Sat.Feb 11, 2023 - Fri.Feb 17, 2023

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ECG Blog #363 — How Many Directions?

Ken Grauer, MD

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?

Blog 78
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10% Computed Radiography Reimbursement Cut in Effect: Get the Facts

Cassling

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%.

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Contemporary percutaneous management of coronary calcification: current status and future directions

Open Heart

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.

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Journal Club 2 – Diltiazem Dosing in Atrial Fibrillation with Rapid Ventricular Response

ECG Cases

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.

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Eating eggs can protect your Heart?

Heart 2023 Conference

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.

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Myocarditis update from Sweden

Dr. Anish Koka

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

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Main operating room deliveries for patients with high-risk cardiovascular disease

Open Heart

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.

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Endovascular Treatment for Basilar Artery Occlusion: Revisiting Evidence From Randomized Clinical Trials

Stroke: Vascular and Interventional Neurology

Stroke: Vascular and Interventional Neurology, Ahead of Print. BACKGROUNDAcute ischemic stroke attributed to basilar artery occlusion is known to be associated with high rates of mortality and disability. However, the previous clinical trials did not provide evidence to support the efficacy of endovascular treatment (EVT) in patients with basilar artery occlusion.

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Can AI-enhanced heart screening address health disparities?

Medical Xpress - ECG

Clinicians and researchers around the world are combining artificial intelligence, known as AI, with health care to help identify patients at greater risk of cardiovascular diseases, such as stroke and heart failure. However, as use of these AI-enhanced tools grows, researchers at Mayo Clinic are asking, "Do these tools work reliably for people of color?

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2023 STS Coronary Conference Agenda

Society of Thoracic Surgeons - Allied Health

2023 STS Coronary Conference Agenda gtrainyte Tue, 02/14/2023 - 09:13 Session titles and presenters are subject to change. Course Directors Marc Ruel, MD, MPH, Ottawa, ON, Canada Joseph F. Sabik III, MD, Cleveland, OH, USA Sigrid Sandner, MD, Vienna, Austria David Glineur, MD, PhD, Ottawa, ON, Canada Building an Advanced Coronary Surgery Program Day 1: Saturday, June 3, 2023 7:00 a.m. – 8:00 a.m.

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EM Quick Hits 46 – Wilderness Medicine, Bowel Prep Hyponatremia, Non-Convulsive Status Epilepticus, Morel Lavallee Lesions, Pacemaker ECGs, Loans vs Investing

ECG Cases

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

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Intravenous Thrombolysis in an Endovascular Treatment–Dominant Era: What Does the Future Hold?

Stroke: Vascular and Interventional Neurology

Stroke: Vascular and Interventional Neurology, Volume 3, Issue 6 , November 1, 2023. The definitive target of acute ischemic stroke is rapid and effective reperfusion. This is vastly conditional on rapid recognition of symptoms and efficient transport mechanisms that bring the patient to optimal health care facility. This review summarizes evidence from cardiology in this field and highlights the need of such measures to be incorporated in systems of care for stroke, and further information is n

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Two 70 year olds with chest pain, and 3 pitfalls of the STEMI paradigm

Dr. Smith's ECG Blog

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

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Atrial functional mitral regurgitation: prevalence, characteristics and outcomes from the National Echo Database of Australia

Open Heart

Aims Atrial functional mitral regurgitation (AFMR) is characterised by left atrial and consequent mitral annular dilatation causing mitral regurgitation. AFMR is likely to become more common with population ageing, alongside increases in atrial fibrillation and heart failure with preserved ejection fraction; conditions causing atrial dilatation. Here, we aim to define the prevalence and characterise the patient and survival characteristics of AFMR in the National Echocardiographic Database of Au

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What is going on in V2 and V3, with a troponin I rising to 1826 ng/L at 4 hours?

Dr. Smith's ECG Blog

I was reading EKGs on the system before a shift, and saw this one: What do you think? I was worried that the ST depression and T-wave inversion in V2 and V3 might be posterior OMI. I went to the chart and found that the patient was a sepsis patient with hypotension and a K of 3.0. There was no chest pain. So I thought it probably is not posterior OMI and I just moved on and kept reading EKGs.

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Chest pain, among other symptoms. What do you see?

Dr. Smith's ECG Blog

This patient had many complaints including chest pain. The computer called this Acute STEMI What do you think? STEMI never has a very short QT. This QT interval is 320 ms, with a QTc of around 350, depending on which correction formula you use. (There is Bazett, Fridericia, Hodges, Framingham and Rautaharju -- see here at mdcalc: [link] If the ST Elevation here were due to STEMI, it would be an LAD Occlusion.