A 30-something woman with chest pain and h/o pulmonary hypertension due to chronic pulmonary emboli
A 30-something woman with known history of pulmonary hypertension due to chronic pulmonary emboli presented with 12 hours of substernal chest pain.Here was her ED ECG:What do you think?This precordial T-wave inversion is typical of right ventricular hypertrophy (RVH). However, most other features of RVH are not present. There is an incomplete RBBB, which does support RVH. But there is no right axis deviation (axis is however borderline at 83 degrees, nearly vertical. There is no large R-wave in V1. However, these findings are not sensitive enough for RVH to rule it out.The T-wave morphology, along with the known history of pulmonary hypertension, should alert you to look for a previous ECG.I saw this and thought immediately that this was probably her baseline EKG. We looked for old ones, and indeed previous ECGs were identical.The patient ruled out for both PE and MI while in the ED, and could be discharged. This was her baseline ECG. Our diagnosis was gastroesophageal reflux.Here are a couple other cases of RVH:55 year old woman with chest pain and precordial T-wave InversionsThis one does have right axis deviation and a large R-wave in V1A 50-something male with DyspneaThis one also has right axis deviation and a large R-wave in V1
We describe the development, experimental evaluation, and comparison of the ECG signals obtained using our proposed approach and a gold standard medical device, through metrics that allow the evaluation of morphological similarities. Results point to a high correlation between the two evaluated setups, thus supporting the idea of meaningfully collecting ECG data along medical auscultation points with the proposed form factor. Moreover, this work has led us to conclude that for the studied population, signals acquired on focuses F1, F2, and F3 are usually highly correlated with leads V1 and V2 of the standard ECG medical recording procedure.
Authors: Yoon D, Jang JH, Choi BJ, Kim TY, Han CH Abstract Biosignals like electrocardiogram or photoplethysmogram have been widely used for monitoring and determining status of patients. However, it has been recently discovered that more information than that we have used traditionally were included in the biosignals after artificial intelligence (AI) was applied. Most meaningful advancement of current AI was in deep learning. The deep learning-based models show the best performance in most area in current due to the distinguished characteristic that it is able to extract important features from raw data. For that...
CONCLUSIONS: These findings suggest that there are significant differences in personality traits between hypertensive patients with and without vascular and cardiac damage. PMID: 31955182 [PubMed - in process]
From every indication of the text storm between reps, this year's NANS is the one **NOT** to miss. It's going to be the duck's nuts!
This week's very cool case was donated by Dr. Mike Feely. We haven't had anything like this one before on the blog!The specimen below was submitted by a young woman who found this " worm " by her arm, right below her mouth, upon waking from a nap. She reported having abdominal pain with associated diarrhea for several weeks prior to presentation, but was otherwise healthy. After being in formalin:Histologic sections (H&E):Identification? Any additional information that you would like?
A new study casts doubt on the popular notion that smoking weed or using CBD may help cancer patients cope with pain.
Researchers at the University of Israel assessed the sleep quality and levels of pain of 128 people over 50 being treated at a specialist clinic.
OBJECTIVES: Alcohol for intercostal neuralgia may induce severe injection pain. Although nerve block provided partial pain relief, alcohol might be diluted, and the curative effect decreased when the local anesthetic and alcohol were given at the same point. Therefore, we observed the modified method for intercostal neuralgia, a Two-point method, in which the local anesthetic and alcohol were given at different sites. METHOD: Thirty patients diagnosed with intercostal neuralgia were divided into 2 groups: Single-point group and Two-point group. In the Single-point group, alcohol and local anesthetic were injected at the sa...
CONCLUSION: Ultrasound could be as sensitive and specific as contrast-enhanced MRI for the diagnosis of subclinical synovitis and tenosynovitis.
(Reuters Health) ― As many as one in three adults diagnosed with asthma may not actually have the chronic lung disorder, a Canadian study suggests. Researchers did lung function tests on 613 adults who had been diagnosed with asthma within the past five years. If participants took asthma medicines, researchers gradually weaned them off the drugs over four clinic visits to see how well their lungs worked without treatment. The evaluations ruled out asthma in 203 of the participants, or 33 percent. After one year of follow-up, 181 of these people still did too well on lung tests to be diagnosed with asthma, researchers rep...