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https://www.readbyqxmd.com/read/29738675/the-role-of-technology-and-telemetry-medicine-in-the-initial-management-of-a-st-segment-elevated-myocardial-infarction-in-a-rural-emergency-department
#1
Michael L Hood
CONTEXT: The 12-lead electrocardiogram (ECG) is an integral part of the diagnostic tools available for recognising a patient who is experiencing an ST-segment elevated myocardial infarction (STEMI). Consequently, a great emphasis is placed on the rapid acquisition and expert interpretation of the 12-lead ECG so that the appropriate reperfusion management might be commenced to optimise patient outcomes by preventing further damage to the myocardium. With the advancement of telemetric and diagnostic abilities of the modern ECG machine, the role of frontline rural emergency clinicians is as important as ever...
May 2018: Rural and Remote Health
https://www.readbyqxmd.com/read/29736948/chest-lead-st-j-amplitudes-using-arm-electrodes-as-reference-instead-of-the-wilson-central-terminal-in-smartphone-ecg-applications-influence-on-st-elevation-myocardial-infarction-criteria-fulfillment
#2
Thomas Lindow, Henrik Engblom, Ardavan Khoshnood, Ulf Ekelund, Marcus Carlsson, Olle Pahlm
BACKGROUND: "Smartphone 12-lead ECG" for the assessment of acute myocardial ischemia has recently been introduced. In the smartphone 12-lead ECG either the right or the left arm can be used as reference for the chest electrodes instead of the Wilson central terminal. These leads are labeled "CR leads" or "CL leads." We aimed to compare chest-lead ST-J amplitudes, using either CR or CL leads, to those present in the conventional 12-lead ECG, and to determine sensitivity and specificity for the diagnosis of STEMI for CR and CL leads...
May 7, 2018: Annals of Noninvasive Electrocardiology
https://www.readbyqxmd.com/read/29736558/modifiable-factors-associated-with-prolonged-door-to-balloon-time-in-patients-with-st-segment-elevation-myocardial-infarction-undergoing-primary-percutaneous-coronary-intervention
#3
Masahiko Noguchi, Junya Ako, Takeshi Morimoto, Yosuke Homma, Takashi Shiga, Kotaro Obunai, Hiroyuki Watanabe
Door to balloon (D2B) time was reported an important factor of the clinical outcome of patients with ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI). D2B time is influenced by various factors; however, modifiable factors have not been adequately evaluated. The purpose of this study was to identify modifiable factors associated with prolonged D2B time. We historically included 239 consecutive STEMI patients who visited emergency department and underwent primary PCI between April 2013 and September 2016...
May 7, 2018: Heart and Vessels
https://www.readbyqxmd.com/read/29728297/heart-failure-complicating-myocardial-infarction-a-report-of-the-peruvian-registry-of-st-elevation-myocardial-infarction-perstemi
#4
Manuel Chacón-Diaz, Ofelia Araoz-Tarco, Walter Alarco-León, Oscar Aguirre-Zurita, Maritza Rosales-Vidal, Patricia Rebaza-Miyasato
OBJECTIVES: The aim of this study is to determine the incidence, associated factors, and 30-day mortality of patients with heart failure (HF) after ST elevation myocardial infarction (STEMI) in Peru. METHODS: Observational, cohort, multicentre study was conducted at the national level on patients enrolled in the Peruvian registry of STEMI, excluding patients with a history of HF. A comparison was made with the epidemiological characteristics, treatment, and 30 day-outcome of patients with (Group 1) and without (Group 2) heart failure after infarction...
May 1, 2018: Archivos de Cardiología de México
https://www.readbyqxmd.com/read/29724744/measuring-outcome-differences-associated-with-stemi-screening-and-diagnostic-performance-a-multicentred-retrospective-cohort-study-protocol
#5
Maame Yaa A B Yiadom, Bryn E Mumma, Christopher W Baugh, Brian W Patterson, Angela M Mills, Gilberto Salazar, Mary Tanski, Cathy A Jenkins, Timothy J Vogus, Karen F Miller, Brittney E Jackson, Christoph U Lehmann, Stephen C Dorner, Jennifer L West, Thomas J Wang, Sean P Collins, Robert S Dittus, Gordon R Bernard, Alan B Storrow, Dandan Liu
INTRODUCTION: Advances in ST-segment elevation myocardial infarction (STEMI) management have involved improving the clinical processes connecting patients with timely emergency cardiovascular care. Screening upon emergency department (ED) arrival for an early ECG to diagnose STEMI, however, is not optimal for all patients. In addition, the degree to which timely screening and diagnosis are associated with improved time to intervention and postpercutaneous coronary intervention outcomes, under more contemporary practice conditions, is not known...
May 3, 2018: BMJ Open
https://www.readbyqxmd.com/read/29724738/gender-disparities-in-first-medical-contact-and-delay-in-st-elevation-myocardial-infarction-a-prospective-multicentre-swedish-survey-study
#6
Sofia Sederholm Lawesson, Rose-Marie Isaksson, Maria Ericsson, Karin Ängerud, Ingela Thylén
OBJECTIVES: Compare gender disparities in ST-elevation myocardial infarction (STEMI) regarding first medical contact (FMC) and prehospital delay times and explore factors associated with prehospital delay in men and women separately. DESIGN: Cross-sectional study based on medical records and a validated questionnaire. Eligible patients were enrolled within 24 hours after admittance to hospital. SETTING: Patients were included from November 2012 to January 2014 from five Swedish hospitals with catheterisation facilities 24/7...
May 3, 2018: BMJ Open
https://www.readbyqxmd.com/read/29708085/weekly-checks-improve-real-time-prehospital-ecg-transmission-in-suspected-stemi
#7
Nicole T D'Arcy, Nichole Bosson, Amy H Kaji, Quang T Bui, William J French, Joseph L Thomas, Yvonne Elizarraraz, Natalia Gonzalez, Jose Garcia, James T Niemann
IntroductionField identification of ST-elevation myocardial infarction (STEMI) and advanced hospital notification decreases first-medical-contact-to-balloon (FMC2B) time. A recent study in this system found that electrocardiogram (ECG) transmission following a STEMI alert was frequently unsuccessful.HypothesisInstituting weekly test ECG transmissions from paramedic units to the hospital would increase successful transmission of ECGs and decrease FMC2B and door-to-balloon (D2B) times. METHODS: This was a natural experiment of consecutive patients with field-identified STEMI transported to a single percutaneous coronary intervention (PCI)-capable hospital in a regional STEMI system before and after implementation of scheduled test ECG transmissions...
April 30, 2018: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/29681178/-the-significance-of-ecg-recorded-at-hospitalization-in-determining-the-prognosis-of-patients-treated-with-myocardial-infarction
#8
András Jánosi, Péter Ofner, János Tomcsányi, Gábor Müller, Richárd Hável, Asma Réka Soczó, Timea Váradi, Tamás Ferenci
INTRODUCTION AND AIM: By using the database of the National Registry of Myocardial Infarction, the authors examine the prognosis of patients treated with acute myocardial infarction, in case of whom there was new or presumably new left bundle branch block (nLBBB) on the ECG recorded at hospitalization. METHOD: We recorded the details of 18 091 patients treated with acute myocardial infarction (AMI) between 1 January 2014 and 30 June 2015 in the National Registry of Myocardial Infarction...
April 2018: Orvosi Hetilap
https://www.readbyqxmd.com/read/29622964/correlation-of-corrected-qt-dispersion-with-the-severity-of-coronary-artery-disease-detected-by-syntax-score-in-non-diabetic-patients-with-stemi
#9
Hatem Helmy, Ahmed Abdel-Galeel, Yehia Taha Kishk, Khaled Mohammed Sleem
Introduction: Determination of the QT interval dispersion by means of a standard ECG at rest has been widely used for cardiovascular risk assessment during the last 15 years as one of the recent explanations for the development of life threatening ventricular arrhythmias. However, little is known about the relation between QT dispersion and the severity of coronary artery atherosclerosis as defined by SYNTAX score. Aim of work: The present study was done to assess the correlation between QTc dispersion and the severity of coronary artery disease in acute ST elevation myocardial infarction (STEMI) detected by SYNTAX score...
June 2017: The Egyptian heart journal: (EHJ): official bulletin of the Egyptian Society of Cardiology
https://www.readbyqxmd.com/read/29555534/myocardial-reperfusion-for-acute-myocardial-infarction-under-an-optimized-antithrombotic-medication-what-can-you-expect-in-daily-practice
#10
Samuel Pinelli, Nelly Agrinier, Nidhal Bouchahda, Pierre Adrien Metzdorf, Edoardo Camenzind, Batric Popovic
AIMS: To assess both epicardiac macrovascular as well as microvascular and tissue reperfusion following different intravenous preadmission antithrombotic strategies prior primary PCI in STEMI patients. METHODS AND RESULTS: Consecutive STEMI patients (n = 488) undergoing pPCI received prehospitally either bivalirudin (n = 179), bivalirudin and periprocedural GPIIb/IIIa inhibitors (GPI) (n = 109), heparin (n = 99) or heparin and periprocedural GPI (n = 101)...
February 27, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29548521/the-utility-of-the-triage-electrocardiogram-for-the-detection-of-st-segment-elevation-myocardial-infarction
#11
Samantha Noll, Heidi Alvey, Namita Jayaprakash, Aniruddha Paranjpe, Joseph Miller, Michele L Moyer, Richard Nowak
INTRODUCTION: Current AHA/ACC guidelines on the management of ST-elevation myocardial infarction (STEMI) suggest that an ECG is indicated within 10minutes of arrival for patients arriving to the Emergency Department (ED) with symptoms concerning for STEMI. In response, there has been a creep towards performing ECGs more frequently in triage. The objectives of this study were to quantify the number of triage ECGs performed at our institution, assess the proportion of ECGs performed within current hospital guidelines, and evaluate the rate of STEMI detection in triage ECGs...
February 3, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29542414/clinical-presentation-quality-of-care-risk-factors-and-outcomes-in-women-with-acute-st-elevation-myocardial-infarction-stemi-an-observational-report-from-six-middle-eastern-countries
#12
Abdulla Shehab, Khalid F AlHabib, Akshaya Srikanth Bhagavathul, Ahmad Hersi, Hussam Alfaleh, Mostafa Q Alshamiri, Anhar Ullah, Khadim Sulaiman, Wael Almahmeed, Jassim Al Suwaidi, Alwai A Alsheikh-Ali, Haitham Amin, Mohammed Al Jarallah, Amar M Salam
BACKGROUND: Most of the available literature on ST-Elevated myocardial infarction (STEMI) in women was conducted in the developed world and data from Middle-East countries was limited. AIM: To examine the clinical presentation, patient management, quality of care, risk factors and in-hospital outcomes of women with acute STEMI compared with men using data from a large STEMI registry from the Middle East. METHODS: Data were derived from the third Gulf Registry of Acute Coronary Events (Gulf RACE-3Ps), a prospective, multinational study of adults with acute STEMI from 36 hospitals in 6 Middle-Eastern countries...
March 14, 2018: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/29541260/risk-stratification-and-in-hospital-morality-in-patients-presenting-with-acute-coronary-syndrome-acs-in-bahrain
#13
Taysir S Garadah, Khalid Bin Thani, Leena Sulibech, Ahmed A Jaradat, Mohamed E Al Alawi, Haytham Amin
Background: Risk factors and short-term mortality in patients presented with Acute Coronary Syndrome (ACS) in Bahrain has not been evaluated before. Aim: In this prospective observational study, we aim to determine the clinical risk profiles of patients with ACS in Bahrain and describe the incidence, pattern of presentation and predictors of in-hospital clinical outcomes after admission. Methods: Patients with ACS were prospectively enrolled over a 12 month period...
2018: Open Cardiovascular Medicine Journal
https://www.readbyqxmd.com/read/29507028/stroke-thrombolysis-complicated-by-st-elevation-myocardial-infarction-stemi
#14
Mark Flower, James Harvey, Jonathan Hunter
An 84-year-old male Jehovah's Witness presented to the emergency department 1 hour after onset of left facial droop and left upper limb weakness. Thrombolytic stroke treatment was commenced as per local thrombolytic protocol with intravenous recombinant tissue plasminogen activator (rtPA) at 2 hours and 25 min following onset of symptoms. Almost immediately after rtPA infusion the patient reported chest pain and had ECG changes consistent with a diagnosis of anterior ST elevation myocardial infarction...
March 5, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29484640/helicopter-vs-ground-transportation-of-patients-bound-for-primary-percutaneous-coronary-intervention
#15
K S Funder, L S Rasmussen, V Siersma, N Lohse, R Hesselfeldt, F Pedersen, O M Hendriksen, J Steinmetz
BACKGROUND: Implementation of the first Danish helicopter emergency medical service (HEMS) was associated with reduced time from first medical contact to treatment at a specialized centre for patients with suspected ST elevation myocardial infarction (STEMI). We aimed to investigate effects of HEMS on mortality and labour market affiliation in patients admitted for primary percutaneous coronary intervention (PCI). METHODS: In this prospective observational study, we included patients with suspected STEMI within the region covered by the HEMS from January 1, 2010, to April 30, 2013, transported by either HEMS or ground emergency medical services (GEMS) to the regional PCI centre...
April 2018: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29464219/typical-pericarditis-ecg-findings-after-falling-from-height-the-pr-segment-depression-or-st-segment-elevation
#16
Murat Sucu, Gokhan Altunbas, Fatma Yilmaz Coskun
Acute pericarditis (AP) following blunt thoracic trauma is rare and difficult to diagnosis. A 43-year-old man with offered to the emergency department (ED) after falling from height before a week ago. The ECG performed in the ED was abnormal, ECG revealed PR segment depression in leads DII, DIII, aVF, and V3-6 and a preliminary diagnosis of acute inferolateral STEMI was presumed. Patients have evidence of systemic inflammation, including leukocytosis, elevated erythrocyte sedimentation rate. We are reporting a case of post-traumatic acute pericarditis presenting with PR-segment depression and normal cardiac enzymes mimicking acute STEMI...
December 2017: Turkish Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29447789/comprehensive-electrocardiogram-to-device-time-for-primary-percutaneous-coronary-intervention-in-st-segment-elevation-myocardial-infarction-a-report-from-the-american-heart-association-mission-lifeline-program
#17
Jay S Shavadia, William French, Anne S Hellkamp, Laine Thomas, Eric R Bates, Steven V Manoukian, Michael C Kontos, Robert Suter, Timothy D Henry, Harold L Dauerman, Matthew T Roe
BACKGROUND: Assessing hospital-related network-level primary percutaneous coronary intervention (PCI) performance for ST-segment elevation myocardial infarction (STEMI) is challenging due to differential time-to-treatment metrics based on location of diagnostic electrocardiogram (ECG) for STEMI. METHODS: STEMI patients undergoing primary PCI at 588 PCI-capable hospitals in AHA Mission: Lifeline (2008-2013) were categorized by initial STEMI identification location: PCI-capable hospitals (Group 1); pre-hospital setting (Group 2); and non-PCI-capable hospitals (Group 3)...
March 2018: American Heart Journal
https://www.readbyqxmd.com/read/29432372/ecg-to-decision-time-impact-on-30-day-mortality-and-reperfusion-times-for-stemi-care
#18
Richard Mullvain, Daniel M Saman, Ashlee Rostvedt, Pauline Landgren
OBJECTIVES: Little data are published on the unique care performance metric of electrocardiogram-to-decision time (E2Decide) for primary percutaneous coronary intervention (PCI) treatment of ST-elevation myocardial infarction (STEMI). The objective of this study is to evaluate E2Decide time on mortality and delayed reperfusion. METHODS: This was a retrospective study of STEMI activations treated with primary PCI at 2 PCI-capable hospitals located in Duluth, Minnesota, and Fargo, North Dakota, originating in 3 different settings: (1) primary PCI-capable hospital emergency departments, (2) non-PCI facilities, and (3) in the field by emergency medical services...
March 2018: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/29420570/qt-interval-evaluation-in-primary-percutaneous-coronary-intervention-of-st-segment-elevation-myocardial-infarction-for-prediction-of-myocardial-salvage-index
#19
Andrea Igoren Guaricci, Patrizia Carità, Valentina Lorenzoni, GraziaPia Casavecchia, Mark Rabbat, Riccardo Ieva, Natale Daniele Brunetti, Daniele Andreini, Matteo Di Biase, Giancarlo Marenzi, Antonio Bartorelli, Mauro Pepi, Gianluca Pontone
Assessing the efficacy of revascularization therapy in patients with ST-segment elevation myocardial infarction (STEMI) is extremely important in order to guide subsequent management and assess prognosis. We aimed to determine the relationship between corrected QT-interval (QTc) changes on standard sequential ECG and myocardial salvage index in anterior STEMI patients after successful primary percutaneous coronary intervention. Fifty anterior STEMI patients treated by primary percutaneous coronary intervention underwent quantitative ECG analysis and cardiac magnetic resonance...
2018: PloS One
https://www.readbyqxmd.com/read/29406044/reciprocal-st-segment-changes-in-myocardial-infarction-ischemia-at-distance-versus-mirror-reflection-of-st-elevation
#20
Gaurang Nandkishor Vaidya, Steve Antoine, Syed Haider Imam, Hani Kozman, Harold Smulyan, Daniel Villarreal
BACKGROUND: Reciprocal ST-depression in the electrocardiograms (ECGs) of patients with ST-elevation myocardial infarction (STEMI) results from either true ischemia at a distance via collateral circulation diverting blood to the infarcted region or an electrical phenomenon that results from a mirror reflection of ST-elevation. We aimed to identify the role of reciprocal ECG changes in predicting collateral circulation to the infarcted area determined angiographically. METHODS: In a retrospective study, ECG and angiography of 53 STEMI patients admitted to SUNY Upstate Medical University in 2014 were reviewed independently by experts blinded to the results of ECG and coronary angiography...
February 2018: American Journal of the Medical Sciences
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