Utilization of the Electrocardiographic “Spiked Helmet” Sign in the Diagnosis of Intra-Abdominal Pathology Within the Emergency Setting

The differential diagnosis of electrocardiographic (ECG) ST-segment elevation includes a multitude of cardiopulmonary pathologies, including myocardial infarction, pericarditis, myocarditis, pulmonary embolism, takotsubo syndrome, ventricular aneurysm, and Brugada syndrome, among others (1). However, under the appropriate clinical presentation, this ECG finding expands to include extrathoracic pathology as part of the differential. A lesser-known manifestation of ST-segment elevation referred to as the “spiked helmet” sign (SHS) may represent a key diagnostic clue to the emergency provider of a critically evolving intra-abdominal pathology.
Source: The Journal of Emergency Medicine - Category: Emergency Medicine Authors: Tags: Visual Diagnosis in Emergency Medicine Source Type: research

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CONCLUSIONS: More than half of middle-aged women without cardiovascular symptoms present alterations in one or more exercise testing parameters. Alterations in the functional capacity or heart rate behavior, as verified by exercise testing, are associated with age, smoking, an overweight status and obesity.
Source: Clinics - Category: General Medicine Source Type: research
Source: Clinical Interventions in Aging - Category: Geriatrics Tags: Clinical Interventions in Aging Source Type: research
For decades, healthy patients were told to take a low-dose aspirin as a precaution to help prevent heart problems, but the guidelines changed this year. For patients who have had a heart attack, stroke or open heart surgery, a daily aspirin is still recommended and can be a lifesaver. But the blood-thinning effect from aspirin could cause a major bleeding event, so for many healthy patients, the daily aspirin habit was not worth the risk.
Source: CNN.com - Health - Category: Consumer Health News Source Type: news
MONDAY, Sept. 16, 2019 -- Debate over the benefits and drawbacks of daily low-dose aspirin has flared in recent years, with guidelines now generally urging against the regimen to prevent a first heart attack or stroke in healthy people. But some...
Source: Drugs.com - Daily MedNews - Category: General Medicine Source Type: news
In this study, approximately 10% of Transient STEMI had no culprit found:Early or late intervention in patients with transient ST ‐segment elevation acute coronary syndrome: Subgroup analysis of the ELISA‐3 trialOne must use all available data, including the ECG, to determine what happened.Final Diagnosis?If the troponin remained under the 99% reference, then it would be unstable angina.  If it rose above that level before falling, it would be acute myocardial injury due to ischemia, which is, by definition, acute MI.  If that is a result of plaque rupture, then it is a type I MI.  The clinical presentat...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs
Authors: Blankenberg S, Wittlinger T, Nowak B, Rupprecht HJ Abstract Elevation of cardiac troponins above the 99th percentile of a healthy reference population is established as a marker for myocardial cell damage and is crucial for the diagnosis of myocardial infarction. In addition, corresponding clinical evidence of acute myocardial ischemia i.e. symptoms, changes in the electrocardiogram (ECG), wall motion abnormalities or suggestive angiographic findings are required for the diagnosis of myocardial infarction. Using modern highly sensitive assays myocardial infarction can be detected more frequently and e...
Source: Herz - Category: Cardiology Tags: Herz Source Type: research
One of our graduates, Rochelle Zarzar, who is now an education fellow, sent me this from one of the hospitals she works at now:An elderly woman presented with chest pain.  She had been nauseous the night before and did not feel well, then awoke 2 hours prior with chest pain.She had had a completely normal angiogram 3 months prior.Here is that angiogram report:The left main coronary artery is normal.Left anterior descending is a type 3 vessel and is normal.Left circumflex is nondominant and normal.The right coronary artery is dominant and normal.The nurses immediately recorded an ECG.  This was 2 hours after the o...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs
Anticoagulation in atrial fibrillation (AF) secondary to acute coronary syndrome, acute pulmonary disease or sepsis may not prevent stroke, but may increase risk of bleeding, says an new study published in JACC Clinical Electrophysiology [1]. The authors retrospectively evaluated a cohort of over 2300 patients aged 65 years or more who were hospitalized with acute coronary syndrome, acute pulmonary disease which included worsening of chronic obstructive pulmonary disease, pneumonia, influenza, pulmonary embolism and pleural effusion or sepsis associated with new onset AF during admission. Over a three year follow...
Source: Cardiophile MD - Category: Cardiology Authors: Tags: Cardiology ECG / Electrophysiology Source Type: blogs
Intracardiac thrombus in Behçet's disease. Reumatismo. 2016 Dec 16;68(3):148-153 Authors: Ben Ghorbel I, Belfeki N, Houman MH Abstract Behçet's disease (BD) is a multisystem inflammatory disorder. Intracardiac thrombus (ICT) formation is an uncommon but important complication of BD. Of the cases of Behçet's disease, we selected those with ICT. All patients fulfilled the diagnostic criteria of the International Study Group of Behçet's disease. The ICT in each case was confirmed by ultrasonography, computed tomography and MRI. Clinical features and laboratory parameters were ...
Source: Reumatismo - Category: Rheumatology Authors: Tags: Reumatismo Source Type: research
Conclusions The validity of cardiovascular diagnoses in the DNPR is overall high and sufficient for use in research since 2010.
Source: BMJ Open - Category: Journals (General) Authors: Tags: Open access, Cardiovascular medicine, Epidemiology Research Source Type: research
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