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
A 76 Year Old Female With Recurrent Syncope, Lightheadedness, Palpitations and Negative Stress Test
Written by Lucas Goss MD, peer reviewed by Meyers, Smith, BraceyA 76 year old female with a history of arial fibrillation not on anticoagulation, non-obstructive CAD found on coronary CTA 2 years prior, HTN, HLD, recurrent lightheadedness, and syncope status post loop recorder placement, presented for another episode of feeling lightheaded, diaphoretic, and feeling like she “was going to die.” She was discharged just the day prior for her second hospitalization for similar episodes. She was actually at the pharmacy to pick up her medicines the day after discharge when this episode occurred, and pharmacy staff sat her d...
Source: Dr. Smith's ECG Blog - September 4, 2021 Category: Cardiology Authors: Pendell Source Type: blogs
A 60 year old man with chest pain -- many fascinating aspects to this ECG
Written and submitted by Lucas Goss MD, peer reviewed by Smith, Meyers, BraceyA 60-year old man with history of CAD and prior stents to the LAD and ramus presented with acute chest tightness and shortness of breath. He arrives to the ED at about 1 hour and 15 minutes after onset of pain, and his triage ECG is shown below:ECG#1 (no baseline available for comparison):What do you think?Sinus rhythm with PVCNo evidence of hyperkalemiaQT within normal limitsNegative P-wave in V2, so at least V1 and V2 are placed too highSTE in V2-V5, as well as lead II, III, aVFTerminal QRS distortion (TQRSD) in V3 and perhaps almost also V4&nb...
Source: Dr. Smith's ECG Blog - August 19, 2021 Category: Cardiology Authors: Pendell Source Type: blogs
Fight Aging! Newsletter, August 16th 2021
In conclusion, cancer survivors, especially older individuals, demonstrate greater odds of and accelerated functional decline, suggesting that cancer and/or its treatment may alter aging trajectories.
Linking Particulate Air Pollution and Dementia in a Small Region of the US
https://www.fightaging.org/archives/2021/08/linking-particulate-air-pollution-and-dementia-in-a-small-region-of-the-us/
It is fairly settled that evident particulate air pollution, such as daily exposure to smoke from wood-fueled cooking fires, has a strongly detrimental effect on long-term health. The mechanisms involved are inflam...
Source: Fight Aging! - August 15, 2021 Category: Research Authors: Reason Tags: Newsletters Source Type: blogs
VEGF Upregulation Slows Age-Related Capillary Density Loss, Extending Health and Life Span in Mice
The aging of the vasculature has detrimental effects on organs throughout the body. The most structurally apparent issue is that of atherosclerosis, the buildup of fatty deposits that narrow and weaken blood vessels. This ultimately leads to heart failure, stroke, heart attack, and death. A close second is the stiffening of blood vessels, due to a variety of processes such as cross-linking to reduce elasticity in blood vessel walls, and inflammation-linked disruption of the vascular smooth muscle tissue responsible for contraction and dilation of blood vessels. This stiffening causes raised blood pressure, which in turn pr...
Source: Fight Aging! - August 10, 2021 Category: Research Authors: Reason Tags: Medicine, Biotech, Research Source Type: blogs
Aortic Occlusion to Enhance Blood Flow to Brain and Heart: Interview with Habib Frost, CEO of Neurescue
Neurescue, a medtech company based in Denmark, created the NEURESCUE system, a balloon catheter designed to occlude the aorta, resulting in a significant increase in blood flow to the heart and brain. The mechanism is intended to provide emergency treatment for patients suffering a hemorrhage or cardiac arrest.
Both hemorrhage and cardiac arrest represent unmet needs, resulting in a significant number of deaths each year. At present only one in ten people survive a cardiac arrest, illustrating the stark outcomes of this patient population.
Aortic occlusion can help to control blood loss and, by increasing blood flow ...
Source: Medgadget - July 8, 2021 Category: Medical Devices Authors: Conn Hastings Tags: Cardiology Emergency Medicine Exclusive Vascular Surgery Source Type: blogs
Cardiology MCQs
Modified Blalock-Taussig shunt is:
End to side anastomosis of subclavian artery to a pulmonary artery
Side to side anastomosis of main pulmonary artery to aorta
Side to side anastomosis of subclavian artery to a pulmonary artery using a conduit
Anastomosis of superior vena cava to right pulmonary artery
Correct answer: 3. Side to side anastomosis of subclavian artery to a pulmonary artery using a conduit
In classic Blalock-Taussig shunt, the subclavian artery is divided and anastomosed to the pulmonary artery as an end to side anastomosis. In modified Blalock – Taussig shunt, a Gore – Tex graft is used to connect th...
Source: Cardiophile MD - July 4, 2021 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs
Clinical importance of LBBB
Left bundle branch block (LBBB) is usually associated with structural heart disease, unlike right bundle branch block which may be seen without associated heart disease. LBBB is one cause for paradoxical splitting of second heart sound. Normal split closes in expiration. In paradoxical splitting, split is audible in expiration and closes in inspiration.
In normal conduction sequence, left bundle branch is activated first. Hence a left bundle branch block can affect the initial vector in the ECG. This leads to errors in interpretation of Q waves in myocardial infarction. Secondary ST segment and T wave abnormalities common...
Source: Cardiophile MD - June 17, 2021 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: ECG / Electrophysiology Source Type: blogs
Acute Chest pain. All P-waves are not conducting. Is it OMI?
A 50-something male complained of acute onset chest discomfort about 30 minutes PTA while at rest with radiation described as numbness to the back of his neck and both arms. He denied history of CAD, but he reported that he has history of smoking, hyperlipidemia, and pre-diabetes. He reports some shortness of breath and anxiety.Here is his first ED ECG, ECG 1:What is the rhythm? Are there any signs of OMI?There is an annotated version below, and Ken Grauer does a laddergram of this one at the bottom of the post.Notice that there is high degree AV block. This is the essential feature. Acute...
Source: Dr. Smith's ECG Blog - June 17, 2021 Category: Cardiology Authors: Steve Smith Source Type: blogs
The story of my first balloon pump
During the first six months as an ICU nurse, I vividly recall seeing my first balloon pump — a cardiac assist device sitting in the aorta that helps the heart pump blood more effectively and improves perfusion to the coronary arteries. I became mesmerized by the possibilities of mechanical circulatory support. I was nowhere nearRead more …Find jobs at Careers by KevinMD.com. Search thousands of physician, PA, NP, and CRNA jobs now. Learn more. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - June 8, 2021 Category: General Medicine Authors: < span itemprop="author" > < a href="https://www.kevinmd.com/blog/post-author/lauren-powers" rel="tag" > Lauren Powers, RN, CCRN < /a > < /span > Tags: Conditions Cardiology Source Type: blogs
Non invasive cardiac output monitoring
Conventionally, measurement of cardiac output was done invasively. Initially with dye dilution techniques and later by thermodilution techniques. Both needed pulmonary artery catheterization, which in turn was likely to cause morbidity if used for continuous monitoring. Almost all non-invasive cardiac imaging modalities like echocardiography, computed tomography, magnetic resonance imaging and nuclear imaging can measure cardiac output. But these are not suitable for bedside monitoring, though echocardiography may be used for intermittent bedside assessment.
Assessment of cardiac output though desirable, was most often ti...
Source: Cardiophile MD - June 6, 2021 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Cardiology Source Type: blogs
Fight Aging! Newsletter, May 31st 2021
In conclusion, iMSC-sEVs could rejuvenate the senescence of NPCs and attenuate the development of IVDD.
Cell Signaling via Exosomes in the Development of Vascular Calcification
https://www.fightaging.org/archives/2021/05/cell-signaling-via-exosomes-in-the-development-of-vascular-calcification/
Vascular calcification is a feature of aging, a process in which cells in the blood vessel wall take on inappropriate identities and activities that are more appropriate to bone tissue. Evidence of recent years implicates chronic inflammation and the presence of senescent cells in this process. Senescent cells cau...
Source: Fight Aging! - May 30, 2021 Category: Research Authors: Reason Tags: Newsletters Source Type: blogs
Vascular Degeneration in the Brain as the Common Link Between Lifestyle and Dementia
Researchers here propose that the unifying underlying mechanism for lifestyle influences on dementia risk is chronic inflammation. That inflammation causes vascular degeneration and a consequent decline in the blood supply to the brain, which in turn contributes - to some degree - to all of the observed issues in the aging brain. When present to a large degree, these vascular issues are categorized as vascular dementia, a widely studied condition. But it is entirely plausible that subclinical vascular degeneration is an important mediating factor linking lifestyle and dementia. A competing hypothesis involves the role of p...
Source: Fight Aging! - May 28, 2021 Category: Research Authors: Reason Tags: Daily News Source Type: blogs
Defining Hypertension : Why we remain in “ Status confusious ” despite 50 years of clinical trials ?
Next to the atmospheric pressure, the most curious pressure to understand is stored within human blood. Yes, it is the “blood pressure”, fondly referred to as BP by both physicians and patients. (When worried men & women visit us and say, that they are suffering from BP, please make it a point to clarify, BP is a sign of existence of life, rather than a dreaded pathology )
Why should blood have pressure?
BP is lateral pressure exerted by flowing blood on the vessel wall (or is it the propelling pressure head ? It is to be noted, cuff pressure doesn’t measure this !) BP is generated by the heart in...
Source: Dr.S.Venkatesan MD - May 8, 2021 Category: Cardiology Authors: dr s venkatesan Tags: Hypertension 2013 STEMI AHA ACC Guidelines blood pressure lowering treatment trialist collaboration hypertension and dyslipidemia Hypertension current guidelines jnc 6 7 8 hypertesnion Lancet BP LTT trial LDL vs diastolic BP vs fasting blood Source Type: blogs
Cerebral hemodynamics in AF : ” Irregularly irregular ” brain perfusion and risk of “ dementia cordis ”
No doubt, the heart is a biological wonder with its non-stop pump function. Still, it cannot function as a continuous rotary pump like the electrical motors do. It has no other option but to contract in a pulsatile manner. However, the mean pressure in circulation is fairly constant, flow is kept continuous, and fairly laminar. This is made possible by the built-in elastic pressure in the aorta and the poorly understood but vitally important parameter vascular tone. Aging widens the pulse pressure due to dissipation of vascular tone. Atrial fibrillation adds new bizarre dynamism to this pulsatility and challenges the aorti...
Source: Dr.S.Venkatesan MD - May 4, 2021 Category: Cardiology Authors: dr s venkatesan Tags: Uncategorized affirm race trial atrial fibrialltion rate vs rhythm control atrial fibrillation cerebral bllod flow in atrial fibrillation nir spectroscopy in atrial fibrillation Source Type: blogs
