A man in his 60s with shockable arrest, then ROSC, and no STEMI - what will you do?

Conclusion: I suspect one or more of the anterior leads was placed too high on the chest (especially given the deep negative P wave in lead V1) — butregardless, the poor R wave progression we see in ECG #1 is consistent with prior anterior infarction (and this patient ’s past medical history is remarkable for a prior “silent” heart attack).ReST-T Wave Changes — There are some nonspecific ST-T wave changes in some limb leads (ie,leads I, II, aVL) — but these do not look acute. Of much more concern (as per Drs. Oberst, Mogul and Meyers) — there is 0.5-1.0mm of J-point ST elevation in leads V1-through V5, with a similar amount of J-point ST depression in lead V6.KEY Point: TheT waves in leads V3, V4, V5 and V6 are alldisproportionately tall, peaked, andwider-than-they-should-be at their base, especially given the modest R wave amplitude in these leads. In the context of the acute clinical situation of this case — this fits my definition ofhyperacute T waves. Prompt cardiac cathis clearly indicated based on this ECG.COMPARING the 2 Tracings: I like to put serial ECGs together when comparing them — as this greatly facilitates seeing subtle differences (Figure-1).There is much more baseline artifact in ECG #2. That said — the rhythm is still sinus, and QRS morphology in the limb leads is virtually the same. I don’t think there has been any significant change in ST-T wave morphology in the limb leads between ECG #1 an...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs

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hat H Abstract PURPOSE: Individuals with poor physical and mental health may face elevated risk for suicide, particularly suicide by firearm. METHODS: This retrospective cohort study used statewide, longitudinally-linked ED patient record and mortality data to examine 12-month incidence of firearm suicide among emergency department (ED) patients presenting with a range of physical health problems. Participants included all residents presenting to a California ED in 2009-2013 with nonfatal visits for somatic diagnoses hypothesized to increase suicide risk, including myocardial infarction, congestive heart fail...
Source: Annals of Epidemiology - Category: Epidemiology Authors: Tags: Ann Epidemiol Source Type: research
This study is the first to provide a direct link between this inflammation and plaque development - by way of IFITM3. Scientists know that the production of IFITM3 starts in response to activation of the immune system by invading viruses and bacteria. These observations, combined with the new findings that IFITM3 directly contributes to plaque formation, suggest that viral and bacterial infections could increase the risk of Alzheimer's disease development. Indeed, researchers found that the level of IFITM3 in human brain samples correlated with levels of certain viral infections as well as with gamma-secretase activ...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
Fight Aging! publishes news and commentary relevant to the goal of ending all age-related disease, to be achieved by bringing the mechanisms of aging under the control of modern medicine. This weekly newsletter is sent to thousands of interested subscribers. To subscribe or unsubscribe from the newsletter, please visit: https://www.fightaging.org/newsletter/ Longevity Industry Consulting Services Reason, the founder of Fight Aging! and Repair Biotechnologies, offers strategic consulting services to investors, entrepreneurs, and others interested in the longevity industry and its complexities. To find out m...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
By LINDA T. HAND Every day, we make thousands of choices. Some of them – even those that seem trivial at the time – will change the course of our lives. This concept was memorably illustrated in the 1998 film Sliding Doors, which imagined two very different paths for Gywneth Paltrow’s character, Helen, based entirely on whether or not she makes or misses the London Tube on her commute home—the film’s eponymous sliding doors.  Helen doesn’t have the luxury of weighing her possible futures and altering her choices accordingly, perhaps quickening her pace or stopping for a la...
Source: The Health Care Blog - Category: Consumer Health News Authors: Tags: Health Tech Health Technology Linda Hand Prealize Health proactive healthcare Source Type: blogs
Is it ever OK to joke about mental illness or suicide? In today’s Not Crazy podcast, Gabe and Lisa welcome Frank King, a comedian who’s turned his struggles with major depression and suicidal thinking into comedic material. What do you think? Is joking about suicide too heavy? Or is humor a good coping mechanism? Join us for an in-depth discussion on gallows humor. (Transcript Available Below) Subscribe to Our Show! And Please Remember to Rate &Review Us!   Guest Information for ‘Frank King — Joking and Suicide’ Podcast Episode Frank King, Suicide Prevention speaker and Trainer w...
Source: World of Psychology - Category: Psychiatry & Psychology Authors: Tags: Depression Disorders General Inspiration & Hope Interview Mental Health and Wellness Not Crazy Podcast Suicide Source Type: blogs
CONCLUSION: On the basis of a broadly based research and participatory development process, a set of indicators has been developed that enables comprehensive evaluation of the regional quality of care of cross-indication, integrated care models focusing on common diseases. In order to be able to increasingly evaluate aspects of care coordination and patient orientation, health promotion as well as nursing, palliative and emergency care in the future, it would be helpful if routine data were collected or made accessible in these areas as well. PMID: 32467041 [PubMed - as supplied by publisher]
Source: Zeitschrift fur Evidenz, Fortbildung und Qualitat im Gesundheitswesen - Category: Health Management Tags: Z Evid Fortbild Qual Gesundhwes Source Type: research
ConclusionsA history of MST is common among older women veterans and associated with a range of medical and mental health diagnoses. These findings call attention to the need for additional research in this understudied population, and the importance of trauma-informed care approaches for women across the lifespan.
Source: Journal of General Internal Medicine - Category: Internal Medicine Source Type: research
In this episode, Gabe talks with PsychCentral.com editor-in-chief Dr. John Grohol about the importance of planning for the end of life.  We all know that everybody dies, but at the same time, no one wants to think about their own inevitable death. Do you know how you would like the end of your life to go?  What if you needed to make that decision for a loved one? Do you know what they want? Would they want to be resuscitated? Do they want to die at home or in a hospital? Do you even know what kinds of decisions need to be made, or what the options are?  Listen in as Dr. John explains that there is a degre...
Source: World of Psychology - Category: Psychiatry & Psychology Authors: Tags: Aging Death & Dying General LifeHelper The Psych Central Show Source Type: blogs
Conclusions: Magnesium sulfate is an important adjuvant drug in the practice of anesthesia, with several clinical effects and a low incidence of adverse events when used at recommended doses. Introduction Magnesium is the fourth most common ion in the body, and it participates in several cellular processes, including protein synthesis, neuromuscular function and stability of nucleic acid, as well as regulating other electrolytes such as calcium and sodium. Magnesium acts as a cofactor in protein synthesis, neuromuscular function and stability and the function of nucleic acids. It is a component of adenosine 5-triph...
Source: Frontiers in Pharmacology - Category: Drugs & Pharmacology Source Type: research
Fight Aging! provides a weekly digest of news and commentary for thousands of subscribers interested in the latest longevity science: progress towards the medical control of aging in order to prevent age-related frailty, suffering, and disease, as well as improvements in the present understanding of what works and what doesn't work when it comes to extending healthy life. Expect to see summaries of recent advances in medical research, news from the scientific community, advocacy and fundraising initiatives to help speed work on the repair and reversal of aging, links to online resources, and much more. This content is...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
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