Ken Grauer, MD

DECEMBER 23, 2023

The ECG in Figure-1 — was obtained from a patient with palpitations. The patient was hemodynamically stable in association with this rhythm. QUESTIONS: What is the rhythm in Figure-1 ? — How certain are you of your answer? — Why is QRS morphology changing ? Figure-1: The initial ECG in today's case. My Interpretation of the ECG in Figure-1: Since the patient is hemodynamically stable — there is time for systematic assessment of the rhythm.

Blog 170

Blog Tachycardia Tricuspid Atrial Flutter 170

Cardiovascular Diabetology

DECEMBER 18, 2023

Elevated glycated hemoglobin (HbA1c) is associated with a higher burden of subclinical atherosclerosis (SA). However, the association with SA of earlier insulin resistance markers is poorly understood. The stu.

Atherosclerosis 145

Atherosclerosis Research 145

Dr. Malcolm Kendrick

DECEMBER 10, 2023

10th December 2023 A very important study – please watch Very high low density lipoprotein levels with no impact on plaque progression I interrupt my series on what is wrong with the health service to bring you breaking news. I was sent the e-mail below, directing me to a short YouTube presentation by Dr Shawn Baker. It highlights a study which provides very strong evidence that a very high LDL (as seen in some people who go on a keto diet), has no impact on coronary artery plaque progression.

Plaque 145

Plaque Cholesterol Diet Diabetes 145

Cardiovascular Ultrasound

DECEMBER 13, 2023

Physical activity contributes to changes in cardiac morphology, which are known as “athlete’s heart”. Therefore, these modifications can be characterized using different imaging modalities such as echocardiogr.

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Med Page Today

DECEMBER 26, 2023

(MedPage Today) -- Four new risk factors for young-onset dementia were identified in the prospective U.K. Biobank study. Orthostatic hypotension, vitamin D deficiency, high C-reactive protein (CRP) levels, and social isolation emerged as new risk.

Risk Factors 142

Risk Factors Dementia 142

American Heart News - Stroke News

SEPTEMBER 11, 2023

American Heart Association Hypertension Scientific Sessions – Abstract 452. An analysis of data from a long-running study of more than 11,000 adults from four diverse communities in the United States has found that adults who had high blood pressure while both seated upright and lying supine (flat on their backs) had a higher risk of heart disease, stroke, heart failure or premature death compared to adults without high blood pressure while upright and supine.

Blood Pressure 143

Blood Pressure Heart Failure Heart Disease Hypertension 143

Medical Xpress - Cardiology

DECEMBER 21, 2023

What role do omega-6 fatty acids play in cardiovascular disease and diabetes? Scientists from Mannheim, together with researchers from Heidelberg, Frankfurt, and Hangzhou in China, have investigated the breakdown of omega-6 fatty acids and gained new insights into how their oxidation products influence the metabolism.

Research 138

Research Cardiovascular Disease Diabetes 138

Journal of Clinical Investigation - Cardiology

DECEMBER 15, 2023

A paucity of chemotherapeutic options for metastatic brain cancer limits patient survival and portends poor clinical outcomes. Using a CNS small-molecule inhibitor library of 320 agents known to be blood-brain barrier permeable and approved by the FDA, we interrogated breast cancer brain metastasis vulnerabilities to identify an effective agent. Metixene, an antiparkinsonian drug, was identified as a top therapeutic agent that was capable of decreasing cellular viability and inducing cell death

Cancer 133

Cancer Outcomes 133

ECG Weekly Workout

DECEMBER 31, 2023

HPI: A 50-year-old man decides to get “his life in order” for the new year. He quits smoking, decides to eat healthier and exercise more, and to be more compliant with his blood pressure medications. A week into the new year he wakes up feeling weak and achy with nausea and vomiting. He is lightheaded when sitting or standing and has trouble getting out of bed.

CME 130

CME Blood Pressure Exercise Bradycardia 130

HCPLive

DECEMBER 20, 2023

Analysis of the NUDGE-FLU study reveals electronic nudges designed to boost influenza vaccination were more effective in older adults without diabetes, highlighting the need for tailored approaches in diabetes populations.

Diabetes 129

Diabetes 129

Ken Grauer, MD

NOVEMBER 10, 2023

== — CLICK HERE — for a V ideo presentation of this case! Below are slides used in my video presentation. For full discussion of this case — See ECG Blog #220 — == The long lead II rhythm strip shown in Figure-1 was obtained from an 51-year-old man who presented to the ED ( Emergency Department ) with "palpitations" that began 1 hour earlier. HOW would you interpret this tracing?

Blog 177

Blog Tachycardia Arrhythmia 177

Science Daily - Heart Disease

DECEMBER 13, 2023

Individuals infected with COVID-19 are also at an increased risk of suffering from heart rhythm disturbances, such as atrial fibrillation, according to a new study.

COVID-19 133

COVID-19 Heart Rhythm Atrial Fibrillation 133

Dr. Malcolm Kendrick

DECEMBER 8, 2023

8th December 2023 Nothing can simply be ‘good enough’. Before beginning this blog, I thought I would introduce you to the first two laws of regulation ‘ regulation-omics’ : I know that many of the things that are obliterating productivity in the NHS are happening in all health care services, everywhere. A couple of blogs back I mentioned a US study which looked at all the guidelines primary care practitioners (PCPs) are now required to follow.

Blood Pressure 126

Blood Pressure Blog Document Nursing 126

ECG Guru

DECEMBER 18, 2023

If a wide complex tachycardia occurs, the probability is very high that it is a ventricular tachycardia (approx. 80%, in patients with a previous myocardial infarction (.) approx. 90%). Here we see a broad complex tachycardia that looks like an RBBB + LAFB, which is regular. In this constellation, 3 causes must be considered: 1. fascicular tachycardia from the left posterior fascicle of the left tawara fascicle (QRS width usually only around 130 ms, but sometimes significantly longer). 2.

Myocardial Infarction 124

Myocardial Infarction Tachycardia 124

Med Page Today

DECEMBER 6, 2023

(MedPage Today) -- About one in five healthy people ages 50 and older had an organ that was aging at an accelerated rate, which may increase mortality and signal organ-specific disease, a study of nearly 5,700 people suggested. In an analysis.

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Dr. Smith's ECG Blog

SEPTEMBER 19, 2023

Case submitted by anonymous. Written by Smith. Ken's piece at the bottom is excellent. A 50-something presented with s udden 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.

Tachycardia 127

Tachycardia Cardiogenic Shock Angina Coronary Angiogram 127

Medical Xpress - Cardiology

DECEMBER 27, 2023

Sequence variants that protect against pericarditis have been discovered at a genomic locus encoding interleukin-1 immune cytokines. A newly approved drug treatment for pericarditis inhibits these cytokines, according to a new study.

Pericarditis 136

Pericarditis 136

Science Daily - Stroke

NOVEMBER 30, 2023

Researchers have succeeded in restoring lost brain function in mouse models of stroke using small molecules that in the future could potentially be developed into a stroke recovery therapy.

Stroke 123

Stroke Strokes Research 123

Journal of Clinical Investigation - Cardiology

DECEMBER 15, 2023

Cell therapies such as tumor-infiltrating lymphocyte (TIL) therapy have shown promise in the treatment of patients with refractory solid tumors, with improvement in response rates and durability of responses nevertheless sought. To identify targets capable of enhancing the antitumor activity of T cell therapies, large-scale in vitro and in vivo clustered regularly interspaced short palindromic repeats (CRISPR)/Cas9 screens were performed, with the SOCS1 gene identified as a top T cell–enhancing

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American Heart News - Heart News

DECEMBER 6, 2023

Research Highlights: A study of married or partnered, middle-aged and older heterosexual couples in the U.S., England, China and India found that in 20% to 47% of the couples, both spouses/partners had high blood pressure. The prevalence of both.

Blood Pressure 120

Blood Pressure Research 120

HCPLive

DECEMBER 15, 2023

Laura Donlin, PhD, highlights the significance of identifying new subtypes of rheumatoid arthritis, emphasizing the potential for a paradigm shift in RA treatment toward personalized care and early interventions.

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Ken Grauer, MD

NOVEMBER 25, 2023

== CLICK HERE — for a V ideo presentation of this case! ( 19:40 min. ) Below are slides used in my video presentation. For full discussion of this case — See ECG Blog #191 — == The 2-lead rhythm strip shown in Figure-1 was obtained from an elderly woman who presented to the ED following a syncopal episode. On the basis of this rhythm strip — she was diagnosed as being in complete AV Block.

Blog 165

Blog Download Arrhythmia 165

ECG Cases

SEPTEMBER 12, 2023

In this ECG Cases blog Dr. Jesse MacLaren guides us through 10 cases of patients who present with generalized weakness or acute neurologic symptoms and discusses how to look for ECG signs of dysrhythmias, electrolyte emergencies, acute coronary occlusion, and demand ischemia in patients with generalized weakness and in patients with neurologic symptoms, to consider predisposing factors like LVH; seizure-like activity from cardiac syncope; TIA/CVA embolic sources like atrial fibrillation or LV th

Dysrhythmia 114

Dysrhythmia Atrial Fibrillation Embolism Blog 114

Dr. Malcolm Kendrick

DECEMBER 28, 2023

29th December 2023 The underlying forces In the last few blogs, I have been writing about the proliferation of guidelines, targets, and regulatory work in the NHS. Hopefully I have managed to give you a sense of how much time and effort these pile on to everyday work. Time and effort which eats away at clinical time, erodes morale and drives down productivity.

Hospital 116

Hospital Blog Blood Pressure Inpatient 116

NOVARAD

DECEMBER 19, 2023

In today's interconnected world, quick and easy access to information is the norm, yet the healthcare sector has sometimes struggled to keep pace. After all, there were once days of using CDs to share essential medical images. It was not only inconvenient but also raised concerns about accessibility and the well-being of patients.

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Med Page Today

DECEMBER 22, 2023

(MedPage Today) -- The FDA continues its investigation into counterfeit semaglutide (Ozempic) products -- which may still be available for purchase -- and has already seized thousands of units, the agency announced Thursday. In its warning.

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Dr. Smith's ECG Blog

SEPTEMBER 3, 2023

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.

Chest Pain 120

Chest Pain Defibrillator STEMI Coronary Artery Disease 120

Medical Xpress - Cardiology

DECEMBER 12, 2023

A new artificial intelligence (AI) model designed by Scripps Research scientists could help clinicians better screen patients for atrial fibrillation (or AFib)—an irregular, fast heartbeat that is associated with stroke and heart failure. The model picks up on tiny variations in a person's normal heartbeat that signify AFib risk, which standard screening tests cannot detect.

AFIB 136

AFIB Atrial Fibrillation Heart Failure Research 136

Cardiovascular Diabetology

DECEMBER 20, 2023

This study aimed to investigate the risks of all-cause and cardiovascular mortality associated with blood pressure (BP) levels of 130–139/80–89 mmHg in Chinese adults with different glucose metabolism, during.

Blood Pressure 111

Blood Pressure Research 111

Journal of Clinical Investigation - Cardiology

DECEMBER 15, 2023

The progression of proteinuric kidney diseases is associated with podocyte loss, but the mechanisms underlying this process remain unclear. Podocytes reenter the cell cycle to repair double-stranded DNA breaks. However, unsuccessful repair can result in podocytes crossing the G1/S checkpoint and undergoing abortive cytokinesis. In this study, we identified Pfn1 as indispensable in maintaining glomerular integrity — its tissue-specific loss in mouse podocytes resulted in severe proteinuria and ki

Kidney Disease 118

Kidney Disease 118

American Heart News - Heart News

DECEMBER 19, 2023

DALLAS, Dec. 19, 2023 — Technologies that less invasively restore blood flow to blocked or narrowed arteries; a medicine that outsmarts high blood pressure’s development; and new evidence that diabetes drugs may offer heart health benefits to people that.

Technology 115

Technology Research Diabetes 115

HCPLive

DECEMBER 13, 2023

Patients with gout who did not experience recurrent flares had a shorter mean time between diagnosis and the start of urate-lowering therapy compared with those who had ≥1 flare.

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Ken Grauer, MD

SEPTEMBER 22, 2023

The ECG in Figure-1 — was obtained from a middle-aged man with palpitations and shortness of breath. He was hemodynamically stable at the time this tracing was recorded. How would YOU interpret the ECG in Figure-1 ? Is there evidence of a recent or ongoing acute MI? What might you do first? Figure-1: The initial ECG in today's case. ( To improve visualization — I've digitized the original ECG using PMcardio ).

Blog 163

Blog Chest Pain Bradycardia Physiology 163

ECG Guru

DECEMBER 23, 2023

The Patient: A 60-year-old man at work. He experienced a sudden onset of substernal chest pain, nausea & vomiting, and dizziness. He states the pain is a 5 on 1-10 scale. No cardiac history or current medications. The ECGs: The first ECG , taken at 12:30:05, shows a sinus rhythm with ventricular bigeminy. In some leads, you can see the sinus P waves hidden in the beginnings of the PVCs, so we know the underlying sinus rhythm is about 82 bpm.

STEMI 105

STEMI Chest Pain 105

ECG Cases

NOVEMBER 28, 2023

On this month's EM Quick Hits podcast: Anand Swaminathan on update to ED management of postpartum hemorrhage, Nour Khatib on serotonin syndrome and its mimics, Katie Lin on an approach to recognition and management of severe TBI and brain herniation syndromes, Hans Rosenberg on the ED management of ulcerative colitis, Heather Cary on pediatric c-spine immobilization controversies and techniques, Navpreet Sahsi on the difference between humanitarian and development work The post EM Quick Hits 53

Pediatrics 106

Pediatrics Hemorrhage 106

NOVARAD

DECEMBER 11, 2023

In today’s healthcare world, sharing medical images securely and in compliance with regulations is nothing short of a tightrope walk. As we move further into the digital age, the task of keeping sensitive patient data under lock and key while still at the ready for healthcare professionals has become a priority. That’s where PACS image sharing steps into the limelight.

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Med Page Today

DECEMBER 26, 2023

(MedPage Today) -- An intensive food-as-medicine program didn't improve glycemic control in adults with type 2 diabetes any better than usual care in a randomized clinical trial. After 6 months, both groups had a similar drop in HbA1c -- 1.5.

Diabetes 131

Diabetes 131