Rate vs Rhythm Control in Atrial Fibrillation
Rate vs rhythm control as a management strategy in atrial fibrillation has been a long standing topic for debate. Though at one look rhythm control would appear to be the ideal strategy, long term adverse effects of the currently available medications for rhythm control is the often cited down side. AFFIRM [1] and RACE [2] trials were the main reason for the debate as they failed to show any benefit for the rhythm control strategy. AF-CHF trial in those with AF and congestive heart failure also failed to show any advantage for the rhythm control strategy [3]. But there have been important criticisms as well [4]. In AFFIRM...
Source: Cardiophile MD - October 26, 2023 Category: Cardiology Authors: Johnson Francis Tags: ECG / Electrophysiology General Cardiology Source Type: blogs
A man in his 60s with syncope and ST depression. What does the ECG mean?
Written by Sean Trostel MD, peer reviewed by Meyers, Smith, Grauer, etc.A man in his 60s with a history of severe alcohol use disorder and epidural abscess on long-term ciprofloxacin presented to the emergency department after an episode of syncope while standing in line at a grocery store.He did not have chest pain.Here is his triage ECG: What do you think?My interpretation:Sinus rhythm, normal QRS, widespread wavy ST depression leading into late T/U-waves with very prolonged QT. No evidence of OMI. QTc/QUc is in the range of 630 msec.What is the most likely cause of the patient ’s ECG findings, and wha...
Source: Dr. Smith's ECG Blog - October 25, 2023 Category: Cardiology Authors: Pendell Source Type: blogs
Does this T wave pattern mean anything?
Written by Michael Doyle DO and Timothy Palmieri MD. Edited by Bracey, Meyers, Grauer, and SmithA 50-something-year-old female with a history of an unknown
personality disorder and alcohol use disorder arrived via EMS following cardiac arrest with return
of spontaneous circulation. The described rhythm was an irregular, wide complex
rhythm. By EMS report, open pill bottles were found nearby at the scene, including quetiapine, fluoxetine, hydroxyzine, and gabapentin. She was successfully revived
after several rounds of ACLS including defibrillation and amiodarone.On arrival to the ED the patient was intubated with normal vi...
Source: Dr. Smith's ECG Blog - October 23, 2023 Category: Cardiology Authors: Bracey Source Type: blogs
A Periodic Look at Elements
It’s National Chemistry Week! To celebrate, we’re looking back at a few recent blog posts highlighting elements important for human health and scientific research. Check out the posts and tell us what your favorite element is in the comments section!
Credit: Adapted from Compound Interest. CC BY-NC-ND 4.0.
Got Calcium?
Calcium is the most abundant mineral in our bodies. It’s essential for lots of important functions—including keeping bones strong and allowing muscles to move. Even clicking on this post to learn more about its many roles requires calcium!
Credit: Adapted from Compound...
Source: Biomedical Beat Blog - National Institute of General Medical Sciences - October 18, 2023 Category: Research Authors: Chrissa Chverchko Tags: Chemistry, Biochemistry and Pharmacology Element Source Type: blogs
A 20-something woman with cardiac arrest.
The patient is a 20 something female. She is healthy with no known cardiac disease. She was admitted to the neurology department due to headache and vomiting. She was found to have a viral CNS infection. A few days into her hospital stay she developedchest discomfort and the following ECG was recorded. What do you think? Why such large T-waves? Are these hyperacute T-waves? Are these ECG changes related to the CNS infection perhaps? What disease processes would you put on your list of differential diagnoses?When I saw the ECG of this patient I saw that there was definitely something " off " . I didn ' t get...
Source: Dr. Smith's ECG Blog - October 18, 2023 Category: Cardiology Authors: Magnus Nossen Source Type: blogs
What is the natural history of TCFA “ Thin cap fibro atheroma ” ?
(Why should the number 65 bother us in TCFA-detected by OCT? Does this number really deserve that respect? Trying to find some truths from 8 questions with & without evidence.)
1. Does TCFA really make a plaque vulnerable?
A.Yes
B. No
C. Maybe
Answer: Yes & Maybe. But there seem to be more important factors other than TCFA for a plaque to become vulnerable making TCFA not really a big deal.
2. TCFP is more common in which lesions?
A.Flow limiting lesion
B.Nonflow limiting lesion
C.No relationship between TCFA and flow
Answer: No relation, rather a random relationship.
3. What...
Source: Dr.S.Venkatesan MD - October 10, 2023 Category: Cardiology Authors: dr s venkatesan Tags: Uncategorized Source Type: blogs
Should we activate the cath lab? A Quiz on 5 Cases.
Imagine you just started your ED shift. It ' s a busy Friday afternoon. Triage is backed up, and 10 minutes into your shift one of the ED nurses brings your several ECGs that has not been overread by a physician. All of the patients presented with chest pain, and they are all in triage.Which, if any, of these patients has OMI, with myocardium at risk and need for emergent PCI?ECG#1ECG#2ECG#3ECG#4ECG#5See outcomes of all 5 below, with the Queen of Hearts AI Bot interpretation.YOU TOO CAN HAVE THE PM Cardio AI BOT!! (THE PM CARDIO OMI AI APP)If you want this bot to help you make the early diagnosis of OMI and...
Source: Dr. Smith's ECG Blog - October 8, 2023 Category: Cardiology Authors: Magnus Nossen Source Type: blogs
A 50-something with Regular Wide Complex Tachycardiaa: What to do if electrical cardioversion does not work?
Case submitted by anonymous. Written by Smith. Ken ' s piece at the bottom is excellent.A 50-something presented with sudden onset palpitations 8 hrs prior while sitting at desk at work. He had concurrent sharp substernal chest pain that resolved, but palpitations continued.Over past 3 months, he has had similar intermittent episodes of sharp chest pain while running, but none at rest. Past medical history includes coronary stenting 17 years prior. A brief chart review revealed his most recent echo in 2018, with LV EF 67%, “very small” inferior wall motion abnormality.Initial ED ECG:What do you think?This wa...
Source: Dr. Smith's ECG Blog - September 20, 2023 Category: Cardiology Authors: Steve Smith Source Type: blogs
A 50-something with Regular Wide Complex Tachycardia: What to do if electrical cardioversion does not work?
Case submitted by anonymous. Written by Smith. Ken ' s piece at the bottom is excellent.A 50-something presented with sudden onset palpitations 8 hrs prior while sitting at desk at work. He had concurrent sharp substernal chest pain that resolved, but palpitations continued.Over past 3 months, he has had similar intermittent episodes of sharp chest pain while running, but none at rest. Past medical history includes coronary stenting 17 years prior. A brief chart review revealed his most recent echo in 2018, with LV EF 67%, “very small” inferior wall motion abnormality.Initial ED ECG:What do you think?This wa...
Source: Dr. Smith's ECG Blog - September 20, 2023 Category: Cardiology Authors: Steve Smith Source Type: blogs
Cells Release Insulin in Response to Music
Researchers at ETH Zurich have developed an insulin delivery system that relies on music as a trigger. The unusual technology is based on calcium ion channels that typically reside in the cell membrane. Such channels are sensitive to mechanical deformation and these researchers discovered that sound waves will activate the channels. When insulin-producing cells are genetically modified to express this channel, they will experience an influx in calcium ions when music is played close by, prompting them to release insulin. The concept could be useful as a treatment for diabetes, whereby such cells, housed in a specialized ca...
Source: Medgadget - September 19, 2023 Category: Medical Devices Authors: Conn Hastings Tags: Genetics Medicine diabetes ETH Zurich Source Type: blogs
No, we can ’ t allow BAV to be a threat,.. to our heart-throb !
Interventional cardiologists generally do not believe (rather relish) in simple balloon dilatations to remove any vascular blocks. It is a mundane job for their talent-ridden hands. After conquering the coronaries, we made exclusive the valvular stents. No surprise, TAVR has taken over the aortic interventions with all its glamour and vigor, though it is definitely not an ideal choice in all.
SCAI, the prestigious journal in Interventional cardiology has a recent article , that has a not-so pleasant message for TAVR lovers.
PIIS2772930323004453Download
It poses a direct challenge to cardiologists’ heart...
Source: Dr.S.Venkatesan MD - September 18, 2023 Category: Cardiology Authors: dr s venkatesan Tags: Uncategorized Source Type: blogs
No, we can ’ t allow BAV, to be a threat for TAVR !
Interventional cardiologists generally do not believe (rather relish) in simple balloon dilatations to remove any vascular blocks. It is a mundane job for their talent-rich hands. After conquering the coronaries, we made exclusive valvular stents. No surprise, TAVR has taken over the aortic interventions with all its glamour and vigor, though it is definitely not an ideal choice in all.
SCAI, the prestigious journal in Interventional cardiology has a recent article , that has a not-so pleasant message for TAVR lovers.
PIIS2772930323004453Download
Very soon, BAV could pose a direct challenge to cardiologists&#...
Source: Dr.S.Venkatesan MD - September 18, 2023 Category: Cardiology Authors: dr s venkatesan Tags: bav vs tavr TAVR /TAVI tavr tavi TAVR VS SAVR Uncategorized Source Type: blogs
A 40 year old with nonspecific symptoms including dizziness
.What do you notice about the ECG?There is a very short QT interval. This is often found in hypercalcemia. See Ken Grauer ' s comments below for detail.Thus, the patient ' s chemistry was done and revealed ionized hypercalcemia of 6.3 mg/dL (normal 4.4 - 5.2)Followup: he was found to have hyperparathyroidism===================================MY Comment, by KEN GRAUER, MD (9/12/2023):===================================Today ' s ECG is remarkable for an uncommon but important finding that we periodically review, because it otherwise is all-too-easy to overlook. For example — Did YO...
Source: Dr. Smith's ECG Blog - September 12, 2023 Category: Cardiology Authors: Steve Smith Source Type: blogs
“The Greatest Scientist of All Time” says Scientific American. Who is it?
BY MIKE MAGEE
When it comes to our earthly survival as a human species, words are often under-powered and off-the-mark. Clearer concepts, definitions and terms are required for clarity. Here are five terms that are useful and worth remembering:
Planetary Boundaries
Earth Systems
Human Perturbations
Planetary Scale Destabilization
Holocene Epoch vs. Anthropogenic Epoch
These terms all tie back to a single source – a child of World War II, only seven when his home in Amsterdam was overrun by Nazis. His father was a waiter, his mother a cook in a local hospital. He’d later recall with a sh...
Source: The Health Care Blog - September 11, 2023 Category: Consumer Health News Authors: Ryan Bose-Roy Tags: Non-Health Chemistry Mike Magee Ozone Paul Crutzen Scientific American Source Type: blogs
Fight Aging! Newsletter, August 28th 2023
In conclusion, we identified 20 genes with significant evolutionary signals unique to long-lived species, which provided new insight into the lifespan extension of mammals and might bring new strategies to extend human lifespan.
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Trials of Xenotransplantation of Pig Organs into Humans Continue
https://www.fightaging.org/archives/2023/08/trials-of-xenotransplantation-of-pig-organs-into-humans-continue/
Researchers have genetically engineered pigs to overcome the known barriers to transplantation of pig organs into humans, and have reached the stage of conducting transplants i...
Source: Fight Aging! - August 27, 2023 Category: Research Authors: Reason Tags: Newsletters Source Type: blogs
