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ECG clinical cases

Sandeep Jha, Rickard Zeijlon, Aaron Shekka Espinosa, Jessica Alkhoury, Jonatan Oras, Elmir Omerovic, Björn Redfors
Takotsubo syndrome (TS) is an increasingly recognized acute heart failure syndrome which is self-limiting in most cases but can result in life-threatening complications. TS is difficult to distinguish from acute myocardial infarction (AMI) early in the disease course and currently lacks evidence-based treatment recommendations. Areas covered: Based on the available literature this systematic review discusses the clinical management of patients with TS during (i) the diagnostic workup; (ii) acutely after establishing the TS diagnosis; and (iii) after recovery of cardiac function...
December 4, 2018: Expert Review of Cardiovascular Therapy
Sushil A Luis, Nandan S Anavekar, Peter C Spittell, Krishnaswamy Chandrasekaran
We present the case of a 26-year-old female restrained front-seat passenger who presents following a motor vehicle accident, with CT angiogram features suggestive of possible acute aortic injury. However, clinical features including relative hemodynamic stability and absence of typical symptoms were discordant with these imaging findings. This case illustrates that even with ECG-gating, CT angiogram artifact mimicking acute aortic injury may still occur. Careful evaluation and clinical correlation is of vital importance, both to ensure acute aortic injury is not missed and that patients are not erroneously sent for aortic surgery when there is no aortic injury...
December 4, 2018: Echocardiography
Aleksander Kosmala, Bernhard Petritsch, Andreas Max Weng, Thorsten Alexander Bley, Tobias Gassenmaier
OBJECTIVES: To assess radiation dose and image quality of coronary computed tomography angiography (cCTA) with a third-generation dual-source scanner in a real-world patient population. METHODS: Scans of otherwise unselected, consecutive patients referred for clinically indicated cCTA between June 2015 and November 2017 were included for retrospective analysis. Scan protocol was based on heart rate: prospectively ECG-gated high-pitch spiral below 60 beats per minute (bpm), prospectively ECG-gated sequential scan between 61 and 70 bpm, and retrospective spiral above 70 bmp or at irregular heart rates...
November 30, 2018: European Radiology
Enes Elvin Gul, Sohaib Haseeb, Osama Al Amoudi, Adrian Baranchuk
Brugada phenocopies (BrP) are clinical entities that are characterized by ECG patterns identical to those of Brugada syndrome, but are the result of various clinical conditions. We describe the case of a 41-year-old male who exhibited BrP due to a left ventricular aneurysm in the context of chronic coronary artery disease.
November 2018: Journal of Electrocardiology
T Lossau, H Nickisch, T Wissel, R Bippus, H Schmitt, M Morlock, M Grass
Excellent image quality is a primary prerequisite for diagnostic non-invasive coronary CT angiography. Artifacts due to cardiac motion may interfere with detection and diagnosis of coronary artery disease and render subsequent treatment decisions more difficult. We propose deep-learning-based measures for coronary motion artifact recognition and quantification in order to assess the diagnostic reliability and image quality of coronary CT angiography images. More specifically, the application, steering and evaluation of motion compensation algorithms can be triggered by these measures...
November 15, 2018: Medical Image Analysis
Y D Li, Maimaitimin Maimaitiabudula, X H Zhou, Y M Lu, J H Zhang, Q Xing, B P Tang
Objective: Present study analyzed the association betwen the postassium voltage-gated channel KQT-like subfamily member 1 gene (KCNQ1) mutation and the clinical and the electrocardiographic features in 2 pedigrees with congenital long QT syndrome type 1 (LQT1) in Xinjiang Uygur Autonomous Region. Methods: Three family members were diagnosed as LQT1 patients in 2 Uygur congenital LQT1 families, these 3 LQT1 patients served as long QT group, 24 Uygur healthy volunteers served as control group. Electrocardiogram (ECG) and the gene detection were applied to compare the ECG and molecular genetic features between the long QT group and control group, and to explore the relationship between the KCNQ1 gene mutation and the clinical and the electrocardiographic features in these 2 families with congenital long QT syndrome type 1...
November 24, 2018: Zhonghua Xin Xue Guan Bing za Zhi
Benedetta Pambianco, Agnese Sbrollini, Ilaria Marcantoni, Micaela Morettini, Sandro Fioretti, Laura Burattini
Respiration rate and variability are indicators of health-condition changes. In chronic disease management, it is becoming increasingly desirable to use wearable devices in order to minimize invasiveness and maximize comfort. However, not all wearable devices integrate sensors for direct acquisition of respiratory (DAR) signal. In these cases, the breathing extraction can be done through indirect methods, typically from the electrocardiogram (ECG). The aim of the present study is to propose a single-ECG-lead procedure based on the Segmented-Beat Modulation Method (SBMM) as a suitable tool for ECG-derived respiratory (EDR) signal estimation and respiration frequency (RF) identification...
July 2018: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
Qinghai Wang, Yinghui Shang, Shicheng Li, Yanxiang Wu, Chenyu Wang, Xiaowei Yan
RATIONALE: Complete heart block (CHB) is a common clinical manifestation. Systemic sclerosis (SSc) is a rare etiology of CHB that has not received enough attention. Whether pacemaker implantation is required remains inconclusive, especially when patients have no symptoms or mild symptoms of CHB. PATIENT CONCERNS: In this study, we report the case of a 48-year-old Chinese male who suffers from SSc and CHB. DIAGNOSE: The patient was previously diagnosed with left anterior hemiblock (LAHB) and right bundle block with normal heart function...
November 2018: Medicine (Baltimore)
Syed Ghufran Khalid, Jufen Zhang, Fei Chen, Dingchang Zheng
Introduction: Blood pressure (BP) has been a potential risk factor for cardiovascular diseases. BP measurement is one of the most useful parameters for early diagnosis, prevention, and treatment of cardiovascular diseases. At present, BP measurement mainly relies on cuff-based techniques that cause inconvenience and discomfort to users. Although some of the present prototype cuffless BP measurement techniques are able to reach overall acceptable accuracies, they require an electrocardiogram (ECG) and a photoplethysmograph (PPG) that make them unsuitable for true wearable applications...
2018: Journal of Healthcare Engineering
Kamil Gulsen, Orhan Ince, Gokmen Kum, Flora Ozkalayci, Irfan Sahin, Ertugrul Okuyan
BACKGROUND: Fragmented QRS evaluated in 12-derivation electrocardiography has widely been accepted as a sign of myocardial fibrosis. The prognostic value of that marker has been demonstrated, particularly, in cardiac diseases that accompany myocardial scar and fibrosis. Myocardial fibrosis is also an issue in patients with aortic stenosis. In this study, we wanted to determine whether fragmented QRS could predict all-cause mortality in aortic stenosis patients after transcatheter aortic valve replacement (TAVR)...
November 7, 2018: Annals of Noninvasive Electrocardiology
Ilsa L Haeusler, Xin Hui S Chan, Philippe J Guérin, Nicholas J White
BACKGROUND: Several quinoline and structurally related antimalarial drugs are associated with cardiovascular side effects, particularly hypotension and electrocardiographic QT interval prolongation. A prolonged QT interval is a sensitive but not specific risk marker for the development of Torsade de Pointes-a potentially lethal polymorphic ventricular tachyarrhythmia. The increasing use of quinoline and structurally related antimalarials in mass treatments to eliminate malaria rapidly highlights the need to review their cardiovascular safety profiles...
November 7, 2018: BMC Medicine
Jonathan R Skinner, Annika Winbo, Dominic Abrams, Jitendra Vohra, Arthur A Wilde
Forty per cent (40%) of sudden unexpected natural deaths in people under 35 years of age are associated with a negative autopsy, and the cardiac ion channelopathies are the prime suspects in such cases. Long QT syndrome (LQTS), Brugada syndrome (BrS) and catecholaminergic polymorphic ventricular tachycardia (CPVT) are the most commonly identified with genetic testing. The cellular action potential driving the heart cycle is shaped by a specific series of depolarising and repolarising ion currents mediated by ion channels...
October 4, 2018: Heart, Lung & Circulation
Tayfun Kara, Ajda Mutlu Mıhçıoğlu, Semra Yılmaz, İsmail Akaltun
OBJECTIVE: Many children diagnosed with attention-deficit/hyperactivity disorder are treated with methylphenidate (MPH). The purpose of this study was to evaluate the relationship between long-term use of osmotic-release oral system methylphenidate (OROS MPH) and cardiac functions. METHODS: The study involved 116 subjects 6-18 years of age. Fifty-eight of these were in the case group and were using OROS MPH (extended-release capsules). Fifty-eight children not receiving treatment were included in the control group...
November 2, 2018: Journal of Child and Adolescent Psychopharmacology
Jan Nedoma, Stanislav Kepak, Marcel Fajkus, Jakub Cubik, Petr Siska, Radek Martinek, Petr Krupa
The publication presents a comparative study of two fibre-optic sensors in the application of heart rate (HR) and respiratory rate (RR) monitoring of the human body. After consultation with clinical practitioners, two types of non-invasive measuring and analysis systems based on fibre Bragg grating (FBG) and fibre-optic interferometer (FOI) have been designed and assembled. These systems use probes (both patent pending) that have been encapsulated in the bio-compatible polydimethylsiloxane (PMDS). The main advantage of PDMS is that it is electrically non-conductive and, as well as optical fibres, has low permeability...
October 31, 2018: Sensors
Annemarie B Docherty, Shirjel Alam, Anoop S Shah, Alastair Moss, David E Newby, Nicholas L Mills, Simon J Stanworth, Nazir I Lone, Timothy S Walsh
PURPOSE: To establish the incidence of myocardial infarction (MI) in ICU patients with co-existing cardiovascular disease (CVD), and explore its association with long-term survival. METHODS: In a multi-centre prospective cohort study in 11 UK ICUs, we enrolled 273 critically ill patients with co-existing CVD. We measured troponin I (cTnI) with a high sensitivity assay for 10 days; ECGs were carried out daily for 5 days and analysed by blinded cardiologists for dynamic changes...
October 29, 2018: Intensive Care Medicine
Francesco Santoro, Thomas Stiermaier, Francesca Guastafierro, Nicola Tarantino, Ingo Eitel, Natale Daniele Brunetti
Standard pharmacological therapy in Takotsubo syndrome (TTS) is still debated and there is a lack of prospective data. In their recent work in BMC Cardiovascular Disorders Abanador-Kamper et al. found that stroke in TTS has an event rate of 2.8% after 30 days and 4.2% after 12 months and they question which patients need oral anticoagulation. According to our clinical data, TTS patients with LV thrombi may be at high risk of stroke. These patients are characterized by apical ballooning pattern, high prevalence of ST-elevation and higher troponin I levels...
October 29, 2018: BMC Cardiovascular Disorders
Waldemar Elikowski, Małgorzata Małek-Elikowska, Natalia Fertała, Magdalena Zawodna, Alina Baszko, Zofia Trypuć
The term takotsubo syndrome (TTS) is derived from a comparison of left ventricular (LV) appearance in its apical form to the shape of the pot which is a trap used for octopus catching. In the classical animal model on rats, its occurrence can be triggered by experimental immobilization (IMO). Former observations of capture myopathy, seen in animals after extreme exertion, showed coexistence of rhabdomyolysis related to skeletal muscle injury and myocardial damage. The authors describe a case of a 66-year-old obese female in whom TTS was triggered by an uncommonly stressful event when she had been trapped in the bathtub for several hours...
October 29, 2018: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
N S Krylova, E A Kovalevskaya, N G Poteshkina, D V Titov, A E Vanyukov, E A Mershina, V E Sinitsin
A clinical case of apical hypertrophic cardiomyopathy (HCM) in 44‑years old man is presented. In this patient exercise ECG testing and 24‑hour ECG monitoring revealed exercise-induced ST depression in the angiographically confirmed absence of coronary atherosclerosis. The uncommonness of this observation was the combination of HCM with a rare anomaly of coronary arteries origin.
June 2018: Kardiologiia
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
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