Arrhythmia Masquerading as Cardiac Ischemia

A 45-year-old woman with a history of medication-controlled essential hypertension, stage 2 chronic kidney disease, type 2 diabetes mellitus, and a pack-a-day cigarette habit presented less than 60 minutes after acute onset of severe shortness of breath that awoke her from sleep. She had felt well the previous day, and went to bed with no complaints.   Around 4 a.m., she woke up from sleep very dyspneic, with moderate chest “discomfort” over her left chest that radiated to her back and was unchanged by position or respirations. She denied other symptoms such as fever, cough, nausea, vomiting, numbness, or abdominal pain.   Her blood pressure was 138/76 mm Hg, pulse 87 bpm, respiratory rate 26, and SpO2 was 95%. She was afebrile, and her physical exam was unremarkable: clear breath sounds, no S3 or murmur, and no lower extremity edema. She felt slightly less dyspneic with supplemental oxygen. She was treated with an aspirin orally. A sublingual nitroglycerin improved her chest discomfort, and a chest radiograph was clear. Her presenting electrocardiogram is shown in Figure 1.   The ECG is consistent with a supraventricular tachycardia (SVT), likely to be atypical atrioventricular nodal reentrant tachycardia (AVNRT). The key feature to note is the absence of P waves before the QRS complex and retrograde P-waves evident following the QRS as part of the T-wave. The discomfort in her chest and neck is likely secondary to atrial contraction against ...
Source: Spontaneous Circulation - Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

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Source: Anxiety, Stress and Coping - Category: Psychiatry & Psychology Authors: Source Type: research
Authors: Zhang J, Guo Y, Jia T, Guo H, Meng F, Xue S PMID: 31961111 [PubMed - as supplied by publisher]
Source: Panminerva Medica - Category: General Medicine Tags: Panminerva Med Source Type: research
Postoperative management of hallux valgus varies widely. Setting preoperative expectations is an important aspect of attaining a successful outcome, but this is not routinely reviewed in the literature. This chapter offers suggestions on successfully navigating this area of patient care. Current concepts focus on pain control, immobilization, and return to activities. This chapter also reviews the current literature in these areas and sets out the authors ’ preferred management in the postoperative setting.
Source: Foot and Ankle Clinics - Category: Orthopaedics Authors: Source Type: research
Publication date: Available online 23 January 2020Source: Journal of Minimally Invasive GynecologyAuthor(s): Prathiba M. De Silva, Ayesha Mahmud, Paul P. Smith, T. Justin ClarkAbstractObjectiveTo identify the most effective analgesia for women undergoing office hysteroscopy.Data sourcesMedline, Embase, CINAHL and the Cochrane library were searched from inception until August 2019 investigating the effect of different analgesics on pain control in office hysteroscopy.Methods of study selectionRandomised controlled trials were included that investigated the effect of analgesics on pain experienced by women undergoing diagnos...
Source: Journal of Minimally Invasive Gynecology - Category: OBGYN Source Type: research
Publication date: Available online 23 January 2020Source: Journal of Minimally Invasive GynecologyAuthor(s): Whitney Trotter Ross, Jordan M. Newell, Richard Zaino, Allen R. Kunselman, Gerald J. Harkins, Andrea S. BentonAbstractStudy ObjectiveTo evaluate the diagnosis of appendiceal endometriosis in coincidental appendectomy specimens using a standard versus modified histopathologic analysis.DesignProspective analysis of 300 consecutive patients undergoing coincidental appendectomy at time of a primary gynecologic procedure.SettingAcademic tertiary referral hospital in the Northeastern United States.PatientsWomen ages 22 to...
Source: Journal of Minimally Invasive Gynecology - Category: OBGYN Source Type: research
In conclusion, these results indicated that SXD produced beneficial sedative and hypnotic bioactivities mediated by regulating the serotonergic and immune system.
Source: Metabolic Brain Disease - Category: Neurology Source Type: research
High blood pressure: A common diagnosis, that shows hardly any symptoms, but can be deadly. Hardened arteries and blood forced too hard against artery walls can lead to a heart attack or stroke. Fortunately, there are lifestyle improvements that can lower blood pressure and potentially save your life.
Source: Daily Express - Health - Category: Consumer Health News Source Type: news
Abbott Laboratories has been wildly successful with its FreeStyle Libre continuous glucose monitor (CGM) since winning FDA approval in 2017, but it seems some investors and patients may be getting restless as the U.S. market waits for the second-generation of the blockbuster technology. We first noted some signs of impatience for Libre 2 in our coverage of Abbott's third-quarter earnings call in October. One reader commented on that article that "I don’t particularly care about investors becoming impatient, as a Freestyle Libre user I am growing impatie...
Source: MDDI - Category: Medical Devices Authors: Tags: Business Source Type: news
CONCLUSIONS: acromegaly may be associated with more polyps in SB. PMID: 31960686 [PubMed - as supplied by publisher]
Source: Revista Espanola de Enfermedades Digestivas - Category: Gastroenterology Tags: Rev Esp Enferm Dig Source Type: research
We present the case of a 74-year-old man, with a history of residual schizophrenia, who underwent abdominal-pelvic CT with intravenous contrast, due to abdominal acute pain, that showed a stenosis at the origin of the celiac trunk and a large aneurysm of the hepatic artery, secondary to a mediam arcuate ligament syndrome, of the diaphragm was observed. PMID: 31960685 [PubMed - as supplied by publisher]
Source: Revista Espanola de Enfermedades Digestivas - Category: Gastroenterology Tags: Rev Esp Enferm Dig Source Type: research
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