Very fast regular tachycardia: 2 ECGs from the same patient. What is going on?
This was written by Magnus Nossen, from Norway, with comments and additions by SmithA 50 something smoker with no previous medical hx contacted EMS due to acute onset chest pain. Upon EMS arrival the patient appeared acutely ill and complained of chest pain. An ECG was recorded immediately and is shown below. How do you interpret the ECG?ECG#1There is a regular tachycardia with a ventricular rate of about 180 bpm. Smith comment: When there is a regular wide complex tachycardia, first assess whether it is sinus or not. At a rate of 180, this is unlikely. The patient is unstable. Therefore, the first s...
Source: Dr. Smith's ECG Blog - September 27, 2023 Category: Cardiology Authors: Magnus Nossen Source Type: blogs
How Could Digital Technology Make An Impact On Primary Care?
I truly hope that very soon I do not have to make an appointment at the GP when I suspect signs of a disease, but my GP will send me a message that she spotted something irregular in my latest test results and my digital health data, so I’d better visit. Let me show you in detail how primary care should be carried out in the future!
Digital health should become an organic part of primary care in the future
I live a fairly healthy life. I use data to improve my lifestyle and to make better decisions by optimising my sleep pattern, my physical, my cognitive or my emotional abilities; and I had several genetic tests....
Source: The Medical Futurist - September 21, 2023 Category: Information Technology Authors: berci.mesko Tags: Digital Health Research Healthcare Innovation technology wearables GP primary care general practitioner Source Type: blogs
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
Computer: " Normal ECG, " TIMI-3 flow at angiography: Does this ECG manifest Occlusion MI?
A 60-something awoke with 10/10 crushing chest pain. He walked in to triage.Here is the ECG:Computer interpretation: Normal ECGInterventionalistafter doing PCI: SUBTLE STT CHANGES IN LIMB LEADSTo me, this first ECG is diagnostic of inferior OMI.I sent this ECG to the Queen of Hearts (PMcardio OMI), and here is the verdict:YOU TOO CAN HAVE THE PM Cardio AI BOT!! (THE PM CARDIO OMI AI APP)If you want this bot to help you make the early diagnosis of OMI and save your patient and his/her myocardium, you can sign up to get an early beta version of the bot here. It is not yet available, but this is y...
Source: Dr. Smith's ECG Blog - September 5, 2023 Category: Cardiology Authors: Steve Smith Source Type: blogs
Evaluation of Prosthetic Aortic Valve Obstruction
This discussion will focus beyond the basic clinical evaluation, ECG, chest X-ray and hematological workup. Hematological workup is important in aortic valve obstruction because of likelihood of associated hemolytic anemia and acquired von Willebrand Syndrome. Former is due to destruction of red blood cells across the narrowed aortic valve, and latter due to loss of the largest multimers of von Willebrand factor. High shear stress across the narrowed aortic valve exposes a region of the von Willebrand factor which is susceptible to a specific von Willebrand protease. This can lead on to gastrointestinal angiodysplasia (He...
Source: Cardiophile MD - August 9, 2023 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
Profound ST depression in II, III, aVF
Conclusion:Type II MI probable due to hypoxia and tachycardia from resp arrest and amphetamine use. Whether the ST Depression on the ECG represents ischemia or not is uncertain, but it does not represent acute coronary syndrome.===================================MY Comment, by KEN GRAUER, MD (7/26/2023):===================================The most interesting aspects of today ’s case are: i) The tale told by the 6 ECGs; and, ii) The surprise finding of positive troponins! The Sum is More than Each of its Parts:If we look back at the initial ECG&nb...
Source: Dr. Smith's ECG Blog - July 27, 2023 Category: Cardiology Authors: Steve Smith Source Type: blogs
Outpatient Vascular Care: Good, bad or ugly?
BY ANISH KOKA
Filling in the holes of recent stories in the New York Times, and Propublica on the outpatient care of patients with peripheral arterial disease
Most have gotten used to egregiously bad coverage of current events that fills the pages of today’s New York Times, but even by their now very low standards a recent telling of a story about peripheral artery disease was very bad.
The scintillating allegation by Katie Thomas, Jessica Silver-Greenberg and Robert Gebeloff is that “medical device makers are bankrolling doctors to perform artery clearing procedures that can lead to amputationsâ€...
Source: The Health Care Blog - July 24, 2023 Category: Consumer Health News Authors: Ryan Bose-Roy Tags: Medical Practice Anish Koka Medical Devices Outpatient vascular care Source Type: blogs
Blood Pressure Meds vs Blood Thinners: What ’ s The Difference?
Conclusion
In conclusion, while blood pressure medicines and blood thinners are both crucial to heart health, their roles and mechanisms of action are notably distinct. Blood pressure medication works primarily on the vascular system, aiding in reducing blood pressure by relaxing blood vessels or altering the heart’s function. On the other hand, blood thinners target the blood itself, working to prevent the formation of potentially dangerous blood clots.
Throughout this article, one thing becomes undeniably clear: the importance of regular consultations with your healthcare provider. When it comes to managing m...
Source: The EMT Spot - July 20, 2023 Category: Emergency Medicine Authors: Michael Rotman, MD, FRCPC, PhD Tags: Blood Pressure Source Type: blogs
Heart Valves Made in Minutes
Researchers at Harvard University have developed a technique that lets them create biomaterial heart valves in a matter of minutes. The approach, called ‘Focused Rotary Jet Spinning’, has been described by the researchers as ‘a cotton-candy machine with a hair dryer behind it.’ Essentially, the technique involves using jets of air to direct polymer strands onto a heart valve shaped frame. This results in a porous scaffold that allows cardiac cells to enter and grow. The formed constructs also have the mechanical properties to function as a one-way valve within the heart. The scaffolds contain nanoscale ...
Source: Medgadget - July 6, 2023 Category: Medical Devices Authors: Conn Hastings Tags: Cardiac Surgery Cardiology Materials Source Type: blogs
Can You Run In Marathons With Hypertension?
Marathons and hypertension: Understand the risks, learn how to stay safe while running, and explore alternative activities to keep your heart healthy and thriving.
Quick Summary
Marathons pose risks for individuals with hypertension: The intense physical exertion can lead to sudden increases in blood pressure, dehydration, irregular heart rhythms, and strain on the kidneys, potentially causing serious complications like heart attacks or strokes.
Safety measures for hypertensive individuals: If participating in a marathon, monitor blood pressure regularly, follow a supervised training regimen, stay hydrated, w...
Source: The EMT Spot - June 10, 2023 Category: Emergency Medicine Authors: Michael Rotman, MD, FRCPC, PhD Tags: Blood Pressure Source Type: blogs
Dangers And Risks Of High Blood Pressure
Conclusion
Despite its silent nature, high blood pressure gradually damages organs over time. The interconnectedness of the circulatory system means that all organs reachable by blood are at risk.
Hypertension can lead to critical complications such as heart enlargement, coronary artery disease, stroke, cognitive decline, erectile dysfunction, kidney disease, proteinuria, vision problems, and vascular damage.
The importance of proactive measures to manage and prevent these adverse effects is emphasized.
Regular blood pressure monitoring, adopting a healthy lifestyle, and working with healthcare professionals ar...
Source: The EMT Spot - June 1, 2023 Category: Emergency Medicine Authors: Michael Rotman, MD, FRCPC, PhD Tags: Blood Pressure Source Type: blogs
27 Dangers And Risks Of High Blood Pressure
Conclusion
Despite its silent nature, high blood pressure gradually damages organs over time. The interconnectedness of the circulatory system means that all organs reachable by blood are at risk.
Hypertension can lead to critical complications such as heart enlargement, coronary artery disease, stroke, cognitive decline, erectile dysfunction, kidney disease, proteinuria, vision problems, and vascular damage.
The importance of proactive measures to manage and prevent these adverse effects is emphasized.
Regular blood pressure monitoring, adopting a healthy lifestyle, and working with healthcare professionals ar...
Source: The EMT Spot - June 1, 2023 Category: Emergency Medicine Authors: Michael Rotman, MD, FRCPC, PhD Tags: Blood Pressure Source Type: blogs
Clinical Examination of Cardiovascular System For Medical Students
Discussion on blood pressure is not included here as a separate topic is dedicated to it.
Though the most commonly examined pulse is the radial, to check some of the characteristics, a more proximal pulse like the brachial or carotid needs to be examined. Following parameters of the pulse are routinely documented: 1. The rate: Normal rate in adult is 60-100 per minute. It is higher in children. Younger the child, higher the pulse rate.
Rhythm: Regular and irregular rhythms are possible. Mild variation with respiration is called respiratory sinus arrhythmia, with higher rate in inspiration. Respiratory sinus arrhythmia may...
Source: Cardiophile MD - May 30, 2023 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
Vein on a Chip Includes Flexible Valves
Researchers at the University of Birmingham in the United Kingdom have developed a microfluidic device that mimics a human vein, including anatomical features such as valves, and physiological features such as pulsatile flow. The device is intended to make it easier to study processes such as blood clotting, which could help scientists to develop new treatments for conditions such as deep vein thrombosis. The valves can open and close during flow, mimicking the real deal, and the central channel of the device is lined with endothelial cells. The researchers hope that the technology will provide plenty of insights without t...
Source: Medgadget - May 9, 2023 Category: Medical Devices Authors: Conn Hastings Tags: Cardiac Surgery Cardiology Materials Vascular Surgery DVT unibirmingham Source Type: blogs
A 20-something with intermittent then acute chest pain
This was sent to me by a partner:" Curious what you think of this one we had overnight. Healthy male under 25 years old with a pretty good story for acute onset crushing chest pain relieved with nitro. He had another episode the day before after exerting himself. No pericardial effusion on ultrasound. "What do you think?First, many on Twitter said " Pericarditis " . This is NOT pericarditis, which virtually NEVER has ST depression any where except aVR. When there is ST depression (as in aVL, V2, V3), then top on the differential is OMI or myocarditis.See our publication: ST depression in ...
Source: Dr. Smith's ECG Blog - April 25, 2023 Category: Cardiology Authors: Steve Smith Source Type: blogs
