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A 50-something with Regular Wide Complex Tachycardia: What to do if electrical cardioversion does not work?
Case submitted by anonymous. Written by Smith. Ken ' s piece at the bottom is excellent.A 50-something presented with sudden onset palpitations 8 hrs prior while sitting at desk at work. He had concurrent sharp substernal chest pain that resolved, but palpitations continued.Over past 3 months, he has had similar intermittent episodes of sharp chest pain while running, but none at rest. Past medical history includes coronary stenting 17 years prior. A brief chart review revealed his most recent echo in 2018, with LV EF 67%, “very small” inferior wall motion abnormality.Initial ED ECG:What do you think?This wa...
Source: Dr. Smith's ECG Blog - September 20, 2023 Category: Cardiology Authors: Steve Smith Source Type: blogs
A 50-something with Regular Wide Complex Tachycardiaa: What to do if electrical cardioversion does not work?
Case submitted by anonymous. Written by Smith. Ken ' s piece at the bottom is excellent.A 50-something presented with sudden onset palpitations 8 hrs prior while sitting at desk at work. He had concurrent sharp substernal chest pain that resolved, but palpitations continued.Over past 3 months, he has had similar intermittent episodes of sharp chest pain while running, but none at rest. Past medical history includes coronary stenting 17 years prior. A brief chart review revealed his most recent echo in 2018, with LV EF 67%, “very small” inferior wall motion abnormality.Initial ED ECG:What do you think?This wa...
Source: Dr. Smith's ECG Blog - September 20, 2023 Category: Cardiology Authors: Steve Smith Source Type: blogs
Instacart IPO Is an Expensive Lesson for Venture Firms
When Instacart lists in the coming week, it will leave many of its later investors with significant paper losses—a sign of the pain venture capitalists are facing after years of fast-and-loose spending.#instacart
Source: Reuters: Health - September 17, 2023 Category: Consumer Health News Source Type: news
Judge for yourself the management of this patient with " NSTEMI, multivessel disease "
DISCUSSION:The administration of
opioid analgesia prior to cath in patients with concern for ACS is associated
with longer door-to-balloon times, and greater peak troponin levels. The rate
of Occlusion MI in those who received pre-cath opioids was double the rate of
those without pre-cath opioids, and STEMI(-) OMI patients who received pre-cath
opioids waited 10 hours on average longer to get cath than those who did not
received opioids. These results add support to our hypothesis that a major
mechanism of harm caused by opioid medications in ACS patients involves delays
to the cath lab for patients with STEMI(-) OMI.=====...
Source: Dr. Smith's ECG Blog - September 10, 2023 Category: Cardiology Authors: Pendell Source Type: blogs
50 year-old in remote rural community with chest pain and ‘normal’ ECG
Submitted by anonymous, edited by Jesse McLarenThe first person " I " and " me " is this anonymous sender. A 50 year old presented to the emergency department of a
remote rural community (where the nearest cath lab is a plane ride away) with
one hour of mild chest pain radiating to the back and jaw, and an ECG labeled ‘normal’ by the computer interpretation. What do you think, and how would you
manage the patient?There ’s normal sinus rhythm, normal conduction, normal axis,
normal R wave progression and normal voltages. There’s clear T wave inversion
in III/aVF, which is reciprocal to subtle ST elevation and h...
Source: Dr. Smith's ECG Blog - September 8, 2023 Category: Cardiology Authors: Jesse McLaren Source Type: blogs
A 50-something with chest pain.
This was sent by anonymous The patient is a 55-year-old male who presented to the emergency department after approximately 3 to 4 days of intermittent central boring chest pain initially responsive to nitroglycerin, but is now more constant and not responsive to nitroglycerin. It is unknown when this pain recurred and became constant.More past history: hypertension, tobacco use, coronary artery disease with two vessel PCI to the right coronary artery and circumflex artery several years prior. He reports feeling nauseated with emesis. He reports that this chest pain feels different than prior chest...
Source: Dr. Smith's ECG Blog - September 3, 2023 Category: Cardiology Authors: Steve Smith Source Type: blogs
Postoperative Analgesics Score as a Predictor of Chronic Postoperative Inguinal Pain After Inguinal Hernia Repair: Lessons Learned From a Retrospective Analysis
ConclusionThe prospective use of the analgesic score established here could be helpful to identify patients that are at risk to develop CPIP. These patients could benefit from a structured follow-up to allow early therapeutic intervention to prevent chronification and restore the quality of life.
Source: World Journal of Surgery - September 2, 2023 Category: Surgery Source Type: research
As cannabis laws relax, neuroscientist warns of its dangers for developing brain
One morning in June, barely 5 months after the first dispensary for recreational cannabis opened in New York state, neuroscientist Yasmin Hurd spoke via Zoom to an audience of educators and specialists who work with or run programs for children. The session’s organizers, alarmed by how many children in their South Bronx community were now getting their hands on cannabis, had sought Hurd’s expertise on the drug’s effects.
Hurd put up a slide of the human brain, its bumps and grooves tinged blue, green, yellow, and red to indicate the distribution of the receptors to which tetrahydrocannabinol (THC), the psychoact...
Source: Science of Aging Knowledge Environment - August 31, 2023 Category: Geriatrics Source Type: research
Mpox Pain Management with Topical Agents: A Case Series
We present two patients' painful experiences with Monkeypox and suggest lessons learned.PMID:37651724 | DOI:10.1080/15360288.2023.2250762
Source: Journal of Pain and Palliative Care Pharmacotherapy - August 31, 2023 Category: Palliative Care Authors: Mariam Shabbir Maria Lorraine Bugayong Michael Anthony DeVita Source Type: research
