Syncope in a 20-something woman
A 20-something was outside exerting herself. She states that it was hot outside and that she was probably dehydrated. At one point, she felt lightheaded and then can ' t remember anything until waking up in the ambulance. Her friends saw her lose consciousness and fall on the ground. She regained consciousness spontaneously before responders arrived. Fire department was on scene first, who noted a cyanotic color to the patient ' s face. EMS arrived and also noted cyanotic color which improved en route to HCMC. She denies head pain, neck pain, back pain, abdominal pain or any pain at this ...
Source: Dr. Smith's ECG Blog - July 17, 2018 Category: Cardiology Authors: Steve Smith Source Type: blogs
Resuscitated cardiac arrest – Cardiology MCQ – Answer
Thirty year old male was resuscitated from cardiac arrest. His temperature was 37 degrees centigrade and serum potassium was 4.5 mEq/litre. ECG showed an abnormal wave at the end of the QRS complex. He is likely to have:
Correct answer: c) Arrhythmogenic right ventricular dysplasia
The wave at the end of the QRS is likely to be Epsilon wave. It is sometimes called ‘post excitation’ by analogy with the delta wave seen at the beginning of the QRS in pre-excitation. Hypothermia and hypokalemia can cause cardiac arrest, which are excluded from the data given. Osborne wave in hypothermia is also seen at the end ...
Source: Cardiophile MD - June 12, 2018 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs
Resuscitated cardiac arrest – Cardiology MCQ
Thirty year old male was resuscitated from cardiac arrest. His temperature was 37 degrees centigrade and serum potassium was 4.5 mEq/litre. ECG showed an abnormal wave at the end of the QRS complex. He is likely to have:
a) Hypertrophic obstructive cardiomyopathy
b) Long QT syndrome
c) Arrhythmogenic right ventricular dysplasia
d) Acute myocardial infarction
Please post your answer as a comment below. Correct answer will be published on: Jun 12, 2018 @ 19:45 (Source: Cardiophile MD)
Source: Cardiophile MD - June 10, 2018 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs
Artificial Intelligence Spots Congenital Long QT Syndrome on ECGs
Clinical researchers at Mayo Clinic, working with AliveCor, the company that essentially introduced mobile electrocardiography (ECG) to the mass market, have published a study abstract demonstrating that artificial intelligence can be used to spot patients with congenital Long QT Syndrome (LQTS). The readings come from lead 1 of a 12-lead clinical grade ECG, which means that AliveCor’s single lead ECGs, such as the Kardia Band for the Apple Watch, should be able to do the same trick.
Some details according to AliveCor:
As many as 50% of patients with genetically confirmed LQTS have a normal QT interval on the standa...
Source: Medgadget - May 11, 2018 Category: Medical Devices Authors: Editors Tags: Cardiology Informatics Medicine Net News Pediatrics Source Type: blogs
Besides the Nonspecific T-wave Inversion in aVL, What Else is Abnormal on this ECG?
This case was sent by Laszlo Farkas, a paramedic from Hungary. He discussed it with Janos Borbas MD and Robert Sepp MD from University of Szeged 2nd Department of Internal Medicine and Cardiology Clinic. The case inspired me to resurrect a case that I published 10 years ago with the same ECG finding (2nd case below).What is the finding?What does it signify?CaseAn elderly male presented with chest pain. Here is the first ED ECG:Hint: the finding is NOT the T-wave inversion in aVLThis ECG that I published 10 years ago in Critical Decisions in Emergency and Acute Care Electrocardiography has th...
Source: Dr. Smith's ECG Blog - April 14, 2018 Category: Cardiology Authors: Steve Smith Source Type: blogs
Cardiology MCQ Test 6
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Source: Cardiophile MD - October 27, 2017 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
All about alternans
Here is all you wanted to know about alternans: Traube’s pulse, total pulsus alternans, diastolic pulsus alternans, right ventricular pulsus alternans, biventricular pulsus alternans and electrical alternans!
Traube’s pulse – pulsus alternans
Pulsus alternans or Traube’s pulse was described by Ludwig Traube in 1872 [1]. Pulsus alternans is nothing but alternating pulses having different volumes and is a feature of left ventricular dysfunction. It is well known that pulsus alternans can be augmented by a premature ventricular contraction [2].
A rare case of pulsus alternans due to 2:1 left bundle branch...
Source: Cardiophile MD - January 25, 2017 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology biventricular pulsus alternans Brody's effect diastolic pulsus alternans electrical alternans right ventricular pulsus alternans total pulsus alternans Traube's pulse Source Type: blogs
DM / DNB Cardiology Entrance Mock Test 17
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Source: Cardiophile MD - February 16, 2016 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs
DM / DNB Cardiology Entrance Mock Test 9
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Source: Cardiophile MD - January 27, 2016 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ DM / DNB Cardiology Entrance Featured Source Type: blogs
DM / DNB Cardiology Entrance Mock Test 8
This study found that though it is often associated with coronary artery disease (CAD), it can also occur in those without significant CAD. It was not specifically associated with disease of right coronary artery disease.
This cardioinhibitory response may be a manifestation of the Bezold-Jarisch reflex. Bezold-Jarisch reflex inhibits sympathetic activity (sympathetic withdrawal) and increases parasympathetic activity, resulting in bradycardia, which may be associated with vasodilatation, nausea and hypotension. Bezold-Jarisch has been described in the setting of inferior wall infarction and coronary angiography. Origin...
Source: Cardiophile MD - January 26, 2016 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ Cardiology X-ray Featured Source Type: blogs
Antibiotics: Preserve the miracle?
The placebo effect is well-known in modern medicine. Unfortunately, the most effective medicines we’ve ever discovered are more often used as placebos rather than cures. What are these medicines? Antibiotics.
They’ve added 20 years to the average human life expectancy, some would call this a “miracle”. In-fact “preserve the miracle” is the official slogan for Antibiotic Awareness Week. But it’s a word that carries some baggage, after all miracles don’t come with adverse consequences.
Antibiotics, like other medicines have side-effects. In the patient these can range from allergies and Stevens-Johnson syndro...
Source: Life in the Fast Lane - January 20, 2016 Category: Emergency Medicine Authors: Jarrad Hall Tags: Immunology Infectious Disease Microbiology antibiotics Faustian bargain placebo resistance Source Type: blogs
Can Too Much Exercise Harm the Heart? - The New York Times
http://well.blogs.nytimes.com/2015/12/30/can-too-much-exercise-harm-the-heart/?partner=rss&emc=rss&_r=0 Can Too Much Exercise Harm the Heart? iStockPhys EdGretchen Reynolds on the science of fitness.With many of us contemplating marathons or other prolonged endurance events in 2016, we, our spouses and other family members most likely have wondered whether such strenuous training could be harmful to our hearts. Could any of us, in making ambitious resolutions, exercise too much? A newly published scientific review offers both reassurance and some caution. It found that while most athletes' hearts can withstand...
Source: Dr Portnay - December 30, 2015 Category: Cardiology Authors: Dr Portnay Source Type: blogs
On the Preventability of Lethal Errors: A Response to Dr. Koka
By JOHN T JAMES, PhD
In my opinion, the title of Dr. Koka’s post (“Very Bad Numbers“) is far too inflammatory for a subject that needs to be taken seriously. Dr. Koka’s summary of the approach I took in my JPS study is a reasonable summary, minus a few key points. Preventability of lethal errors is the problematic issue. The nine authors of the Classen paper did postulate that virtually all serious adverse events they found are preventable; I did not pull this out of the air. Preventability is a highly subjective area. A few years ago everyone assumed that hospital acquired infections were simply the c...
Source: The Health Care Blog - December 3, 2015 Category: Consumer Health News Authors: Simon Nath Tags: THCB Errors John T James Patient Safety Source Type: blogs
Gollob score and modified Gollob score – Cardiology MCQ
Gollob score and modified Gollob score have been proposed for the risk stratification of:
a) Long QT syndrome
b) Short QT syndrome
c) Brugada syndrome
d) Early repolarization syndrome
Correct answer: b) Short QT syndrome
The Gollob scoring system [1] allots points for shortening of QT interval, shortening of J point to T peak interval, clinical history, familly history and genotype. A score of 4 or more is considered to confer high probability, 3 points an intermediate probability and 2 or less points a low probability. The scoring system has been modified by the same group in pediatric patients [2].
References
Gollob MH,...
Source: Cardiophile MD - September 26, 2015 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ DM / DNB Cardiology Entrance ECG / Electrophysiology Featured Source Type: blogs
Long QT Syndrome with Continuously Recurrent Polymorphic VT: Management
A young woman presented with intermittent shocks from her implantable defibrillator. She was intermittently unconscious and unable to give history. The monitor showed intermittent polymorphic ventricular tachycardia. The physician was presented with this ECG at the same moment he was observing the repeated syncope:Time zeroIt is a bigeminal rhythm with a very bizarre PVC. The PVC has an incredibly long QT, but the intervening native rhythms do not. However, when I saw this (it was texted to me), it immediately reminded me of this case, so I knew by sheer recognition that it was lo...
Source: Dr. Smith's ECG Blog - July 8, 2015 Category: Cardiology Authors: Steve Smith Source Type: blogs
