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Therapy: Dialysis
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Total 64 results found since Jan 2013.
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
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
Bonus Features – February 5, 2023 – 78% of data breaches result from hacks or IT incidents, Nova Scotia taps Oracle Cerner for EHR modernization, and more
This article will be a weekly roundup of interesting stories, product announcements, new hires, partnerships, research studies, awards, sales, and more. Because there’s so much happening out there in healthcare IT we aren’t able to cover in our full articles, we still want to make sure you’re informed of all the latest news, announcements, and stories happening to help you better do your job.
Research and Studies
Nearly 80% of healthcare’s data breaches can be attributed to hacking and IT incidents, according to a recent report from managed security services provider Fortified Health Security. That represents ...
Source: EMR and HIPAA - February 5, 2023 Category: Information Technology Authors: Brian Eastwood Tags: Health IT Company Healthcare IT Security and Privacy Telemedicine and Remote Monitoring Adam Kautzner ADAMS Center Agewell AHIMA AnMed AristaMD Aruba Atlanta Women's Health Group Atlas Dataset Brightside Health CCS Cerner C Source Type: blogs
Monitoring Congestive Heart Failure Through Speech: Interview with Tamir Tal, CEO of Cordio Medical
Cordio Medical, a medtech company based in Israel, has developed HearO, an app that can assist in monitoring congestive heart failure. The technology is based on the phenomenon whereby congestive heart failure patients demonstrate changes in their vo...
Source: Medgadget - November 11, 2022 Category: Medical Devices Authors: Conn Hastings Tags: Cardiology Diagnostics Exclusive CHF Congestive Heart Failure Source Type: blogs
I was shown this ECG without any information. What do you think?
I was shown this ECG; " Steve, what do you think of this? " :What is going on?I said: " This is pulse tapping artifact and a long QT " Why did I say that?Whenever you see a very bizarre EKG, you should think about pulse tapping artifact. This is when one of the limb lead electrodes is placed over an artery, especially when placed over a dialysis fistula.When you suspect this, your next task is look for the one lead among leads I, II, and III which is NOT bizarre. Lead I in this ECG is not bizarre [though it does show a very long QT (or QU)].Leads I is formed by the right arm and left arm electro...
Source: Dr. Smith's ECG Blog - November 8, 2022 Category: Cardiology Authors: Steve Smith Source Type: blogs
Heart failure in chronic kidney disease – Cardiology Basics
Heart failure in chronic kidney disease – Cardiology Basics
Prevalence of both heart failure and chronic kidney disease (CKD) are increasing as the population is aging globally. Hence heart failure in chronic kidney disease is seen more often. Presence of CKD in heart failure increases morbidity and mortality. Though there is increasing use of effective medications and special devices like cardiac resynchronization therapy in heart failure patients in general, those with CKD have not been benefited well.
CKD is defined as abnormalities of kidney structure or function, present for >3 months, with implications for h...
Source: Cardiophile MD - October 21, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
What is pulmonary edema? Cardiology Basics
Pulmonary edema is collection of fluid within the lung alveoli.
The most important cause of pulmonary edema is heart failure, specifically, left ventricular failure. Pulmonary edema can also occur when there is fluid overload in the body as in renal failure.
Other causes of pulmonary edema are mitral stenosis, pulmonary venous obstruction and increased permeability of the pulmonary capillaries. Increased permeability of the pulmonary capillaries occurs in noncardiogenic pulmonary edema – e.g. adult respiratory distress syndrome or ARDS.
Sudden breathlessness is the most important symptom of pulmonary edema as the lungs ...
Source: Cardiophile MD - October 8, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
Another deadly and confusing ECG. Are you still one of the many people who will be fooled by this ECG, or do you recognize it instantly?
Submitted and written byDestiny Folk MD, peer reviewed by Meyers, Smith, Grauer, McLarenA man in his early 30s with no significant past medical history was brought to the ED by EMS after being found unresponsive by a friend. EMS arrived and found him awake and alert. He complained of generalized weakness and left lower extremity numbness. He reported that 12 hours prior to arrival he used fentanyl and cocaine. He reported difficulty walking and felt as if his left leg was “asleep.” He denied any chest pain or shortness of breath and stated he felt at his baseline yesterday prior to drug use. On arrival in the ED, he wa...
Source: Dr. Smith's ECG Blog - May 5, 2022 Category: Cardiology Authors: Pendell Source Type: blogs
Acute respiratory distress: Correct interpretation of the initial and serial ECG findings, with aggressive management, might have saved his life.
Written by Pendell Meyers with edits by SmithA man in his 60s called EMS apparently for shortness of breath. EMS found him in distress and hypoxemic requiring 4 L nasal cannula to maintain oxygen saturation greater than 93%.Here is his triage ECG:What do you think?An old ECG was available on file, from 2 years ago:RBBB, otherwise normal.The triage ECG is diagnostic of life threatening hyperkalemia (sodium channel blockade would also produce this pattern, but the patient was not known to be on any sodium blocking medications). There is the very common brugada pattern STEMI mimic seen in V1 and partially in V3 and aVR....
Source: Dr. Smith's ECG Blog - January 16, 2022 Category: Cardiology Authors: Pendell Source Type: blogs
Remote patient monitoring: a health IT perspective PODCAST
“The primary benefits for mobile care units are the fact that they decrease patient travel times by arriving at their residences and ensuring that appointments are never missed. It also relieves the stress of finding transportation for dialysis patients, outright eliminating the need for the CMS to find alternative transport methods for patients. By utilizingRead more …Remote patient monitoring: a health IT perspective [PODCAST] originally appeared inKevinMD.com.
Source: Kevin, M.D. - Medical Weblog - July 29, 2021 Category: General Medicine Authors: < span itemprop="author" > < a href="https://www.kevinmd.com/blog/post-author/the-podcast-by-kevinmd" rel="tag" > The Podcast by KevinMD < /a > < /span > Tags: Podcast Cardiology Health IT Nephrology Source Type: blogs
Hypotension, altered mental status, and aVR sign - activate the cath lab?
ConclusionsSTE-aVR with multilead ST depression was associated with acutely thrombotic coronary occlusion in only 10% of patients. Routine STEMI activation in STE-aVR for emergent revascularization is not warranted, although urgent, rather than emergent, catheterization appears to be important.
Source: Dr. Smith's ECG Blog - July 21, 2021 Category: Cardiology Authors: Pendell Source Type: blogs
If I listen hard enough, each patient has a sacred story to share
From a medical perspective, Mr. G’s case seemed straightforward. His GFR had fallen. His kidneys were failing. Dialysis would be required as the best treatment for his renal condition. When I met with Mr. G later in the afternoon, he was in despair. He could not see how dialysis would save his life and expressed […]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 - February 6, 2021 Category: General Medicine Authors: < span itemprop="author" > < a href="https://www.kevinmd.com/blog/post-author/johnathan-yao" rel="tag" > Johnathan Yao < /a > < /span > Tags: Education Cardiology Medical school Source Type: blogs
A woman in her 60s with VFib arrest and no STEMI on her post-ROSC ECG.
This study had a fatal flaw: they did not keep track of all the " Non-STEMI patients " who were NOT enrolled, but instead were sent for immediate angiogram. It was done in Europe, where the guidelines suggest taking all shockable arrests emergently to the cath lab. So it is highly likely that physicians were very reluctant to enroll patients whom they suspected had Occlusion MI (OMI), even if they didnot have STEMI. These physicians did not want a patient with an OMI that was not a STEMI to be randomized to no angiogram. This strong suspicion is supported by their data: only 22 of 437 ...
Source: Dr. Smith's ECG Blog - November 17, 2020 Category: Cardiology Authors: Pendell Source Type: blogs
“ Dialysable LV dysfunction In CKD ” : Myocardial edema clearance plays a role.
In CKD, LVH is a near-constant feature with echo showing thick, bright echoes from IVS. The LV mass increases, partly due to physiological hypertrophy ,also contributed by deposits of uremic middle molecules and fluid collection in the interstitium as myocardial edema.This, is recognised as T 2 weighted MRI signals. Chronic fluid stasis may progress to myocardial fibrosis. (Kidney Blood Press Res 2018;43:134–142 )
Effect of Frusemide on myocardial edema
We know, loop diuretics cause aggressive depletion of ECF volume and to a lesser extent Interstitial fluid. The effect of diuretic on myocardial wate...
Source: Dr.S.Venkatesan MD - October 11, 2020 Category: Cardiology Authors: dr s venkatesan Tags: cardiology research topics for fellows cardiology thesis topics Uncategorized myocardial edema in ckd myocardial edema mri Source Type: blogs
A Vigilante in Statistical Badlands
This study, for instance, attributes a patient’s waitlist/transplant outcome to the very last dialysis facility the patient was associated with. In epidemiology speak, this means the causal inference authors are trying to draw between for-profit status and good transplant outcomes is subject to time-varying confounding. As an example, if one is seeking an association between testosterone levels and risk of a heart attack, using the last testosterone level available would be a poor way of doing this study because testosterone levels are known to vary over time. The same applies to dialysis facilities. Patients chan...
Source: The Health Care Blog - May 25, 2020 Category: Consumer Health News Authors: Christina Liu Tags: Medical Practice Physicians Eric Weinhandl JAMA medical research public health Public Policy public policy research Source Type: blogs
