Can a bedside echocardiogram help rule out STEMI in patients with suspicious ECG ?
Can a bedside echocardiogram help rule out STEMI in patients with suspicious ECG?No, it can’t (Though, it may be tempting to use a rapid echo to look for wall motion defect to rule out ACS ) If your answer was No, probably you don’t need to read any further in this post. Diagnosis of STEMI* is based onClinicalECGBio-Markers *Please note, two of the most popular investigations namely Echo and Coronary angiogram are missing in the list.Middle-aged man with chest pain. Can an echocardiogram help you confirm STEMI here? Most likely not. It may still be a evolving STEMI. But, observation, serial ECGs, and Troponin is the answer. (ECG -Source /Representative)Though, echocardiography, a great noninvasive imaging tool at the point of care, it stands almost helpless in the diagnosis of the commonest cardiac emergency ie ACS. It can be called as mother of all paradox even visualizing the myocardium directly with high-quality imaging will not tell you, whether there is ongoing ACS or not. Relying on wall motion defects without diagnostic ECG changes to diagnose STEMI can be misleading for the simple reason, both unstable angina and old MI can be a 100 % confounding effect. Similarly, absence of WMA doesn’t rule out an evolving STEM(Apart from the bizarre behavior of Ischemic cascade, In the early hours only subendocardial wall stress is noted, that is not good enough to cause visible WMA)Role of CAG ...
Former PA Training Instructor Elected to U.S. House of Representatives | Inside PA Training Congresswoman Karen Bass As strident as midterm election politics were this year, and whatever your political stripe, you'll probably be pleased to hear that the US House of Representatives will have its first PA in office when the 122nd Congress convenes this January. With www.mypatraining.com
In conclusion, both elastic stable intramedullary nailing and external fixation can achieve satisfactory clinical and radiographic outcomes in children with acute Monteggia fractures. However, the rate of residual pain and less satisfactory clinical appearance was higher in patients managed by external fixation compared to those treated by elastic stable intramedullary nailing. According to our results, elastic stable intramedullary nailing should be used as primary treatment option in children with acute Monteggia fracture requiring surgical management.
The aim of this study was to explore the clinical features and surgical treatment methods of unstable midfoot injuries in children. Eleven children with severe unstable midfoot injuries admitted to Jishuitan Hospital, Beijing, from June 2009 to October 2016 were enrolled, including seven patients with Lisfranc injuries and four patients with Chopart injuries. All Lisfranc injuries had radiographic data from the healthy sides, and radiographs of the affected sides showed that all injured Lisfranc joints separated more than 3 mm compared with the healthy sides. The treatment methods employed a joint-spanning external fixator...
Publication date: Available online 2 August 2020Source: Nutrition, Metabolism and Cardiovascular DiseasesAuthor(s): Yue Zhang, Xiaosong Ding, Bing Hua, Qingbo Liu, Hui Gao, Hui Chen, Xue-Qiao Zhao, Weiping Li, Hongwei Li
The widely used inhalational anesthetic sevoflurane was effective as a topical analgesic in treating otherwise refractory pain in an elderly patient with a severe leg ulcer.Reuters Health Information
Publication date: Available online 3 August 2020Source: Journal of Cardiology CasesAuthor(s): Ken Nakamura, Kouan Orii, Makoto Hanai, Takayuki Abe, Hirofumi Haida
Conclusion CCS patients have a distinctive fingerprint of exhaled breath, and analysis by BIONOTE-V has the potential for identifying these patients. Moreover, it seems that this technique can correctly identify patients according to anatomical disease severity at ICA. If the preliminary data of this proof of concept study will be confirmed, this rapid and noninvasive diagnostic tool able to identify CCS might have an impact in routine clinical practice.
Conclusion Cardiac involvement is common and has significant prognostic implications in the evaluated patients with p.Glu89Gln mutation. Heart failure and rhythm disturbances are the main causes of death. An earlier identification of the disease is crucial to improve prognosis.
Conclusions In our study, only a few ECG voltage criteria used for the detection of LVH in clinical practice showed an acceptable performance in the HCM population. Further studies are needed to clarify the role of ECG for LVH detection in HCM patients.
No abstract available