Collapse, Ventricular Tachycardia, Cardioverted, Comatose on Arrival. OMI is a clinical diagnosis.
A middle-aged woman cried out, then collapsed. She had bystander CPR. First responders palpated a pulse. Paramedics found her to be in Ventricular Tachycardia. She underwent synchronized cardioversion.On arrival, she had this ECG:What do you think?There is sinus rhythm. The ECG shows unequivocal ST Elevation in I and aVL, with reciprocal inferior ST Depression, and also STE in V3-V6. There is unequivocal subepicardial (transmural) ischemia on this ECG. This is probably a proximal LAD occlusion, right?Not so fast!!This patient dropped to the ground, and in spite of VT with a pulse (not VF...
Source: Dr. Smith's ECG Blog - December 20, 2021 Category: Cardiology Authors: Steve Smith Source Type: blogs
Chest pain and RBBB with right axis deviation, and downsloping ST Elevation. What is downsloping ST Elevation?
4916132A 50-something male smoker with h/o Diabetes, but with no cardiac history presented by ambulance with acute chest pain. It was described as severe, pleuritic, with radiation to bilateral shoulder blades, and associated with shortness of breath. Constant. He had never had this before.His chest wall was exquisitely tender and palpation exactly reproduced his pain.He had this prehospital ECG.What do you think?There is a right bundle branch block, and also right axis deviation due toleft posterior fascicular block. An old ECG was available that did not have BBB of any kind, but a more r...
Source: Dr. Smith's ECG Blog - December 15, 2021 Category: Cardiology Authors: Steve Smith Source Type: blogs
Paragonix Leads Organ Transportation with Liver and Heart Milestones
Paragonix Technologies, a leading provider of donor organ preservation and transport systems, recently launched a new donor liver preservation system (LIVERguard) and global liver registry.
The LIVERguard System provides a highly controlled, state-of-the art environment for hypothermic liver preservation, coupled with real-time digital monitoring to safeguard a donor liver throughout the transplant journey from donation to transplantation. Like all Paragonix systems, the LIVERguard System represents a fundamental advance over the use of ice and off-the-shelf coolers that have been the standard-of-care in organ transplan...
Source: Medgadget - December 9, 2021 Category: Medical Devices Authors: Alice Ferng Tags: Cardiac Surgery Exclusive paragonix Source Type: blogs
New Hydrogel Material for Vocal Cord Repair
Researchers at McGill University developed a tough hydrogel that can resist mechanical forces found in the body. However, the material still provides a friendly environment for encapsulated cells to grow and enables the deep perfusion of blood and other tissue fluids. The injectable biomaterial may be useful in repairing tissues that experience constant mechanical stress, such as the heart, skeletal muscles and vocal cords.
“People recovering from heart damage often face a long and tricky journey. Healing is challenging because of the constant movement tissues must withstand as the heart beats. The same is tru...
Source: Medgadget - December 6, 2021 Category: Medical Devices Authors: Conn Hastings Tags: ENT Materials Oncology Surgery mcgilluniversitycanada Source Type: blogs
Fight Aging! Newsletter, November 29th 2021
Fight Aging! publishes news and commentary relevant to the goal of ending all age-related disease, to be achieved by bringing the mechanisms of aging under the control of modern medicine. This weekly newsletter is sent to thousands of interested subscribers. To subscribe or unsubscribe from the newsletter,
please visit:
https://www.fightaging.org/newsletter/
Longevity Industry Consulting Services
Reason, the founder of Fight Aging! and Repair Biotechnologies, offers strategic consulting services to investors, entrepreneurs, and others interested in the longevity industry and its complexities. To find out m...
Source: Fight Aging! - November 28, 2021 Category: Research Authors: Reason Tags: Newsletters Source Type: blogs
AMPK Activator O304 as an Exercise Mimetic Drug
Most of the work aimed at treating aging as a medical condition is focused on stress response upregulation, finding ways to trigger some of the regulatory pathways and mechanisms involved in beneficial cellular reactions to the mild stresses of exercise, reduced calorie intake, hypoxia, heat, cold, and so forth. Improved cell behavior leads to improved tissue function, which in turn slows the progression of degenerative aging. Many of these pathways converge on autophagy, and evidence from the study of calorie restriction suggests that improved autophagy is the largest contributing factor.
Autophagy is the name give...
Source: Fight Aging! - November 25, 2021 Category: Research Authors: Reason Tags: Medicine, Biotech, Research Source Type: blogs
Shark fin post arrest: do you understand the ECG?
Case submitted by Dr. Daryl Williams, written by Pendell Meyers, peer reviewed by Smith and BraceyA physician bystander witnessed a middle-aged or slightly elderly man suddenly collapse while walking down the street, very close to the hospital. The physician immediately started CPR and called EMS. EMS arrived quickly and found the patient to be in VFib. After several shocks the patient achieved ROSC.A minute or so after arrival to the ED, he went back into VFib and was immediately shocked back out into sinus rhythm.His EMS ECG during initial ROSC was available for the ED team:Here is his ED ECG:What do you think?Both ...
Source: Dr. Smith's ECG Blog - November 22, 2021 Category: Cardiology Authors: Pendell Source Type: blogs
Fight Aging! Newsletter, November 22nd 2021
This study nicely illustrates the importance of the cellular metabolic state of myeloid cells: it highlights that not only the availability of glucose, but also its channeling into different pathways (glycolysis versus glycogen synthesis) contributes to maintaining proper myeloid function.
On the Ability of Redundant Blood Vessels to Lower Cardiovascular Mortality
https://www.fightaging.org/archives/2021/11/on-the-ability-of-redundant-blood-vessels-to-lower-cardiovascular-mortality/
A few strategies offer the possibility of growing additional redundant blood vessels, though this is far from rigorously p...
Source: Fight Aging! - November 21, 2021 Category: Research Authors: Reason Tags: Newsletters Source Type: blogs
A woman in her 60s with syncope and vomiting. Does she need a pacemaker?
Written by Pendell Meyers with some edits by Steve SmithA woman in her 60s on chemotherapy presented to the Emergency Department for a syncopal episode just prior to arrival. She was walking to the bathroom when she suddenly felt nauseous and passed out. EMS was called by the patient ' s daughter, and en route to the ED she vomited twice. On arrival to the ED, she adamantly denies chest pain but says she ' s " just still not feeling well. " She had no prior known cardiac disease.Triage at 0755:The rhythm is most either atrial fibrillation with complete heart block and resulting junctional escape, or atrial flutter wi...
Source: Dr. Smith's ECG Blog - November 19, 2021 Category: Cardiology Authors: Pendell Source Type: blogs
On the Ability of Redundant Blood Vessels to Lower Cardiovascular Mortality
A few strategies offer the possibility of growing additional redundant blood vessels, though this is far from rigorously proven. Intermittently provoking hematopoietic stem cells to leave the bone marrow via CXCL12 upregulation, for example. Humans are not completely uniform in their major blood vessel networks, there are variant populations with more redundancy. The value of that greater redundancy is illustrated here by a look at a patient possessing a Kugel's artery, a rare additional vessel that can allow survival in cases of obstructed coronary arteries due to the progression of atherosclerosis. Redundancy in blood ve...
Source: Fight Aging! - November 15, 2021 Category: Research Authors: Reason Tags: Daily News Source Type: blogs
Collapse, pulse present, ECG shows inferior OMI. Then there is loss of pulses with continued narrow complex on the monitor ( " PEA arrest " )
An elderly woman was witnessed to collapse. 911 was called and when EMS arrived, she was unresponsive with shallow respirations, a GCS of 3, pulse of 70 and BP of 78/67 by cuff pressure.3 prehospital ECGs were recorded:There is an obvious inferior OMI/STEMI, right?The patient then had a PEA arrest while on the cardiac monitor, and CPR was started.On arrival, all the usual things were done for cardiac arrest.Transthoracic cardiac POCUS was of low quality, and so after intubation aTEE probe was inserted.Aside: here is a recent report of our experience with over 550 TEE exams in the Hennpin ED: Feasibility, utility...
Source: Dr. Smith's ECG Blog - November 8, 2021 Category: Cardiology Authors: Steve Smith Source Type: blogs
Acute Pulmonary Edema, PEA Arrest, LBBB, First degree AV Block, and STD maximal in V3, V4
An elderly woman had sudden SOB and 911 was called. Medics found her with labored breathing and 75% saturations. She was put on high flow oxygen. After placing her in the ambulance, she had a PEA arrest. She was intubated and ventilated, and given compression decompression CPR with theResQPod andResQPump.Aside:these 2 devices were invented by researcher Keith Lurie, who is in the Department of EM here at Hennepin; this isthe only method of CPR ever proven in a randomized trial to improve outcome in cardiac arrest see this ResQTrial, published in Lancet in 2011:Treatment of out-of-hospital cardi...
Source: Dr. Smith's ECG Blog - October 25, 2021 Category: Cardiology Authors: Steve Smith Source Type: blogs
What is the effect of Atrial fibrillation on blood pressure ?
Atrial fibrillation has a direct effect on systemic blood pressure as stroke volume swings from beat to beat because of changing RR Interval ( preload ). The variation in systolic pressure actually reflects not only the changing stroke volume but also the enhanced contractility of the ventricle to the preload( Frank-Starling principle ). The net effect is reflected in the pulse as an irregularly irregular pulse (Both rate and volume /Amplitude).* However, In dysfunctional ventricles or in acute AF* this variation in systolic BP can be significant. Also realize, If the preload is changing every beat, there is a consider...
Source: Dr.S.Venkatesan MD - October 3, 2021 Category: Cardiology Authors: dr s venkatesan Tags: Cardiology - Clinical Blood pressure in atrial fibillation cardiology research topic cardiology thesis topic pulse deficit Source Type: blogs
What is the Impact of Atrial fibrillation on blood pressure ? … It is also irregularly irregular !
Atrial fibrillation has a direct effect on systemic blood pressure as stroke volume swings from beat to beat because of changing RR Interval ( preload ). The variation in systolic pressure actually reflects not only the changing stroke volume but also the enhanced contractility of the ventricle to the preload( Frank-Starling principle ). The net effect is reflected in the pulse as an irregularly irregular pulse (Both rate and volume /Amplitude).* However, In severely dysfunctional ventricles this variation in systolic BP can be minimal. Also realize, If the preload is changing every beat, there is a considerable dynami...
Source: Dr.S.Venkatesan MD - October 3, 2021 Category: Cardiology Authors: dr s venkatesan Tags: Cardiology - Clinical Blood pressure in atrial fibillation cardiology research topic cardiology thesis topic pulse deficit Source Type: blogs
Cardiac Arrest at the airport, with an easy but important ECG for everyone to recognize
Written by Pendell MeyersEvery once in a while we need to go back and cover some easy but important ECGs.This will be far too easy for most readers of this blog, so please go find a learner and show them this case. Make sure they understand this case well, so that they will be able to learn from the harder versions of this case.A middle aged female suffered sudden witnessed cardiac arrest at the airport, with quick bystander CPR.EMS arrived and found her in VF. She was successfully defibrillated.Her EMS ECG on the way to the ED was sent to us:What do you think?There is likely sinus tachycardia with a prolonged PR int...
Source: Dr. Smith's ECG Blog - September 23, 2021 Category: Cardiology Authors: Pendell Source Type: blogs
