2023

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ECG Video Blog #403 (220) — Ps,Qs,3Rs Approach to this Tachycardia.

Ken Grauer, MD

== — CLICK HERE — for a V ideo presentation of this case! Below are slides used in my video presentation. For full discussion of this case — See ECG Blog #220 — == The long lead II rhythm strip shown in Figure-1 was obtained from an 51-year-old man who presented to the ED ( Emergency Department ) with "palpitations" that began 1 hour earlier. HOW would you interpret this tracing?

Blog 193
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Early insulin resistance in normoglycemic low-risk individuals is associated with subclinical atherosclerosis

Cardiovascular Diabetology

Elevated glycated hemoglobin (HbA1c) is associated with a higher burden of subclinical atherosclerosis (SA). However, the association with SA of earlier insulin resistance markers is poorly understood. The stu.

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Very high LDL no impact on plaque progression

Dr. Malcolm Kendrick

10th December 2023 A very important study – please watch Very high low density lipoprotein levels with no impact on plaque progression I interrupt my series on what is wrong with the health service to bring you breaking news. I was sent the e-mail below, directing me to a short YouTube presentation by Dr Shawn Baker. It highlights a study which provides very strong evidence that a very high LDL (as seen in some people who go on a keto diet), has no impact on coronary artery plaque progression.

Plaque 145
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Cardiac imaging in athlete’s heart: current status and future prospects

Cardiovascular Ultrasound

Physical activity contributes to changes in cardiac morphology, which are known as “athlete’s heart”. Therefore, these modifications can be characterized using different imaging modalities such as echocardiogr.

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Young-Onset Dementia Tied to New Risk Factors

Med Page Today

(MedPage Today) -- Four new risk factors for young-onset dementia were identified in the prospective U.K. Biobank study. Orthostatic hypotension, vitamin D deficiency, high C-reactive protein (CRP) levels, and social isolation emerged as new risk.

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Blood pressure should be measured lying down: study

American Heart News - Stroke News

American Heart Association Hypertension Scientific Sessions – Abstract 452. An analysis of data from a long-running study of more than 11,000 adults from four diverse communities in the United States has found that adults who had high blood pressure while both seated upright and lying supine (flat on their backs) had a higher risk of heart disease, stroke, heart failure or premature death compared to adults without high blood pressure while upright and supine.

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VT? Or Supraventricular tachycardic rhythm with aberrancy?

Dr. Smith's ECG Blog

A 70 something male presented in severe respiratory distress. The patient had altered mental status and so he was prepared for intubation. Before intubation, he became hypotensive. On the monitor patient had wide-complex tachycardia. The following 12-lead was obtained: What do you think? Differential is ventricular tachycardia versus supraventricular tachycardia with aberrancy versus sinus tachycardia with a aberrancy.

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Research offers new insights into how breakdown of omega-6 fatty acids influences metabolism

Medical Xpress - Cardiology

What role do omega-6 fatty acids play in cardiovascular disease and diabetes? Scientists from Mannheim, together with researchers from Heidelberg, Frankfurt, and Hangzhou in China, have investigated the breakdown of omega-6 fatty acids and gained new insights into how their oxidation products influence the metabolism.

Research 138
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Clinical characteristics, treatment, and blood pressure control in patients with hypertension seen by primary care physicians in Spain: the IBERICAN study

Frontiers in Cardiovascular Medicine

Objectives To determine the clinical profile, according to the history of hypertension, the risk of developing hypertension, current antihypertensive treatment and BP control rates in patients with hypertension from the IBERICAN cohort. Methods IBERICAN is an ongoing prospective cohort study, whose primary objective is to determine the frequency, incidence, and distribution of CVRF in the adult Spanish population seen in primary care settings.

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Increased risk of heart rhythm disruption after COVID-19

Science Daily - Heart Disease

Individuals infected with COVID-19 are also at an increased risk of suffering from heart rhythm disturbances, such as atrial fibrillation, according to a new study.

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ECG Blog #409 — Every-Other-Beat.

Ken Grauer, MD

The ECG in Figure-1 — was obtained from a patient with palpitations. The patient was hemodynamically stable in association with this rhythm. QUESTIONS: What is the rhythm in Figure-1 ? — How certain are you of your answer? — Why is QRS morphology changing ? Figure-1: The initial ECG in today's case. My Interpretation of the ECG in Figure-1: Since the patient is hemodynamically stable — there is time for systematic assessment of the rhythm.

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New study finds many couples around the world may share high blood pressure

American Heart News - Heart News

Research Highlights: A study of married or partnered, middle-aged and older heterosexual couples in the U.S., England, China and India found that in 20% to 47% of the couples, both spouses/partners had high blood pressure. The prevalence of both.

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Amal Mattu’s ECG Case of the Week – January 1, 2024

ECG Weekly Workout

HPI: A 50-year-old man decides to get “his life in order” for the new year. He quits smoking, decides to eat healthier and exercise more, and to be more compliant with his blood pressure medications. A week into the new year he wakes up feeling weak and achy with nausea and vomiting. He is lightheaded when sitting or standing and has trouble getting out of bed.

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Lost brain function restored in mice after stroke

Science Daily - Stroke

Researchers have succeeded in restoring lost brain function in mouse models of stroke using small molecules that in the future could potentially be developed into a stroke recovery therapy.

Stroke 130
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Blood Test May Be Able to Tell Which Organs Have Accelerated Aging

Med Page Today

(MedPage Today) -- About one in five healthy people ages 50 and older had an organ that was aging at an accelerated rate, which may increase mortality and signal organ-specific disease, a study of nearly 5,700 people suggested. In an analysis.

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Electronic 'Nudges' to Improve Influenza Vaccine Uptake May Be Less Effective in Patients with Diabetes

HCPLive

Analysis of the NUDGE-FLU study reveals electronic nudges designed to boost influenza vaccination were more effective in older adults without diabetes, highlighting the need for tailored approaches in diabetes populations.

Diabetes 129
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A 50-something with Regular Wide Complex Tachycardia: What to do if electrical cardioversion does not work?

Dr. Smith's ECG Blog

Case submitted by anonymous. Written by Smith. Ken's piece at the bottom is excellent. A 50-something presented with s udden onset palpitations 8 hrs prior while sitting at desk at work. He had concurrent sharp substernal chest pain that resolved, but palpitations continued. Over past 3 months, he has had similar intermittent episodes of sharp chest pain while running, but none at rest.

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Metixene is an incomplete autophagy inducer in preclinical models of metastatic cancer and brain metastases

Journal of Clinical Investigation - Cardiology

A paucity of chemotherapeutic options for metastatic brain cancer limits patient survival and portends poor clinical outcomes. Using a CNS small-molecule inhibitor library of 320 agents known to be blood-brain barrier permeable and approved by the FDA, we interrogated breast cancer brain metastasis vulnerabilities to identify an effective agent. Metixene, an antiparkinsonian drug, was identified as a top therapeutic agent that was capable of decreasing cellular viability and inducing cell death

Cancer 133
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New AI-powered algorithm could better assess people's risk of common heart condition

Medical Xpress - Cardiology

A new artificial intelligence (AI) model designed by Scripps Research scientists could help clinicians better screen patients for atrial fibrillation (or AFib)—an irregular, fast heartbeat that is associated with stroke and heart failure. The model picks up on tiny variations in a person's normal heartbeat that signify AFib risk, which standard screening tests cannot detect.

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What’s wrong with the NHS? – Part 4

Dr. Malcolm Kendrick

8th December 2023 Nothing can simply be ‘good enough’. Before beginning this blog, I thought I would introduce you to the first two laws of regulation ‘ regulation-omics’ : I know that many of the things that are obliterating productivity in the NHS are happening in all health care services, everywhere. A couple of blogs back I mentioned a US study which looked at all the guidelines primary care practitioners (PCPs) are now required to follow.

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AFL WITH 2:1 CONDUCTION IN A PATIENT WITH PREEXISTING RBBB + LAFB

ECG Guru

If a wide complex tachycardia occurs, the probability is very high that it is a ventricular tachycardia (approx. 80%, in patients with a previous myocardial infarction (.) approx. 90%). Here we see a broad complex tachycardia that looks like an RBBB + LAFB, which is regular. In this constellation, 3 causes must be considered: 1. fascicular tachycardia from the left posterior fascicle of the left tawara fascicle (QRS width usually only around 130 ms, but sometimes significantly longer). 2.

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ECG Blog #396 — Why the Flat Line?

Ken Grauer, MD

The ECG in Figure-1 — was obtained from a middle-aged man with palpitations and shortness of breath. He was hemodynamically stable at the time this tracing was recorded. How would YOU interpret the ECG in Figure-1 ? Is there evidence of a recent or ongoing acute MI? What might you do first? Figure-1: The initial ECG in today's case. ( To improve visualization — I've digitized the original ECG using PMcardio ).

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New technologies and medications that can prevent, reduce CVD top 2023 scientific research

American Heart News - Heart News

DALLAS, Dec. 19, 2023 — Technologies that less invasively restore blood flow to blocked or narrowed arteries; a medicine that outsmarts high blood pressure’s development; and new evidence that diabetes drugs may offer heart health benefits to people that.

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Physiology Friday #198: The Anabolic Response to Postexercise Protein Intake Has "No Upper Limit"

Physiologically Speaking

Greetings! Welcome to the Physiology Friday newsletter. This newsletter is brought to you by Examine.com — the best place on the internet for health and nutrition information — and my new eBook, “VO2 Max Essentials.” Details can be found at the end of the post! Physiologically Speaking is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber.

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ECG Cases 45 ECG in Weakness and Neurological Symptoms

ECG Cases

In this ECG Cases blog Dr. Jesse MacLaren guides us through 10 cases of patients who present with generalized weakness or acute neurologic symptoms and discusses how to look for ECG signs of dysrhythmias, electrolyte emergencies, acute coronary occlusion, and demand ischemia in patients with generalized weakness and in patients with neurologic symptoms, to consider predisposing factors like LVH; seizure-like activity from cardiac syncope; TIA/CVA embolic sources like atrial fibrillation or LV th

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Beware of Fake Ozempic, FDA Warns

Med Page Today

(MedPage Today) -- The FDA continues its investigation into counterfeit semaglutide (Ozempic) products -- which may still be available for purchase -- and has already seized thousands of units, the agency announced Thursday. In its warning.

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Report: Most Adults Fail to Recognize Diabetes as Cardiovascular Risk Factor

HCPLive

Among adults in middle- to high-income nations, awareness of diabetes as a cardiovascular risk factor remains a persistent issue.

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A 50-something with chest pain.

Dr. Smith's ECG Blog

This was sent by anonymous The patient is a 55-year-old male who presented to the emergency department after approximately 3 to 4 days of intermittent central boring chest pain initially responsive to nitroglycerin, but is now more constant and not responsive to nitroglycerin. It is unknown when this pain recurred and became constant. More past history: hypertension, tobacco use, coronary artery disease with two vessel PCI to the right coronary artery and circumflex artery several years prior.

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Rational design of a SOCS1-edited tumor-infiltrating lymphocyte therapy using CRISPR/Cas9 screens

Journal of Clinical Investigation - Cardiology

Cell therapies such as tumor-infiltrating lymphocyte (TIL) therapy have shown promise in the treatment of patients with refractory solid tumors, with improvement in response rates and durability of responses nevertheless sought. To identify targets capable of enhancing the antitumor activity of T cell therapies, large-scale in vitro and in vivo clustered regularly interspaced short palindromic repeats (CRISPR)/Cas9 screens were performed, with the SOCS1 gene identified as a top T cell–enhancing

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A study of genetics of pericarditis increases understanding of newly approved drug treatment

Medical Xpress - Cardiology

Sequence variants that protect against pericarditis have been discovered at a genomic locus encoding interleukin-1 immune cytokines. A newly approved drug treatment for pericarditis inhibits these cytokines, according to a new study.

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What’s wrong with the NHS? – part five

Dr. Malcolm Kendrick

29th December 2023 The underlying forces In the last few blogs, I have been writing about the proliferation of guidelines, targets, and regulatory work in the NHS. Hopefully I have managed to give you a sense of how much time and effort these pile on to everyday work. Time and effort which eats away at clinical time, erodes morale and drives down productivity.

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Use of Anticoagulant Drug after Aortic Valve Replacement Lowers Mortality Risk, Mayo Clinic Study Finds

DAIC

milla1cf Tue, 12/12/2023 - 07:00 December 12, 2023 — Patients who received the anticoagulant drug warfarin after bioprosthetic aortic valve replacement had lower incidence of mortality and a decreased risk of blood clots, according to a retrospective study published in Mayo Clinic Proceedings. The use of bioprosthetic aortic valve replacement has increased significantly during the past decade.

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ECG Blog #410 — How Tall are the T Waves?

Ken Grauer, MD

QUESTION: HOW would YOU interpret the ECG in Figure-1 — if no clinical information was provided? Figure-1: The initial ECG in today's case. ( To improve visualization — I've digitized the original ECG using PMcardio ). = The H ISTORY in T oday's C ASE: The patient in today's case is a teenager who presented to the ED ( E mergency D epartment ) in cardiac arrest after electrocution.

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Deaths from heart valve infections drop across U.S. overall, but surged among young adults

American Heart News - Heart News

Research Highlights: An analysis of death certificate data from 1999 to 2020 showed a decline in deaths related to infective endocarditis throughout most of the United States yet found an alarming increase of 2%-5% among adults ages 25-44. There was.

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Medical Image Sharing App Eliminates CDs & Makes Your Job Easier

NOVARAD

In today's interconnected world, quick and easy access to information is the norm, yet the healthcare sector has sometimes struggled to keep pace. After all, there were once days of using CDs to share essential medical images. It was not only inconvenient but also raised concerns about accessibility and the well-being of patients.

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Ep 187 Crashing Anaphylaxis – AMAX4 Algorithm and The Max McKenzie Case

ECG Cases

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 114
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Food as Diabetes Medicine? Maybe Not, Trial Suggests

Med Page Today

(MedPage Today) -- An intensive food-as-medicine program didn't improve glycemic control in adults with type 2 diabetes any better than usual care in a randomized clinical trial. After 6 months, both groups had a similar drop in HbA1c -- 1.5.

Diabetes 131