2023

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ECG Blog #409 — Every-Other-Beat.

Ken Grauer, MD

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 169
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Early insulin resistance in normoglycemic low-risk individuals is associated with subclinical atherosclerosis

Cardiovascular Diabetology

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.

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Very high LDL no impact on plaque progression

Dr. Malcolm Kendrick

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.

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Cardiac imaging in athlete’s heart: current status and future prospects

Cardiovascular Ultrasound

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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Young-Onset Dementia Tied to New Risk Factors

Med Page Today

(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.

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Blood pressure should be measured lying down: study

American Heart News - Stroke News

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.

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Research offers new insights into how breakdown of omega-6 fatty acids influences metabolism

Medical Xpress - Cardiology

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.

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More Trending

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Metixene is an incomplete autophagy inducer in preclinical models of metastatic cancer and brain metastases

Journal of Clinical Investigation - Cardiology

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

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A 50-something with Regular Wide Complex Tachycardia: What to do if electrical cardioversion does not work?

Dr. Smith's ECG Blog

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.

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Amal Mattu’s ECG Case of the Week – January 1, 2024

ECG Weekly Workout

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.

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ECG Video Blog #403 (220) — Ps,Qs,3Rs Approach to this Tachycardia.

Ken Grauer, MD

== — 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?

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Electronic 'Nudges' to Improve Influenza Vaccine Uptake May Be Less Effective in Patients with Diabetes

HCPLive

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.

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What’s wrong with the NHS? – Part 4

Dr. Malcolm Kendrick

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.

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Increased risk of heart rhythm disruption after COVID-19

Science Daily - Heart Disease

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.

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Blood Test May Be Able to Tell Which Organs Have Accelerated Aging

Med Page Today

(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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AFL WITH 2:1 CONDUCTION IN A PATIENT WITH PREEXISTING RBBB + LAFB

ECG Guru

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.

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A study of genetics of pericarditis increases understanding of newly approved drug treatment

Medical Xpress - Cardiology

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.

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Lost brain function restored in mice after stroke

Science Daily - Stroke

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.

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Rational design of a SOCS1-edited tumor-infiltrating lymphocyte therapy using CRISPR/Cas9 screens

Journal of Clinical Investigation - Cardiology

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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A 50-something with chest pain.

Dr. Smith's ECG Blog

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.

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New study finds many couples around the world may share high blood pressure

American Heart News - Heart News

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.

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ECG Blog #405 — Is AV Block Complete (vs AV Dissociation)

Ken Grauer, MD

== 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 158
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Laura Donlin, PhD: Study Discovers New Subtypes of Rheumatoid Arthritis

HCPLive

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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What’s wrong with the NHS? – part five

Dr. Malcolm Kendrick

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.

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ECG Cases 45 ECG in Weakness and Neurological Symptoms

ECG Cases

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

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Beware of Fake Ozempic, FDA Warns

Med Page Today

(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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Long-term effects of blood pressure 130–139/80–89 mmHg on all-cause and cardiovascular mortality among Chinese adults with different glucose metabolism

Cardiovascular Diabetology

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.

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New AI-powered algorithm could better assess people's risk of common heart condition

Medical Xpress - Cardiology

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.

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Medical Image Sharing App Eliminates CDs & Makes Your Job Easier

NOVARAD

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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Profilin1 is required for prevention of mitotic catastrophe in murine and human glomerular diseases

Journal of Clinical Investigation - Cardiology

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

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A 60-year-old diabetic with chest pain, cath lab activated

Dr. Smith's ECG Blog

I came to work one day and one of my partners said, "Hey, Steve, we had a STEMI this afternoon!" I said, "Cool, can I see the ECG?' Of course he said: "Yes, it was a 60 year old diabetic with Chest pain." So he showed me the ECG recorded in triage: What did I say? "That is not a STEMI. That is Arterial Pulse Tapping Artifact (APTA)." He said: "What?

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New technologies and medications that can prevent, reduce CVD top 2023 scientific research

American Heart News - Heart News

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.

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ECG Blog #396 — Why the Flat Line?

Ken Grauer, MD

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 156
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1 in 6 Patients with Gout Experience Second Flare within 1 Year

HCPLive

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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Use of Anticoagulant Drug after Aortic Valve Replacement Lowers Mortality Risk, Mayo Clinic Study Finds

DAIC

milla1cf Tue, 12/12/2023 - 07:00 December 12, 2023 — Patients who received the anticoagulant drug warfarin after bioprosthetic aortic valve replacement had lower incidence of mortality and a decreased risk of blood clots, according to a retrospective study published in Mayo Clinic Proceedings. The use of bioprosthetic aortic valve replacement has increased significantly during the past decade.

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EM Quick Hits 53 Postpartum Hemorrhage, Serotonin Syndrome, TBI Herniation Syndromes, Ulcerative Colitis, Pediatric C-Spine Immobilization, Global EM

ECG Cases

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

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Dementia-Sleep Link Has a New Twist

Med Page Today

(MedPage Today) -- Sleep regularity in midlife and at older ages may be a novel dementia risk factor, data from 88,000 people in Great Britain suggested. Day-to-day consistency in sleep-wake patterns showed a U-shaped association with incident.

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