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Total 3662 results found since Jan 2013.
A 50-something with Regular Wide Complex Tachycardia: What to do if electrical cardioversion does not work?
Case submitted by anonymous. Written by Smith. Ken ' s piece at the bottom is excellent.A 50-something presented with sudden 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. Past medical history includes coronary stenting 17 years prior. A brief chart review revealed his most recent echo in 2018, with LV EF 67%, “very small” inferior wall motion abnormality.Initial ED ECG:What do you think?This wa...
Source: Dr. Smith's ECG Blog - September 20, 2023 Category: Cardiology Authors: Steve Smith Source Type: blogs
A 50-something with Regular Wide Complex Tachycardiaa: What to do if electrical cardioversion does not work?
Case submitted by anonymous. Written by Smith. Ken ' s piece at the bottom is excellent.A 50-something presented with sudden 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. Past medical history includes coronary stenting 17 years prior. A brief chart review revealed his most recent echo in 2018, with LV EF 67%, “very small” inferior wall motion abnormality.Initial ED ECG:What do you think?This wa...
Source: Dr. Smith's ECG Blog - September 20, 2023 Category: Cardiology Authors: Steve Smith Source Type: blogs
No, we can ’ t allow BAV to be a threat,.. to our heart-throb !
Interventional cardiologists generally do not believe (rather relish) in simple balloon dilatations to remove any vascular blocks. It is a mundane job for their talent-ridden hands. After conquering the coronaries, we made exclusive the valvular stents. No surprise, TAVR has taken over the aortic interventions with all its glamour and vigor, though it is definitely not an ideal choice in all.
SCAI, the prestigious journal in Interventional cardiology has a recent article , that has a not-so pleasant message for TAVR lovers.
PIIS2772930323004453Download
It poses a direct challenge to cardiologists’ heart...
Source: Dr.S.Venkatesan MD - September 18, 2023 Category: Cardiology Authors: dr s venkatesan Tags: Uncategorized Source Type: blogs
Life style modification & CVD prevention : Spot the new entry
Discussing lifestyle modification is an essential cliché in every preventive cardiology consult, For most, it still means good nutrition exercise, and stress relief. It is true, that the average human longevity has increased considerably in the last century. However, this apparent gain in life expectancy by the stunning discoveries in science ( 10 years ?) has already been eaten up, by the self-inflicted, poor styles in life. The new kid on the block, i.e. social media is playing a powerful amplifying effect.
Spot a new entry in lifestyle interventions.
Here is a fresh list of lifestyle modifications from the ...
Source: Dr.S.Venkatesan MD - September 8, 2023 Category: Cardiology Authors: dr s venkatesan Tags: Uncategorized Source Type: blogs
50 year-old in remote rural community with chest pain and ‘normal’ ECG
Submitted by anonymous, edited by Jesse McLarenThe first person " I " and " me " is this anonymous sender. A 50 year old presented to the emergency department of a
remote rural community (where the nearest cath lab is a plane ride away) with
one hour of mild chest pain radiating to the back and jaw, and an ECG labeled ‘normal’ by the computer interpretation. What do you think, and how would you
manage the patient?There ’s normal sinus rhythm, normal conduction, normal axis,
normal R wave progression and normal voltages. There’s clear T wave inversion
in III/aVF, which is reciprocal to subtle ST elevation and h...
Source: Dr. Smith's ECG Blog - September 8, 2023 Category: Cardiology Authors: Jesse McLaren Source Type: blogs
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
Dip and plateau pattern of ventricular pressure tracing in constrictive pericarditis
Thickened and stiff pericardium in chronic constrictive pericarditis has poor compliance reducing the distension of cardiac chambers to a limited fixed total volume. Transmission of intrathoracic pressure to the pericardial cavity is also prevented by thickening of the pericardium [1]. Manifestation of compression occurs when the total cardiac volume reaches the pericardial volume in diastole. The severe restriction causes elevation of pulmonary and systemic venous pressure which becomes equal to diastolic pressures in all cardiac chambers. Relative change is more on the right sided chambers. Inspiratory fall in intratho...
Source: Cardiophile MD - August 31, 2023 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
New ESC 2023 Cardiomyopathy guidelines: Truths trail by 17 years!
It was 2006
Allow me to recount an unassuming piece of a PowerPoint presentation from my institute, Madras Medical College, at the annual Cardiological Society meeting in New Delhi. The paper was categorized under miscellaneous sessions. I vividly remember the day. I have to admit, It was a nearly empty hall E, located in the basement of Hotel Ashoka. After the talk, I looked up to find that neither the chairman nor the handful of kind academic souls had any questions or comments to make. Pausing for a few moments, I quietly walked down the podium with an inexplicable silent pain.
The title of the presentation was &#...
Source: Dr.S.Venkatesan MD - August 27, 2023 Category: Cardiology Authors: dr s venkatesan Tags: cardiomyopathy Dilated cardiomyopathy hypertrophic cardiomyopathy ischemic cardiomyopathy Uncategorized drsvenkatesan ESC 2023 new cardiomyopathy guideline ndlvc non dilated cardiomyopathy Source Type: blogs
How can PDA mask a coarctation of aorta?
Coarctation of aorta may be missed when there is a large patent ductus arteriosus. This is because the ampulla of the ductus arteriosus is typically across the narrowed segment of aorta in coarctation of aorta. The wide ampulla in a way ameliorates the obstruction, making clinical detection of coarctation difficult. A good pulse can be felt in the lower limbs in such situations. There could be sudden deterioration with shock and mult-organ failure when such an associated patent ductus arteriosus is closed in an infant with an undetected coarctation of aorta. Detection of coarctation could also be difficult by transthoraci...
Source: Cardiophile MD - August 25, 2023 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology 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
75 year old dialysis patient with nausea, vomiting and lightheadedness
Written by Jesse McLaren A 75 year-old patient with diabetes and end stage renal
disease was sent to the ED after dialysis for three days of nausea, vomiting,
loose stool, lightheadedness and fatigue. RR18 sat 99% HR 90 BP 90/60, afebrile. Below is the 15 lead ECG. What do you think? There ’s normal sinus rhythm, normal conduction, normal axis,
normal R wave progression and normal voltages. There’s subtle inferior ST
elevation with straightening of the ST segment, reciprocal ST depression and T
wave inversion in aVL, and ST depression in V2. This is diagnostic of
infero-posterior OMI, but it is falsely n...
Source: Dr. Smith's ECG Blog - August 19, 2023 Category: Cardiology Authors: Jesse McLaren Source Type: blogs
Chest pain and T wave inversion, NSTEMI?
Case submitted and written by Dr. Mazen El-Baba and Dr. Emily Austin, with edits from Jesse McLarenA 50 year-old patient presented to the Emergency Department with sudden onset chest pain that began 14-hours ago. The nurse alerted the MD because the patient was still symptomatic, diaphoretic and “looking unwell”. What do you think? ECG interpretation: sinus rhythm, normal conduction (PR, QRS, and QTc), normal axis, delayed R-wave progression, and normal voltages. There ’s primary TWI inferiorly (aVF and III) and V6, with reciprocal tall T-wave in lead I/aVL, and a Q wave in III. The...
Source: Dr. Smith's ECG Blog - August 10, 2023 Category: Cardiology Authors: Jesse McLaren Source Type: blogs
Evaluation of Prosthetic Aortic Valve Obstruction
This discussion will focus beyond the basic clinical evaluation, ECG, chest X-ray and hematological workup. Hematological workup is important in aortic valve obstruction because of likelihood of associated hemolytic anemia and acquired von Willebrand Syndrome. Former is due to destruction of red blood cells across the narrowed aortic valve, and latter due to loss of the largest multimers of von Willebrand factor. High shear stress across the narrowed aortic valve exposes a region of the von Willebrand factor which is susceptible to a specific von Willebrand protease. This can lead on to gastrointestinal angiodysplasia (He...
Source: Cardiophile MD - August 9, 2023 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
Lecture by Smith: Selected Cases of Occlusion MI (OMI), or not, on the ECG
This may be my best lecture yet. I gave it virtually to the Kaiser group.You can access it also on the " Lectures and Podcasts " link on the Banner above.https://drive.google.com/file/d/1SSe2AmEyfkrQhRJt1FGmVxvnt3g3c4BN/view?usp=drive_link===================================MY Comment, by KEN GRAUER, MD (8/6/2023):===================================Brilliant talk by Dr. Smith on the state of the art addressing the “need for OMI — and the fallacy of STEMI ”. For skeptics (including cardiologists) — Any questions about “Who is Dr. Smith?” are compellingly answered by the several...
Source: Dr. Smith's ECG Blog - August 6, 2023 Category: Cardiology Authors: Steve Smith Source Type: blogs
OMI Pocket Guide
📕OMI Pocket Guide TheOMI Pocket Guide (https://omiguide.org) is a user-friendly online resource designed to help healthcare professionals learn how to recognize subtle signs of acute coronary occlusion on the ECG which represent occlusion myocardial infarctions (OMI). Learning to recognize OMIs is an important clinical skill because it helps identify the subpopulation of " NSTEMIs " who are likely to be found with total thrombotic occlusion at the time of cardiac catherization.Although there are more criteria to consider when looking for OMIs compared to STEMIs, anyone can learn them, and this guid...
Source: Dr. Smith's ECG Blog - August 3, 2023 Category: Cardiology Authors: Mark Hellerman Source Type: blogs
