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https://www.readbyqxmd.com/read/27900920/-sudden-loss-of-consciousness-during-labour
#1
L T van Genugten, L P Morssink, E L van der Kooi
This case describes a 36-year-old woman, gravida 4 para 2 at 41 weeks and 3 days gestation, who appeared unconscious during labour for 75 minutes. After excluding physical disorders, it transpired that she was having a conversion disorder. A patient with a decreased level of consciousness in childbirth must be assessed using the ABCDE method, positioned in left lateral tilt to prevent inferior vena cava compression. After stabilization of the vital functions and establishing the patient's history, physical examination and laboratory tests are components of the initial clinical assessment...
2016: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/27899826/an-elective-course-in-cardiovascular-electrophysiology-for-pharmacy-learners
#2
Diptiman D Bose
Objective. To implement an integrated, comprehensive, and learner-centered elective course focused at exposing learners to the interpretation of electrocardiograms and highlighting the mechanisms underlining the abnormal electrophysiological events. Design. Learners were presented with foundational information on the mechanisms underlying electrophysiological changes associated with the development of arrhythmias. They then discussed the interpretation of electrocardiogram (ECG) recordings and diagnosis of cardiovascular events...
October 25, 2016: American Journal of Pharmaceutical Education
https://www.readbyqxmd.com/read/27886932/newer-echocardiographic-techniques-in-cardiac-resynchronization-therapy
#3
REVIEW
John Gorcsan, Bhupendar Tayal
Echocardiographic imaging plays a major role in patient selection for cardiac resynchronization therapy (CRT). One-third of patients do not respond; there is interest in advanced echocardiographic imaging to improve response. Current guidelines favor CRT for patients with electrocardiographic (ECG) QRS width of 150 milliseconds or greater and left bundle branch block. ECG criteria are imperfect; there is interest in advanced echocardiographic imaging to improve patient selection. This discussion focuses on newer echocardiographic methods to improve patient selection, improve delivery, and identify patients at risk for poor outcomes and serious ventricular arrhythmias...
January 2017: Heart Failure Clinics
https://www.readbyqxmd.com/read/27846815/endomyocardial-biopsy-via-the-femoral-access-still-safe-and-valuable-diagnostic-tool
#4
Sylwia Sławek, Aleksander Araszkiewicz, Agnieszka Gaczkowska, Justyna Koszarska, Damian Celiński, Marek Grygier, Maciej Lesiak, Stefan Grajek
BACKGROUND: The endomyocardial biopsy has proven to be an integral diagnostic tool for surveillance of cardiac allograft rejection and identification of myocardial diseases. Nevertheless, this invasive procedure is not risk-free. This study focuses on the risk of complications and diagnostic performance of right ventricular endomyocardial biopsy (EMB). METHODS: In this single-center retrospective study, we analyzed 315 EMB procedures performed between July 2008 and May 2015 in 73 patients...
November 15, 2016: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/27837002/safety-of-domperidone-in-treating-nausea-associated-with-dihydroergotamine-infusion-and-headache
#5
Nathaniel M Robbins, Hiroyuki Ito, Melvin M Scheinman, Peter J Goadsby
OBJECTIVE: To determine the safety of domperidone in the treatment of nausea associated with dihydroergotamine (DHE) infusion and headache. METHODS: We audited our use of domperidone for the inpatient management of nausea, focusing on known safety concerns, particularly potential cardiac arrhythmias. RESULTS: We reviewed 103 consecutive admissions of 90 patients admitted for IV DHE by infusion. Most admissions were to treat chronic migraine with (n = 53) or without (n = 46) aura...
November 11, 2016: Neurology
https://www.readbyqxmd.com/read/27834139/microrna-130a-regulation-of-desmocollin-2-in-a-novel-model-of-arrhythmogenic-cardiomyopathy
#6
Stefan R Mazurek, Tyler Calway, Cynthia Harmon, Priyanka Farrell, Gene H Kim
BACKGROUND: MicroRNAs are small noncoding RNA molecules that play a critical role in regulating physiological and disease processes. Recent studies have now recognized microRNAs as an important player in cardiac arrhythmogenesis. Molecular insight into arrhythmogenic cardiomyopathy (AC) has primarily focused on mutations in desmosome proteins. To our knowledge, models of AC due to microRNA dysregulation have not been reported. Previously, we reported on miR-130a mediated down-regulation of Connexin43...
November 9, 2016: MicroRNA
https://www.readbyqxmd.com/read/27807020/miliary-tuberculosis-in-an-immunocompetent-male-with-a-fatal-outcome
#7
Louise Dunphy, Elizabeth Keating, T Parke
A man aged 33 years, born in Nepal, but resident in the UK for 7 years presented to the emergency department with a 4-day history of general malaise, fever (temperature 38.6°C) and a non-productive cough. His medical history was unremarkable and no high-risk behaviour was identified. Clinical examination confirmed decreased air entry bilaterally with bibasal crackles. He was tachycardic, with a heart rate of 120 bpm. Further investigation with a 12-lead ECG confirmed supraventricular tachycardia (SVT) which was terminated with vagal manoeuvres...
November 2, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27759433/emergency-physician-accuracy-in-interpreting-electrocardiograms-with-potential-st-segment-elevation-myocardial-infarction-is-it-enough
#8
Giacomo Veronese, Federico Germini, Stella Ingrassia, Ombretta Cutuli, Valeria Donati, Luca Bonacchini, Maura Marcucci, Andrea Fabbri
BACKGROUND: Electrocardiogram (ECG) interpretation is widely performed by emergency physicians. We aimed to determine the accuracy of interpretation of potential ST-segment elevation myocardial infarction (STEMI) ECGs by emergency physicians. METHODS: Thirty-six ECGs resulted in putative STEMI diagnoses were selected. Participants were asked to focus on whether or not the ECG in question met the diagnostic criteria for an acutely blocked coronary artery causing a STEMI...
October 19, 2016: Acute Cardiac Care
https://www.readbyqxmd.com/read/27746315/trpa1-mediates-changes-in-heart-rate-variability-and-cardiac-mechanical-function-in-mice-exposed-to-acrolein
#9
Nicole Kurhanewicz, Rachel McIntosh-Kastrinsky, Haiyan Tong, Allen Ledbetter, Leon Walsh, Aimen Farraj, Mehdi Hazari
Short-term exposure to ambient air pollution is linked with adverse cardiovascular effects. While previous research focused primarily on particulate matter-induced responses, gaseous air pollutants also contribute to cause short-term cardiovascular effects. Mechanisms underlying such effects have not been adequately described, however the immediate nature of the response suggests involvement of irritant neural activation and downstream autonomic dysfunction. Thus, this study examines the role of TRPA1, an irritant sensory receptor found in the airways, in the cardiac response of mice to acrolein and ozone...
October 13, 2016: Toxicology and Applied Pharmacology
https://www.readbyqxmd.com/read/27743384/a-low-power-and-miniaturized-electrocardiograph-data-collection-system-with-smart-textile-electrodes-for-monitoring-of-cardiac-function
#10
Ming Dai, Xueliang Xiao, Xin Chen, Haoming Lin, Wanqing Wu, Siping Chen
With the increasing aging population as well as health concerns, chronic heart disease has become the focus of public attention. A comfortable, low-powered, and wearable electrocardiogram (ECG) system for continuously monitoring the elderly's ECG signals over several hours is important for preventing cardiovascular diseases. Traditional ECG monitoring apparatus is often inconvenient to carry, has many electrodes to attach to the chest, and has a high-power consumption. There is also a challenge to design an electrocardiograph that satisfies requirements such as comfort, confinement, and compactness...
October 14, 2016: Australasian Physical & Engineering Sciences in Medicine
https://www.readbyqxmd.com/read/27734807/robust-qrs-peak-detection-by-multimodal-information-fusion-of-ecg-and-blood-pressure-signals
#11
Quan Ding, Yong Bai, Yusuf Bugra Erol, Rebeca Salas-Boni, Xiaorong Zhang, Xiao Hu
QRS peak detection is a challenging problem when ECG signal is corrupted. However, additional physiological signals may also provide information about the QRS position. In this study, we focus on a unique benchmark provided by PhysioNet/Computing in Cardiology Challenge 2014 and Physiological Measurement focus issue: robust detection of heart beats in multimodal data, which aimed to explore robust methods for QRS detection in multimodal physiological signals. A dataset of 200 training and 210 testing records are used, where the testing records are hidden for evaluating the performance only...
October 13, 2016: Physiological Measurement
https://www.readbyqxmd.com/read/27733923/ecg-artefact-identification-and-removal-in-mhealth-systems-for-continuous-patient-monitoring
#12
Syed Anas Imtiaz, James Mardell, Siavash Saremi-Yarahmadi, Esther Rodriguez-Villegas
Continuous patient monitoring systems acquire enormous amounts of data that is either manually analysed by doctors or automatically processed using intelligent algorithms. Sections of data acquired over long period of time can be corrupted with artefacts due to patient movement, sensor placement and interference from other sources. Owing to the large volume of data these artefacts need to be automatically identified so that the analysis systems and doctors are aware of them while making medical diagnosis. Three important factors are explored that must be considered and quantified for the design and evaluation of automatic artefact identification algorithms: signal quality, interpretation quality and computational complexity...
September 2016: Healthcare Technology Letters
https://www.readbyqxmd.com/read/27727006/qtc-interval-lengthening-in-first-episode-schizophrenia-fes-patients-in-the-earliest-stages-of-antipsychotic-treatment
#13
Desheng Zhai, Yan Lang, Gaopan Dong, Yijun Liu, Xin Wang, Dushuang Zhou, Taizhen Cui, Yuxin Yang, Wenxi Zhang, Ying Zhao, Ruiling Zhang
Antipsychotic use is reported to be associated with a higher risk of sudden cardiac death and new users are especially susceptible to that risk. In this study, we focused on the ability of antipsychotics to prolong the QTc interval at the earliest stages of antipsychotic use. We employed a retrospective cohort study design in a naturalistic setting where having three ECG measurements over time (at baseline and after drug exposure) in antipsychotic-naïve, first-episode schizophrenia (FES) inpatients. The results revealed, in this relatively homogeneous, drug naïve FES patient sample, that QTc intervals were statistically significantly prolongated after a relatively short term (2-4weeks) of antipsychotic treatments, compared with baseline...
October 7, 2016: Schizophrenia Research
https://www.readbyqxmd.com/read/27718759/early-drug-development-assessment-of-proarrhythmic-risk-and-cardiovascular-safety
#14
Robert M Lester, Joy Olbertz
hERG assays and thorough ECG trials have been mandated since 2005 to evaluate the QT interval and potential proarrhythmic risk of new chemical entities. The high cost of these studies and the shortcomings inherent in these binary and limited approaches to drug evaluation have prompted regulators to search for more cost effective and mechanistic paradigms to assess drug liability as exemplified by the CiPA initiative and the exposure response ICH E14(R3) guidance document. Areas Covered: This review profiles the changing regulatory landscape as it pertains to early drug development and outlines the analyses that can be performed to characterize preclinical and early clinical cardiovascular risk...
October 10, 2016: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/27681456/relationships-between-heart-rate-variability-and-pulse-rate-variability-obtained-from-video-ppg-signal-using-zca
#15
Luca Iozzia, Luca Cerina, Luca Mainardi
In this paper, classical time- and frequency-domain variability indexes obtained by pulse rate variability (PRV) series extracted from video-photoplethysmography signals (vPPG) were compared with heart rate variability (HRV) parameters extracted from ECG signals. The study focuses on the analysis of the changes observed during a rest-to-stand manoeuvre (a mild sympathetic stimulus) performed on 60 young, normal subjects (age: [Formula: see text] years). The objective is to evaluate if video-derived PRV indexes may replace HRV in the assessment of autonomic responses to external stimulation...
September 28, 2016: Physiological Measurement
https://www.readbyqxmd.com/read/27681167/time-and-frequency-domain-analysis-of-beat-to-beat-p-wave-duration-pr-interval-and-rr-interval-can-predict-asystole-as-form-of-syncope-during-head-up-tilt
#16
Gianfranco Piccirillo, Federica Moscucci, Claudia Fiorucci, Claudia Di Iorio, Fabiola Mastropietri, Damiano Magrì
To seek possible differences in short-period temporal RR interval, P-wave and PR interval dispersion and spectral coherence in patients with a head-up tilt test positive for vasovagal syncope with or without prolonged asystole, severe symptoms and at high risk of trauma. We retrospectively reviewed 5 min ECG and blood pressure recordings obtained at baseline, at rest and during head-up tilt in 40 patients diagnosed as having recurrent vasovagal syncope confirmed at a head-up tilt test. We analysed autoregressive spectral power for all the ECG-derived variables, focusing on temporal P-wave and PR interval dispersion indexes as well as their spectral coherence calculated on the same 5 min recordings at rest and during tilt...
November 2016: Physiological Measurement
https://www.readbyqxmd.com/read/27680787/b1-feasibility-of-combined-doppler-ecg-assessment-of-internal-jugular-veins
#17
I Dierickx, S Van Hooland, K Tomsin, D Vanercke, W Cools, H Fransen, W Gyselaers
INTRODUCTION: Studying the venous compartment may add valuable information on background mechanisms and (patho)physiology of the cardiovascular system in normal pregnancies and pregnancies complicated by preeclampsia. Every component of the venous pulse wave is reflecting a specific stage of the cardiac cycle in the right atrium, and can be recognized in the neck veins, the hepatic and the renal veins. Previous studies have demonstrated the repeatability and reproducibility of venous Doppler sonography and venous pulse transit time in renal interlobar and hepatic veins...
August 2016: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27660578/surface-electrocardiogram-predictors-of-sudden-cardiac-arrest
#18
REVIEW
Samy A Abdelghani, Todd M Rosenthal, Daniel P Morin
BACKGROUND: Heart disease is a major cause of death in industrialized nations, with approximately 50% of these deaths attributable to sudden cardiac arrest. If patients at high risk for sudden cardiac arrest can be identified, their odds of surviving fatal arrhythmias can be significantly improved through prophylactic implantable cardioverter defibrillator placement. This review summarizes the current knowledge pertaining to surface electrocardiogram (ECG) predictors of sudden cardiac arrest...
2016: Ochsner Journal
https://www.readbyqxmd.com/read/27621772/12-lead-electrocardiogram-features-of-arrhythmic-risk-a-focus-on-early-repolarization
#19
REVIEW
Caterina Rizzo, Francesco Monitillo, Massimo Iacoviello
The 12-lead electrocardiogram (ECG) is still the most used tool in cardiology clinical practice. Considering its easy accessibility, low cost and the information that it provides, it remains the starting point for diagnosis and prognosis. More specifically, its ability to detect prognostic markers for sudden cardiac death due to arrhythmias by identifying specific patterns that express electrical disturbances of the heart muscle, which may predispose to malignant arrhythmias, is universally recognized. Alterations in the ventricular repolarization process, identifiable on a 12-lead ECG, play a role in the genesis of ventricular arrhythmias in different cardiac diseases...
August 26, 2016: World Journal of Cardiology
https://www.readbyqxmd.com/read/27596512/-a-rare-case-of-chest-pain
#20
Beáta Bodócsi, István Koncz, Zsigmond Hum, Orsolya Serfőző, József Pap-Szekeres, István Szabó
Chest pain is a common symptom in patients who visit Emergency Departments. The main task is to exclude life-threatening diseases such as acute coronary syndrome, pulmonary embolization and dissection of thoracic aorta. The authors present the history of a patient, who had an intense chest pain for 7 hours. In accordance with the diagnostic algorithm of chest pain, ECG, blood collection, chest X-ray and chest computed tomography angiography were performed. Acute coronary syndrome, pulmonary embolization and dissection of the thoracic aorta were excluded, however, chest computed tomography CT revealed a huge hiatal hernia as an incidental finding...
September 2016: Orvosi Hetilap
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