction, which can enhance toxicity.

Heart Failure 52

Heart Failure Atrial Fibrillation Document Hospital 52

HeartRhythm

OCTOBER 19, 2023

Hypertrophic cardiomyopathy (HCM)-related sudden cardiac death (SCD) rates with contemporary management are low; however, high-intensity exercise can induce fatal arrhythmias in HCM patients. Thus, current guidelines recommend avoiding high-intensity exercise in HCM patients at high risk for SCD1,2. The 2020 ESC guidelines for exercise in patients with cardiovascular diseases recommend an exercise treadmill test (ETT) for risk stratification before providing exercise advice to HCM patients HCM3.

Exercise 40

Exercise Cardiomyopathy Sudden Cardiac Death Cardiovascular Disease 40

Circulation: Cardiovascular Quality & Outcomes

OCTOBER 20, 2023

Circulation: Cardiovascular Quality and Outcomes, Volume 16, Issue 11 , Page e009609, November 1, 2023. BACKGROUND:The relationship between marijuana use and cardiovascular health remains uncertain, with several observational studies suggesting a potential association with increased adverse atherosclerotic cardiovascular disease (ASCVD) outcomes. This study examined the relationship between marijuana use, ASCVD risk factors, and cardiometabolic risk profiles.METHODS:US adults (18–59 years) witho

Risk Factors 40

Risk Factors Cardiovascular Disease Cholesterol Biomarkers 40

Circulation

OCTOBER 20, 2023

Circulation, Ahead of Print. BACKGROUND:Homozygous familial hypercholesterolemia (HoFH) is a rare genetic disorder characterized by severely elevated low-density lipoprotein cholesterol (LDL-C) levels due to profoundly defective LDLR (LDL receptor) function. Given that severely elevated LDL-C starts in utero, atherosclerosis often presents during childhood or adolescence, creating a largely unmet need for aggressive LDLR-independent lipid-lowering therapies in young patients with HoFH.

Pediatrics 40

Pediatrics Cholesterol Atherosclerosis Circulation 40

Journal of Cardiovascular Electrophysiology

OCTOBER 19, 2023

Abstract The QDOT MICRO™ Catheter is a novel open-irrigated contact force-sensing radiofrequency ablation catheter. It offers very high-power short-duration (vHPSD) ablation with 90 W for 4 s to improve safety and efficacy of catheter ablation procedures. Although the QDOT MICRO™ Catheter was mainly designed for pulmonary vein isolation (PVI) its versatility to treat atrial fibrillation (AF) and other types of arrhythmias was recently evaluated by the FAST and FURIOUS study series and other stud

Arrhythmia 40

Arrhythmia Ablation Atrial Flutter Atrial Fibrillation 40

HeartRhythm

OCTOBER 19, 2023

Precision medicine is the vision of healthcare where therapy is tailored to each patient. As part of this vision, digital twinning technology promises to deliver a digital representation of organs or even patients, using tools capable of simulating personal health conditions and predicting patient or disease trajectories based on relationships learned both from data and from biophysics knowledge.

Patient Care 40

Patient Care Technology 40

Hypertension Journal

OCTOBER 19, 2023

Hypertension, Ahead of Print. BACKGROUND:Hypertension is the most potent stroke risk factor and is also related to cerebral small vessel disease. We studied the relation between mid-to-late-life hypertension trends and cerebral white matter injury in community-dwelling individuals from the FHS (Framingham Heart Study).METHODS:FHS Offspring cohort participants with available mid-life and late-life blood pressure measurements and brain magnetic resonance imaging were included.

Hypertension 40

Hypertension Blood Pressure Risk Factors Strokes 40

Circulation: Cardiovascular Quality & Outcomes

OCTOBER 19, 2023

Circulation: Cardiovascular Quality and Outcomes, Volume 16, Issue 11 , Page e010148, November 1, 2023. BACKGROUND:Although disparities in cardiac rehabilitation (CR) participation are well documented, the role of community-level distress is poorly understood. This study evaluated the relationship between community-level distress and CR participation, access to CR facilities, and clinical outcomes.METHODS:A retrospective cohort study was conducted on a 100% sample of Medicare beneficiaries under

Cardiac Rehabilitation 40

Cardiac Rehabilitation Inpatient Myocardial Infarction Outcomes 40

Circulation

OCTOBER 19, 2023

Circulation, Ahead of Print. BACKGROUND:The thrombectomy-capable stroke center (TSC) is a recently introduced intermediate tier of accreditation for hospitals at which patients with acute ischemic stroke receive care. The comparative quality and clinical outcomes of reperfusion therapies at TSCs, primary stroke centers (PSCs), and comprehensive stroke centers (CSCs) have not been well delineated.METHODS:We conducted a retrospective, observational, cohort study from 2018 to 2020 that included pat

Stroke 40

Stroke Strokes Thrombolysis Certification 40

HeartRhythm

OCTOBER 18, 2023

Pulmonary vein isolation (PVI) is increasingly utilized for the treatment of atrial fibrillation (AF).1 One method of achieving PVI is cryoablation, which has demonstrated comparable success to radiofrequency ablation, but does present unique challenges.

Atrial Fibrillation 40

Atrial Fibrillation Pulmonary Ablation 40

Hypertension Journal

OCTOBER 19, 2023

Hypertension, Volume 80, Issue 12 , Page 2523-2532, December 1, 2023. Target: BP™ is a national initiative launched by the American Heart Association and the American Medical Association in 2017 in response to the high prevalence of uncontrolled blood pressure (BP) in the United States. Target: BP™ provides support to health care organizations and health care teams, with no user fees, to improve the quality of care for adults with hypertension by providing education and resources and recognizing

Blood Pressure 40

Blood Pressure Download Hypertension Education 40

Stroke Journal

OCTOBER 18, 2023

Stroke, Volume 54, Issue 12 , Page 3165-3168, December 1, 2023. BACKGROUND:RICAMIS trial (The Remote Ischemic Conditioning for Acute Moderate Ischemic Stroke) has demonstrated efficacy of remote ischemic conditioning (RIC) in acute ischemic stroke. We conducted a post hoc analysis of RICAMIS to investigate whether large artery atherosclerosis (LAA) subtype contributed to the outcomes.METHODS:This is a post hoc analysis of the RICAMIS trial.

Atherosclerosis 40

Atherosclerosis Strokes Stroke Outcomes 40

Circulation

OCTOBER 19, 2023

Circulation, Volume 148, Issue 24 , Page 1932-1944, December 12, 2023. BACKGROUND:The consequences of exercise-induced premature ventricular contractions (PVCs) in asymptomatic individuals remain unclear. This study aimed to assess the association between PVC burdens during submaximal exercise and major adverse cardiovascular events (MI/HF/LTVA: myocardial infarction [MI], heart failure [HF], and life-threatening ventricular arrhythmia [LTVA]), and all-cause mortality.

Exercise 40

Exercise Myocardial Infarction Heart Failure Cardiomyopathy 40

HeartRhythm

OCTOBER 18, 2023

“Atrial fibrillation begets atrial fibrillation” describes the experimental observation, that artificial maintenance of atrial fibrillation (AF) leads to a marked shortening of atrial effective refractory period, and increase in inducibility and stability of AF, which is completely reversible within one week of sinus rhythm (1). In addition to these electrophysiological and reversible changes, which occur relatively early during AF, AF has been shown to be also associated with cardiac structural

Atrial Fibrillation 40

Atrial Fibrillation Electrophysiology Heart Failure 40

Science Daily - Stroke

OCTOBER 18, 2023

Researchers have discovered that turning brain immune cells into neurons successfully restores brain function after stroke-like injury in mice. These findings suggest that replenishing neurons from immune cells could be a promising avenue for treating stroke in humans.

Stroke 40

Stroke Strokes Research 40

Science Daily - Heart Disease

OCTOBER 17, 2023

A team has identified an essential internal control mechanism that can promote the maturation of human stem cell-derived heart muscle cells, possibly leading to new therapies for heart disease and cardiac damage.

Heart Disease 40

Heart Disease 40

European Journal of Heart Failure

OCTOBER 18, 2023

Mineralocorticoid receptor antagonist (MRA) use in severe chronic kidney disease and heart failure with reduced ejection fraction (HFrEF). CI, confidence interval; eGFR, estimated glomerular filtration rate; HR, hazard ratio. ABSTRACT Aims Mineralocorticoid receptor antagonists (MRAs) improve outcomes in heart failure with reduced ejection fraction (HFrEF) but remain underused and are often discontinued especially in patients with chronic kidney disease (CKD) due to concerns on renal safety.

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Kidney Disease Heart Failure Hospital Outcomes 40