Repost: 63 minutes of ventricular fibrillation, followed by shock. What is going on?
In this study, 5% of VF arrest was due to PE: V fib is initial rhythm in PE in 3 of 60 cases. On the other hand, if the presenting rhythm is PEA, then pulmonary embolism is likely. When there is VF in PE, it is not the initial rhythm, but occurs after prolonged PEA renders the myocardium ischemic.--Another study by Courtney and Kline found that, of cases of arrest that had autopsy and found that a presenting rhythm of VF/VT had an odds ratio of 0.02 for massive pulmonary embolism as the etiology, vs 41.9 for PEA. ===================================MY Comment by KEN ...
Source: Dr. Smith's ECG Blog - June 27, 2020 Category: Cardiology Authors: Steve Smith Source Type: blogs
Serial ECGs highly suspicious for inferior OMI: Give thrombolytics prior to transfer for PCI?
One of my former residents texted this info to me with the EKGs:" I have here a 50 something-year-old female with multiple stents who presents with a concerning pain history. Pain relief with nitroglycerin, and I am starting a nitroglycerin drip. " I ’m worried about a hyperacute RCA infarct. " There is no old ECG available." I have to transfer for PCI, and am wondering if I should give thrombolytics first. "Here is the initial ECG:Inferior STE less than 1 mm, with reciprocal inverted T-wave and STD in aVL I recorded this one 15 minutes later:Now with straightening of the ST segmentsLooking at it now...
Source: Dr. Smith's ECG Blog - June 11, 2020 Category: Cardiology Authors: Steve Smith Source Type: blogs
Blood Volume Analysis Using The BVA-100: Interview with Michael Feldschuh, Daxor CEO
This study highlights the
value of our technology and its potential to improve heart failure outcomes.
There have been dozens of peer-reviewed studies that have established
the value of the BVA-100 test for clinical use, confirming that accurate blood
volume measurement leads to better informed physicians, better treatment
strategies, and improves patient outcomes and resource utilization.
Medgadget: What are the problems with surrogate measures of blood volume that clinicians sometimes use in the absence of a device such as the BVA-100?
Michael Feldschuh: Physicians predominantly rely on
clinical assessment...
Source: Medgadget - June 8, 2020 Category: Medical Devices Authors: Conn Hastings Tags: Anesthesiology Cardiac Surgery Cardiology Critical Care Emergency Medicine Exclusive Source Type: blogs
AI-Powered Teleradiology FDA Cleared for Triage in Departments Swamped by COVID-19: Interview with David Stavens, CEO of Nines
Nines, a teleradiology company based in Palo Alto, CA, recently received FDA clearance for their NinesAI medical device, which supports the automated radiological review of CT Head images for the possible presence of two time-critical, life-threatening indications: intracranial hemorrhage and mass effect. The technology can help radiologists in triaging cases. Nines is the first company to receive FDA clearance for AI technology that triages mass effect conditions.
Teleradiology is an
increasingly vital service for healthcare providers, whereby radiological images
are sent to a radiologist in a remote location for analy...
Source: Medgadget - May 21, 2020 Category: Medical Devices Authors: Conn Hastings Tags: Exclusive Radiology Telemedicine Source Type: blogs
Scores predicting bleeding risk in AF
Anticoagulation is vital for reducing the risk of stroke in atrial fibrillation (AF). There are several scores predicting bleeding risk in AF. These can be used to weigh between the need for anticoagulation and the risk of bleeding with it while taking an individualised decision.
HAS-BLED: Hypertension, Abnormal liver or renal function, Stroke, Bleeding, Labile INRs, Elderly (>65 years), Drugs or Ethanol Abuse
HEMORR2HAGES: (Hepatic or Renal Disease, Ethanol Abuse, Malignancy History, Older than age 75, Reduced platelet count or function, Rebleeding risk, Hypertension, Anemia, Genetic factors (CYP2C9 single nucleotide ...
Source: Cardiophile MD - April 14, 2020 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Cardiology Source Type: blogs
ALPHASTROKE, A Better Way to Diagnose Strokes: Interview with CEO Matt Kesinger
Strokes affect nearly 800,000 Americans per year. One of the most important prognostic factors is the time from symptom onset to treatment. Currently, strokes are usually diagnosed by first-responders using a quick physical exam — a subjective method that can result in incorrect diagnoses, delayed treatment, and poor outcomes.
Forest Devices hopes to change that. The Pittsburgh-based company’s product, ALPHASTROKE, is a portable triage tool that allows first-responders to diagnose strokes more accurately than with a conventional clinical exam. The company’s studies have shown that ALPHASTROKE can diagnose stro...
Source: Medgadget - February 25, 2020 Category: Medical Devices Authors: Cici Zhou Tags: Diagnostics Neurology Source Type: blogs
World ’s First Portable MRI Cleared by FDA
Magnetic resonance imaging (MRI) has revolutionized medicine, but MRI scanners are so demanding that access to them is still a challenge. MRI machines typically require specially built rooms with magnet quench vent pipes, entry systems that check people for metals attracted to magnets, and specific protocols to ensure safety. Patients, therefore, have to be brought to the MRI scanners rather than the other way around.
This is about to change in many cases, as Hyperfine, a company with offices in New York City and St Guilford, Connecticut, won FDA clearance for the first MRI scanner that can be wheeled to the patient bed...
Source: Medgadget - February 17, 2020 Category: Medical Devices Authors: Medgadget Editors Tags: Emergency Medicine Neurology Neurosurgery Radiology Source Type: blogs
How would you manage this patient?
A woman was found outside with altered mental status.She was GCS 3. BP 80/40Here is her ECG:Diagnosis?Sinus bradycardia with Osborn waves. Temperature was 24.3 degrees Celsius.She was intubated (carefully, so as not to irritate her heart into ventricular fibrillation).She requiresinternal rewarming at this temperature. External rewarming would be dangerous, as it results in both rewarming shock (hypotension/shock due to shunting of core blood flow to the surface) and " core afterdrop " (shunting of cold surface blood to the core, dropping core temperature).Because she has an appropriate blood pressure and...
Source: Dr. Smith's ECG Blog - January 1, 2020 Category: Cardiology Authors: Steve Smith Source Type: blogs
Fight Aging! Newsletter, December 16th 2019
This study shows that CA are released from periventricular and subpial regions to the cerebrospinal fluid and are present in the cervical lymph nodes, into which cerebrospinal fluid drains through the meningeal lymphatic system. We also show that CA can be phagocytosed by macrophages. We conclude that CA can act as containers that remove waste products from the brain and may be involved in a mechanism that cleans the brain. Moreover, we postulate that CA may contribute in some autoimmune brain diseases, exporting brain substances that interact with the immune system, and hypothesize that CA may contain brain markers that m...
Source: Fight Aging! - December 15, 2019 Category: Research Authors: Reason Tags: Newsletters Source Type: blogs
Cancer Survivors have Double the Risk of Suffering a Later Stroke
We present a contemporary analysis of risk of fatal stroke among more than 7.5 million cancer patients and report that stroke risk varies as a function of disease site, age, gender, marital status, and time after diagnosis. The risk of stroke among cancer patients is two times that of the general population and rises with longer follow-up time. The relative risk of fatal stroke, versus the general population, is highest in those with cancers of the brain and gastrointestinal tract. The plurality of strokes occurs in patients older than 40 years of age with cancers of the prostate, breast, and colorectum. Patients of any ag...
Source: Fight Aging! - December 9, 2019 Category: Research Authors: Reason Tags: Medicine, Biotech, Research Source Type: blogs
A 41 year old with chest pain and a Nondiagnostic Triage ECG. Thrombolytics prior to transfer for PCI.
Conclusion:Transfer for PCI without thrombolytics is best if PCI at receiving facility can be done in less than 120 minutes from first medical contact, or less than 90 minutes from STEMI diagnosis in first ED.Thrombolytics prior to Transfer to a PCI capable facility, then rescue PCI if no reperfusion for STEMITRANSFER AMI(Cantor et al. 2009).High risk STEMI: BP less than 100, HR greater than 100 Killip class II, III, ST depression of at least 2 mm in precordial leads, ST elevation in right precordial leads (right ventricular MIAll patients get TNK-tPA.80-90% received clopidogrel 300 mg (75 mg for age over...
Source: Dr. Smith's ECG Blog - November 7, 2019 Category: Cardiology Authors: Steve Smith Source Type: blogs
A man in his 50s with witnessed arrest and ST elevation in aVR
Written by Meyers, edits by SmithA 50-ish year old man was working construction when he suddenly collapsed. Coworkers started CPR within 1 minute of collapse. EMS arrived within 10 minutes and continued CPR and ACLS, noting alternating asystole and sinus bradycardia during rhythm checks. He received various ACLS medications and arrived at the ED with a perfusing rhythm.Initial vitals included heart rate around 100 bpm and BP 174/96. Here is his initial ECG, very soon after ROSC:What do you think?Sinus tachycardia. There is incomplete RBBB (QRS duration less than 120 ms). There is diffuse STD, maximal in V4-V5 a...
Source: Dr. Smith's ECG Blog - November 2, 2019 Category: Cardiology Authors: Pendell Source Type: blogs
Plant-based diets are best … or are they?
This study is also a reminder that the health impact of a particular intervention (such as diet) may not be easy to predict or explain. In most cases, the risk of stroke and heart disease tend to rise or fall together, but that wasn’t the case in this research.
Beware the study’s limitations
This study linking a vegetarian diet with a higher risk of hemorrhagic stroke has a number of important limitations that should temper the concerns of vegetarians.
The study was observational. That means it simply observed what happened among different people who followed different diets over time, without being able to account fo...
Source: Harvard Health Blog - October 31, 2019 Category: Consumer Health News Authors: Robert H. Shmerling, MD Tags: Healthy Eating Heart Health Hypertension and Stroke Source Type: blogs
NICO Myriad NOVUS Provides Xenon Lighting for Brain Resections
NICO Corporation, a company based in Indianapolis, Indiana, is releasing its new NICO Myriad NOVUS resection tool. The FDA cleared product combines xenon illumination with NICO’s proven myriad neural tissue removal technology.
Xenon lights reproduce the visible spectrum of daylight much better than most other bulbs, although LED contenders are now available, and so are often the optimal choice when working in a confined environment and where precision is key.
The Myriad NOVUS is intended to help with intracerebral hemorrhage clot evacuation and subcortical tumor resection, whether using a microscope, surgical...
Source: Medgadget - October 23, 2019 Category: Medical Devices Authors: Medgadget Editors Tags: Neurosurgery Source Type: blogs
Fight Aging! Newsletter, October 21st 2019
In this study, AT1-AAs were detected in the sera of patients with peripheral arterial disease (PAD) and the positive rate was 44.44% vs. 17.46% in non-PAD volunteers. In addition, analysis showed that AT1-AAs level was positively correlated with PAD. To reveal the causal relationship between AT1-AAs and vascular aging, an AT1-AAs-positive rat model was established by active immunization. The carotid pulse wave velocity was higher, and the aortic endothelium-dependent vasodilatation was attenuated significantly in the immunized rats. Morphological staining showed thickening of the aortic wall. Histological examination showe...
Source: Fight Aging! - October 20, 2019 Category: Research Authors: Reason Tags: Newsletters Source Type: blogs
