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Procedure: Ultrasound
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Total 378 results found since Jan 2013.
Ischemic ST depression maximal in V1-V4 (vs. V5-V6), even if less than 0.1 millivolt, is specific for Occlusion Myocardial Infarction (vs. subendocardial non-occlusive ischemia)
Conclusion: Among high-risk ACS patients, the specificity for OMI of suspected ischemic STDmaxV1-4 was 97%. STEMI criteria missed half of OMIs detected by STDmaxV1-4. These data support that any ischemic STD maximal in V1-V4 in ACS is due to OMI until proven otherwise.
Source: Dr. Smith's ECG Blog - June 27, 2021 Category: Cardiology Authors: Steve Smith Source Type: blogs
LBBB: Using the (Smith) Modified Sgarbossa Criteria would have saved this man ' s life
Case submitted and written by Dr. Jesse McLaren (@ECGcases), ofEmergency Medicine CasesReviewed by Pendell Meyers and Steve SmithAn 85yo with a history of hypertension developed chest pain and collapsed, and had bystander CPR. The paramedics found the patient with ROSC and a GCS 7, and an ECG showing LBBB with possible lateral ST elevation. The patient was brought to the ED as a possible Code STEMI and was seen directly by cardiology. On arrival, GCS was 13 and the patient complained of ongoing chest pain. Vitals were HR 58 BP 167/70 R20 sat 96%. Below is the first ED ECG, labeled LBBB by the machine. Are there any indicat...
Source: Dr. Smith's ECG Blog - June 11, 2021 Category: Cardiology Authors: Pendell Source Type: blogs
Tiny Implantable Ultrasound Chip for Physiological Monitoring
Researchers at Columbia University have developed a microscopic implantable chip for physiological monitoring. It has a total volume of less than 0.1 mm3. To put that in perspective, the chip is as small as a dust mite, and can only be viewed using a...
Source: Medgadget - May 17, 2021 Category: Medical Devices Authors: Conn Hastings Tags: Cardiology Diagnostics Materials Medicine Surgery Telemedicine Source Type: blogs
This patient with " NSTEMI " was not allowed to go to the cath lab. Then the ED provider obtained an emergent coronary CT angio. What do you think it showed?
Submitted by Shakita Crichlow MD, edits by MeyersA female in her 60s presented with chest pain off and on starting the day before presentation. The chest pain was left sided, pressure-like, intermittent, without aggravating or alleviating factors, and associated with mild shortness of breath. She become worried when she took her blood pressure at home and found it to be 200 systolic, so she decided to come to the ED at that point. Here is her initial ECG:What do you think?Raw findings: - Sinus rhythm - STE in leads II, III, and aVF, reaching at least 1.0 mm in III and aVF - Large Q wave in lead II...
Source: Dr. Smith's ECG Blog - April 30, 2021 Category: Cardiology Authors: Pendell Source Type: blogs
Neoatherosclerosis
Neointimal proliferation can occur within a coronary stent. Chronic inflammation within the neointima with infiltration of macrophages leads to neoatherosclerosis and result in in-stent restenosis. Disruption of neoatheroma can cause acute thrombotic occlusion [1]. Hence neoatherosclerosis is a complication of percutaneous coronary intervention and can present with recurrence of angina or acute coronary syndrome.
Occurrence of neoatherosclerosis is earlier in drug eluting stents than in bare metal stents and has a greater prevalence. Late stent thrombosis due to rupture of the plaques with thin fibrous cap is associated ...
Source: Cardiophile MD - April 26, 2021 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Cardiology Source Type: blogs
Wireless Sensor Measures Deep Tissue Oxygen Levels
Researchers at the University of California, Berkeley have developed an ultrasound-powered implantable sensor that can measure oxygen levels in tissues deep within the body and transmit these data to an external device. The technology could be useful...
Source: Medgadget - April 19, 2021 Category: Medical Devices Authors: Conn Hastings Tags: Anesthesiology Cardiac Surgery Cardiology Critical Care Emergency Medicine Plastic Surgery Rehab Vascular Surgery Source Type: blogs
Rapid Compression Device to Prevent Deep Vein Thrombosis
Researchers at Penn Medicine have developed a wearable sleeve that provides rapid pulsatile compression, and aims to mimic the compression our calf muscles experience during walking. The technology, being commercialized by Osciflex, a spin out from P...
Source: Medgadget - April 13, 2021 Category: Medical Devices Authors: Conn Hastings Tags: Cardiology Geriatrics Medicine Surgery Vascular Surgery Source Type: blogs
Paroxysmal Atrial Fibrillation with RVR, hypotension, volume depletion, good EF, AND pulmonary edema. Strange. Why? What to do?
A 30-something woman presented with a few days of feeling ill. She had a history of paroxysmal atrial fibrillation, bio-prosthetic mitral valve, and tricuspid valvuloplasty, and was on Coumadin.Records showed she is usually in sinus rhythm and has normal LV function.She presented hypotensive (systolic pressure 80), with diffuse B lines, flat IVC, good LV function, and an irregular, fast heart beat.Here is here ECG:Atrial fib with RVR and some probable ischemic ST depression in V3-V6Here is her POCUS:What do you think? There is asmall LV with good function and alarge left atrium, andmoderately large RV.Ther...
Source: Dr. Smith's ECG Blog - April 4, 2021 Category: Cardiology Authors: Steve Smith Source Type: blogs
History of cardiology : Robert F Rushmer, a cardiac scientist par excellence .
Few individual’s works mattered more than others in the field of cardiology. Here was a man born in Utah, studied at Rush university trained in Mayo, settled in Seattle as a pediatrician. But his passion drove him to become a specialist cardiac physiologist with an urge to find the answers to all those lingering queries that arise as a practicing clinical cardiologist. He built an exclusive animal lab to study the mechanics and physics of circulation and cardiac pumps.
He can be called new age, Harvey. He seemed to always bother, how is it that the 6 liters of blood traverse from he...
Source: Dr.S.Venkatesan MD - February 1, 2021 Category: Cardiology Authors: dr s venkatesan Tags: Basic sciecne Basic science -Physiology Best books in cardiology bio ethics great cardiologists best books in cardiac physiology best cardiology books cardiovascular physiology famous Seattle doctors Great Men in cardiology history of Source Type: blogs
Wellens ' syndrome: to stent or not? IVUS negative, Symptoms persist, Stress Testing, Instantaneous Wave Free Ratio, and Fractional Flow Reserve.
A 55 y.o. male with no cardiac PMHX presented for 2 weeks of exertional chest pain, worsened on the day prior to presentation. On the day of presentation, the chest discomfort was particularly intense, and associated with diaphoresis and nausea. It was resolved (pain free) when the ECG was recorded:This ECG was read as " nonspecific " by the providers. What do you think?These is classic Wellens ' pattern A (biphasic, terminal T-wave inversion), and it isWellens 'syndrome (Angina, resolved -- pain free -- with preserved R-waves and Wellens ' pattern A T-waves). The morphology of these T-wav...
Source: Dr. Smith's ECG Blog - January 28, 2021 Category: Cardiology Authors: Steve Smith Source Type: blogs
HARPOON System for Mitral Valve Repair: Interview with Daveen Chopra, Edwards Lifesciences
Degenerative mitral regurgitation occurs when the mitral valve prolapses, causing blood to leak back into the atrium every time the heart beats. The condition can be asymptomatic for many people, but for some it can cause a variety of issues, includi...
Source: Medgadget - January 15, 2021 Category: Medical Devices Authors: Conn Hastings Tags: Cardiac Surgery Cardiology Exclusive Radiology Source Type: blogs
Nanodroplets and Ultrasound to Drill Through Blood Clots
Penetrating compacted and extensive blood clots has been one of the main challenges of vascular surgery. Various catheter-based devices have been invented and are in use today, but many patients present with plaques that are just too difficult even f...
Source: Medgadget - January 8, 2021 Category: Medical Devices Authors: Medgadget Editors Tags: Cardiology Radiology Vascular Surgery Source Type: blogs
Acute chest pain, ST Depression in V2 and V3, relief with Nitroglycerine, " normal " coronaries, and apical ballooning. Is it takotsubo?
This was submitted by Michael Fischer, one of our outstanding2nd year EM residents at Hennepin Healthcare.CaseA previously healthy female in her 40s presented 1 hour after abrupt onset 10/10 crushing chest pain that started while brushing her hair that morning. The pain radiated to her bilateral jaw and right shoulder, and did not seem to be exertional or pleuritic in nature. Here is her pre-hospital ECG: What do you think?Smith: V2 and V3 have some minimal ST depression with downsloping. This is highly suggestive of posterior MI.This was read by EMS as non-specific. Aspirin 324mg was given by EMS. Ni...
Source: Dr. Smith's ECG Blog - January 8, 2021 Category: Cardiology Authors: Steve Smith Source Type: blogs
ECG with Aslanger ' s Pattern. CT Pulmonary Angiogram Reveals LAD Ischemia (Septal Transmural). But this is not Contradictory.
A 52 y.o. male presented with persistent central chest pressure, without radiation, SOB or diaphoresis, which began at rest approximately one hour prior to arrival. He had never had pain like this before. He felt slightly nauseous earlier but no vomiting. He is denying any back pain or abdominal pain. An ECG was recorded during pain:What do you think?This shows significant ST depression in I, II, and V4-V6, with reciprocal ST Elevation in aVR. This suggests diffuse subendocardial ischemia. However, along with that subendocardial ischemia, there is also STE in lead III with...
Source: Dr. Smith's ECG Blog - January 4, 2021 Category: Cardiology Authors: Steve Smith Source Type: blogs
A woman in her 40s with acute chest pain
Case written by Neha Ray MD, Brandon Fetterolf MD, and Pendell Meyers MDA woman in her 40s with a history of rheumatoid arthritis, anemia, and thrombocytopenia presented to the ED with acute onset chest pain starting around 5am on the morning of presentation. It woke her from sleep. The chest pain was midsternal, severe, sharp, and constant. On the previous night she had had a mild version of the same pain that she thought was heartburn (esophageal reflux). She reported some radiation to the left arm. She also reports 3 episodes of non-bloody vomiting over the course of the morning. She had a recent admission fo...
Source: Dr. Smith's ECG Blog - November 29, 2020 Category: Cardiology Authors: Pendell Source Type: blogs
