Physical Examination as a Helpful Aid in Decision-Making in Challenging ECGs
Discussion continuedThe absence of pace spikes suggests this is not a pacemaker/ICD-related rhythm in this patient with an ICD.The presence of thinned myocardium and known large amount of scar tissue makes for a nidus for VT. Thus VT is very probable.A wide native QRS can be expected in a patient with a dilated heart and a history of heart failure, even if it is sinus rhythm. so the question of whether those are P-waves is critical.Additionally, the qR morphology, particularly in a patient with right bundle branch block (RBBB) type wide QRS complex tachycardia (WQCT), lends further support for VT.Furthermore, a pertinent p...
Source: Dr. Smith's ECG Blog - January 1, 2024 Category: Cardiology Authors: Emre Aslanger Source Type: blogs

Beta-Blockers For High Blood Pressure: Types, Side Effects, Drug Interactions
Conclusion In conclusion, beta-blockers serve as an indispensable tool in the realm of modern medical treatment, particularly in managing a broad range of cardiovascular conditions. Their unique mechanism of action, which includes decreasing heart rate and blood pressure, confers a significant cardio-protective effect. This, combined with their versatility and the extensive clinical experience with their use, has cemented beta-blockers as a first-line treatment for various conditions, from hypertension and heart failure to anxiety and migraines. Although beta-blockers present unique benefits, it’s crucial...
Source: The EMT Spot - July 24, 2023 Category: Emergency Medicine Authors: Michael Rotman, MD, FRCPC, PhD Tags: Blood Pressure Source Type: blogs

Alpha-Beta-Blockers For High Blood Pressure: Types, Side Effects, Drug Interactions
Conclusion In conclusion, the advent of alpha-beta-blockers has marked a significant advancement in cardiovascular treatment. These medications, combining the properties of both alpha and beta blockers, have demonstrated superiority in managing various cardiovascular conditions. They offer the potential for enhanced blood pressure control, cardiovascular protection, and versatility in the management of several cardiovascular conditions. The choice of using alpha-beta-blockers, however, must be tailored to the individual patient. Considerations such as past medical records, present health conditions, concurrent ...
Source: The EMT Spot - July 20, 2023 Category: Emergency Medicine Authors: Michael Rotman, MD, FRCPC, PhD Tags: Blood Pressure Source Type: blogs

A woman in her 60s with large T-waves. Are they hyperacute, hyperkalemic, or something else?
 Case written by Brandon Friedman M.D., edits by MeyersA woman in her 60s with a history of chronic atrial fibrillation on Eliquis, ESRD on hemodialysis, type-II diabetes mellitus, prior CVA, hypertension, and hyperlipidemia presented to the emergency department with multiple complaints after missing dialysis. She described a feeling of general unwellness, diarrhea, right-sided abdominal pain, bilateral leg pain, bilateral leg swelling, and diffuse itching. She missed her last two dialysis appointments, with her last session occurring one week prior to presentation. On initial assessment, she was found to be tachycard...
Source: Dr. Smith's ECG Blog - May 1, 2023 Category: Cardiology Authors: Pendell Source Type: blogs

A 40-something woman with acute pulmonary edema -- see the Speckle Tracking echocardiogram.
A 49 year old woman with h/o COPD only presented with sudden dyspnea.  She had acute pulmonary edema on exam.  PrehospitalConventional algorithm interpretation: ANTERIOR INFARCT, STEMITransformed ECG by PM Cardio:PM Cardio AI Bot interpretation:OMI with High ConfidenceWhat do you think?There is STE and hyperacute T-waves in V2 and V3, with significant STE in I and aVL, and inferior reciprocal STD.This is proximal LAD Occlusion until proven otherwise.On arrival, lung ultrasound confirmed pulmonary edema (B lines).  An ECG was recorded:ED ECG 1:The findings are still present but not nearly as profound now...
Source: Dr. Smith's ECG Blog - April 12, 2023 Category: Cardiology Authors: Steve Smith Source Type: blogs

Cardiac failure Info desk : Diuretics never save lives, while Dapagliflozin does it in style !
An Interaction in IMCU How is Mr. K, who was shifted from ward 102 ? Yes sir, It was acute decompensated LV failure, Patient was in impending pulmonary edema. In fact, he developed. He is fine now, How did he come around? He was too sick I thought. “Just pushed 60 mg Frusemide IV, luckily he also had good BP, so with an infusion of NTG, titrated Carvedilol a little bit, he came out nicely. I guess it is Ischemic DCM”. “Good, You have done a nice job” “Don’t make me embarrassed sir. It is such a routine in our ER.  To make him curious, I asked “Which drug do you think that saved hi...
Source: Dr.S.Venkatesan MD - December 17, 2021 Category: Cardiology Authors: dr s venkatesan Tags: cardiac failure Cardiology -guidelines cardiology -Therapeutics cardiology wisdom cardiology-ethics Cardiology-Land mark studies Ethics in Medicine evidence based cardiology acc aha esc guidelines on heart failure bumatanide Cardiac fa Source Type: blogs

Cardiac failure Info desk :Diuretics never save lives, while Dapagliflozin does it in style !
An Interaction in IMCU How is Mr. K, who was shifted from ward 102 ? Yes sir, It was acute decompensated LV failure, Patient was in impending pulmonary edema. In fact, he developed. He is fine now, How did he come around? He was too sick I thought. “Just pushed 60 mg Frusemide IV, luckily he also had good BP, so with an infusion of NTG, titrated Carvedilol a little bit, he came out nicely. I guess it is Ischemic DCM”. “Good, You have done a nice job” “Don’t make me embarrassed sir. It is such a routine in our ER.  To make him curious, I asked “Which drug do you think that s...
Source: Dr.S.Venkatesan MD - December 17, 2021 Category: Cardiology Authors: dr s venkatesan Tags: cardiac failure Cardiology -guidelines cardiology -Therapeutics cardiology wisdom cardiology-ethics Cardiology-Land mark studies Ethics in Medicine evidence based cardiology acc aha esc guidelines on heart failure bumatanide Cardiac fa Source Type: blogs

Left ventricular remodeling
Left ventricular remodeling occurs in response to left ventricular stress and injury. It is progressive and occurs after large myocardial infarctions and dilated cardiomyopathy. Left ventricular volume increases and the normal elliptical shape becomes globular. Left ventricular remodeling is associated with changes at microscopic level which include myocyte hypertrophy, apoptosis and increased interstitial collagen deposition [1]. Left ventricular remodeling is a central pathophysiological mechanism in advancing heart failure. Reversal of remodeling with treatment is an important goal in the management of heart failure. ...
Source: Cardiophile MD - April 2, 2021 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Cardiology Source Type: blogs

Acute Chest pain which then resolves spontaneously
A 50-something woman presented with sudden onset of left sided chest pain while driving, radiating down left arm, in addition to feeling diaphoretic, dizzy, and lightheaded. She presented immediately to the ED and had this ECG recorded:QTc was 432 msWhat do you think? One of our fellows and a resident were worried about the ST Elevation in V3-V5, and but they were uncertain if it was possibly normal variant STE.They calculated the formula at21.05, which very strongly suggests acute LAD occlusion.  18.2 is the most accurate cutoff value, but at 19.0 it is very very specific.  21.05 is nearly always ...
Source: Dr. Smith's ECG Blog - January 23, 2021 Category: Cardiology Authors: Steve Smith Source Type: blogs

Fight Aging! Newsletter, November 9th 2020
In this study, young adult mice were submitted to endurance exercise training and the function, differentiation, and metabolic characteristics of satellite cells were investigated in vivo and in vitro. We found that injured muscles from endurance-exercised mice display improved regenerative capacity, demonstrated through higher densities of newly formed myofibres compared with controls (evidenced by an increase in embryonic myosin heavy chain expression), as well as lower inflammation (evidenced by quantifying CD68-marked macrophages), and reduced fibrosis. Enhanced myogenic function was accompanied by an increased ...
Source: Fight Aging! - November 8, 2020 Category: Research Authors: Reason Tags: Newsletters Source Type: blogs

RyR2 as a Target to Prevent Alzheimer's Symptoms in a Mouse Model of the Condition
Mouse models of Alzheimer's disease are quite artificial: mice, and indeed most mammals, do not naturally exhibit the relevant mechanisms underlying Alzheimer's disease, such as aggregation of amyloid-β. The details of the model become important in determining whether or not discoveries and interventions are relevant in anything other than the model. Thus one shouldn't become too excited by any small adjustment to cellular metabolism that appears to have profound effects on the progression of the condition in these models. Maybe it will be relevant to the human condition, but the odds are not good, looking at the history ...
Source: Fight Aging! - November 2, 2020 Category: Research Authors: Reason Tags: Daily News Source Type: blogs

Antiarrhythmic drug classification
The popular Vaughan Williams classification was published in 1975 [1]. It is still being used by most of us. The Sicilian Gambit published in 1991 [2] has not been so popular because of its complexity. Vaughan Williams classification is approximately as follows:  Class I: Sodium channel blockers ◦a: Moderate Na channel block. e.g. Quinidine, Disopyramide ◦b: Weak Na channel block. e.g. Lignocaine, Mexiletine ◦c: Marked Na channel block. e.g. Flecainide, Propafenone  Class II: Beta blockers  Class III: Potassium channel blockers: Amiodarone, Sotalol, Ibutilide  Class IV: Calcium channel blockers In 2018, an exten...
Source: Cardiophile MD - October 13, 2020 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: ECG / Electrophysiology Source Type: blogs

Prescription Drugs That Block Weight Loss
A number of drugs prescribed to treat common conditions, such as hypertension, allergies, depression, inflammation, and diabetes, block your ability to lose weight. Several of these drugs actually cause weight gain, and most doctors fail to inform their patients of such side effects. Among the drugs that block weight loss are: Beta-blockers: metoprolol, atenolol, carvedilol, and propranolol  Antidepressants: amitriptyline (Elavil), nortriptyline (Pamelor), doxepin, paroxetine (Paxil), trazodone, and others Steroids: prednisone and hydrocortisone (but not inhaled or nasal steroids for allergies) Antihistamines: diphenhydr...
Source: Wheat Belly Blog - May 7, 2019 Category: Cardiology Authors: Dr. Davis Tags: News & Updates blood sugar drugs failed weight loss fatigue weight loss hypertension insulin prescription drugs undoctored wheat belly Wheat Belly Total Health Source Type: blogs

Investigations and management of dilated cardiomyopathy
Investigations in dilated cardiomyopathy Chest X-ray PA view will assess the cardiac size in dilated cardiomyopathy and show evidence of pulmonary congestion. Sick persons may present with features of frank pulmonary edema in the form of hilar haze or bat wing pattern of pulmonary edema. Significant left ventricular dysfunction can exist without much of cardiomegaly on chest X-ray as well. ECG may show sinus tachycardia, left atrial overload and sometimes left ventricular hypertrophy. A wide QRS complex with left bundle branch block pattern may indicate potential benefit from cardiac resynchronization therapy (CRT). ECG ...
Source: Cardiophile MD - March 30, 2019 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: General Cardiology Source Type: blogs

Live the Wheat Belly lifestyle, get off prescription medications
Take a look at the list of medications people have been able to stop by following the Wheat Belly lifestyle. These represent medications prescribed by doctors to, in effect, “treat” the consequences of consuming wheat and grains. They prescribe drugs to treat inflammation, swelling, skin rashes, gastrointestinal irritation, high blood sugars, airway allergy, joint pain, high blood pressure, leg edema and other abnormal effects caused by wheat and grains. The list includes anti-inflammatory and pain medication, acid reflux drugs, injectable and oral drugs for diabetes, numerous anti-hypertensive agents, asthma i...
Source: Wheat Belly Blog - October 27, 2018 Category: Cardiology Authors: Dr. Davis Tags: News & Updates autoimmune blood sugar bowel flora cholesterol Gliadin gluten-free grain-free grains Inflammation undoctored Weight Loss wheat belly Source Type: blogs