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https://www.readbyqxmd.com/read/27920726/hrvanalysis-a-free-software-for-analyzing-cardiac-autonomic-activity
#1
Vincent Pichot, Frédéric Roche, Sébastien Celle, Jean-Claude Barthélémy, Florian Chouchou
Since the pioneering studies of the 1960s, heart rate variability (HRV) has become an increasingly used non-invasive tool for examining cardiac autonomic functions and dysfunctions in various populations and conditions. Many calculation methods have been developed to address these issues, each with their strengths and weaknesses. Although, its interpretation may remain difficult, this technique provides, from a non-invasive approach, reliable physiological information that was previously inaccessible, in many fields including death and health prediction, training and overtraining, cardiac and respiratory rehabilitation, sleep-disordered breathing, large cohort follow-ups, children's autonomic status, anesthesia, or neurophysiological studies...
2016: Frontiers in Physiology
https://www.readbyqxmd.com/read/27914889/ventricular-tachycardia-and-prolonged-qt-interval-presenting-as-seizure-like-activity-a-case-report
#2
Max Wentlandt, Stephen C Morris, Steven H Mitchell
Seizures can be difficult to distinguish from other causes of transient cerebral hypoxia in the emergency room. We present a case of seizure activity in a woman in whom EKG led to a diagnosis of intermittent monomorphic and polymorphic ventricular tachycardia (torsades de pointes), highlighting the need for careful consideration of alternative causes of seizures, even in patients with known epilepsy.
November 22, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27889211/takotsubo-cardiomyopathy-associated-with-epinephrine-use-a-systematic-review-and-meta-analysis
#3
Salik Nazir, Saroj Lohani, Niranjan Tachamo, Sushil Ghimire, Dilli Ram Poudel, Anthony Donato
BACKGROUND: Takotsubo cardiomyopathy is a syndrome of transient cardiac dysfunction that is frequently associated with sudden emotional or physical stress. Epinephrine use has been implicated in precipitating Takotsubo cardiomyopathy in multiple case reports and case series. We sought to systematically review the current English literature on this association. METHODS: We searched relevant articles on Takotsubo cardiomyopathy associated with epinephrine administration and extracted data on demographic characteristics, clinical features, investigations and clinical outcomes...
November 22, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27875636/evaluation-of-coronary-artery-disease-in-potential-liver-transplant-recipients
#4
REVIEW
Brian J Hogan, Enoka Gonsalkorala, Michael A Heneghan
Improvements in the management of patients undergoing Liver Transplantation (LT) have resulted in a significant increase in survival over recent years. Cardiac disease is now the leading cause of early mortality and the stress of major surgery, haemodynamic shifts, the possibility of haemorrhage or reperfusion syndrome require the recipient to have good baseline cardiac function. The prevalence of coronary artery disease (CAD) is increasing in liver transplant candidates, especially in those with Non-Alcohol related Fatty Liver Disease (NAFLD)...
November 22, 2016: Liver Transplantation
https://www.readbyqxmd.com/read/27813028/the-role-of-serial-fdg-pet-for-assessing-therapeutic-response-in-patients-with-cardiac-sarcoidosis
#5
Pei-Ing Lee, Gang Cheng, Abass Alavi
BACKGROUND: The purpose of this study was to determine the feasibility of serial quantitative 2-deoxy-2-[18F]fluoro-D-glucose (FDG) positron emission tomography (PET) to monitor the response of cardiac sarcoidosis to treatment. METHODS AND RESULTS: A total of 38 PET scan intervals (54 PET scans) were obtained in 16 patients with cardiac sarcoidosis who underwent serial FDG PET during treatment. FDG-avid lesions of the heart were interpreted quantitatively using 4 PET parameters: maximum standardized uptake value (SUVmax), partial volume corrected mean standardized uptake value (SUVmean), partial volume corrected metabolic volume product (MVP), and global metabolic volume product (gMVP)...
November 3, 2016: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
https://www.readbyqxmd.com/read/27805591/transthoracic-speckle-tracking-echocardiography-for-the-quantitative-assessment-of-left-ventricular-myocardial-deformation
#6
Kai O Hensel, Lucia Wilke, Andreas Heusch
The value of conventional echocardiography is limited by differences in inter-individual image interpretation and therefore largely dependent on the examiners' expertise. Speckle tracking Echocardiography (STE) is a promising but technically challenging method that can be used to quantitatively assess regional and global systolic and diastolic myocardial performance. Myocardial strain and strain rate can be measured in all three dimensions - radial, circumferential, longitudinal - of myocardial deformation...
October 20, 2016: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/27804168/the-fifth-takotsubo-variant
#7
Paul G Bridgman, Christina W Chan
We document the fifth pattern of takotsubo cardiomyopathy, in which the mid-LV is hyperdynamic but the apex and base are akinetic or hypokinetic. This is a reverse mid-ventricular takotsubo. The patient is a 79-year-old woman admitted with chest pain and initially a normal EKG. Her troponin I rose to 5.4 μg/L (0.02-0.03 μg/L) and she developed QT prolongation and widespread T-wave inversion. Coronary angiography showed only very mild atheroma. Follow-up echocardiogram six weeks later showed normal left ventricular function...
November 2, 2016: Echocardiography
https://www.readbyqxmd.com/read/27801921/a-case-of-ileus-and-st-segment-elevation
#8
Osama Siddique, Somwail Rasla, Seth Clark, Aravind Kokkirala
ST segment elevation is associated with non-cardiac pathologies but is not as well reported as myocardial infarction. We present a case of a 63-year-old man who was admitted for an overdose on cyclobenzaprine with signs of anti-cholinergic toxicity. He developed signs of ileus on imaging and became progressively obtunded. He was noted to have ST segment elevations on electrocardiogram (EKG) with no troponin elevation. Patient required urgent catheterization which showed normal coronary arteries. His bowel was decompressed subsequently resulting in resolution of the ST segment changes...
November 1, 2016: Rhode Island Medical Journal
https://www.readbyqxmd.com/read/27756556/silent-atrial-fibrillation-and-cryptogenic-strokes
#9
REVIEW
James E Dalen, Joseph S Alpert
A new suspected cause of cryptic strokes is "silent atrial fibrillation." Pacemakers and other implanted devices allow continuous recording of cardiac rhythm for months or years. They have discovered that short periods of atrial fibrillation lasting minutes or hours are frequent and usually are asymptomatic. A meta-analysis of 50 studies involving more than 10,000 patients with a recent stroke found that 7.7% had new atrial fibrillation on their admitting electrocardiogram. In 3 weeks during and after hospitalization, another 16...
October 15, 2016: American Journal of Medicine
https://www.readbyqxmd.com/read/27754006/js-ish-esh-2-update-on-the-detection-and-follow-up-of-early-hypertensive-heart-disease
#10
Enrico Agabiti Rosei
Current Hypertension Guidelines emphasize the importance of assessing the presence of preclinical organ damage. In fact, an extensive evaluation of organ damage may increase the number of patients classified at high CV risk and therefore strongly influence the clinical management of patients. Hypertensive heart disease remains to date the form of organ damage for which there is the greatest amount of evidence of a strong independent prognostic significance. In the presence of a chronic pressure overload, a parallel addition of sarcomers takes place with an increase in myocyte width, which in turn increases left ventricular wall thickness; myocyte hypertrophy is also associated with apoptosis, collagen deposition and ventricular fibrosis with an impairment of coronary hemodynamics as well, thus profoundly influencing functional properties of the left (and right) ventricle...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27742420/acute-myocarditis-and-st-segment-elevation
#11
Muhammad Shahid, Edward Hoey, Sandeep Basavarajaiah
We report a case of focal myocarditis in a young boy mimicking acute ST-segment elevation MI. He presented with chest pain and the EKG changes were consistent with infero-laeral ST-segment elevation MI. Coronary angiogram revealed smooth arteries with no obstruction. Troponin was significantly elevated and the echocardiogram exhibited mildly impaired LV function with hypokinetic inferior and lateral walls. Subsequently performed cardiac magnetic resonance imaging confirmed the diagnosis of myocarditis by exhibiting classic features of delayed gadolinium enhancement in the epi and mid-myocardial regions of the lateral wall sparing the sub-endocardial region...
August 24, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/27725296/dural-traction-a-possible-cause-of-hemodynamic-changes-during-single-level-transforaminal-lumbar-interbody-fusion
#12
Jonathan M Weimer, Martin Marinov, Rafi Avitsian
A 58-year old male with grade II L4-L5 spondylolisthesis and degenerative changes presented for single level transforaminal lumbar interbody fusion. During decompression of the L4 foramina, distraction of the disc space, and placement of the interbody cage and pedicle screws, episodes of extreme bradycardia with up to 5 seconds of asystole were detected on both EKG and invasive hemodynamic monitoring. The events correlated with and could possibly be a result of traction on the dura. Lumbar spinal surgery may be associated with electrophysiological and hemodynamic abnormalities, and anesthesia providers should be aware of such possibilities and the need to respond appropriately with sympathomimetic or vagolytic interventions...
October 7, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27706873/hot-off-the-press-the-use-of-very-low-concentrations-of-high-sensitivity-troponin-t-to-rule-out-acute-myocardial-infarction-using-a-single-blood-test
#13
Corey Heitz, Justin Morgenstern, William K Milne
This prospectively planned, secondary analysis of data from a large multi-center trial evaluated the diagnostic characteristics of using hs-cTnT levels below the level of detection (LoD), along with EKG findings, to rule out AMI on presentation to the ED. The primary outcome was diagnosis of AMI and the secondary outcome was major adverse cardiac events (MACE) within 30 days. A total of 1,282 patients were included in the study, 16.6% of which were diagnosed with AMI at the index visit. This article is protected by copyright...
October 5, 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/27698507/case-study-of-fatal-stroke-following-intranasal-lidocaine
#14
Daniel L Moellentin, Dale Stewart, James Barbour
A 39-year-old man presented with new onset right hemiparesis and aphasia within an hour of using approximately 120 mL lidocaine 4% topical solution intranasally. Lidocaine had been prescribed over a 3-week period for pain due to multiple debridements of the nasal septum. A total of 650 mL of 4% lidocaine (26 g) had been dispensed to the patient during this time. The patient had a significant history of drug abuse, including snorting crushed tablets. Otherwise he was a healthy man with no chronic diseases or conditions...
September 2016: Hospital Pharmacy
https://www.readbyqxmd.com/read/27688678/all-that-looks-like-brugada-is-not-brugada-case-series-of-brugada-phenocopy-caused-by-hyponatremia
#15
Yashwant Agrawal, Sourabh Aggarwal, Jagadeesh K Kalavakunta, Vishal Gupta
Brugada syndrome (BS), a life-threatening channelopathy associated with reduced inward sodium current due to dysfunctional sodium channels, is characterized by ST-segment elevation with downsloping "coved type" (type 1) or "saddle back" (type 2) pattern in V1-V3 precordial chest leads (1, 2). Brugada phenocopy, a term describing conditions inducing Brugada-like pattern of electrocardiogram (EKG) manifestations in patients without true BS, is an emerging condition (3). We describe a case series of Brugada phenocopy with hyponatremia...
October 2016: Journal of the Saudi Heart Association
https://www.readbyqxmd.com/read/27663867/a-neural-marker-of-medical-visual-expertise-implications-for-training
#16
Liam Rourke, Leanna C Cruikshank, Larissa Shapke, Anthony Singhal
Researchers have identified a component of the EEG that discriminates visual experts from novices. The marker indexes a comprehensive model of visual processing, and if it is apparent in physicians, it could be used to investigate the development and training of their visual expertise. The purpose of this study was to determine whether a neural marker of visual expertise-the enhanced N170 event-related potential-is apparent in the EEGs of physicians as they interpret diagnostic images. We conducted a controlled trial with 10 cardiologists and 9 pulmonologists...
September 23, 2016: Advances in Health Sciences Education: Theory and Practice
https://www.readbyqxmd.com/read/27642917/js-ish-esh-2-update-on-the-detection-and-follow-up-of-early-hypertensive-heart-disease
#17
Enrico Agabiti Rosei
Current Hypertension Guidelines emphasize the importance of assessing the presence of preclinical organ damage. In fact, an extensive evaluation of organ damage may increase the number of patients classified at high CV risk and therefore strongly influence the clinical management of patients. Hypertensive heart disease remains to date the form of organ damage for which there is the greatest amount of evidence of a strong independent prognostic significance. In the presence of a chronic pressure overload, a parallel addition of sarcomers takes place with an increase in myocyte width, which in turn increases left ventricular wall thickness; myocyte hypertrophy is also associated with apoptosis, collagen deposition and ventricular fibrosis with an impairment of coronary hemodynamics as well, thus profoundly influencing functional properties of the left (and right) ventricle...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27628760/provider-response-to-qtc-prolongation-on-standard-12-lead-ekg-do-we-notice-or-do-we-care
#18
Meghan M Good, Fady S Riad, Chester B Good, Alaa A Shalaby
BACKGROUND: Drugs and electrolyte imbalances are widely recognized as common triggers of a prolonged QT interval. We conducted a chart review to assess provider response to prolonged QT reported on a standard 12-lead electrocardiogram (EKG). METHODS: We identified all Veterans Affairs Pittsburgh Healthcare System patients in a 6-month period with an EKG reporting a corrected QT (QTc) >500 ms. We excluded confounding or uninterpretable EKGs. Charts were reviewed to assess medications and electrolytes at the time of the EKG as well as the setting (inpatient vs outpatient) in which the EKG was obtained...
November 2016: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/27609724/omnious-t-wave-inversions-wellens-syndrome-revisited
#19
Swe Zin Mar Win Htut Oo, Koroush Khalighi, Archana Kodali, Cho May, Thein Tun Aung, Richard Snyder
Wellens' syndrome is characterized by T-wave changes in electrocardiogram (EKG) during pain-free period in a patient with intermittent angina chest pain. It carries significant diagnostic and prognostic value because this syndrome represents a pre-infarction stage of coronary artery disease involving proximal left anterior descending (LAD) artery, which can subsequently lead to extensive anterior myocardial infarctions (MIs) and even death without coronary angioplasty. Therefore, it is crucial for every physician to recognize EKG features of Wellens' syndrome in order to take appropriate immediate intervention to reduce mortality and morbidity for MI...
2016: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/27593589/induction-of-rapid-reproducible-hepatic-ablations-using-next-generation-high-frequency-irreversible-electroporation-h-fire-in%C3%A2-vivo
#20
Imran A Siddiqui, Eduardo L Latouche, Matthew R DeWitt, Jacob H Swet, Russell C Kirks, Erin H Baker, David A Iannitti, Dionisios Vrochides, Rafael V Davalos, Iain H McKillop
INTRODUCTION: Irreversible electroporation (IRE) offers an alternative to thermal tissue ablation in situ. High-frequency IRE (H-FIRE), employing ultra-short bipolar electrical pulses, may overcome limitations associated with existing IRE technology to create rapid, reproducible liver ablations in vivo. METHODS: IRE electrodes (1.5 cm spacing) were inserted into the hepatic parenchyma of swine (n = 3) under surgical anesthesia. In the absence of paralytics or cardiac synchronization five independent H-FIRE ablations were performed per liver using 100, 200, or 300 pulses (2250 V, 2-5-2 μs configuration)...
September 2016: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
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