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Total 287 results found since Jan 2013.

A middle-aged man with acute chest pain.
A 50-something male had onset of chest pain 1 hour prior to ED arrival.  It is constant, 9/10, left-sided CP that radiates into left arm and jaw. Endorses some associated SOB, but denies back pain, fever, cough, chills, leg swelling, or other new symptoms. Has never had this before. Takes metoprolol for HTN. Here is the triage ECG:What do you think?This was not identified as OMI by either the conventional algorithm nor the triage faculty physician.Smith: I think leads V3 and V4 are highly concerning, and all but diagnostic, for acute LAD occlusion.  I would activate the cath lab, or at least look f...
Source: Dr. Smith's ECG Blog - September 1, 2023 Category: Cardiology Authors: Steve Smith Source Type: blogs

What does statin do to Cholesterol absorbtion from Intestine ?
A.Reduces B Increases C.No effect D. Iam not sure Does this sound a difficult question ? Many felt so. Hence, I decided to ask the all too popular AI machine. It became a brief little chat with GPT, that surprised me . https://chat.openai.com/share/6b96c54e-ad52-472a-9ebd-b7b1e1c762be Statin: Some untold story. Last century’s rockstar drug, statin do stimulate Cholesterol abosorbtion as well as hepatic synthesis.We must be aware, It is a less popularised truth (Intentionally ? ) among the cardiolgy community, Ofcourse LDL comes down, at the cost of residual pre -choleterol particles th...
Source: Dr.S.Venkatesan MD - August 19, 2023 Category: Cardiology Authors: dr s venkatesan Tags: Uncategorized Source Type: blogs

Distal vs proximal strut crossing in BFL : Who is trying to sustain the confusion ?
Anyone who is flushed with millions can become a member of The Hurlingham Club in London or the Yacht Club in Monaco, or other glamorous clubs in the world. But, EBC* is different. Only cardiologists are privileged to enter. EBC is obviously different and unique. It is probably the only club addressing exclusively bifurcation coronary lesions. Apart from immense pride and academic entertainment, it teaches us some deep technical points. (By the way, BFL* is the minuscule spoke in the gigantic wheels of global atherosclerosis) Approach to BFL Although 90% of BFL still require a only drugs or simple single stent or a p...
Source: Dr.S.Venkatesan MD - July 4, 2023 Category: Cardiology Authors: dr s venkatesan Tags: Uncategorized Source Type: blogs

Carta Healthcare Secures $25 Million in Series B Funding with Additional Investments from Memorial Hermann Health System and UnityPoint Health
Top Health Systems Invest in Innovative Technology Company to Simplify Data Abstraction and Deliver Data Insights to Drive Quality Improvement Carta Healthcare®, a company whose mission is to improve patient care by harnessing the value of clinical data, announced today the final closing of its $25 million series B financing, thanks to additional investments from leading health systems Memorial Hermann Health System and UnityPoint Health. These additional investments follow the initial $20 million series B financing announced in November 2022, which included investors such as Paramark Ventures, Frist Cressey Ventures, Ame...
Source: EMR and HIPAA - June 15, 2023 Category: Information Technology Authors: Healthcare IT News Tags: Health IT Company Healthcare IT American College of Cardiology Asset Management Ventures Carta Carta Healthcare Clinical Data CU Healthcare Innovation Fund Feby Abraham Frist Cressey Ventures Health IT Funding Health IT Fundings He Source Type: blogs

A young lady with wide complex tachycardia. My first time actually making this diagnosis de novo in real life in the ED!
 Written by Pendell MeyersA woman in her 30s with minimal past medical history presented simply stating she was " feeling unwell. " Her symptoms started suddenly about 48 hours ago, but had continued to worsen, including epigastric discomfort, nausea, cough, and dyspnea and lightheadedness on exertion. She denied chest pain and denied feeling any palpitations, even during her triage ECG:What do you think?Despite otherwise normal vital signs, she was appropriately triaged to the critical care area of the ED.She was awake, alert, well perfused, with normal mental status and overall unremarkable physical exam except for ...
Source: Dr. Smith's ECG Blog - June 3, 2023 Category: Cardiology Authors: Pendell Source Type: blogs

Health Equity In The AI And Digital Health Era: Promise or Peril?
This report estimated that poor health reduces global GDP by 15% each year.  On the flip side, equalizing healthcare access and quality has healthful effects on the economy at large. Digital technology could narrow the health equity gap by simplifying complex medical processes and removing travel barriers to healthcare access. Figures indicate that underrepresented and/or disadvantaged (poor, rural, minority, women, LGBTQ, etc) groups have significantly less access to all the cutting-edge solutions digital health offers. Thus the gap is not only not closing, but it’s rather further widening right now. W...
Source: The Medical Futurist - May 30, 2023 Category: Information Technology Authors: Andrea Koncz Tags: TMF Artificial Intelligence in Medicine Health Sensors & Trackers Personalized Medicine Telemedicine & Smartphones digital health literacy health equity digital health equity AI Source Type: blogs

Feeling guilty now, for a past professional crime !
Having retired, find little more time in browsing the academic images lying idle in old computers.It is intresting, still a tiring job to pick any useful learning stuff, from heaps of data hiding in different hard drives. This set of ECGs I could retrive from the year 2011, A 31-year-old male presented to our CCU at 4.50 PM. The treatment was Initiated in 10 minutes and completed in an hour, (Those days cath lab wasn’t functioning 24/7, more importantly, there was no external interference with our professional decision-making process) The ECG was repeated at 7.15 PM I think this case is much rele...
Source: Dr.S.Venkatesan MD - May 26, 2023 Category: Cardiology Authors: dr s venkatesan Tags: Uncategorized Source Type: blogs

45 yo with jaw pain radiating to left shoulder for 6 hours
This case was provided by Steven Souchtchenko, a recent graduate of our Hennepin Healthcare EM/IM residency (i.e., a former trainee of mine).CaseA 45 yo man with no previous cardiac history presented to an ED not associated with a cath lab.  He complained of jaw pain radiating to left shoulder for 6 hours.  He stated he had had a brief similar episode the evening prior.Here is his ED ECG.What do you think?When this was shown to me I immediately said " Proximal LAD OMI " .  Then I ran it through theQueen of Hearts AI app and she said " OMI with high confidence " .I showed it to Pendell, who said: " Clear...
Source: Dr. Smith's ECG Blog - May 18, 2023 Category: Cardiology Authors: Steve Smith Source Type: blogs

A 30-something woman with intermittent CP, a HEART score of 2 and a Negative CT Coronary Angiogram on the same day
This was sent by a colleague.A 34 yo woman with a history of HTN, h/o SVT s/p ablation 2006, and 5 months post-partum presented with intermittent central chest pain and SOB.  She had one episode of pain the previous night and two additional episodes early on morning the morning she presented.  Deep breaths are painful and symptoms come and go.  She had one BP that was measured at 160/120, uncertain when and what the BP was at other moments.  Home meds were labetalol and nifedipine.  There are T-wave inversions in precordial leads.  The patient is pain free, so it is qu...
Source: Dr. Smith's ECG Blog - May 10, 2023 Category: Cardiology Authors: Steve Smith Source Type: blogs

A man in his 70s with acute chest pain and paced rhythm.
Sent by Pete McKenna M.D.  Edits by Meyers and SmithA man in his 70s with PMH of hypertension, hyperlipidemia, type 2 diabetes, CVA, dual-chamber Medtronic pacemaker, presented to the ED for evaluation of  acute chest pain.Triage ECG:What do you think?This is diagnostic of proximal LAD occlusion.  This is a huge anterolateral OMI.  Deadly.  I cannot be anything else.Code STEMI was activated by the ED physician based on the diagnostic ECG for LAD OMI in ventricular paced rhythm. There is concordant ST elevation in I, aVL with reciprocal concordant STD in inferior leads, as well as excessiv...
Source: Dr. Smith's ECG Blog - May 8, 2023 Category: Cardiology Authors: Pendell Source Type: blogs

Evidence-based medicine and bias: the truth about common therapies and clinical trials
Evidence-based medicine is a term that attendings like to pepper into their teaching rounds, and medical students like to conspicuously incorporate into their assessment and plan. There is so much clinical trial data out there that it is impossible to stay up to date on the most recent guidelines or the newest landmark trial that Read more… Evidence-based medicine and bias: the truth about common therapies and clinical trials originally appeared in KevinMD.com.
Source: Kevin, M.D. - Medical Weblog - May 7, 2023 Category: General Medicine Authors: Tags: Conditions Cardiology Source Type: blogs

Compare these two ECGs. Do either, neither, or both show anything important?
One case sent by Dr. Sean Rees MD, written by Pendell Meyers, other case by Sam Ghali and Steve SmithTake a look at these two ECGs below from two patients in the ED, first without any clinical context. Full case details and outcomes are below.Case 1:Case 2: Case 1:What do you think?This was sent to Dr. Smith by SamGhali (@EM_RESUS) with zero other info.  Smith ' s response was: " OMI Mimic. "Later, this info was supplied by Sam:This ECG was recorded in a 23-year-old African American man with a history of psychiatric illness, acute alcohol/drug intoxication, brought in by police officers status post being ...
Source: Dr. Smith's ECG Blog - April 17, 2023 Category: Cardiology Authors: Pendell Source Type: blogs

RBBB and LAFB. Is it trifascicular block? The complexities of Wenckebach, with Ken Grauer analysis.
This patient presented with complications of his dialysis fistula.Medical history:History of Ischemic Heart DiseaseHistory of Congestive Heart FailureDiabetes Mellitus requiring treatment with insulinPre-operative serum creatinine>2 mg/dLHe had this ECG recorded:What do you think?There is AV 2nd degree AV Block (Mobitz I, Wenckebach) with RBBB and LAFBThe physicians recognized the RBBB and LAFB, but not the Wenckebach. They compared to a previous ECG and thought they were identical.  Here is the previous ECG from 2 months prior for pre-op for cataract surgeryThis appears to be atrial fibrillation with RBB...
Source: Dr. Smith's ECG Blog - April 6, 2023 Category: Cardiology Authors: Steve Smith Source Type: blogs

Watch what happens when you teach others how to find OMI
 Submitted by Dr. Caio Aguiar from Brazil, written by Pendell MeyersIt is immensely rewarding to receive these emails, like I received from Dr. Aguiar last week:" Last year I had a couple of lessons with you while on my internship.I finished my residency of Emergency Medicine and I ’m working at a great Emergency Department here in Brazil.Since then, I started looking for OMI EKG findings and not just STEMI.So, I ' m a follower of your blog, and I think I have a interesting case that I attended yesterday. "Case" Male, 43yo, come to ED with Epigastric Pain started 3 hours ago. Risk Factors: High Cholesterol. Vitals S...
Source: Dr. Smith's ECG Blog - March 21, 2023 Category: Cardiology Authors: Pendell Source Type: blogs

Fight Aging! Newsletter, March 20th 2023
This study also provides the potential for de novo generation of complex organs in vivo. T Cells May Play a Role in the Brain Inflammation Characteristic of Neurodegenerative Conditions https://www.fightaging.org/archives/2023/03/t-cells-may-play-a-role-in-the-brain-inflammation-characteristic-of-neurodegenerative-conditions/ Alzheimer's disease, and other forms of neurodegenerative condition, are characterized by chronic inflammation in brain tissue. Unresolved inflammatory signaling is disruptive of tissue structure and function. Here, researchers provide evidence for T cells to become involved in this...
Source: Fight Aging! - March 19, 2023 Category: Research Authors: Reason Tags: Newsletters Source Type: blogs