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https://www.readbyqxmd.com/read/28235505/tension-pneumomediastnum-a-rare-cause-of-acute-intraoperative-circulatory-collapse-in-the-setting-of-unremarkable-tee-findings
#1
Jonathan B Weaver, Avinash B Kumar
DESIGN: Case report. SETTING: Operating room. PATIENT: 25YF, ASA IV E who underwent an emergent decompressive craniectomy for refractory intracranial hypertension secondary to acute intracranial hemorhage. INTERVENTIONS: A 25Y caucasian female presented with acute intracranial hemorrhage with intraventricular extension secondary to Moya Moya disease. Post admisison, she underwent an emergent decompressive craniectomy for medically refractory intracranial hypertension...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28218629/fever-induced-brugada-pattern-misdiagnosed-as-an-acute-myocardial-infarction
#2
David Tadin, Roberto Quintal
The Brugada syndrome is a rare condition associated with increased risk of ventricular tachyarrhythmias and sudden cardiac death (SCD). The Brugada pattern on electrocardiogram (EKG) is known to be revealed by several precipitants including febrile illnesses. The appearance of a Brugada pattern on EKG with fever may indicate an elevated risk of arrhythmia or sudden cardiac death. We report a case in which the electrocardiographic abnormality of Brugada pattern induced by sepsis was initially misinterpreted as a ST-segment elevation myocardial infarction (STEMI)...
January 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28217615/type-1-brugada-pattern-electrocardiogram-induced-by-hypokalemia
#3
Thein Swe, Muhammad Hassan Dogar
Coved-type ST-segment elevation in the right precordial leads are the characteristics of Brugada syndrome, an inherited arrhythmogenic ion channel disease, which could lead to ventricular arrhythmia and sudden death. Hypokalemia alone may induce Type 1 Brugada pattern electrocardiogram (EKG), and the association has rarely been reported. We describe a patient with hypokalemia 2.9 mmol/L and the appearance of new right bundle branch block pattern with coved ST-segment elevations with inverted T wave in leads V1-V2...
July 2016: Journal of Family Medicine and Primary Care
https://www.readbyqxmd.com/read/28215710/altered-mental-status-in-the-emergency-department-can-an-electrocardiogram-show-the-right-way-to-go
#4
Andre Dias, Emiliana Franco, Jasmine Martinez, Vincent M Figueredo
A 38-year-old African American male patient with a past medical history of human immunodeficiency virus and schizophrenia who was noncompliant with medications presented to the emergency department (ED) after activation of the local crisis response center for altered mental status. Upon arrival he was lethargic and uncooperative, unable to provide any significant details apart from pleuritic chest pain. His blood pressure was 133/88 mmHg, heart rate 43 beats per minute and initial body temperature 36.1 °C which prompted an electrocardiogram (EKG)...
February 2, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/28211133/an-unusual-short-rp-tachycardia-what-is-the-mechanism
#5
Joshua Balog
A 68-year-old man with a history of a structurally normal heart by echocardiography, an unsuccessful ablation of a narrow complex tachycardia and frequent symptoms of palpitations presents for an electrophysiology study and ablation. Baseline 12-lead EKG demonstrated sinus rhythm without ventricular preexcitation. This article is protected by copyright. All rights reserved.
February 17, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28208140/first-diagnosis-of-atrial-fibrillation-at-the-time-of-stroke
#6
Leila H Borowsky, Susan Regan, Yuchiao Chang, Alison Ayres, Steven M Greenberg, Daniel E Singer
BACKGROUND: Atrial fibrillation (AF) is a major cause of ischemic stroke. Individuals with undiagnosed AF lack the stroke protection afforded by oral anticoagulants. We obtained a contemporary estimate of the percentage of AF patients newly diagnosed at the time of stroke. METHODS: We identified patients admitted to the Massachusetts General Hospital (MGH) from January 1, 2010 to December 31, 2013 with acute ischemic stroke and either previously or newly diagnosed AF using hospital stroke registry data and stroke and AF ICD-9 code searches of hospital databases...
February 17, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28149669/survey-of-experts-on-current-endothelial-keratoplasty-techniques
#7
Winston Chamberlain, Ariana Austin, Mark Terry, Bennie H Jeng, Jennifer Rose-Nussbaumer
OBJECTIVE: To survey cornea specialists' opinions on different endothelial keratoplasty techniques and to gauge the perceived need for and utility of a randomized controlled trial (RCT) comparing them. METHODS: A short survey was distributed to a group of cornea specialists at the Endothelial Keratoplasty Group meeting at the American Academy of Ophthalmology meeting in November 2015. RESULTS: Thirty-three of 80 practicing surgeons present at the EKG meeting participated in the survey, yielding a response rate of 41%...
October 2016: Journal of Clinical & Experimental Ophthalmology
https://www.readbyqxmd.com/read/28133551/large-left-ventricular-thrombus-in-a-patient-with-systemic-and-venous-thromboembolism-secondary-to-protein-c-and-s-deficiency
#8
Mohit Pahuja, Bujji Ainapurapu, Aiden Abidov
58-year-old Hispanic female presented with an altered mental status. A CT scan of the head demonstrated multiple scattered infarcts and a large right temporal lobe infarct. We also diagnosed the patient with right popliteal and femoral vein thrombosis, bilateral pulmonary embolism, and a transient right radial artery occlusion. Her 12-lead EKG showed lateral ST elevation. Emergent coronary angiogram revealed normal coronaries. Echocardiogram demonstrated a large mobile mass attached to the anterolateral free wall with overall normal contractility of the left ventricle...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/28104974/rare-manifestation-of-digoxin-toxicity-right-bundle-branch-block
#9
Dalvir Gill, Samana Zaidi
A 76-year-old female, with medical history significant for systolic congestive heart failure, who presented to the emergency department with lethargy and abdominal pain with diarrhea for the past 3 weeks. Due to hypotension, the patient received multiple boluses of isotonic saline and was started on norepinephrine. Laboratories were significant for severe digoxin toxicity (29 ng/mL), in setting of acute kidney injury. Electrocardiogram (EKG) revealed a new right bundle branch block (RBBB). She was given Digibind and her repeat digoxin level was 20 ng/mL...
December 2016: Journal of Basic and Clinical Pharmacy
https://www.readbyqxmd.com/read/28101033/maximizing-the-benefit-cost-ratio-of-anthracyclines-in-metastatic-breast-cancer-case-report-of-a-patient-with-a-complete-response-to-high-dose-doxorubicin
#10
Kevin Shee, Alan T Kono, Susan P D'Anna, Mark A Seltzer, Xiaoying Lu, Todd W Miller, Mary D Chamberlin
Despite the clinical efficacy of anthracycline agents such as doxorubicin, dose-limiting cardiac toxicities significantly limit their long-term use. Here, we present the case of a 33-year-old female patient with extensive metastatic ER+/PR+/HER2- mucinous adenocarcinoma of the breast, who was started on doxorubicin/cyclophosphamide therapy after progressing on paclitaxel and ovarian suppressor goserelin with aromatase inhibitor exemestane. The patient was comanaged by cardiology, who carefully monitored measures of cardiac function, including EKGs, serial echocardiograms, and profiling of lipids, troponin, and pro-BNP every 2 months...
September 2016: Case Reports in Oncology
https://www.readbyqxmd.com/read/28095934/the-effect-of-ambulance-staffing-models-in-a-metropolitan-fire-based-ems-system
#11
Eric J Cortez, Ashish R Panchal, James E Davis, David P Keseg
: Introduction The staffing of ambulances with different levels of Emergency Medical Service (EMS) providers is a difficult decision with evidence being mixed on the benefit of each model. Hypothesis/Problem The objective of this study was to describe a pilot program evaluating alternative staffing on two ambulances utilizing the paramedic-basic (PB) model (staffed with one paramedic and one emergency medical technician[EMT]). METHODS: This was a retrospective study conducted from September 17, 2013 through December 31, 2013...
January 18, 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/28040387/takotsubo-cardiomyopathy-associated-with-miller-fisher-syndrome
#12
Dalvir Gill, Kan Liu
51-year-old female who presented with progressive paresthesia, numbness of the lower extremities, double vision, and trouble walking. Physical exam was remarkable for areflexia, and ptosis. Her initial EKG showed nonspecific ST segment changes and her Troponin T was elevated to 0.41ng/mL which peaked at 0.66ng/mL. Echocardiogram showed a depressed left ventricular ejection fraction to 35% with severely hypokinetic anterior wall and left ventricular apex was severely hypokinetic. EMG nerve conduction study showed severely decreased conduction velocity and prolonged distal latency in all nerves consistent with demyelinating disease...
December 22, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28028584/the-prognostic-significance-of-atrial-fibrillation-in-heart-failure-with-preserved-ejection-function-insights-from-karen-a-prospective-and-multicenter-study
#13
Christian Bosseau, Erwan Donal, Lars H Lund, Emmanuel Oger, Camilla Hage, Geneviève Mulak, Jean-Claude Daubert, Cecilia Linde
The prognostic value of atrial fibrillation (AF) in heart failure with preserved ejection fraction (HFPEF) remains controversial. We sought to study the prognostic value of AF in a prospective cohort and to characterize the HFPEF patients with AF. KaRen was a prospective, multicenter, international, observational study intended to characterize HFPEF; 538 patients presenting with an acute decompensated cardiac failure and a left ventricular EF > 45% were included. EKG and echocardiogram performed 4-8 week following the index hospitalization were analyzed in core centers...
December 27, 2016: Heart and Vessels
https://www.readbyqxmd.com/read/28012712/unintended-consequences-of-adjusting-citalopram-prescriptions-following-the-2011-fda-warning
#14
Lauren B Gerlach, Helen C Kales, Donovan T Maust, Claire Chiang, Claire Stano, Hae Mi Choe, Kara Zivin
OBJECTIVES: In 2011, the U.S. Food and Drug Administration (FDA) issued a safety announcement cautioning providers against prescribing citalopram above 40 mg per day given concerns for QT prolongation. We assessed the impact of a health system quality improvement initiative to identify patients taking higher than the recommended dose of citalopram. DESIGN: Retrospective cohort study. SETTING: Nine primary care clinics within the University of Michigan from March 2012 to February 2013...
November 18, 2016: American Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/27978784/correlation-between-decreased-parasympathetic-activity-and-reduced-cerebrovascular-reactivity-in-patients-with-lacunar-infarct
#15
Kannakorn Intharakham, Kesorn Suwanprasert, Sombat Muengtaweepongsa
Reduced cerebrovascular reactivity (CVR) was found in patients with recent lacunar infarct. However, its mechanisms were controversial. The breath holding maneuver as vasodilatory stimulus is clinically useful for an estimation of cerebrovasomotor reactivity in well co-operative patients. Patients with lacunar infarct have no higher cortical dysfunction and remain well co-operation. The breath holding maneuver is feasible and safe to perform in patients with lacunar infarct. Autonomic nervous system regulates systemic vascular activity...
13, 2016: Current Neurovascular Research
https://www.readbyqxmd.com/read/27939476/differences-in-cardiovascular-function-comparing-prior-preeclamptics-with-nulliparous-controls
#16
Ira M Bernstein, Sarah A Hale, Gary J Badger, Carole A McBride
OBJECTIVE: The objective of the current study was to evaluate cardiovascular function; including blood pressure, cardiac output, pulse wave velocity and vascular compliance in nonpregnant nulliparous women compared to women with a history of preterm preeclampsia. STUDY DESIGN: This was a case control study. Blood pressure was measured using the Finapres Pro. Baseline cardiac output was determined by echocardiography. Pulse wave velocity was estimated using simultaneous electrocardiographic tracings and ultrasound determined arterial flow waveforms and calculated as estimated distance divided by the time interval between EKG r-wave peak and ultrasound derived peak popliteal artery flow...
October 2016: Pregnancy Hypertension
https://www.readbyqxmd.com/read/27927211/genetic-variations-of-aldehyde-dehydrogenase-2-and-alcohol-dehydrogenase-1b-are-associated-with-the-etiology-of-atrial-fibrillation-in-japanese
#17
Yukiko Nakano, Hidenori Ochi, Yuko Onohara, Akinori Sairaku, Takehito Tokuyama, Hiroya Matsumura, Shunsuke Tomomori, Michitaka Amioka, Naoya Hironomobe, Chikaaki Motoda, Nozomu Oda, Kazuaki Chayama, Che-Hong Chen, Eric R Gross, Daria Mochly-Rosen, Yasuki Kihara
BACKGROUND: Alcohol consumption and oxidative stress are well-known risk factors for developing atrial fibrillation (AF). Single nucleotide polymorphisms (SNPs) of alcohol dehydrogenase (ADH1B) and aldehyde dehydrogenase 2 (ALDH2) genes encoding enzymes of alcohol and reactive aldehyde metabolism, respectively, are prevalent among East Asians. Here, we examined whether these SNPs were associated with AF in Japanese patients. METHODS AND RESULTS: Five hundred seventy-seven Japanese patients with AF undergoing catheter ablation and 1935 controls at Hiroshima University Hospital were studied...
December 7, 2016: Journal of Biomedical Science
https://www.readbyqxmd.com/read/27920726/hrvanalysis-a-free-software-for-analyzing-cardiac-autonomic-activity
#18
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
#19
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
#20
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...
February 15, 2017: International Journal of Cardiology
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