CO poisoning. Routine ECG recorded before hyperbaric therapy....Are they related?

This patient was working on his truck in a garage without ventilation and the vehicle was running. He felt dizzy and lost consciousness. The next thing he remembers is waking up in the ambulance. He was last seen normal at 09:00 AM and was found down at 10:30 AM. He denied chest pain, abdominal pain, SOB or any other symptoms, though he did endorse chest pressure when asked specifically.He underwent a routine ECG prior to hyperbaric therapy for CO poisoning:Obvious Massive STEMI, Proximal LAD OcclusionHis CO level returned at 34%.Further h/o revealed that he had had a proximal LAD stent placed for a Non-Occlusion MI more than one year prior, and had been on clopidogrel for one year but was no longer on it.The cath lab was activated.The interventionalist told the patient that his ECG might be the result of CO poisoning only.I shook my head because this would be nearly impossible from CO poisoning only.  Itmight be possible with an extremely severely tight stenosis in the proximal LAD, but such a STEMI is never the result of CO poisoning alone.It was clear to me that this would be a proximal LAD occlusion, possibly at the site of the previous stent.It was decided to go the cath lab first, and then to the hyperbaric chamber for hyperbaric oxygen.Angiogram: Culprit Lesion (s): Thrombotic, in-stent occlusion of the proximal LAD24 hour echo:Regional wall motion abnormality-distal septum anterior and apex, akinetic.Regional wall motion abnormality-anterolateral, akinetic.Region...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs

Related Links:

Authors: Fournier E Abstract Carpal tunnel syndrome (CTS) is too common a condition not to daily interact with the practitioner, if only because of its entanglement to other pathologies, causal or chance association. The typical symptomatology, with hand paresthesia and morning pain upon waking, is related to a median nerve injury in the confined space of the carpal tunnel, more often by local inflammation and tenosynovitis of the finger flexors (repetitive activity of the hands). SCC may be secondary to situations (pregnancy) or conditions (edema, hypothyroidism…), which exaggerate the ordinary pathophysiol...
Source: Revue de Medecine Interne - Category: Internal Medicine Tags: Rev Med Interne Source Type: research
Authors: Pastor-Galán I, Hernández-Boluda JC, Correa JG, Alvarez-Larrán A, Ferrer-Marín F, Raya JM, Ayala R, Velez P, Pérez-Encinas M, Estrada N, García-Gutiérrez V, Fox ML, Payer A, Kerguelen A, Cuevas B, Durán MA, Ramírez MJ, Gómez-Casares MT, Mata-Vázquez MI, Mora E, Martínez-Valverde C, Arbelo E, Angona A, Magro E, Antelo ML, Somolinos N, Cervantes F, en representación del Grupo Español de Enfermedades Mieloproliferativas Filadelfia Negativas (GEMFIN) Abstract BACKGROUND AND OBJECTIVE MYELOFIBROSIS: is an infrequen...
Source: Medicina Clinica - Category: General Medicine Tags: Med Clin (Barc) Source Type: research
Scott J. Davidoff, M.D. - Main Line Spine Scott J. Davidoff, M.D. is a physician at Main Line Spine who specializes in physical medicine, pain medicine, and sports medicine. mainlinespine.com i'm posting the bio of this physician simply for illustrative purposes. this group for example has a bunch of the docs there who have done a fellowship at a number of non accredited places yet they are all saying they are board certified and this person is even the president of american board of pain? how can someone be the president of the board when doing a ...
Source: Student Doctor Network - Category: Universities & Medical Training Authors: Tags: Pain Medicine Source Type: forums
AbstractTragedy is a founding theme in disability studies. Critical disability studies have, since their inception, argued that understandings of disability as tragedy obscure the political dimensions of disability and are a barrier facing disabled persons in society. In this paper, we propose an affirmative understanding of tragedy, employing the philosophical works of Nietzsche, Spinoza and Hasana Sharp. Tragedy is not, we argue, something to be opposed by disability politics; we can affirm life within it. To make our case, we look to an ongoing ethnography of two Canadian children ’s rehabilitation clinics. Lookin...
Source: Journal of Medical Humanities - Category: Medical Ethics Source Type: research
AbstractThis literature review presents a critical appraisal of the dominant approaches toward the sexuality and relationships of people with acquired brain injury. In particular, we sought to identify and review existing programs focusing on sexuality and relationships which use an educational and/or peer –peer approach. A systematic and comprehensive search of the EBSCOHOST database was conducted within an unlimited time-frame to yield the highest number of relevant results possible, along with hand-searching of key journals and databases. Reports, papers and webpages, documents commonly referred to as ‘grey ...
Source: Sexuality and Disability - Category: Disability Source Type: research
AbstractMacrophages promote vasculogenesis during retinal neovascularization (RNV) by increasing the recruitment and differentiation of bone marrow-derived cells (BMCs). Different subtypes of macrophages (M1 and M2 macrophages) are associated with RNV. However, the mechanism underlying the regulation of BMCs by different macrophage subtypes during RNV remains unclear. In the present study, we investigated the role and mechanism of action of different macrophage subtypes that regulate BMCs during the development of RNV. The retinal avascular area and neovascularization (NV) tuft area in M2 macrophage group in vivo were the ...
Source: Cell and Tissue Research - Category: Cytology Source Type: research
ConclusionErgonomic interventions focusing on modification of workstations, and promoting and delivering ongoing ergonomic education are very important to reduce the problem.
Source: Journal of Public Health - Category: Health Management Source Type: research
Publication date: Available online 25 January 2020Source: British Journal of Oral and Maxillofacial SurgeryAuthor(s): H. Saghafi, P. Benington, A. AyoubAbstractThe aim of this study was to compare the impact that the orthodontics-first approach and the surgery-first approach have on quality of life, anxiety, and depression in patients treated for dentofacial deformities. Data were collected on 32 patients (aged 17–47 years) who were all treated at a single multidisciplinary orthognathic clinic. They completed a 22-item Orthognathic Quality of Life Questionnaire (OQLQ), a seven-item Generalised Anxiety Disorder (GAD-7...
Source: British Journal of Oral and Maxillofacial Surgery - Category: ENT & OMF Source Type: research
ConclusionsPillar suture combined with tonsillectomy may reduce postoperative bleeding incidence despite increasing pillar edema in pediatric tonsillectomy. Postoperative pain-relief, palatal hematoma, palatal discomfort sensation, site infection, and velopharyngeal insufficiency were not significantly altered compared to tonsillectomy alone. However, further studies are needed to corroborate the results of this study.ResumoIntroduçãoDiversas técnicas cirúrgicas têm sido utilizadas na tonsilectomia no intuito de reduzir complicações.ObjetivosAvaliar os efeitos da sutura dos p...
Source: Brazilian Journal of Otorhinolaryngology - Category: ENT & OMF Source Type: research
Publication date: Available online 25 January 2020Source: Pharmacology &TherapeuticsAuthor(s): Yun-Feng LiAbstractMajor depressive disorder has become a global public health problem of serious concern. Most of the clinical antidepressants are developed under the classic “monoamine hypothesis (strategy)”. These drugs generally have such deficiencies including slow onset and limited efficiency, cognitive impairment and suicidal tendency. Therefore, it is the direction to break through the classic monoamine strategy framework for developing antidepressants that have fast-acting, lower side effects, and cogniti...
Source: Pharmacology and Therapeutics - Category: Drugs & Pharmacology Source Type: research
More News: Angiography | Blogging | Brain | Carbon Monoxide Poisoning | Cardiology | Chronic Pain | Clopidogrel | Depression | Disability | Emergency Medicine | Heart | Heart Attack | Hyperbaric Oxygen Therapy | Neurology | Pain | Plavix | Poisoning | Pregnancy | Thrombosis | Toxicology | Vitamin A