Prolonged QRS independently predicts long-term all-cause mortality in patients with narrow QRS complex undergoing coronary artery bypass grafting surgery (9-year follow-up results).

Conclusions: In CABG patients with a narrow QRS complex, preoperative intermediate prolonged QRS is an independent predictor of all-cause mortality in long-term follow-up. PMID: 33014085 [PubMed]
Source: Polish Journal of Cardio-Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Tags: Kardiochir Torakochirurgia Pol Source Type: research

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Conclusion: This represents the largest study of patients with VPR and angiographically-proven ACO. The MSC were highly sensitive and specific for the diagnosis of ACO in patients presenting to the ED with VPR and symptoms of acute coronary syndrome.===================================MY Comment by KEN GRAUER, MD (10/4/2020):===================================Today ’s case provides a superb example of how acute OMI can sometimes be definitively recognized even in the presence ofpacing. Unfortunately, this was not recognized by the cardiology team despite...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs
Authors: Namat RA, Burlacu A, Tinica G, Covic A, Mitu F Abstract Introduction: Marked isolated elevation of cardiac biomarkers (CK-MB, cardiac troponin I, heart-type fatty acid binding protein, hFABP) within 48 hours after coronary artery bypass surgery (CABG), even in the absence of electrocardiographic/angiographic evidence of myocardial infarction (MI), indicates prognostically significant cardiac procedural myocardial injury. There are no data exploring the relationship between the complexity of coronary atherosclerotic burden and early post-CABG myocardial injury. Aim: To analyse correlations and predictive st...
Source: Polish Journal of Cardio-Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Tags: Kardiochir Torakochirurgia Pol Source Type: research
Written by Pendell Meyers, submitted by Daryl Williams, edits by Steve SmithA man in his sixties with prior CAD and CABG experienced chest pain and pressure off and on for three days. He saw his primary doctor during this time who had suspected GI related symptoms and increased his PPI medication. On the third day it became more intense and had associated radiation to his neck and left arm, and this reminded the patient of his prior MI symptoms, so he presented to the Emergency Department. It is unclear how long he had constant symptoms during those three days.Here is his triage ECG (no prior was available in our system):W...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs
We report the cases of two patients who developed a massive spasm of the native coronary system in the immediate postoperative period, following a coronary artery bypass grafting operation with different outcomes. The first patient was hemodynamic stable and it was manifested as ischemic electrocardiographic changes in different leads (ST elevation or depression). He was treated with intracoronary and intravenous administration of nitroglycerin and calcium channel blocker and had a favorable outcome. The second patient died due to multiorgan failure and hemorrhagic shock, after the implantation of a central venoarterial ex...
Source: Journal of Cardiac Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: CASE REPORT Source Type: research
DiscussionThus, no further ECGs were recorded and there was no angiogram or stress test or CT coronary angiogram.  Acute MI does not often present with syncope alone, without any other symptom, so the pretest probability of acute MI is low.However, the troponins are high and, in my opinion, the data above does not rule out the possibility of type 1 MI.  There were very elevated troponins without a significant known stress (which might cause a type 2 MI).  The troponins are NOT consistent with STEMI (OMI), which typically has a troponin I of at least 5 ng/mL.  Nevertheless, I don't think a thrombosis rel...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs
Conclusion: Our study revealed that the topical lidocaine administration before endotracheal intubation prevented increase of QT dispersion duration in patients undergoing coronary artery bypass grafting. Trial Registration: NCT03304431
Source: Revista Brasileira de Cirurgia Cardiovascular - Category: Cardiovascular & Thoracic Surgery Source Type: research
Authors: Eckner D, Pauschinger M, Ademaj F, Martinovic K Abstract This disease with its multiple ischemic and non-ischemic manifestations is classified based on the fourth universal definition of myocardial infarction (MI). An acute myocardial injury is defined as a significant increase of cardiac troponins (cTn). In patients with an additional myocardial ischemia, which is defined by certain clinical, electrocardiographic, imaging and angiographic criteria, the diagnosis of acute MI can be made. Etiologically, MI can be divided into 5 types: type 1 ischemic by plaque rupture or plaque erosion with t...
Source: Herz - Category: Cardiology Tags: Herz Source Type: research
Authors: Heyworth PB, Essack N, Rahman A Abstract A 24-year-old male presented to hospital following syncope with electrocardiographic changes and was found to have left main coronary artery occlusion requiring emergent coronary artery bypass grafting. PMID: 32357139 [PubMed - as supplied by publisher]
Source: The Journal of Invasive Cardiology - Category: Cardiology Tags: J Invasive Cardiol Source Type: research
Written by Pendell MeyersA man in his 60s with history of CAD, CABG, HTN, DM, and smoking presented with chest pain,and shortness of breath over the past 1 hour, and a mild cough over the past few days, of course asking for COVID testing.Here is his ECG on presentation (shown to me with no information):What do you think?Raw Findings: - RBBB (some will also say LPFB) - Negative T-waves in V1-V3 - STD in V1-V6, I, aVL - STE in aVR - V2 has strange QRS morphology that does not seem to fit in the progression between V1 and V3, possibly lead misplacementInterpretation:In the context of RBBB, it is norma...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs
We report a case of a 56-year-old man with a medical history of chronic cigarette smoking, dyslipidemia, and obesity. The patient had no myocardial infarction before. He was admitted for evaluation of important shortness of breath at effort without chest pain for 5 months. Physical exam find an enlarged left ventricular. The electrocardiogram revealed Q waves and ST segment elevation in leads V1 to V6. Transthoracic echocardiogram showed a large thrombosed apical left ventricular false aneurysm, severe left ventricular dysfunction, which were confirmed by cardiac magnetic resonance imaging, this exam also showed no viabili...
Source: Annales de Cardiologie et d'Angeiologie - Category: Cardiology Authors: Tags: Ann Cardiol Angeiol (Paris) Source Type: research
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