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Differential Diagnosis of New Giant T-Wave Inversions
To the Editor The electrocardiogram (ECG) presented by Dr Cai and colleagues is indeed a great challenge. Two days after a fall, an older patient was admitted to the hospital with a hip fracture that was treated by external fixation and skin traction. On hospital day 2, the patient suddenly lost consciousness. An ECG immediately performed showed giant negative T waves (>20 mm) in the precordial leads and a QTc prolongation of 535 milliseconds. Cardiac troponin was elevated. Findings of computed tomography and magnetic resonance imaging (performed because of neurologic deficits) showed bilateral multifocal subacute ische...
Source: JAMA Internal Medicine - July 10, 2023 Category: Internal Medicine Source Type: research

Study the Value of Interleukin-6 As Diagnostic and Predictive marker of Cardiac Events in St Segment Elevation Myocardial Infarction
ConclusionFrom this current study we revealed that: STEMI patients have increased level of interleukin-6 compared to those normal persons. Interleukin-6 may be a potentially useful marker for diagnosis of STEMI. Interleukin-6 may be helpful prognostic value for future cardiac mortality in STEMI patients. The level of interleukin-6 is not affected by the extent of myocardial damage and necrosis. Interleukin-6 is an inflammatory cytokine.Recommendations From this study we recommend the use of interleukin-6 level as good diagnostic marker for diagnosis of ST segment elevation myocardial infarction, Also this study recommend t...
Source: QJM - October 1, 2021 Category: Internal Medicine Source Type: research

Perioperative Risk Factors of Atrial Fibrillation Post CABG Surgeries, a Retrospective Non-Randomized Study
ConclusionThe current study found that low ejection fraction, dilated left atrium, hypertension, smoking, old age, male gender, prolonged bypass time, prolonged cross clamping time, renal impairment, previous myocardial infarction, ungrafted dominant right coronary artery, low temperatures on bypass, early ischemic changes postoperative, hypokalemia, use of adrenaline and nor adrenaline, all of these factors were a significant predictors for development of atrial fibrillation after cardiac surgery.
Source: QJM - October 1, 2021 Category: Internal Medicine Source Type: research

Relationship of electrocardiographic changes and severity of acute cerebral ischemic stroke in old patients: A clinical observational study
This study was aim to provide referential data for this topic. Totally 200 old patients with acute CIS in our hospital from January 2017 to December 2019 were included into this study. According to the ST-T segment changes in ECG, these patients were divided into 3 groups: persistent ischemic group (n = 38), transient ischemic group (n = 106) and non-ischemic group (n = 56). The characteristics and incidence of abnormal ECG and their relationship with disease severity, infarct size and prognosis were respectively analyzed under the severe, moderate and mild type of disease. The ECG changes of patients wer...
Source: Medicine - July 2, 2021 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Simultaneous cardio-cerebral infarction in the coronavirus disease pandemic era: A case series
Conclusion: Early recognition and immediate treatment is important in different scenarios leading to thrombosis as the outcome. Additionally, addressing the unknown risks that could contribute to our traditional understanding of these causative mechanisms is important. The hypothesis of exacerbated damage caused by inflammatory and immunological endothelial systemic damage should further be explored to be able to delineate new possibilities in managing these conditions.
Source: Medicine - January 29, 2021 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Transdermal opioid patch in treatment of paroxysmal autonomic instability with dystonia with multiple cerebral insults: A case report
Rationale: Paroxysmal autonomic instability with dystonia (PAID) is an underdiagnosed syndrome that describes a collection of symptoms following diverse cerebral insults, such as traumatic brain injury, hydrocephalus, hemorrhagic stroke, or brain anoxia. It is manifested by systemic high blood pressure, hyperthermia, tachycardia, tachypnea, diaphoresis, intermittent agitation, and certain forms of dystonia. Patient concerns: A semi-comatose 46-year-old man was transferred from the regional rehabilitation hospital with various complaints involving fluctuating vital signs, including uncontrolled hyperthermia, hypertensi...
Source: Medicine - October 2, 2020 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Lithium intoxication presenting as altered consciousness and arrhythmia with cardiogenic shock: A case report
Rationale: Lithium has been used to treat bipolar disorder. Lithium has a narrow therapeutic index, with a therapeutic level between 0.6 and 1.5 mEq/L. The possible complications of lithium overdose include altered mental status, hand tremor, muscle weakness, nausea, vomiting, diarrhea, seizure, syncope, and arrhythmia. Lithium intoxication can be fatal and is difficult to diagnose in patients without a history of lithium intake. The occurrence of serious cardiac arrhythmias is rare in lithium intoxication. Patient concerns: An 81-year-old man was brought to the emergency department because of consciousness disturba...
Source: Medicine - November 1, 2018 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Cardiovascular risk factors in patients with combined central retinal vein occlusion and cilioretinal artery occlusion: Case report
AbstractRationale:To analyze cardiovascular risk factors and comorbidity of acute unilateral visual loss due to combined central retinal vein occlusion (CRVO) and cilioretinal artery occlusion (CLRAO).Patient concerns:Among patients with retinal vein or artery occlusion hospitalized at the Department of Ophthalmology between January 2011 and August 2017, subjects with combined CRVO/CLRAO were selected. All of them underwent ophthalmologic and cardiologic examination, including fluorescein angiography, optical coherence tomography, 12-lead electrocardiogram, transthoracic and transesophageal echocardiography, carotid Dopple...
Source: Medicine - January 1, 2018 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Association of ventricular arrhythmia and in-hospital mortality in stroke patients in Florida: A nonconcurrent prospective study
Abstract: Stroke remains one of the leading causes of death in the United States. Current evidence identified electrocardiographic abnormalities and cardiac arrhythmias in 50% of patients with an acute stroke. The purpose of this study was to assess whether the presence of ventricular arrhythmia (VA) in adult patients hospitalized in Florida with acute stroke increased the risk of in-hospital mortality. Secondary data analysis of 215,150 patients with ischemic and hemorrhagic stroke hospitalized in the state of Florida collected by the Florida Agency for Healthcare Administration from 2008 to 2012. The main outcome for th...
Source: Medicine - July 1, 2017 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

ECG markers associated with ischemic stroke at young age - A case-control study.
CONCLUSIONS: P-wave abnormalities on ECG were associated with cardioembolic but also with cryptogenic subtype of IS. PMID: 28657357 [PubMed - as supplied by publisher]
Source: Annals of Medicine - June 30, 2017 Category: Internal Medicine Tags: Ann Med Source Type: research

Utility of Duranta, a wireless patch-type electrocardiographic monitoring system developed in Japan, in detecting covert atrial fibrillation in patients with cryptogenic stroke: A case report
Rationale: Subcutaneous implantable electrocardiographs are highly effective in detecting covert atrial fibrillation (AF) in cryptogenic stroke. However, these invasive devices are not indicated for all cryptogenic stroke patients, and noninvasive improvements over conventional Holter-type ambulatory electrocardiography are needed. We evaluated the clinical application and effectiveness of Duranta (ImageONE Co., Ltd.), a wireless patch-type electrocardiographic monitoring system developed in Japan for chronically ill patients or home-based patients at the end of life. A Duranta device was used to detect covert AF in patien...
Source: Medicine - February 1, 2017 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Intracranial Hemorrhage and Deep T Wave Inversions
A woman in her 70s with a medical history significant for atrial fibrillation and cardioembolic stroke who was receiving long-term anticoagulation therapy with warfarin (international normalized ratio, 2.3) presented to an outside facility with sudden onset of nausea and vertigo. Her mental status declined and she was unable to protect her airway, prompting intubation. Computed tomographic scan (CT) at that time was negative for any intracranial pathologic findings. On arrival to our facility, the patient remained lethargic and unresponsive; therefore, a second noncontrast head CT was performed, which showed no evidence fo...
Source: JAMA Internal Medicine - May 4, 2015 Category: Internal Medicine Source Type: research

Recent advances in the management of transient ischaemic attack: a clinical review
Abstract Transient ischaemic attack (TIA) if untreated carries a high risk of early stroke and is associated with poorer long‐term survival. There have been recent advances in the understanding of TIA, its investigations, management and organisation of services for patient care. Clinically, patients are diagnosed TIA if they have transient sudden‐onset focal neurological symptoms which usually completely and rapidly resolve by presentation. Patients with residual symptoms should be evaluated as potentially having stroke, if they present within 4.5 h of onset, should be urgently evaluated for their potential eligibili...
Source: Internal Medicine Journal - April 1, 2013 Category: Internal Medicine Authors: T. G. Phan, L. Sanders, V. Srikanth Tags: Review Source Type: research