Acute chest pain and a bizarre ECG
Written by Pendell MeyersA middle aged adult presented with acute undifferentiated chest pain.Here is his ECG at triage:What do you think?I sent this ECG with no clinical information to Dr. McLaren, who replied simply " Artifact " . He is referring to an artifactual ECG pattern that corresponds with the cardiac cycle which is known as " arterial pulse tapping artifact. " See the discussion and links at the end of the post for more information, but this phenotype of ECG artifact is not yet well understood (to my knowledge). In some cases, it has been attributed to placement of an electrode near a pulsing anatomic...
Source: Dr. Smith's ECG Blog - August 26, 2022 Category: Cardiology Authors: Pendell Source Type: blogs
Reforming the Organ Donation System
David Kemp andPeter Van DorenThe Washington Postrecently reported on the logistic and technological failings of the United Network for Organ Sharing (UNOS), the private non ‐profit agency with a government ‐enforced monopoly on the United States’ system of procuring organ donations and matching donated organs to the over 100,000 people waiting for them. A report from the White House US Digital Service found that UNOS has been ineffective, lacks transparency, and relies on outdated software, with frequent system failures and cybersecurity concerns. While UNOS has resisted efforts to modernize and refor...
Source: Cato-at-liberty - August 10, 2022 Category: American Health Authors: David Kemp, Peter Van Doren Source Type: blogs
Perfusion Machine Restores Donor Liver for Transplant
Clinical researchers at the University of Zurich in Switzerland have created a perfusion machine to store donor livers before transplant. We originally reported on the machine back in 2020, but now the team has announced that they stored and treated a damaged liver in the machine, which would ordinarily not be suitable for transplantation. After three days of treatment the liver was healthy enough to be implanted, and was successfully placed into a patent, who is still doing well one year later. The technique could expand the potential pool of available donor livers, as it may be possible to “refurbish” less healthy li...
Source: Medgadget - June 7, 2022 Category: Medical Devices Authors: Conn Hastings Tags: Anesthesiology Critical Care Medicine Pathology Surgery liver transplant Liver4Life transplantation UZH_en Source Type: blogs
Another deadly and confusing ECG. Are you still one of the many people who will be fooled by this ECG, or do you recognize it instantly?
Submitted and written byDestiny Folk MD, peer reviewed by Meyers, Smith, Grauer, McLarenA man in his early 30s with no significant past medical history was brought to the ED by EMS after being found unresponsive by a friend. EMS arrived and found him awake and alert. He complained of generalized weakness and left lower extremity numbness. He reported that 12 hours prior to arrival he used fentanyl and cocaine. He reported difficulty walking and felt as if his left leg was “asleep.” He denied any chest pain or shortness of breath and stated he felt at his baseline yesterday prior to drug use. On arrival in the ED, he wa...
Source: Dr. Smith's ECG Blog - May 5, 2022 Category: Cardiology Authors: Pendell Source Type: blogs
Breaking down Optum ’s $6.4 Billion Acquisition of LHC Group
Conclusion
There are WAY too many positive dynamics at play in favor of LHC Group’s portfolio of assets for you to ignore Optum’s acquisition:
Regulations are supporting home-based initiatives, and reimbursement is stable. Lawmaker scrutiny is mounting on SNFs, providing further discharge opportunities and advancement for home health.LHC has a history of operational success in home health and is the missing link among Optum’s various post-acute and at-home initiatives. Optum needed this acquisition to keep up with Humana and others pursuing similar post-acute strategies.Home health is highly fragmented and PDGM...
Source: The Health Care Blog - April 7, 2022 Category: Consumer Health News Authors: matthew holt Tags: The Business of Health Care Blake Madden LHC Optum The Healthy Muse Source Type: blogs
Chest pain + troponin of 1600 + LBBB + 6mm ST elevation = occlusion MI, right?
This case is by Jesse McLaren (@ECGCases), with comments by Smith and GrauerA 50 year-old with CAD and ESRD went to their regular hemodialysis appointment complaining of two days of exertional chest pain. The patient was sent to the ED when high-sensitivity Troponin I returned at 1,526 ng/L (normal<26 in males,<16 in females). They were painfree on arrival, with BP 180/70 and other vitals normal. What do you think? There ’s sinus rhythm with LBBB and appropriate discordant ST changes: there’s no concordant ST elevation, no concordant ST depression in V1-3, and no excessive discordance...
Source: Dr. Smith's ECG Blog - March 31, 2022 Category: Cardiology Authors: Jesse McLaren Source Type: blogs
Cricket + Fresenius Health Partners + InterWell Health CEO on New Biz & “ Take Out Merger ” Chatter
BY JESSICA DaMASSA, WTF HEALTH
Matthew Holt categorized the triple-merger between Cricket Health, Fresenius Health Partners, and InterWell Health as a “take out merger” — proposing that Fresenius orchestrated the deal to “take out” rising-star kidney care startup, Cricket Health. Well, Cricket Health’s CEO Bobby Sepucha (who will also be CEO of the newly combined entity) “takes issue” with the health tech curmudgeon’s “take out” call and we find out the reasons why.
Listening to Bobby’s explanation, it sounds like the shrewd move Fresenius might be making here in giving up its value-b...
Source: The Health Care Blog - March 25, 2022 Category: Consumer Health News Authors: Ryan Bose-Roy Tags: Health Tech WTF Health cricket health Fresenius Health InterWell Health Jessica DaMassa Source Type: blogs
An elderly woman with shortness of breath and an ECG that helps understand it
Written by Pendell Meyers, edits by Smith and GrauerOne of my fantastic residents brought me an ECG on shift and asked for my interpretation without any context:What do you think?I responded that it looks like chronic right ventricular hypertrophy. This is due to the QRS morphology and axis including incomplete RBBB pattern in V1, precordial R wave progression reversal, matching deep S waves in leftward leads I and aVL, very rightward limb lead axis including R wave in aVR. See Ken Grauer ' s comments below where he points out that the tall P-wave in lead II is diagnostic of right atrial enlargement, which supp...
Source: Dr. Smith's ECG Blog - March 6, 2022 Category: Cardiology Authors: Pendell Source Type: blogs
Increasing Representation of People of Color in Medtech: Interview with Kwame Ulmer, Co-Founder of MedTech Color
Medtech Color is a non-profit organization that aims to increase the representation of people of color within the medtech industry. The organization sets out to achieve this by creating networking opportunities, highlighting the barriers faced by black and brown people within the medtech industry, and increasing access to venture capital funding.
The organization reports that less than 1% of venture capital funding is received by black entrepreneurs. To help address this, Medtech Color runs an annual Pitch Competition, where early-stage startups with black and brown founders compete for a variety of a...
Source: Medgadget - March 4, 2022 Category: Medical Devices Authors: Conn Hastings Tags: Exclusive Society Source Type: blogs
Get Ready for (Healthcare) Microgrids
BY KIM BELLARD
We depend on it. Indeed, our daily lives are unimaginable without it. The trouble is, it’s become unreliable. Lives have been lost because it wasn’t performing when it needed to be. It’s built around large facilities that are often decades old. Parts of it don’t communicate/coordinate well with others. Its workforce is aging and burnt out. There is no person or agency charged with ensuring its resiliency. It badly needs to be rethought for the 21st century.
Oh, you thought I was talking about our nation’s power grid? I was talking about ou...
Source: The Health Care Blog - February 22, 2022 Category: Consumer Health News Authors: Ryan Bose-Roy Tags: Health Policy Public Health Kim Bellard microgrid Telemedicine Source Type: blogs
Acute respiratory distress: Correct interpretation of the initial and serial ECG findings, with aggressive management, might have saved his life.
Written by Pendell Meyers with edits by SmithA man in his 60s called EMS apparently for shortness of breath. EMS found him in distress and hypoxemic requiring 4 L nasal cannula to maintain oxygen saturation greater than 93%.Here is his triage ECG:What do you think?An old ECG was available on file, from 2 years ago:RBBB, otherwise normal.The triage ECG is diagnostic of life threatening hyperkalemia (sodium channel blockade would also produce this pattern, but the patient was not known to be on any sodium blocking medications). There is the very common brugada pattern STEMI mimic seen in V1 and partially in V3 and aVR....
Source: Dr. Smith's ECG Blog - January 16, 2022 Category: Cardiology Authors: Pendell Source Type: blogs
Fight Aging! Newsletter, December 6th 2021
In this study, they found these drugs can kill senescent cells from cultures of human fat tissue. The tissue was donated by individuals with obesity who were known to have metabolic troubles. Without treatment, the human fat tissues induced metabolic problems in immune-deficient mice. After treatment with dasatinib and quercetin, the harmful effects of the fat tissue were almost eliminated.
Targeting p21Cip1 highly expressing cells in adipose tissue alleviates insulin resistance in obesity
Insulin resistance is a pathological state often associated with obesity, representing a major risk factor for type 2...
Source: Fight Aging! - December 5, 2021 Category: Research Authors: Reason Tags: Newsletters Source Type: blogs
The Lack of Funding for Chronic Kidney Disease Research is Not an Outlier
In this commentary, scientists note the paucity of funding for chronic kidney disease research, given the widespread suffering and death caused by this presently incurable condition. This and many other areas of medicine are seen as solved problems by the powers that be simply because there is some form of treatment, even palliative treatment, in widespread use. That the treatment does little and many people die doesn't appear to motivate those who could fund progress. There is no sense of urgency and little sense of need. We might make the same comments in the case of atherosclerosis, a condition many consider to be adequ...
Source: Fight Aging! - November 30, 2021 Category: Research Authors: Reason Tags: Daily News Source Type: blogs
Laser Kills Multidrug-Resistant Bacteria for Wound and Blood Decontamination
Scientists at Washington University School of Medicine in St. Louis have developed an ultrashort-pulse laser that can kill multidrug-resistant bacteria and their spores, and without damaging human cells. The laser works by vibrating and breaking protein structures within the bacterial cell, resulting in biochemical disruption and eventual death. The researchers hope that the technique could prove useful in decontaminating wounds and blood products.
Killing multidrug-resistant bacteria is no mean feat, as many of the common antibiotics we use are no longer effective against them. General antibacterial strategies that cou...
Source: Medgadget - November 29, 2021 Category: Medical Devices Authors: Conn Hastings Tags: Medicine Military Medicine Plastic Surgery Source Type: blogs
A Pathognomonic ECG. What is it? (Hint: 2 diagnoses in one)
I was reading through the list of EKGs and saw this one. What is it diagnostic of? (hint: 2 diagnoses in one)There is a very long, flat, ST segment, resulting in a long QT (most long QT is due to a wide T-wave, not a long ST segment). This is diagnostic of hypocalcemia. There are also peaked T-waves of hyperkalemia. This is a common combination in dialysis patients.The ionized calcium was 2.29 mg/dL (normal is 4.40-5.20). The K was 6.2 mEq/L.Here are the symptoms she had (very typical for hypocalcemia):Dialysis patient with left upper extremity numbness and tingling, lightheadedness, perioral ...
Source: Dr. Smith's ECG Blog - November 29, 2021 Category: Cardiology Authors: Steve Smith Source Type: blogs
