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ECG clinical cases

Jin Li, Dominic Wyrsch, Dik Heg, Michael Stoller, Thomas Zanchin, Tilman Perrin, Stephan Windecker, Lorenz Räber, Laurent Roten
BACKGROUND: The outcome of patients undergoing percutaneous coronary interventions (PCIs) varies considerably. Several ECG parameters have recently emerged (PQ interval, P-wave, T-peak-to-T-end interval, T-wave, T/R ratio, J-wave) beyond traditional markers (rhythm, QRS, Q-wave, QT interval, ST segment) and were attributed important prognostic value in the setting of coronary artery disease. The present study integrated for the first time these ECG parameters altogether with the aim to determine their role in predicting patients' outcome after a PCI...
October 17, 2018: Acta Cardiologica
Amanda Quattrocelli, Janet Lang, Andrew Davis, Andreas Pflaumer
Background: Supraventricular tachycardia is a group of rhythm disturbances that affect 1 in 300-1200 Australian children annually. The differentiation of supraventricular tachycardia (SVT) symptoms and age of onset according to their subtype is not well understood in the pediatric population. Most studies rely on ECG criteria only to characterize the subtype of the SVT, which is not applicable to all subtypes. The purpose of this study was to identify the symptoms and ages of onset of SVT subtypes, and to analyze whether ethnicity or severity correlated with the SVT subtype confirmed in an invasive Electrophysiology (EP) study...
October 2018: Journal of Arrhythmia
Gianluigi Rellini, Rita Piazza, Elvira Loiudice, Matteo Cassin, Guglielmo Bernardi, Daniela Pavan, Eugenio Cervesato, Gian L Nicolosi
AIM: The aim of this study is to report the heterogeneity of clinical presentation in Tako-Tsubo syndrome (TTS), including a significant prevalence of normal ECG and echocardiographic patterns in a series of consecutive patients from a single center. METHODS AND RESULTS: From our database we selected a total of 168 cases of TTS. A total of 140 of these (Group A); 14 men (10%), mean age 60.3 years, range 39-87; 126 women (90%), mean age 66.1 years, range 43-93; matched the following reported criteria: typical stenocardic pain immediately following an emotional acute stress, or acute medical or surgical event within the preceding 12 h; acute rise and fall of troponin release; absence of significant coronary disease at coronary angiography...
October 12, 2018: Journal of Cardiovascular Medicine
Giuseppe Limongelli, Marta Rubino, Augusto Esposito, Mariagiovanna Russo, Giuseppe Pacileo
PURPOSE OF REVIEW: To discuss the risk preexisting or new onset cardiomyopathy/heart failure (CMP/heart failure) in pregnant woman, and recent insights regarding their management and therapy. RECENT FINDINGS: Recent data from the European Registry on Pregnancy and Heart disease of the European Society of Cardiology (ROPAC) suggest that, after an adequate prepregnancy evaluation in specialized centres, the vast majority of pregnancies are safe for both mother and foetus...
October 6, 2018: Current Opinion in Obstetrics & Gynecology
Arindam Bose, Vidyut Jain, Girish Kawthekar, Chandrabala Chhabra, Nanda Hemvani, Dhananjay S Chitnis
Objective: The present study was aimed to establish a threshold value for cardiac troponin I (cTnI) for nonacute coronary syndrome (ACS) participants from the local population and also to determine the importance of serial time point estimation of cTnI in acute myocardial infarction (AMI), non-ST-elevated MI (NSTEMI), and unstable angina cases. Methods: The present study included 194 cases, admitted in ICCU with the complaint of anginal pain; 31 were diagnosed with AMI with typical electrocardiography (ECG) changes; whereas, 48 cases were diagnosed with NSTEMI...
September 2018: Indian Journal of Critical Care Medicine
Andrew Silverman, Sonia Taneja, Liliya Benchetrit, Peter Makusha, Robert L McNamara, Alexander B Pine
A 24-year-old man with history of unspecified arrhythmia presented with palpitations and chest pain. Initial electrocardiogram (ECG) revealed irregular tachycardia with varying QRS width: 150 to 200 beats per minute for narrow complexes and 300 beats per minute for wide complexes. Following cardioversion, ECG revealed sinus tachycardia with a preexcitation pattern of positive delta waves in the anterolateral leads and negative delta waves in inferior leads. The patient remained in sinus rhythm and underwent successful ablation of a right posteroseptal accessory pathway...
January 2018: Journal of Investigative Medicine High Impact Case Reports
Xiqiang Wang, Jingjing Sun, Zhuokun Feng, Yuan Gao, Chaofeng Sun, Guoliang Li
Wellens' syndrome is characterised by particular changes in electrocardiogram (ECG) precordial lead T-waves accompanied by proximal stenosis of the left anterior descending (LAD) artery. Two cases of electrocardiographic changes associated with Wellens' syndrome are presented here. Case 1, a 55-year-old female, was transferred to the First Affiliated Hospital of Xi'an Jiaotong University with intermittent and laborious angina pectoris. Her first ECG on admission revealed T-wave inversion in leads V1-V3 and biphasic T-waves in V4...
October 3, 2018: Journal of International Medical Research
Abdullah Cader, Sheldon M Singh, Mohammad I Zia
Brugada syndrome is typically an autosomal dominant genetic disorder with variable expression, characterized by three specific electrocardiogram (ECG) patterns. While Type I Brugada ECG pattern is used as a classic marker for the disease, it is generally masked from ECG except in special cases such as malaria-induced fever. This vignette highlights a unique clinical scenario that can lead to the unmasking of Brugada type 1 pattern. < Learning objective: Brugada syndrome is associated with ventricular arrhythmias which if left untreated can result in syncope or premature death...
October 2018: Journal of Cardiology Cases
Luca Segreti, Kristian Ujka, Tea Cellamaro, Giulio Zucchelli, Andrea Di Cori, Ezio Soldati, Maria Grazia Bongiorni
An 86-year-old man with unremarkable clinical history complaining of asthenia and dyspnea was diagnosed with low-flow low-gradient aortic stenosis [LFLG-AS; left ventricular ejection fraction (LVEF) 40% and transaortic mean gradient 37 mmHg, increasing to 52% and 55 mmHg after dobutamine infusion]. The patient underwent transcatheter aortic valve implantation (TAVI; Edwards CENTERA™ 29, Irvine, CA, USA). The procedure and the following hospital stay were free from complications, with no changes on electrocardiography (ECG)...
June 2018: Journal of Cardiology Cases
Sokichi Kamata, Toshihiro Funatsu, Yoshito Itou, Toshikatsu Yagihara
Coronary malperfusion associated with aortic dissection usually requires aggressive surgical treatment or catheter revascularization. Here, we report a case of conservatively treated coronary malperfusion associated with acute type A dissection before aortic root replacement. An 81-year-old woman was rushed to our hospital in a state of circulatory shock after developing chest pain. She was severely hypotensive on admission, and the electrocardiogram (ECG) revealed anterior and lateral ST elevation. However, the initial fluid resuscitation increased her blood pressure to a normal level, and the ischemic ECG changes disappeared in about 20 min...
January 2018: Journal of Cardiology Cases
Saagar Sanghvi, Fahad Waqar, Mohamed Effat
The incidence of acute myocardial infarction in the setting of acute pancreatitis is very rare. The recognition of such complex diagnosis may be clinically challenging, as the symptoms of both conditions are often indistinguishable. We report a case in which we encountered both conditions concurrently, and hypothesize that the ambient inflammatory and pro-thrombotic milieu of acute pancreatitis resulted in acute coronary thrombosis despite the absence of significant coronary atherosclerosis. Among multiple coronary imaging modalities currently in use, optimal cohesion tomography provided a unique capability for direct visualization of the coronary thrombus...
September 29, 2018: Journal of Thrombosis and Thrombolysis
Katharina Schramm, Florian Lapert, Juliane Nees, Carlijn Lempersz, S Guid Oei, Markus W Haun, Imad Maatouk, Thomas Bruckner, Christof Sohn, Sarah Schott
PURPOSE: Reduction of maternal morbidity and mortality is a major worldwide objective anchored in the millennium goals of the United Nations. To improve fetal and maternal care, a constant attempt to discover groundbreaking technologies is ongoing. One approach is the enhancement of non-invasive fetal ECG devices. Most importantly, acceptance of new technologies by pregnant women is a prerequisite for successful implementation. METHODS: This questionnaire-based study conducted at the University Hospital Heidelberg, Germany between May and June 2017 evaluates pregnant women's attitudes towards a new device for fetal ECG monitoring and its potential home usage...
September 27, 2018: Archives of Gynecology and Obstetrics
Daniele Muser, Pasquale Santangeli, Joseph B Selvanayagam, Gaetano Nucifora
Ventricular Arrhythmias (VAs) may present with a wide spectrum of clinical manifestations ranging from mildly symptomatic frequent premature ventricular contractions to life-threatening events such as sustained ventricular tachycardia, ventricular fibrillation and sudden cardiac death. Myocardial scar plays a central role in the genesis and maintenance of re-entrant arrhythmias which are commonly associated with SHD such as ischemic heart disease, healed myocarditis and non-ischemic cardiomyopathies. However, the arrhythmogenic substrate may remain unclear in up to 50% of the cases after a routine diagnostic workup comprehensive of 12-lead surface ECG, transthoracic echocardiography and coronary angiography/computed tomography...
September 24, 2018: Current Cardiology Reviews
Ivo Bozovic, Stojan Peric, Jovan Pesovic, Bogdan Bjelica, Milos Brkusanin, Ivana Basta, Marija Bozic, Ivan Sencanic, Ana Marjanovic, Marija Brankovic, Dusanka Savic-Pavicevic, Vidosava Rakocevic-Stojanovic
BACKGROUND: Myotonic dystrophy type 2 (DM2) is a multisystem disorder, mostly presented with mild but heterogeneous spectrum of symptoms. OBJECTIVE: The aim of this research was to provide detailed sociodemographic, clinical and laboratory data of a large DM2 cohort from the Serbian registry. METHODS: In 2008, we started to prospectively enter data of all DM patients. We also retrospectively collected data of patients hospitalized from 1990 until 2008...
September 15, 2018: Journal of Neuromuscular Diseases
Piotr Skrzypczyk, Małgorzata Mizerska-Wasiak, Anna Ofiara, Michał Szyszka, Jagoda Kułagowska, Agnieszka Biejat, Michał Brzewski, Beata Kucińska, Bożena Werner, Małgorzata Pańczyk-Tomaszewska
Thromboembolic complications are found in 2-3% of children with nephrotic syndrome (NS); this increased risk is caused by hypovolemia, hemoconcentration, increased number and activity of platelets, hyperfibrinogenemia and loss of coagulation inhibitors. Risk is even higher in case of additional factors e.g. congenital thrombophilia. CASE REPORT: Girl with NS aged 17 11/12 years was admitted to hospital due to respiratory tract infection with cough and back pain. NS started 9 months earlier and she had two bouts of disease, and was treated only with prednisone (current dose - 60 mg/48h)...
September 21, 2018: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
Waldemar Elikowski, Małgorzata Małek-Elikowska, Monika Lisiecka, Zofia Trypuć, Iwona Mozer-Lisewska
Influenza is associated with a high prevalence of cardiac complications, including myocarditis and exacerbation of ischemic heart disease or heart failure (HF). However, only four cases of stress-induced takotsubo cardiomyopathy (TC), all of them triggered by virus A influenza, have been reported so far. Another two TC cases after anti-influenza vaccination are also available in the literature. The authors describe a new case of TC, this time provoked by influenza B. An 89-year-old female with a history of hypertension and chronic obstructive pulmonary disease (COPD) was admitted due to a fever (39oC), muscle aches and cough...
August 29, 2018: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
Marloes J A Joosen, Steven D Klaassen, Elwin Verheij, Tomas van Groningen, Alex S Cornelissen, Mario H Skiadopoulos, Laura Cochrane, Jeff D Shearer
The efficacy and pharmacokinetics of the aqueous co-formulation contents of the Trobigard™ (atropine sulfate, obidoxime chloride) auto-injector were evaluated in a sarin exposed guinea pig model. Two subcutaneous (sc) sarin challenge doses were evaluated in guinea pigs instrumented with brain and heart electrodes for electroencephalogram (EEG) and electrocardiogram (ECG). Sarin challenge doses were chosen to reflect exposure subclasses with sublethal (moderate to severe clinical signs) and lethal consequences...
September 12, 2018: Chemico-biological Interactions
Jan Albert Nicolaas Groot, Leonore Ten Bokum, Hubertus Laurentius Antonius van den Oever
Background: Fluoxetine is a selective serotonin reuptake inhibitor (SSRI) commonly used in the treatment of depression. While most intoxications with SSRI's have favorable outcomes and do not require interventions other than strict observation of vital signs and heart rhythm, clinicians should be aware of the life-threatening complications that may occur. Case presentation: A 61-year-old woman presented to the emergency department after an intentional multiple drug overdose...
2018: Journal of Intensive Care
Ali-Akbar Hajiaghamohammadi, Mohammad-Mahdi Daee, Ali Zargar, Somayeh Ahmadi-Gooraji, Alfred Rahban, Fereshte Attaran
Background: Cirrhosis as the final stage of progressive fibrosis of liver can affect other organs such as lungs, kidneys and heart. "Cirrhotic cardiomyopathy" involves the electrophysiological abnormalities such as QT interval prolongation. We assessed correlation between corrected QT interval prolongation and severity of cirrhosis based on Child Classification in each ECG lead. Methods: In this case-control study, the patients attending the outpatient clinic and inpatient department of internal medicine of Velayat Hospital in Qazvin were enrolled from September 2014 to July 2015...
2018: Caspian Journal of Internal Medicine
Negin Yaghmaie, Mohammad Ali Maddah-Ali, Herbert F Jelinek, Faezeh Marzbanrad
The advent of telehealth applications and remote patient monitoring has led to an increasing need for continuous signal quality monitoring to ensure high diagnostic accuracy of the recordings. Cardiovascular diseases often manifest electrophysiological anomalies, therefore the Electrocardiogram (ECG) is one of the most used signals for diagnostic applications. Various types of noise and artifacts are not uncommon in ECG recordings and assessing the quality of the signal is essential prior to any clinical interpretation...
September 5, 2018: Physiological Measurement
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