The Beat Blog

APRIL 8, 2022

“Doc, your patient is here,” said one of the clinical staff members. We were closing up for the day when my patient arrived over an hour late. He moved slowly and leaned into his cane as if it would split at any moment, looking exhausted. He sat down apologetically to explain the taxing journey that he had taken to get to the clinic that day—a half mile walk to the bus stop to catch the 106, only to hop off and onto the 44 and then the 52.

Cardiogenic Shock 52

Cardiogenic Shock Blood Pressure Heart attacks Heart Attack 52

EMS 12-Lead

APRIL 8, 2022

David Didlake Firefighter / Paramedic Acute Care Nurse Practitioner @DidlakeDW Peer review by Dr. Stephen Smith @smithECGblog I was reviewing ECG’s in our LifeNet database and happened upon this one without any knowledge of clinical circumstances. Figure 1 Raw findings include Sinus Rhythm, narrow QRS duration, small q-waves in Leads I / aVL / V5 / V6 (which is not entirely atypical), an inverted P-wave in V1 to suggest possible lead malposition, a normal QRS/T angle, and a dispersion of alterna

Myocardial Infarction 52

Myocardial Infarction Coronary Angiogram STEMI Ischemia 52

Dr. Smith's ECG Blog

APRIL 8, 2022

Case written and submitted by Brandon Fetterolf MD, edits by Meyers A woman in her early 30s with multiple autoimmune disorders including vasculitis presented with 2-3 hours of mid-left side chest discomfort with radiation to neck and left arm and associated with nausea, diaphoresis and dizziness. Initial ECG on presentation at 1554 (no prior for comparison): What do you think is happening to his 30s woman?

Chest Pain 52

Chest Pain SCAD STEMI Blog 52

Open Heart

APRIL 7, 2022

Background Proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9is) are an important but underutilised option to help optimise lipid management. We developed a new service to improve patient access to these medicines in line with National Institute for Health and Care Excellence recommendations. This paper describes the model and provides lipid-lowering results and feedback from the first 100 referred patients.

Innovation 52

Innovation Cholesterol Education 52

HCM Beat

APRIL 8, 2022

Comprehensive risk assessment combined with shared decision making around the decision to participate in sports seems to be the way of the future, as more fully discussed in the most recent ACC/AHA Guidelines.

Defibrillator 40

Defibrillator Cardiomyopathy Blog 40

EMS 12-Lead

APRIL 2, 2022

David Didlake Firefighter / Paramedic Acute Care Nurse Practitioner @DidlakeDW Expert commentary provided by Dr. Ken Grauer CASE 1 An 82 y/o Male called 911 for sudden onset dizziness while at rest. Upon arrival he was found alert and oriented, and without gross distress. He denied difficulty breathing, epigastric pain, or chest discomfort. BP 110/67 HR 68 RR 14 (non-labored) SpO2 95 RA Physical exam revealed slight pallor and diaphoresis.

Myocardial Infarction 52

Myocardial Infarction Stent Stents STEMI 52

Medical Xpress - ECG

APRIL 4, 2022

A simple electrocardiogram (ECG) can pinpoint hospitalized COVID-19 patients at high risk of death who might need intensive management. That's the finding of a study presented at EHRA 2022, a scientific congress of the European Society of Cardiology (ESC). Specifically, the research showed that a prolonged QT interval on the ECG was an independent risk factor for both myocardial injury and one-year mortality.

COVID-19 40

COVID-19 Hospital Electrocardiogram Risk Factors 40

Dr. Sanjay Gupta

APRIL 4, 2022

We are blessed with 4 heart valves – 2 on the left side which are known as the mitral and aortic valves and 2 on the right side – the tricuspid and pulmonary valves. Sometimes due to a congenital problem, age related changes or even an acquired cause, these valves can start leaking and when they do so to a severe extent, they can adversely impact on a patient’s quality of life as well as their lifespan.

Heart Valves 40

Heart Valves Aortic valve Exercise Quality of Life 40

Open Heart

APRIL 6, 2022

Objective This study summarises the diagnostic validity and clinical utility of genetic testing for patients with hypertrophic cardiomyopathy (HCM) and their at-risk relatives. Methods A systematic search was performed in PubMed (MEDLINE), Embase, CINAHL and Cochrane Central Library databases from inception through 2 March 2020. Subgroup and sensitivity analyses were prespecified for individual sarcomere genes, presence/absence of pathogenic variants, paediatric and adult cohorts, family history

Cardiomyopathy 52

Cardiomyopathy Article 52

Open Heart

APRIL 5, 2022

Objective Atrial dilation is known to be a poor prognostic indicator. However, its clinical, functional and prognostic implications have not been thoroughly explored in secondary mitral regurgitation (SMR). We sought to describe the implications of severe atrial dilation (SAD) in SMR. Methods We included all adult patients with severe SMR due to left ventricle dysfunction (with no organic mitral valve disease) who underwent transthoracic echocardiography between January 2012 and March 2021 at ou

Bicuspid/Mitral 52

Bicuspid/Mitral Atrial Fibrillation Diabetes Outcomes 52

Open Heart

APRIL 4, 2022

Objective Given recent data on published diagnostic accuracies, this study sought to determine the most cost-effective diagnostic strategy for detection of significant coronary artery disease (CAD) in stable angina patients using invasive coronary angiography (ICA) and fractional flow reserve (FFR) as the reference standard. Methods A probabilistic decision-analytical model was developed which modelled a cohort of patients with stable angina.

Angina 52

Angina Coronary Artery Disease 52

Open Heart

APRIL 7, 2022

Aims To define the prevalence of non-sustained tachyarrhythmias and bradyarrhythmias in patients with the m.3243A>G mitochondrial genotype and a previously defined, profile, associated with ‘high sudden-death risk’ Methods and results Patients at high risk of sudden death because of combinations of ventricular hypertrophy, mitochondrial encephalopathy, lactic acidosis and stroke-like episodes family phenotype, epilepsy or high mutation load, due to the m.3243A>G mutation, wer

Arrhythmia 40

Arrhythmia ACE Inhibitor Download Tachycardia 40

Open Heart

APRIL 6, 2022

Background Poor adherence to guideline recommendations for anticoagulation in patients with acute myocardial infarction (MI) and atrial fibrillation (AF) is previously reported. The aim of the present cohort study was to assess time trends in prescription of anticoagulation therapy in a nationwide registry-based cohort of patients with acute MI and AF.

Myocardial Infarction 52

Myocardial Infarction Atrial Fibrillation Heart Failure Stroke 52