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Playback Heart Sounds: The eKuore Pro Digital Stethoscope Review
The white coat, the stethoscope, and the physician are inseparable as of yet. While artificial intelligence promises to become the next symbol of medicine, the eKuore Pro “only” aims to bring a much needed revamp of this ever-useful, iconic medical instrument. We found this wireless digital stethoscope to be fairly easy to use and feature-rich despite being remarkably heavier and pricier than conventional stethoscopes. If you want to know a pinch more detail about how the eKuore Pro performed, read our digital stethoscope review below. From Vet to Med The very mention of the word ‘doctor’ might elici...
Source: The Medical Futurist - May 14, 2019 Category: Information Technology Authors: nora Tags: Health Sensors & Trackers Portable Diagnostics device digital digital health digital stethoscope digital technology future heart Innovation medstudent review teaching Source Type: blogs

USMLE Step 1 tips that may surprise you
To reach my current position as a general cardiologist, I have taken nine board exams. I have also been teaching medical students for over ten years with several colleagues who write questions for the USMLE Step 1 exam. Through this experience, I have observed a number of themes about what works and does not work […]Find jobs at  Careers by KevinMD.com.  Search thousands of physician, PA, NP, and CRNA jobs now.  Learn more.
Source: Kevin, M.D. - Medical Weblog - April 21, 2019 Category: General Medicine Authors: < span itemprop="author" > < a href="https://www.kevinmd.com/blog/post-author/jason-ryan" rel="tag" > Jason Ryan, MD < /a > < /span > Tags: Education Medical school Pulmonology Source Type: blogs

How to study smarter for USMLE Step 1: 5 tips for success
To reach my current position as a general cardiologist, I have taken nine board exams. I have also been teaching medical students for over ten years with several colleagues who write questions for the USMLE Step 1 exam. Through this experience, I have observed a number of themes about what works and does not work […]Find jobs at  Careers by KevinMD.com.  Search thousands of physician, PA, NP, and CRNA jobs now.  Learn more.
Source: Kevin, M.D. - Medical Weblog - April 10, 2019 Category: General Medicine Authors: < span itemprop="author" > < a href="https://www.kevinmd.com/blog/post-author/jason-ryan" rel="tag" > Jason Ryan, MD < /a > < /span > Tags: Education Medical school Residency Source Type: blogs

Data Annotators: The Unsung Heroes Of Artificial Intelligence Development
How do you create a smart algorithm? Where and how do you get the data for it? What do you need for a pattern recognizing program to work well and what are the challenges? Nowadays, everyone seems to be building artificial intelligence-based software, also in healthcare, but no one talks about one of the most important aspects of the work: data annotation and the people who are undertaking this time-consuming, rather monotonous task without the flare that usually encircles A.I. Without their dedicated work, it is impossible to develop algorithms, so we thought it is time to sing an ode to the superheroes of algorithm devel...
Source: The Medical Futurist - April 9, 2019 Category: Information Technology Authors: nora Tags: Artificial Intelligence in Medicine Future of Medicine AI algorithm annotation data data annotation doctor Health Healthcare physician smart algorithm technology Source Type: blogs

How much time are you willing to wait for OMI to become STEMI (if it ever does)?
Written by Pendell Meyers, few edits by SmithA man in his 60s with history of stroke and hypertension but no known heart disease presented with chest pain that started on the morning of presentation at around 8am.Here is his triage ECG when he presented at 1657:What do you think?There is sinus rhythm with normal QRS complex and ST depression in V2-V5, maximal in V3-V4. There is no ST depression in V6, II, III, or aVF, and no significant ST elevation in aVR, all confirming that the ST vector is not consistent with diffuse subendocardial ischemia, but rather a focal ST vector pointed at the posterior wall. It is posterior OM...
Source: Dr. Smith's ECG Blog - February 16, 2019 Category: Cardiology Authors: Pendell Source Type: blogs

One of the Great Books of Emergency Medicine Just Published: Extraordinary Cases in Emergency Medicine
This article that established thrombolytic therapy for STEMI as the domain of emergency medicine, not of cardiology.  It made me realize I needed to recognize coronary occlusion on the ECG and differentiate it from PseudoSTEMI patterns.  We emergency physicians could only rely on ourselves to make the right and timely diagnosis because waiting for a cardiologist was to wait too long.Doug and Hennepin (Ernie Ruiz, Joe Clinton, Dave Plummer, and more) taught me long ago that we Emergency Physicians must be the deciders.And that is just one of his countless contributions to EM over a 37 year career.Doug has collecte...
Source: Dr. Smith's ECG Blog - January 8, 2019 Category: Cardiology Authors: Steve Smith Source Type: blogs

ACS mimickers in ER : Wish I call it “ Ischemic ” pleural effusion ?
A middle aged women , with acute onset left sided chest pain and ECG changes was seen by a general physician. He had little hesitation in labeling the patient as  ACS( To be precious he reported the ECG as lateral wall Ischemia) and asked for an echocardiogram to rule out a heart attack  (This is how cardiology is practiced in many areas) . This patient came to my lab  for the Echocardiogram .The echo window was poor , It showed a structurally normal heart and there was no pericardial effusion. I suspected something systemically wrong in this patient and asked for a X ray chest . Subsequent scrutiny of this  patient...
Source: Dr.S.Venkatesan MD - December 28, 2018 Category: Cardiology Authors: dr s venkatesan Tags: acute coronary syndrome Causes of T wave Inversion ECG changes in pleural effusion mechanism of ECG changes in pleural effsuion pleuro pericardial effusion pleuro pericardial ligamnet pleuro pericardial rub Source Type: blogs

Two cases of ST Elevation with Terminal T-wave Inversion - do either, neither, or both need reperfusion?
Written by Pendell Meyers with edits by Steve SmithI was sent these 2 ECGs with no clinical information other than chest pain:Do either or both of these ECGs show ischemic changes? If so, what should you do and why?Let ' s take them one at a time.What would your response be?I responded: " Awesome classic benign T wave inversion! That ' s the patient ' s baseline normal variant. ... But if it were a good story with exertional syncope or something you ' d have to treat it like it could be HOCM, etc. Tell me more. "There is sinus rhythm with very large voltage and associated repolarization abnormalities. In V3-V6 there are cl...
Source: Dr. Smith's ECG Blog - December 5, 2018 Category: Cardiology Authors: Pendell Source Type: blogs

Was the intern correct?
Written by Pendell Meyers, case submitted by Max Macbarb, edits by Steve SmithA 71 year old gentleman with history of CAD and PCI presented with acute chest pain and normal vitals signs.  He was triaged to the general area of the emergency department after an initial review of this ECG by a senior resident or attending physician correctly interpreted " No STEMI. "An intern who has attended my lectures and has begun reading this blog picked up the chart and flipped to the ECG and saw this:Presentation ECG at 6:57 AM. What do you think?I texted this to Dr. Smith with no clinical information and he replied immediately af...
Source: Dr. Smith's ECG Blog - November 18, 2018 Category: Cardiology Authors: Pendell Source Type: blogs

Artificial Intelligence Diagnoses Heart Murmurs Better Than Expert Cardiologists
At the just concluded American Heart Association’s Scientific Sessions 2018 in Chicago, Eko, the makers of popular digital stethoscopes, showed off a neural network AI algorithm that is able to detect murmurs better than a group of cardiologists. ...
Source: Medgadget - November 14, 2018 Category: Medical Devices Authors: Editors Tags: Cardiology Informatics Medicine Pediatrics Source Type: blogs

Two cases texted to me for concern of inferior hyperacute T waves and a flipped T in aVL - do either, neither, or both need emergent reperfusion?
Written by Pendell MeyersI received two texts recently, in both cases the practitioners were worried about possible inferior hyperacute T-waves with an inverted T-wave in aVL. I was not given any clinical history.What would you tell the team in these two cases?Case 1Case 2My responses:Case 1: " Not hyperacute. The T-wave in aVL is likely that way at baseline, send baseline if available. What ' s the story? "Case 2: " Agree with concern for inferior posterior. This is almost completely diagnostic barring an identical baseline. What ' s the story? "Did you agree with my assessments? Why do I say that Case 1 is not hyperacute...
Source: Dr. Smith's ECG Blog - November 12, 2018 Category: Cardiology Authors: Pendell Source Type: blogs

A young man with back spasms
Written by Pendell Meyers with edits by Steve SmithFirst see this ECG without clinical context:What do you see? Do you agree with the computer ' s read of " nonspecific ST abnormality? "The ECG is highly suspicious for hypokalemia. There is diffuse minimal STD, with prolonged QT interval and characteristic " down-up " T-wave morphology in the precordial leads which is being caused by U-waves. V2 has an especially pronounced U-wave, but there is also a slightly wandering baseline. This morphology is very unlikely to be due to ischemia, and to an experienced electrocardiographer is nearly pathognomonic of hypokalemia +/...
Source: Dr. Smith's ECG Blog - November 7, 2018 Category: Cardiology Authors: Pendell Source Type: blogs

Why pleural effusion is more common on right side in cardiac failure ?
We know pleural effusion (hydrothorax) is disproportionately more common on right side in cardiac failure.Though its a well observed phenomenon, the mechanism of which  has not been clear to us. It could be due to multiple  anatomical , physiological factors.   *The are  right and left lymphatic (Thoracic) ducts that drain the corresponding lungs and pleural space . There can be overlap and contribute to the differential occurrence of pleural effusion   Reference  A meticulous paper written some 75 years ago (1946) from Harvard medical school teach us some important points in this phenomenon. There is still...
Source: Dr.S.Venkatesan MD - October 30, 2018 Category: Cardiology Authors: dr s venkatesan Tags: cardaic physiology cardiac physiology Cardiology Patho physiology Clinical cardiology Infrequently asked questions in cardiology (iFAQs) hydrothorax hydrothorax in cardiac failure pleural effusion in cardiac failure right vs left pleural e Source Type: blogs

Expensive Hospitals: The Enemy Within
By ANISH KOKA MD Everyone agrees that health care is bankrupting the nation. The prevailing winds have carried the argument that a system that pays per unit of health care delivered and thus favors volume over value is responsible. The problem, you see, was the doctors. They were just incentivized to do too much. This incontrovertible fact was the basis for changes in the healthcare system that favored hospital employment and have made the salaried physician the new normal. Yet, health care costs remain ascendant. Why? It turns out overutilization in the US healthcare system isn’t what its cracked up to be. Figure 1...
Source: The Health Care Blog - October 1, 2018 Category: Consumer Health News Authors: anish_koka Tags: Finance Patients Physicians Anish Koka expensive health care finances health care finances Incentives Source Type: blogs

A 65 year old with chest pain, ECG recorded at 50 mm/sec
This case was sent by Peter Hammarlund, from Stockholm, Sweden:Hi Steve,What would you say about this ECG?A 65 yo smoking man with a prior MI 15 years ago who lives in Stockholm, but who was in southern Sweden on vacation. There was no other known previous illness. He suddenly experienced central chest pressure, 9/10, without radiation, but with associated nausea. 5/10 after sublingual NTG.This prehospital ECG was sent to the Hospital and I was on the night shift and reviewed the ECG. What do you say?This is recorded at50 mm/sec on the left (12-lead), and 12.5 mm per sec on the right (for rhythm).That ' s th...
Source: Dr. Smith's ECG Blog - September 26, 2018 Category: Cardiology Authors: Steve Smith Source Type: blogs