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John P Martin-Beaulieu, Karen M Myrick, Thomas Martin, Rachel W Pata, Richard S Feinn
Electrocardiographic changes can be present in marathon runners. These findings may be misinterpreted as malignant by healthcare providers. For example, incomplete right bundle branch block, early ventricular repolarization, and left ventricular hypertrophy by voltage criteria alone are quite common in athletes, yet considered benign.
October 2016: Clinical Case Reports
Jyh-Ming Jimmy Juang, Minoru Horie
In 1992, the Brugada syndrome (BrS) was recognized as a disease responsible for sudden cardiac death, characterized by a right bundle-branch block with ST segment elevation in the leads V1 and V2. This syndrome is highly associated with sudden cardiac death, especially in young males. BrS is currently diagnosed in patients with ST-segment elevation showing type 1 morphology ≥ 2 mm in ≥1 leads among the right precordial leads V1 or V2 positioned in the 2nd, 3rd, or 4th intercostal space, and occurring either spontaneously or after a provocative drug test by the intravenous administration of Class I antiarrhythmic drugs...
October 2016: Journal of Arrhythmia
Sanjeev K Singh, Shripad B Deshpande
OBJECTIVE: Intra-arterial injection of Mesobuthus tamulus (BT) venom produces reflex vasosensory responses modulating cardiorespiratory parameters in albino rats. The present study was conducted to understand the role of kinin receptors in modulating vasosensory reflexes evoked by BT venom. MATERIALS AND METHODS: In urethane-anesthetized rats, tracheostomy was performed to keep the airway patent. The femoral artery was cannulated proximally, as well as distally, to record the blood pressure (BP) and to inject the chemicals, respectively...
July 2016: Indian Journal of Pharmacology
Tomomichi Ishizaka, Yu Yoshimatsu, Yu Maeda, Wataru Takasaki, Katsuyoshi Chiba, Kazuhiko Mori
INTRODUCTION: Load-independent cardiac parameters obtained from the ventricular pressure-volume relationship are recognized as gold standard indexes for evaluating cardiac inotropy.In this study, for better analyses of cardiac risks, load-independent pressure-volume loop parameters were assessed in addition to load-dependent inotropic, hemodynamic and electrocardiographic changes in isoflurane-anesthetized monkeys. METHODS: The animals were given milrinone (a PDE 3 inhibitor), metoprolol (a β-blocker), or dl-sotalol (a β+IKr blocker) intravenously over 10min at two dose levels including clinically relevant doses (n=5/drug)...
October 15, 2016: Journal of Pharmacological and Toxicological Methods
Mojtaba Farjam, Hossein Bahrami, Ehsan Bahramali, Javad Jamshidi, Alireza Askari, Habibollah Zakeri, Reza Homayounfar, Hossein Poustchi, Reza Malekzadeh
BACKGROUND: Non-communicable diseases (NCDs) have become the main causes of morbidity and mortality even in rural areas of many developing countries, including Iran. In view of this increased risk, Fasa Cohort Study (FACS) has been established to assess the risk factors for NCDs with the ultimate goal of providing optimal risk calculators for Iranian population and finding grounds for interventions at the population level. METHODS: In a population-based cohort, at least 10,000 people within the age range of 35 to 70 years old from Sheshdeh, the suburb of Fasa city and its 24 satellite villages are being recruited...
October 18, 2016: BMC Public Health
Patrizia Salice, Mario Giovanni Bianchetti, Alessandra Giavarini, Erica Gondoni, Riccardo Cavalli, Anna Maria Colli, Federico Lombardi
Propranolol is becoming the treatment of choice for complicated infantile hemangioma. We report here data on peripheral blood flow, O2-saturation, electrocardiographic PR-interval, left ventricular function, blood pressure and heart rate that were assessed before and during treatment for ≥4 weeks with propranolol 2 mg/kg of body weight daily in 67 infants <12 months of age in normal sinus rhythm and with structurally normal hearts. Management with propranolol was well tolerated in all and did not modify peripheral blood flow, O2-saturation, electrocardiographic PR-interval and left ventricular fractional shortening or ejection fraction...
October 19, 2016: Pharmacology
Massimo Salvetti, Anna Paini, Claudia Agabiti Rosei, Deborah Stassaldi, Fabio Bertacchini, Giulia Rubagotti, Giulia Maruelli, Laura Verzeri, Carlotta Donini, Maria Lorenza Muiesan, Enrico Agabiti Rosei
OBJECTIVE: The recent results of the SPRINT study suggest that "intensive" reduction of systolic blood pressure (BP) (to less than 120 mmHg) might provide greater cardiovascular protection as compared to less intensive (< 140 mmHg) reduction of BP, at least in some subsets of patients. Only few studies, have investigated the possible effect of tight blood pressure control on indices of left ventricular hypertrophy, and have been mainly based on electrocardiography. Aim of our study was to evaluate cardiac organ damage according to "on treatment" blood pressure values in a large cohort of hypertensive patients undergoing echocardiography (2D, M-mode with conventional and tissue Doppler analysis)at the echo-lab of an ESH Excellence Centre in Italy...
September 2016: Journal of Hypertension
Josep Redon
The ESH-ESC Guidelines published in 2007 stated that "Further emphasis has been given to identification of target organ damage, since hypertension-related subclinical alterations in several organs indicate progression in the cardiovascular disease continuum which markedly increases the risk beyond that caused by the simple presence of risk factors" Several studies have shown that the regression of asymptomatic TOD occurring during treatment reflects the treatment-induced reduction of morbid and fatal CV events, thereby offering valuable information on whether patients are more or less effectively protected by the treatment strategies adopted...
September 2016: Journal of Hypertension
James Sharman
Millions of clinical exercise stress tests are conducted annually worldwide. The fundamental rationale underlying the conduct of these tests is that cardiovascular irregularities may be revealed during an exercise bout that would otherwise remain unnoticed if testing was only conducted under resting conditions. In order to reveal electrocardiographic abnormalities indicative of cardiac disease, maximal intensity exercise may need to be undertaken, whereas the presence of hypertension can be revealed by the blood pressure response at low to moderate intensity exercise...
September 2016: Journal of Hypertension
Onur Kaypakli, Mevlüt Koç, Gökhan Gözübüyük, Durmuş Yıldıray Şahin
AIM: CRT was shown to improve HF prognosis. But many patients do not benefit from CRT. Optimization of LV lead position to the latest activated LV area is important to increase CRT response. We aimed to detect the relationship between LV lead sensing delay and echocardiographic and electrocardiographic response to CRT treatment. METHODS: We prospectively included 156 consecutive patients with HF diagnosis, QRS≥120 ms, LBBB, NYHA II-IV, LVEF<35% and scheduled for CRT (100 male, 56 female; mean age 65...
October 18, 2016: Pacing and Clinical Electrophysiology: PACE
Shai Tejman-Yarden, Bruria Ben-Zeev, Yuval Goldshmit, Georgia Sarquella-Brugada, Assi Cicurel, Uriel Katz, David Mishali, Michael Glikson
BACKGROUND: Pacing can be a successful treatment for pallid breath-holding spells, primarily in individuals with severe bradycardia. PATIENT DESCRIPTION: We describe an 18-month-old girl experiencing severe pallid breath-holding spells in whom repeated electrocardiographic, Holter, and electroencephalographic monitoring tests were all normal. RESULTS: Using a subcutaneous insertable cardiac monitor, severe bradycardia was detected during one of this girl's episodes...
June 25, 2016: Pediatric Neurology
Juliana Filgueiras Medeiros, Fábio Martins Nardo-Botelho, Lara Cristina Felix-Bernardes, Lucas Hollanda-Oliveira, Lucas Bassolli de Oliveira-Alves, Ênia Lúcia-Coutinho, Cristiano Dietrich, Adriano Caixeta, Jose Marconi Almeida-de-Sousa, Ântonio Carlos-Carvalho, Cláudio Cirenza, Ângelo Amato Vicenzo-de-Paola
BACKGROUND AND AIMS: Atrioventricular nodal reentrant tachycardia (AVNRT) is the most common form of paroxysmal supraventricular tachycardia (SVT) whose diagnosis can be strongly suspected based on the surface eletrocardiogram alone. The purpose of this study is to determine the diagnostic accuracy of several electrocardiographic (ECG) criteria for the prediction of AVNRT. METHODS: Between November 2010 and January 2014, a total of 256 patients who underwent electrophysiological testing (EP) with regular, paroxysmal and narrow QRS complex tachycardia were prospectively enrolled...
July 2016: Archives of Medical Research
Mayuresh Chaudhari, Sonu Sharma, Rajesh Kumar Jha, Ramandeep Singh Ahuja, Sandeep Bansal
Primary varicella infection in an immunocompetent young adult is very rare, but it has a high mortality rate due to serious complications. We report a rare association of varicella pneumonia presenting in acute respiratory distress with mild chest pain, however with electrocardiographic and biochemical markers suggestive of acute ST elevation myocardial infarction. Coronary angiography was done to exclude infarction, serum antibody titers confirmed varicella, acyclovir was started, and ARDS was successfully treated with steroid pulse therapy and mechanical ventilator support...
September 2016: Indian Heart Journal
Fatih Sen, Ozcan Ozeke, Ozgur Kirbas, Cengiz Burak, Habibe Kafes, Bahar Tekin Tak, Umran Ozdamar, Kadir Ocak, Serkan Topaloglu, Dursun Aras
Prediction of left main coronary artery (LMCA) or equivalent disease is important with regard to selecting the appropriate treatment strategy. The classical electrocardiographic pattern of LMCA disease includes ST elevation (STE) in lead aVR in the presence of extensive ST depression (most prominent in leads I, II, and V4-6) with the STE in aVR≥V1. Patients with these findings may potentially require early coronary angiography and coronary bypass surgery; therefore selected patients with these findings on exercise testing might benefit from more urgent or expedited angiography...
September 2016: Indian Heart Journal
Priccila Zuchinali, Gabriela C Souza, Maurício Pimentel, Diego Chemello, André Zimerman, Vanessa Giaretta, Joyce Salamoni, Bianca Fracasso, Leandro I Zimerman, Luis E Rohde
Importance: The presumed proarrhythmic action of caffeine is controversial. Few studies have assessed the effect of high doses of caffeine in patients with heart failure due to left ventricular systolic dysfunction at high risk for ventricular arrhythmias. Objective: To compare the effect of high-dose caffeine or placebo on the frequency of supraventricular and ventricular arrhythmias, both at rest and during a symptom-limited exercise test. Design, Setting, and Participants: Double-blinded randomized clinical trial with a crossover design conducted at the heart failure and cardiac transplant clinic of a tertiary-care university hospital...
October 17, 2016: JAMA Internal Medicine
Charlayne McStay, Richard Pierce, Carley Riley
Zonisamide is a sulfonamide drug used primarily for the treatment of partial seizures in adults. We describe the case of a 15-year-old woman with a mood disorder who survived without complications after ingestion of an estimated 7.5 g of zonisamide. To the best of our knowledge, there are 4 case reports of individuals with intentional ingestion of more than 4 g of zonisamide as a single agent. Our patient developed coma and hypotension 4 hours after ingestion and was treated with a catecholamine infusion, endotracheal intubation, and mechanical ventilation...
September 30, 2016: Pediatric Emergency Care
Agnieszka Wsol, Wioletta Wydra, Marek Chmielewski, Andrzej Swiatowiec, Marek Kuch
BACKGROUND: A retrospective study was designed to investigate P-wave duration changes in exercise stress (EST) test for the prediction of angiographically documented substantial coronary artery disease (CAD). METHODS: We analyzed 265 cases of patients, who underwent EST and subsequently coronary angiography. Analysis of P-wave duration was performed in leads II, V5 at rest, and in the recovery period. RESULTS: The sensitivity and specificity for the isolated ST-segment depression were only 31% and 76%, respectively...
October 17, 2016: Cardiology Journal
Santhosh R Devarapally, Sameer Arora, Ali Ahmad, Mike Sood, Amaar El Sergany, Terrence Sacchi, Barry Saul, Rahul Gaglani, John Heitner
BACKGROUND: Right ventricular (RV) failure has proven to be independently associated with adverse outcomes. Electrocardiographic parameters assessing RV function are largely unknown, making echocardiography the first line for RV function assessment. It is however, limited by geometrical assumptions and is inferior to cardiac magnetic resonance imaging (CMRI) which is widely regarded as the most accurate tool for assessing RV function. METHODS: We seek to determine the correlation of ECG parameters of right bundle branch block (RBBB) with RV ejection fraction (EF) and RV dimensions using the CMRI...
October 2016: Cardiovascular Diagnosis and Therapy
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
Ivan Co, Wesley Eilbert, Terry Chiganos
BACKGROUND: The electronic medical record is a relatively new technology that allows quick review of patients' previous medical records, including previous electrocardiograms (ECGs). Previous studies have evaluated ECG patterns predictive of pulmonary embolism (PE) at the time of PE diagnosis, though none have examined ECG changes in these patients when compared with their previous ECGs. OBJECTIVE: Our aim was to identify the most common ECG changes in patients with known PE when their ECGs were compared with their previous ECGs...
October 11, 2016: Journal of Emergency Medicine
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