Dr. Smith's ECG Blog

SEPTEMBER 27, 2023

This was written by Magnus Nossen, from Norway, with comments and additions by Smith A 50 something smoker with no previous medical hx contacted EMS due to acute onset chest pain. Upon EMS arrival the patient appeared acutely ill and complained of chest pain. An ECG was recorded immediately and is shown below. How do you interpret the ECG? ECG#1 There is a regular tachycardia with a ventricular rate of about 180 bpm.

Tachycardia 128

Tachycardia Chest Pain Academic Arrhythmia 128

Ken Grauer, MD

SEPTEMBER 29, 2023

You are asked to interpret the ECG in Figure-1. What is the rhythm in ECG #1 ? Figure-1: You are asked to interpret this tracing. What is the rhythm? MY Thoughts on the ECG in Figure-1: I routinely begin assessment of each 12-lead ECG I encounter — with interpretation of the rhythm. To do this — I apply the P s, Q s, 3 R Approach ( See ECG Blog #185 — for review of my system ).

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Blog Download Arrhythmia Pacemaker 102

ECG Cases

SEPTEMBER 26, 2023

I had the enormous honour of interviewing Dr. Ben McKenzie, EM physician and a PhD candidate at the University of Melbourne studying the topic of resuscitation algorithms in anaphylaxis and asthma. The tragic death of his son Ben McKenzie at the age 15 from hypoxic respiratory arrest as a result of anaphylaxis and asthma in 2021 has led Dr. McKenzie on a mission to prevent deaths from anaphylaxis and asthma by educating emergency providers around the world using his AMAX4 algorithm as a framewor

Education 110

Education 110

ECG Guru

SEPTEMBER 27, 2023

The patient: 4 week old female infant with past medical history of meconium aspiration at birth with APGAR scores of 2,4,6. Intubated and given nitric oxide for pulmonary hypertension. Weaned in NICU over 10 days. Echocardiogram during that time showed stiff pulmonic valve. This ECG was obtained at follow up appointment. Infant is eating well, no cyanotic spells.

Pediatrics 98

Pediatrics Pulmonary Stenosis Echocardiogram 98

Dr. Smith's ECG Blog

SEPTEMBER 29, 2023

This case comes from Jason Winter, of The Facebook Clinical Electrocardiology ECG Page. A 60-something woman called EMS for chest pain. Here is her first prehospital ECG: What do you think? There is very low voltage in the precordial leads, with a total QRS amplitude of only 3.5 mm in V2 and 4 mm in V3. In spite of this low voltage, there is ST elevation (as measured at the J-point and relative to the PQ junction, and as measured by the computer and shown on the right), of 0.54 mm in V2 and 0.65

Chest Pain 124

Chest Pain STEMI Stents Stent 124

MIBHS

SEPTEMBER 29, 2023

Heart surgery, also known as cardiac surgery, is a medical procedure that has saved countless lives by treating various heart conditions. Traditionally, heart surgery involves the use of blood transfusions to replace lost blood during the procedure. However, in recent years, there has been a growing interest in bloodless heart surgery, a technique that eliminates or significantly reduces the need for blood transfusions.

Open-Heart Surgery 52

Open-Heart Surgery Circulation Cancer Hospital 52

Cardiometabolic Health Congress

SEPTEMBER 29, 2023

Cardiometabolic Health Congress faculty member, Fátima Rodriguez, MD, MPH, has committed much of her clinical and research efforts to reducing health disparities in Hispanic-American communities. Cardiometabolic conditions – specifically obesity, diabetes and heart disease – disproportionately affect the 60 million people in the U.S. with Hispanic heritage.

Health Disparities 52

Health Disparities Obesity Heart Disease Cardiovascular Disease 52

Dr. Smith's ECG Blog

SEPTEMBER 29, 2023

Sent by anonymous, written by Pendell Meyers, reviewed by Smith and Grauer A man in his 40s presented to the ED with HTN, DM, and smoking history for evaluation of acute chest pain. He was eating lunch when he had sudden onset chest pressure, 9/10, radiating to his back, with sweating and numbness in both hands. Triage ECG: What do you think? It's a very "fun" ECG, with initial ectopic atrial tachycardia (negative P waves in inferior leads conducting 1:1 with the QRSs), followed by spontaneous r

Chest Pain 118

Chest Pain Tachycardia STEMI Blog 118

Cassling

SEPTEMBER 29, 2023

Lung cancer is a pervasive public health issue in the United States. To date, it remains the leading cause of cancer death among Americans — more than breast, prostate, and colorectal cancers combined. The American Cancer Society estimates 2023 will bring: About 238,340 new cases of lung cancer (117,550 in men and 120,790 in women) About 127,070 deaths from lung cancer (67,160 in men and 59,910 in women) While these statistics paint a stark reality, advances in medical science, screening guideli

Cancer 52

Cancer Public Health Technology Blog 52

ADN Center of Excellence

SEPTEMBER 28, 2023

Every year, on September 29th, the world unites to celebrate World Heart Day. This day serves as a reminder of the vital role our hearts play in keeping us alive and healthy. For cardiologists, it's a moment to reflect on their dedication to heart health and share valuable insights with the world. World Heart Day World Heart Day was established by the World Heart Federation to raise awareness about cardiovascular diseases (CVD) and promote heart-healthy lifestyles.

COVID-19 52

COVID-19 Heart Disease Education Coronary Artery Disease 52

Society of Thoracic Surgeons - Adult Cardiac

SEPTEMBER 27, 2023

Webinar Latin Heart Round Series: Rounds on Patient with Tetralogy of Fallot Undergoing Surgical Palliation dkaczmarek Wed, 09/27/2023 - 13:24 October 20, 2023 Image Experts provide up-to-date insight on the management of patients born with Tetralogy of Fallot. The discussion is based on a real patient and presented by an early career surgeon. Controversial topics such as neonatal management and different surgical approaches were covered, as well as emerging strategies for improved outcomes.

Webinar 52

Webinar Congenital Hospital Outcomes 52

Dr. Smith's ECG Blog

SEPTEMBER 26, 2023

2 middle aged males presented with chest pain. Which had the more severe chest pain at the time of the ECG? Here is the ECG of patient 1 , recorded about 2 hours after pain onset: A Massive Anterolateral STEMI/OMI Peak troponin I over 60,000 ng/L Here is the ECG of patient 2 , recorded about 2 hours after pain onset: This is OMI, but it is not STEMI Peak troponin I 440 ng/L Patient 1 at the top with the massive ST Elevation complained of 5/10 chest pain at the time the ECG was recorded.

Chest Pain 107

Chest Pain STEMI Myocardial Infarction Hospital 107

Dr. Paddy Barrett

SEPTEMBER 26, 2023

When a patient joins my practice, I always ask about sleep. I do this for three reasons: There is a relationship between short sleep and worse cardiovascular outcomes. Poor sleep generally impacts cognitive well-being, nutrition and exercise routines, all of which are key pillars of cardiovascular health. To assess if they have a sleep condition called obstructive sleep apnea, which is also tightly linked to cardiovascular disease and can be treated.

Blood Pressure 52

Blood Pressure Cardiovascular Disease Atrial Fibrillation Coronary Artery Disease 52

ADN Center of Excellence

SEPTEMBER 27, 2023

In the rapidly changing field of cardiology, IVUS (Intravascular Ultrasound) and OCT (Optical Coherence Tomography) have seen significant growth. Keeping up with the times isn't a choice anymore – it's a must. Discover how these essential tools are transforming the sector and the significance of continuous learning in these procedures through medical education.

Education 52

Education Best Practices Stents Stent 52

CTVS

SEPTEMBER 27, 2023

A swimmer, hiker, and martial artist, you’d never guess 64-year-old Trisha McLaughlin struggled with an irregular heartbeat, congestive heart failure, and has undergone a number of heart procedures. She credits the Convergent Procedure performed by CTVS cardiothoracic surgeon Dr. Faraz Kerendi for helping her get back to her healthy and active life.

AFIB 52

AFIB Cardiothoracic Heart Failure Atrial Fibrillation 52

Dr. Smith's ECG Blog

SEPTEMBER 24, 2023

This is written by Magnus Nossen, with some edits by Smith This ECG diagnosis will be obvious to the majority of the readers of this blog. It is not obvious for the majority of doctors or even cardiologists. A 50 something male was seen in the emergency room due to typical chest pain. The pain had started the same day about two hours prior to medical contact.

Chest Pain 89

Chest Pain Atrial Fibrillation AFIB Myocardial Infarction 89

Society of Thoracic Surgeons - Early Career

SEPTEMBER 26, 2023

Podcast #156: The Power of Saying No Do you find it difficult to say no to people? Do you tend to put others' needs before your own? Image Dr. Vanessa Patrick-Ralhan Dr. Vanessa Patrick-Ralhan, author of The Power of Saying No: The New Science of How to Say No that Puts You in Charge of Your Life, talks about empowered refusal and strategies of people who are adept at giving a clear “no” while still honoring personal relationships and keep their reputation intact.

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ECG Cases

SEPTEMBER 26, 2023

The EM Cases Quiz Vault is now on Anki flashcards to help you solidify knowledge of Emergency Medicine Cases podcasts. Herein lies a guide to optimize EM Cases Anki decks, download links and more. The post EM Cases Quiz Vault on Anki appeared first on Emergency Medicine Cases.

Download 52

Download 52

ADN Center of Excellence

SEPTEMBER 24, 2023

In today's ever-evolving medical landscape, physicians across diverse specialities seek to enhance their expertise and make a meaningful impact in the field. The cornerstone of this journey towards excellence often lies in fellowship programs. Why Fellowship Programs? Fellowship programs, renowned for their transformative capabilities, offer a profound avenue for physicians to expand their horizons, deepen their knowledge, and fine-tune their clinical skills.

Innovation 52

Innovation Research Technology Patient Care 52

Heart Sisters

SEPTEMBER 24, 2023

I was so busy that even reading – my great love – had turned into just another item on an overloaded To Do list. Then something happened to change all that.

Risk Factors 52

Risk Factors COVID-19 Heart Disease 52

Science Daily - Stroke

SEPTEMBER 28, 2023

Short-term exposure to air pollution may be linked to an increased risk of stroke. Short-term exposure was defined as occurring within five days of the stroke.

Stroke 53

Stroke Strokes 53

Becker's Hospital Review - Cardiology

SEPTEMBER 27, 2023

Lancaster (Pa.) General Hospital has the lowest 30-day readmission rate for heart failure in the country, according to CMS data.

Heart Failure 52

Heart Failure Hospital CMS 52

Journal of Cardiovascular Pharmacology

SEPTEMBER 28, 2023

Coronary reactive hyperemia (CRH) is impaired in cardiovascular diseases, and angiotensin-II (Ang-II) exacerbates it. However, it is unknown how Ang-II affects CRH in Tie2-sEH Tr (human-sEH-overexpressed) versus wild-type (WT) mice. sEH-overexpression resulted in CRH-reduction in Tie2-sEH Tr versus WT. We hypothesized that Ang-II exacerbates CRH-reduction in Tie2-sEH Tr versus WT.

Ischemia 40

Ischemia Cardiovascular Disease Article 40

Stroke: Vascular and Interventional Neurology

SEPTEMBER 28, 2023

Stroke: Vascular and Interventional Neurology, Volume 3, Issue 6 , November 1, 2023. BackgroundTraumatic direct carotid cavernous fistulas results in a direct communication between the internal carotid artery and the cavernous sinus. Covered stents are not frequently used in neuro‐endovascular procedures due to concerns primarily about occlusion of perforating vessels.

Stents 40

Stents Stent Stroke Strokes 40

Hypertension Journal

SEPTEMBER 28, 2023

Hypertension, Ahead of Print. Race is a social construct, but self-identified Black people are known to have higher prevalence and worse outcomes of hypertension than White people. This may be partly due to the disproportionate incidence of salt sensitivity of blood pressure in Black people, a cardiovascular risk factor that is independent of blood pressure and has no proven therapy.

Blood Pressure 40

Blood Pressure Physiology Hypertension Risk Factors 40

HeartRhythm

SEPTEMBER 27, 2023

As the most common cause of syncope, vasovagal syncope (VVS) is the result of cerebral hypoperfusion caused by sudden-onset bradycardia and mediated by parasympathetic overdrive.1 VVS is generally categorized into three types: cardioinhibitory, vasodepressive and mixed type. Patients with recurrent syncope are first treated with conservative measures such as fluid and salt intake, trigger avoidance, and physical counter-pressure maneuvers.

Bradycardia 40

Bradycardia 40

Science Daily - Heart Disease

SEPTEMBER 26, 2023

An estimated 80 percent of older adults in the U.S. have high blood pressure. Maintaining healthy blood pressure can protect against serious conditions like heart failure, heart attacks, and strokes. A new study found that adding a relatively minimal amount of movement, about 3,000 steps per day, can significantly reduce high blood pressure in older adults.

Blood Pressure 40

Blood Pressure Heart Attack Heart attacks Heart Failure 40

Stroke: Vascular and Interventional Neurology

SEPTEMBER 28, 2023

Stroke: Vascular and Interventional Neurology, Volume 3, Issue 6 , November 1, 2023. BackgroundThe optimal management of patients with symptomatic isolated internal carotid artery (ICA) occlusion is unknown. We aimed to assess whether endovascular treatment (EVT) compared with standard medical care was associated with improved functional outcomes in patients with acute symptomatic isolated intracranial ICA occlusion without involvement of the middle or anterior cerebral artery, that is, ICA‐I oc

Hemorrhage 40

Hemorrhage Stroke Strokes Outcomes 40

Hypertension Journal

SEPTEMBER 28, 2023

Hypertension, Volume 80, Issue 12 , Page 2506-2514, December 1, 2023. Nearly 1.4 billion people worldwide suffer from arterial hypertension, a significant risk factor for cardiovascular disease which is now the leading cause of death. Despite numerous drugs designed to treat hypertension, only ≈14% of hypertensive individuals have their blood pressure under control.

Hypertension 40

Hypertension Blood Pressure Risk Factors Cardiovascular Disease 40

HeartRhythm

SEPTEMBER 26, 2023

Despite advances in catheter ablation and epicardial access techniques, surgical treatment of ventricular tachycardia (VT) continues to have a role in patients with arrhythmic substrates that are not accessible or amenable to treatment by percutaneous techniques.1–4 In addition, the need for other cardiac surgery can be exploited as an opportunity for concomitant direct mapping and ablation.5,6 Because surgical treatment of VT is used rather infrequently, there is a paucity of data comparing dif

Tachycardia 40

Tachycardia Ablation 40

European Journal of Heart Failure

SEPTEMBER 26, 2023

Exercise training in patients with advanced heart failure and left ventricular assist device (Ex-VAD) trial. 6MWT, 6-min walk test; KCCQ, Kansas City Cardiomyopathy Questionnaire physical domain score; peakVO 2 , peak oxygen consumption; RCT, randomized controlled trial. Aims Small studies and observations suggested that exercise training may improve peak oxygen consumption (peakVO 2 ) in patients with advanced heart failure and left ventricular assist device (LVAD).

Exercise 40

Exercise Heart Failure Quality of Life Cardiomyopathy 40

Stroke: Vascular and Interventional Neurology

SEPTEMBER 28, 2023

Stroke: Vascular and Interventional Neurology, Volume 3, Issue 6 , November 1, 2023. BackgroundEndovascular thrombectomy (EVT) is limited to comprehensive stroke centers (CSCs), with patients who first present to primary stroke centers (PSCs) transferred for treatment by road ambulance or helicopter emergency medical services (HEMS). We aimed to determine if there were outcome differences in patients transferred for EVT via HEMS.MethodsA retrospective observational study was performed in the set

Thrombolysis 40

Thrombolysis Stroke Strokes Circulation 40

Hypertension Journal

SEPTEMBER 28, 2023

Hypertension, Volume 80, Issue 12 , Page 2559-2571, December 1, 2023. BACKGROUND:Children from pregnancies affected by preeclampsia have an increased risk of cognitive and behavioral alterations via unknown pathophysiology. We tested the hypothesis that preeclampsia generated reduced brain cortex angiogenesis in the offspring.METHODS:The preeclampsia-like syndrome (PELS) mouse model was generated by administering the nitric oxide inhibitor NG-nitroarginine methyl ester hydrochloride.

Circulation 40

Circulation Hypertension 40

Circulation: Heart Failure

SEPTEMBER 27, 2023

Circulation: Heart Failure, Volume 16, Issue 11 , Page e010849, November 1, 2023. BACKGROUND:MMP (matrix metalloproteinase)-2 participates in extracellular matrix regulation and may be involved in heart failure (HF), atrial fibrillation (AF), and coronary heart disease.METHODS:Among the 4693 ARIC study (Atherosclerosis Risk in Communities) participants (mean age, 75±5 years; 42% women) without prevalent HF, multivariable Cox proportional hazard models were used to estimate associations of plasma

Preserved Ejection Fraction 40

Preserved Ejection Fraction Heart Failure Atrial Fibrillation Heart Disease 40

Circulation: Genomic and Precision Medicine

SEPTEMBER 27, 2023

Circulation: Genomic and Precision Medicine, Volume 16, Issue 5 , Page 442-451, October 1, 2023. Background:Patients with de novo chest pain, referred for evaluation of possible coronary artery disease (CAD), frequently have an absence of CAD resulting in millions of tests not having any clinical impact. The objective of this study was to investigate whether polygenic risk scores and targeted proteomics improve the prediction of absence of CAD in patients with suspected CAD, when added to the PR

Chest Pain 40

Chest Pain Coronary Artery Disease Risk Factors Circulation 40

BMH Medical Journal

SEPTEMBER 26, 2023

In the rapidly advancing digital world, technology is revolutionizing the healthcare industry. Light-Fidelity (LiFi) is emerging as the next-generation communication technology with several benefits including high data rates. LiFi is a high-speed communication technology that can transmit data at the speed of light. LiFi is a cutting edge wireless networking that uses infrared and visible light spectrum data exchange.

Technology 40

Technology Innovation 40

Journal of Cardiovascular Pharmacology

SEPTEMBER 25, 2023

Sepsis-induced cardiac dysfunction represents a major cause of high mortality in intensive care units with limited therapeutic options. Golgi protein 73 (GP73) has been implicated in various diseases. However, the role of GP73 in LPS-induced cardiac dysfunction is unclear. Here, we established sepsis-induced cardiac dysfunction model by LPS administration in wild type (WT) and GP73 knockout (GP73-/-) mice.

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Article 40