A man in his 50s with " gas pain "

Written by Pendell Meyers, sent by AnonymousA man in his 50s with history of type 2 diabetes, HTN, and HLD presented with one day of off and on chest / upper abdominal pain. It had awoken him from sleep earlier, and he described it as " gas pain, " located in the upper epigastrium and radiating upwards. Vitals were within normal limits. The patient presented with active pain, diaphoretic and ill appearing.Here was his triage ECG (sorry for the quality, unable to obtain better images from sender):Last ECG on file is below for comparison. First try this ECG without the baseline, then with. What do you think?Previous ECG on file (never just assume its the baseline, but I think this one looks consistent with a baseline).The presentation ECG shows sinus rhythm at almost 100 bpm. There is STD in V3-V6 (maximal in V4-5) and lead II, aVF, I, and aVL. Because of widespread STD, there is obligatory STE inaVR(theaVerageReciprocal lead of the rest of the ECG).This pattern in isolation would signify diffuse supply/demand mismatch without focal complete occlusion, which would be a very large differential of anything causing severe global supply demand mismatch, including ACS and various other processes. However, there is STE in V1 with a large area T-wave which is hyperacute.This fits the pattern we have described many times including recently, of subtle STE and hyperacute T-wave in V1 with STD in the lateral precordial leads, indicative of LAD occlusion (more specifically, subto...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs

Related Links:

Comorbidity is the presence of one or more additional conditions co-occurring with a primary condition. In this episode, host schizophrenic Rachel Star Withers with her cohost Gabe Howard will be discussing comorbidity with schizophrenia. Comorbidity is associated with worse health outcomes, more complex clinical management and increased health care costs. Occupational therapist and host of the podcast Occupied, Brock Cook, will be joining us to discuss ways that he works with people with schizophrenia to manage multiple health issues.  Highlights from “Comorbidity with Schizophrenia” Episode [01:28] What ...
Source: World of Psychology - Category: Psychiatry & Psychology Authors: Tags: Antipsychotic Inside Schizophrenia Mental Health and Wellness Psychiatry Psychology Psychotherapy Bipolar disorder and schizophrenia comorbid comorbid psychiatric conditions Comorbidities Comorbidity Diagnosis Of Schizophrenia Livi Source Type: blogs
Ryan R. Kelly1,2†, Lindsay T. McDonald1,2†, Nathaniel R. Jensen1,2, Sara J. Sidles1,2 and Amanda C. LaRue1,2* 1Research Services, Ralph H. Johnson VA Medical Center, Charleston, SC, United States 2Department of Pathology and Laboratory Medicine, Medical University of South Carolina, Charleston, SC, United States The significant biochemical and physiological effects of psychological stress are beginning to be recognized as exacerbating common diseases, including osteoporosis. This review discusses the current evidence for psychological stress-associated mental health disorders as risk factors for os...
Source: Frontiers in Psychiatry - Category: Psychiatry Source Type: research
It’s hardly news that the gastrointestinal tract is important to human health: It transports food from the mouth to the stomach, converts it into absorbable nutrients and stored energy, and shuttles waste back out of the body. If you don’t properly nourish yourself, you don’t live. It’s that simple. But in recent years, scientists have discovered that the GI system has an even bigger, more complex job than previously appreciated. It’s been linked to numerous aspects of health that have seemingly nothing to do with digestion, from immunity to emotional stress to chronic illnesses, including can...
Source: TIME: Health - Category: Consumer Health News Authors: Tags: Uncategorized Research Source Type: news
This article reviews the clinical questions and bottom-line answers from these studies. Blood pressure should be measured after a period of rest, using a bare arm, and orthostatic blood pressure is more predictive when measured after one minute of standing rather than three minutes. Intensive blood pressure lowering results in cardiovascular benefits but also renal harms in high-risk patients with an average age of 68 years. The initiation of a statin for primary prevention does not reduce cardiovascular events in adults 65 years or older. Sterile gloves do not reduce the risk of infection for common outpatient skin proced...
Source: American Family Physician - Category: Primary Care Authors: Tags: Am Fam Physician Source Type: research
“A bear, however hard he tries, grows tubby without exercise.” – A. A. Milne You don’t need to knock yourself out at the gym each day to reap the many health benefits of daily exercise. With simple planning and a determination to engage in a healthier lifestyle, you can add easy stints of exercise to your schedule without breaking too much of a sweat. Best of all, you may realize some of these 10 health benefits of daily exercise. Exercise elevates your mood When you are physically active, it stimulates brain chemicals that make you feel better and lifts your mood. Some experts say that exercise of ...
Source: World of Psychology - Category: Psychiatry & Psychology Authors: Tags: Habits Health-related LifeHelper Self-Help Source Type: blogs
View Original Article Here: Tai Chi For Seniors: Exercises, Benefits, and Tips For The Elderly Tai chi, a form of Chinese martial arts that focuses on slow, controlled movements. It’s low impact and gives people with limited mobility a chance to improve their balance, range of motion and coordination. Research shows that tai chi for seniors can reduce the incidence of falls in elderly and at-risk adults by about 43 percent. With fewer than 34 percent of aging adults getting enough exercise, it’s important for caregivers, older individuals and people who work with seniors to know about this gentle but effective ...
Source: Shield My Senior - Category: Geriatrics Authors: Tags: Senior Safety Source Type: blogs
In conclusion, documentation is important, a critical part of advocacy and the development process at the larger scale. It isn't just words, but rather a vital structural flow of information from one part of the larger community to another, necessary to sustain progress in any complex field. We would all do well to remember this - and to see that building this documentation is an activity in which we can all pitch in to help. Evidence Suggests that, at Least in Earlier Stages, Alzheimer's Disease Blocks Rather than Destroys Memories https://www.fightaging.org/archives/2017/07/evidence-suggests-that-at-least-in-ea...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
I hear this nearly every day in my primary care clinic. Many of my patients are overweight or obese, which mirrors the national trend: two out of three adults in the US are overweight or obese. Many of these folks suffer from medical issues such as low back, hip, knee, and foot pain; asthma; obstructive sleep apnea; fatty liver; type 2 diabetes; high blood pressure; high cholesterol; or depression. We know that these conditions often improve with weight loss. So, I often recommend weight loss as a first step in treatment, and the usual approach is through lifestyle change. Lifestyle change programs for weight loss have bee...
Source: Harvard Health Blog - Category: Consumer Health News Authors: Tags: Behavioral Health Exercise and Fitness Healthy Eating Prevention Source Type: blogs
Ada is a 79 year-old Caucasian female who presents to your primary care office to establish care. She recently moved to Idaho to be closer to her daughter, but prior to this move, Ada was living independently. Ada has a history of late-life depression. Other comorbid conditions include hypertension, diabetes mellitus type 2, and osteoarthritis. She is very thin (BMI of 18). She is sitting in her wheelchair with her head back and her eyes closed while her daughter does most of the talking. Ada takes hydrochlorothiazide 25  mg, metformin 500 mg, sertraline 200 mg, alprazolam 0.5 mg as needed for severe an...
Source: Geriatric Nursing - Category: Nursing Authors: Tags: GAPNA Section Source Type: research
Authors: Xu S, Xue Y Abstract Pediatric or childhood obesity is the most prevalent nutritional disorder among children and adolescents worldwide. Approximately 43 million individuals are obese, 21-24% children and adolescents are overweight, and 16-18% of individuals have abdominal obesity. The prevalence of obesity is highest among specific ethnic groups. Obesity increases the risk of heart diseases in children and adults. Childhood obesity predisposes the individual to insulin resistance and type 2 diabetes, hypertension, hyperlipidemia, liver and kidney diseases and causes reproductive dysfunction in adults. Obe...
Source: Experimental and Therapeutic Medicine - Category: Journals (General) Tags: Exp Ther Med Source Type: research
More News: Anatomy | Back Pain | Blogging | Cardiology | Computers | Depression | Diabetes | Diabetes Type 2 | Electrocardiogram | Endocrinology | Learning | Pain | Sleep Disorders | Sleep Medicine | Universities & Medical Training