Filtered By:
Procedure: Electrocardiogram
This page shows you your search results in order of date.
Order by Relevance | Date
Total 507 results found since Jan 2013.
How Could Digital Technology Make An Impact On Primary Care?
I truly hope that very soon I do not have to make an appointment at the GP when I suspect signs of a disease, but my GP will send me a message that she spotted something irregular in my latest test results and my digital health data, so I’d better visit. Let me show you in detail how primary care should be carried out in the future!
Digital health should become an organic part of primary care in the future
I live a fairly healthy life. I use data to improve my lifestyle and to make better decisions by optimising my sleep pattern, my physical, my cognitive or my emotional abilities; and I had several genetic tests....
Source: The Medical Futurist - September 21, 2023 Category: Information Technology Authors: berci.mesko Tags: Digital Health Research Healthcare Innovation technology wearables GP primary care general practitioner Source Type: blogs
A 40 year old with nonspecific symptoms including dizziness
.What do you notice about the ECG?There is a very short QT interval. This is often found in hypercalcemia. See Ken Grauer ' s comments below for detail.Thus, the patient ' s chemistry was done and revealed ionized hypercalcemia of 6.3 mg/dL (normal 4.4 - 5.2)Followup: he was found to have hyperparathyroidism===================================MY Comment, by KEN GRAUER, MD (9/12/2023):===================================Today ' s ECG is remarkable for an uncommon but important finding that we periodically review, because it otherwise is all-too-easy to overlook. For example — Did YO...
Source: Dr. Smith's ECG Blog - September 12, 2023 Category: Cardiology Authors: Steve Smith Source Type: blogs
Judge for yourself the management of this patient with " NSTEMI, multivessel disease "
DISCUSSION:The administration of
opioid analgesia prior to cath in patients with concern for ACS is associated
with longer door-to-balloon times, and greater peak troponin levels. The rate
of Occlusion MI in those who received pre-cath opioids was double the rate of
those without pre-cath opioids, and STEMI(-) OMI patients who received pre-cath
opioids waited 10 hours on average longer to get cath than those who did not
received opioids. These results add support to our hypothesis that a major
mechanism of harm caused by opioid medications in ACS patients involves delays
to the cath lab for patients with STEMI(-) OMI.=====...
Source: Dr. Smith's ECG Blog - September 10, 2023 Category: Cardiology Authors: Pendell Source Type: blogs
A 50-something with chest pain.
This was sent by anonymous The patient is a 55-year-old male who presented to the emergency department after approximately 3 to 4 days of intermittent central boring chest pain initially responsive to nitroglycerin, but is now more constant and not responsive to nitroglycerin. It is unknown when this pain recurred and became constant.More past history: hypertension, tobacco use, coronary artery disease with two vessel PCI to the right coronary artery and circumflex artery several years prior. He reports feeling nauseated with emesis. He reports that this chest pain feels different than prior chest...
Source: Dr. Smith's ECG Blog - September 3, 2023 Category: Cardiology Authors: Steve Smith 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
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
Pulmonary Arterial Hypertension: Unraveling Its Impact On Heart And Lungs
Conclusion
Navigating the complexities of Pulmonary Arterial Hypertension (PAH) might seem daunting. However, with the right knowledge and proactive approach, it’s possible to manage the condition and maintain a good quality of life.
PAH, a unique type of high blood pressure affecting the arteries in the lungs, can put extra strain on the heart. Over time, this can lead to heart failure. The condition’s root cause may vary, from genetic factors to other health issues like heart defects, liver disease, or autoimmune diseases. Remember, sometimes the cause remains unknown, resulting in idiopathic pulmonary ...
Source: The EMT Spot - July 19, 2023 Category: Emergency Medicine Authors: Michael Rotman, MD, FRCPC, PhD Tags: Blood Pressure Source Type: blogs
I was reading ECGs on the system when I came across this one, called " normal " by the conventional computer algorithm
I come in early for every shift to read the ECGs on the system that have not yet been " confirmed " . I came across this one:The computer calls is: " SINUS RHYTHM. NORMAL ECG "What do you think? Be VERY careful when the computer calls the ECG " Normal " . I saw the inferior ST depression (which is reciprocal to subtle STE in aVL) and the subtle ST depression in precordial leads and thought:" If this patient came in with chest pain, then it is an acute OMI. "So I looked on the computer. Turns out that it was a 50-something patient with no previous cardiac history who had called 911 for chest pain...
Source: Dr. Smith's ECG Blog - July 12, 2023 Category: Cardiology Authors: Steve Smith Source Type: blogs
63 year old with " good story for ACS " but negative troponins.....
This was texted to me from a former resident, while working at a small rural hospital, with the statement:" I can ’t convince myself of anything here, but he’s a 63-year-old guy with prior stents and a good story for ACS. " (Chest pain or discomfort)What do you think?Here was my response:" Suspicious for inferior posterior OMI. Get serial ECGs "He then sent a previous from 4 years prior:" This is totally normal, which confirms that the first EKG does indeed represent OMI "Then the patient ' s chest pain resolved and he recorded another:The ST depression in aVL is gone and the T-waves are less hyperacu...
Source: Dr. Smith's ECG Blog - July 2, 2023 Category: Cardiology Authors: Steve Smith Source Type: blogs
Two ECGs texted to me in the same hour. What would you recommend?
Written by Pendell MeyersBoth of these cases were sent to me with no information other than adults with acute chest pain. What would be your response?Case 1:Case 2:What if I told you that Case 1 has an abnormal initial troponin, and Case 2 has a normal initial troponin? Case 1An elderly male presented with chest pain. His vitals were within normal limits except some mild hypertension. Here was his triage ECG:What do you think?I texted back: " I just see LVH with no signs of OMI " .I sent this ECG to the Queen of Hearts (PMcardio OMI), and here is the verdict:You can subscribe for news and early access (via partic...
Source: Dr. Smith's ECG Blog - June 15, 2023 Category: Cardiology Authors: Pendell Source Type: blogs
A young man with another episode of tachycardia. What is it? And why give adenosine in sinus rhythm?
Written by Bobby Nicholson MD and Pendell MeyersA man in his 30s presented to the ED for evaluation of chest pain and palpitations. He described it as a " jackhammering " sensation, associated with palpitations, diaphoresis, and shortness of breath, and he stated it started soon after consuming an " energy drink " (product/contents unknown).He stated these symptoms were the same as a prior episode which required cardioversion. He states that he has
a heart condition which he does not know the name of and that he has felt his
heart race like this once before and needed to be shocked. He was seen by a
cardiologist in fo...
Source: Dr. Smith's ECG Blog - June 11, 2023 Category: Cardiology Authors: Pendell Source Type: blogs
75 year old with 24 hours of chest pain, STEMI negative
Written by Jesse McLaren A 75 year old
with a history of CABG called EMS after 24 hours of chest pain. HR 40, BP
135/70, RR16, O2 100%. Here ’s the paramedic ECG (digitized by PMcardio). What
do you think? There ’s sinus
bradycardia, normal conduction, normal axis, delayed R wave progression, and
normal voltages. There are inferior Q waves and lead III has mild concave ST
elevation, with subtle reciprocal ST depression in I/aVL. This is diagnostic of
inferior OMI, likely from the RCA. The patient has a hi story of CABG so some of
these changes could be old, but with ongoing chest pain and bradycardia in a
hig...
Source: Dr. Smith's ECG Blog - June 8, 2023 Category: Cardiology Authors: Jesse McLaren Source Type: blogs
Another myocardial wall is sacrificed at the altar of the STEMI/NonSTEMI mass delusion (and Opiate pain relief).
I received the following text message with these 3 EKGs (providers text me ECGs all day every day; most are false positives; many are subtle true positives):" Hi Steve, here are 3 EKGs for you (my colleague ' s case). A 67 yo f developed chest pain this morning. "EKG #1Followed 15 minutes by this #2 EKG:Then the patient received aspirin andDilaudid (hydromorphone, same effect as morphine) and the pain went away and there was this 3rd ECG:Smith comment: hydromorphone will make any pain go away (or improve) without any improvement in the underlying pathology. Do NOT give it unless you are committed to t...
Source: Dr. Smith's ECG Blog - May 31, 2023 Category: Cardiology Authors: Steve Smith Source Type: blogs
