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https://www.readbyqxmd.com/read/28329355/international-recommendations-for-electrocardiographic-interpretation-in-athletes
#1
Sanjay Sharma, Jonathan A Drezner, Aaron Baggish, Michael Papadakis, Mathew G Wilson, Jordan M Prutkin, Andre La Gerche, Michael J Ackerman, Mats Borjesson, Jack C Salerno, Irfan M Asif, David S Owens, Eugene H Chung, Michael S Emery, Victor F Froelicher, Hein Heidbuchel, Carmen Adamuz, Chad A Asplund, Gordon Cohen, Kimberly G Harmon, Joseph C Marek, Silvana Molossi, Josef Niebauer, Hank F Pelto, Marco V Perez, Nathan R Riding, Tess Saarel, Christian M Schmied, David M Shipon, Ricardo Stein, Victoria L Vetter, Antonio Pelliccia, Domenico Corrado
Sudden cardiac death (SCD) is the leading cause of mortality in athletes during sport. A variety of mostly hereditary, structural, or electrical cardiac disorders are associated with SCD in young athletes, the majority of which can be identified or suggested by abnormalities on a resting 12-lead electrocardiogram (ECG). Whether used for diagnostic or screening purposes, physicians responsible for the cardiovascular care of athletes should be knowledgeable and competent in ECG interpretation in athletes. However, in most countries a shortage of physician expertise limits wider application of the ECG in the care of the athlete...
February 20, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28325613/head-to-head-comparison-of-the-diagnostic-performance-of-coronary-computed-tomography-angiography-and-dobutamine-stress-echocardiography-in-the-evaluation-of-acute-chest-pain-with-normal-ecg-findings-and-negative-troponin-tests-a-prospective-multicenter-study
#2
Eric Durand, Fabrice Bauer, Nicolas Mansencal, Arshid Azarine, Benoit Diebold, Albert Hagege, Ludivine Perdrix, Martine Gilard, Yannick Jobic, Hélène Eltchaninoff, Mourad Bensalah, Benjamin Dubourg, Jérôme Caudron, Ralph Niarra, Gilles Chatellier, Jean-Nicolas Dacher, Elie Mousseaux
OBJECTIVE: To perform a head-to-head comparison of coronary CT angiography (CCTA) and dobutamine-stress echocardiography (DSE) in patients presenting recent chest pain when troponin and ECG are negative. METHODS: Two hundred seventeen patients with recent chest pain, normal ECG findings, and negative troponin were prospectively included in this multicenter study and were scheduled for CCTA and DSE. Invasive coronary angiography (ICA), was performed in patients when either DSE or CCTA was considered positive or when both were non-contributive or in case of recurrent chest pain during 6month follow-up...
March 2, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28325192/endoscopic-management-of-early-gastric-adenocarcinoma-and-preinvasive-gastric-lesions
#3
REVIEW
Saowanee Ngamruengphong, Seiichiro Abe, Ichiro Oda
Early gastric cancer (ECG) can be difficult to diagnose endoscopically. Endoscopists should be familiar with subtle changes and endoscopic features of EGC. Chromoendoscopy and image-enhanced endoscopy improve diagnostic accuracy and facilitate endoscopic resection. Endoscopic submucosal dissection is a preferred endoscopic technique for resection of EGC and offers a comparable overall survival to surgical resection. Endoscopic management of benign gastric epithelial polyps (fundic gland polyps, hyperplastic polyps, and gastric adenoma) depends on patient symptomatology, patient's comorbidities (eg, familial syndromes), lesions' characteristics, and risk of malignant transformation...
April 2017: Surgical Clinics of North America
https://www.readbyqxmd.com/read/28324986/electrocardiographic-waveforms-fitness-check-device-technique-for-sudden-cardiac-death-risk-screening
#4
O J Escalona, M Mendoza
A novel cardiac health device technique development for reliable, non-invasive and cost-effective heart screening in preventive cardiovascular healthcare is presented. In particular, identification of apparently healthy individuals involved in sports activities (particularly in the young, age <; 35 years) who may be at-risk of sudden-cardiac-death (SCD) is mainly focused here. Nevertheless, the same device technique may be prospectively extended for detecting cardiovascular abnormalities in children and adolescents with type1-diabetes, and also in detecting patients with Brugada syndrome...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28320636/the-significance-of-equivocal-exercise-treadmill-ecg-for-intermediate-risk-chest-pain-assessment-insight-from-coronary-ct-angiography-data
#5
Gary T E Lau, Henry Wei, Jo Wickham, Andrew C Y To
BACKGROUND: Exercise treadmill test (ETT) is commonly the first-line investigation in troponin-negative chest pain patients. Inconclusive results are common and often lead to repeated functional testings. Coronary computed tomographic angiography (CCTA) has excellent negative predictive value for coronary artery disease detection and may play an important role in their diagnostic workup. We aim to analyse ETT and CCTA findings to understand their modern roles in intermediate risk chest pain population with inconclusive ETT...
March 1, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28320607/diagnostic-value-of-st-segment-deviations-during-cardiac-exercise-stress-testing-systematic-comparison-of-different-ecg-leads-and-time-points
#6
Christian Puelacher, Max Wagener, Roger Abächerli, Ursina Honegger, Nundsin Lhasam, Nicolas Schaerli, Gil Prêtre, Ivo Strebel, Raphael Twerenbold, Jasper Boeddinghaus, Thomas Nestelberger, Maria Rubini Giménez, Petra Hillinger, Karin Wildi, Zaid Sabti, Patrick Badertscher, Janosch Cupa, Nikola Kozhuharov, Jeanne du Fay de Lavallaz, Michael Freese, Isabelle Roux, Jens Lohrmann, Remo Leber, Stefan Osswald, Damian Wild, Michael J Zellweger, Christian Mueller, Tobias Reichlin
BACKGROUND: Exercise ECG stress testing is the most widely available method for evaluation of patients with suspected myocardial ischemia. Its major limitation is the relatively poor accuracy of ST-segment changes regarding ischemia detection. Little is known about the optimal method to assess ST-deviations. METHODS: A total of 1558 consecutive patients undergoing bicycle exercise stress myocardial perfusion imaging (MPI) were enrolled. Presence of inducible myocardial ischemia was adjudicated using MPI results...
February 27, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28320124/the-p-wave-terminal-force-in-embolic-strokes-of-undetermined-source
#7
Simona Lattanzi, Claudia Cagnetti, Alessandra Pulcini, Marco Morelli, Simone Maffei, Leandro Provinciali, Mauro Silvestrini
BACKGROUND: The Embolic Stroke of Undetermined Source (ESUS) is a recently developed clinical construct which describes stroke patients for whom the embolic source remains undetermined despite recommended investigations. The aim of the study was to characterize the ESUS population according to the abnormality in the P-wave terminal force in lead V1 (PTFV1). METHODS: We retrospectively identified consecutive patients hospitalized for acute ischemic stroke who met the ESUS diagnostic criteria...
April 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28294860/-coronary-flow-reserve-in-the-left-anterior-and-posterior-descending-arteries-as-an-additional-option-to-dipyridamole-stress-echocardiography-for-detection-of-stenosis
#8
A A Boshchenko, A V Vrublevsky, R S Karpov
AIM: to assess additive diagnostic value of simultaneous evaluation of coronary flow reserve (CFR) in the left anterior descending (LAD) artery and posterior descending artery (PDA) during dipyridamole stress echocardiography (stress-Echo) for detection of LAD and PDA stenoses >50%. METHODS: 108 in-patients (mean age 50+/-11 years) with cardiac chest pain underwent dipyridamole stress-Echo with ECG-analysis, wall motion analysis by 2-dimentional imaging (2D) and coronary flow reserve (CFR) evaluation in both LAD and PDA by pulse-wave Doppler...
April 2016: Kardiologiia
https://www.readbyqxmd.com/read/28291278/missad-hj%C3%A3-rtinfarkt-var-ofta-relaterad-till-atypisk-anamnes-systematisk-genomg%C3%A3-ng-av-bakomliggande-orsaker-till-anm%C3%A3-lda-fall-av-felaktig-diagnostik-vid-akut-hj%C3%A3-rtinfarkt
#9
Thomas Fridén, Kevin Jangali, Jesper Persson, Åke Andrén-Sandberg
Systematic analysis of diagnostic errors in patients with myocardial infarction handled by the Swedish Health and Social Care Inspectorate​ Diagnostic errors in 51 patients with myocardial infarction handled by the Swedish Health and Social Care Inspectorate​ were analyzed. In more than half of the cases, the diagnostic errors occurred in health-care outside of hospitals. Diagnostic errors were more common when patients presented atypical symptoms, but atypical symptoms were equally common in male and female patients...
March 14, 2017: Läkartidningen
https://www.readbyqxmd.com/read/28289841/role-of-exercise-cardiogoniometry-in-coronary-artery-disease-diagnostics
#10
A Weber, J Smid, B Luani, R C Braun-Dullaeus, I Tanev
BACKGROUND: The use of noninvasive diagnostics in coronary artery disease remains underdeveloped. To date, there is no simple and inexpensive method that can lead to a reliable diagnosis. Aside from costly and elaborate imaging techniques, exercise ECG, with its rather moderate sensitivity and specificity, is the main diagnostic method available. METHODS: In this prospective study of 109 patients, the diagnostic value of cardiogoniometry (CGM), a three-dimensional, computer-analyzed vector cardiogram, was determined before and after physical stress, and the results were compared with those obtained from a stress test...
March 13, 2017: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/28287295/-differential-diagnostic-dilemmas-after-use-of-an-out-of-date-antihypertensive-medication-case-report
#11
Péter Arányi, János Tomcsányi
Hydrochlorothiazide became one of the most commonly prescribed first-line antihypertensive medication, though its use is often complicated with serious side-effects. A 66-year-old female patient with a history of hypertension had suffered a transient loss of consciousness, and referred to our cardiology unit with an ST-segment elevation and giant negative T-waves in V1-2 ECG leads, long QT-segment and elevated serum creatine-kinase (5392 U/L) and troponin I (4,357 ng/ml) levels. Acute myocardial infarction was not proven (later coronarography revealed preserved coronary circulation), but severe hyponatraemia and hypokalaemia was detected, explaining a possible symptomatic seizure, and which could be accounted for a 25 mg daily hydrochlorothiazide antihypertensive treatment and - as a precipitating insult - a one-week history of gastroenteritis...
March 2017: Orvosi Hetilap
https://www.readbyqxmd.com/read/28285475/a-soldier-with-an-exertional-heat-injury-ischemic-appearing-electrocardiogram-and-elevated-troponins-a-clinical-case-report
#12
Steven G Schauer, James A Pfaff
Heat injuries are a common occurrence in the military training setting due to both the physically demanding nature of the training and the environments in which we train. Testing is often done after the diagnosis of a heat injury to screen for abnormalities. We present the case of a 20-year-old male Soldier with an abnormal electrocardiogram (ECG) with a possible injury pattern and an elevated troponin level. He underwent a diagnostic cardiac angiogram, which demonstrated no abnormal findings. He was returned to duty upon recovery from the catheterization...
2017: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/28279743/vectrocardiography-identifies-patients-with-electrocardiographically-concealed-long-qt-syndrome-eclqts
#13
Daniel Cortez, J Martijn Bos, Michael J Ackerman
BACKGROUND: Long QT syndrome (LQTS) and genotypic subtypes are associated with distinctive T wave patterns, arrhythmogenic triggers, and corrected QT interval (QTc) risk associations. Twenty percent of patients with LQTS have normal QTc values, electrographically concealed LQTS (ecLQTS). Vectorcardiography (VCG) has value for sudden cardiac death risk assessment. OBJECTIVE: To determine the utility of VCG to identify patients with ecLQTS. METHODS: We performed a retrospective review on patients with ecLQTS, defined as resting QTc values < 440 ms...
March 6, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28279312/the-role-of-post-resuscitation-electrocardiogram%C3%A2-in-patients-with%C3%A2-st-segment%C3%A2-changes-in-the-immediate%C3%A2-post-cardiac-arrest-period
#14
Youn-Jung Kim, Sun-Yang Min, Dong Hun Lee, Byung Kook Lee, Kyung Woon Jeung, Hui Jai Lee, Jonghwan Shin, Byuk Sung Ko, Shin Ahn, Gi-Byoung Nam, Kyoung Soo Lim, Won Young Kim
OBJECTIVES: The authors aimed to evaluate the role of post-resuscitation electrocardiogram (ECG) in patients showing significant ST-segment changes on the initial ECG and to provide useful diagnostic indicators for physicians to determine in which out-of-hospital cardiac arrest (OHCA) patients brain computed tomography (CT) should be performed before emergency coronary angiography. BACKGROUND: The usefulness of immediate brain CT and ECG for all resuscitated patients with nontraumatic OHCA remains controversial...
March 13, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28275419/early-diagnosis-and-treatment-of-coronary-heart-disease-in-symptomatic-subjects-with-advanced-vascular-atherosclerosis-of-the-carotid-artery-type-iii-and-iv-b-findings-using-ultrasound
#15
Ansgar Adams, Waldemar Bojara, Klaus Schunk
BACKGROUND: A study was conducted as to whether the early diagnosis of coronary heart disease (CHD) in symptomatic patients with advanced atherosclerosis of the carotid artery was more successful using ultrasound technology than exercise electrocardiography (ECG). METHODS: Within the scope of an occupational screening program using subjects from diverse employment sectors, people were given the opportunity to determine their risk of heart attack. During the study, the total plaque area (TPA), the maximum plaque thickness in the carotid artery and the PROCAM scores of 3,513 healthy men and 2,088 healthy women between the ages of 20 and 65 were determined...
February 2017: Cardiology Research
https://www.readbyqxmd.com/read/28273995/prinzmetals-angina-masquerading-as-acute-pericarditis
#16
Ashwal Adamane Jayaram, Mugula Sudhakar Rao, R Padmakumar, Uk Abdul Razak
Coronary artery spasm is an intense vasoconstriction of the coronary arteries and may be responsible for the myocardial ischemia, myocardial infarction as well as sudden deaths. Coronary angiography is generally needed to identify the cause. Coronary artery spasm is a multifactorial disease with underlying mechanism still poorly understood. Here, we present case of a 48-year-old male with no significant past history who presented with acute episodic onset chest pain. Clinical, Electrocardiography (ECG) and echocardiographic findings suggested pericarditis but a diagnostic coronary angiography revealed significant coronary vasospasm...
January 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28273368/silent-atrial-fibrillation-epidemiology-diagnosis-and-clinical-impact
#17
REVIEW
Polychronis E Dilaveris, Harold L Kennedy
Silent or subclinical asymptomatic atrial fibrillation (SAF) has currently gained wide interest in the epidemiologic, neurologic, and cardiovascular communities. It is well known that the electrophysiological and mechanical effects of symptomatic and silent atrial fibrillation (AF) are the same. It is probable that because "AF begets AF," progression from paroxysmal to persistent or permanent AF might be more rapid in patients with long-term unrecognized and untreated SAF, because no treatment is sought by or provided to such patients...
March 8, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28270286/initial-experience-of-the-application-of-third-generation-dual-source-ct-scanner-in-high-pitch-angiography-of-aorta
#18
Jixiang Liang, Lingyan Kong, Zhengyu Jin, Yun Wang, Huadan Xue, Yining Wang, Daming Zhang, Jin Chen
Objective To evaluate the value of third-generation dual-source CT scanner in application of high-pitch aorta CT angiography(CTA). Methods Totally 59 patients clinically indicated for whole aorta angiography were divided into 2 groups using a simple random method:in group 1 there were 28 patients who underwent the examination on a third-generation dual-source CT device,with a collimation of 2×192×0.6 mm and a rotation time of 0.25 s;in group 2 there were 31 patients who underwent the examination on a second generation dual-source CT device,with a collimation of 2×128×0...
February 20, 2017: Zhongguo Yi Xue Ke Xue Yuan Xue Bao. Acta Academiae Medicinae Sinicae
https://www.readbyqxmd.com/read/28270285/initial-experience-of-the-application-of-automated-tube-potential-selection-technique-in-high-pitch-dual-source-ct-angiography-of-whole-aorta-using-third-generation-dual-source-ct-scanner
#19
Lingyan Kong, Jixiang Liang, Huadan Xue, Yining Wang, Yun Wang, Zhengyu Jin, Daming Zhang, Jin Chen
Objective To evaluate the application of automated tube potential selection technique in high-pitch dual-source CT aortic angiography on a third-generation dual-source CT scanner. Methods Whole aorta angiography were indiated in 59 patients,who were divided into 2 groups using a simple random method:in group 1 there were 31 patients who underwent the examination with automated tube potential selection using a vascular setting with a preferred image quality of 288 mA/100 kV;in group 2 there were 28 patients who underwent the examination with a tube voltage of 100 kV and automated tube current modulation using a reference tube current of 288 mA...
February 20, 2017: Zhongguo Yi Xue Ke Xue Yuan Xue Bao. Acta Academiae Medicinae Sinicae
https://www.readbyqxmd.com/read/28270281/application-of-the-low-dose-one-stop-shop-cardiac-ct-protocol-with-third-generation-dual-source-ct
#20
Lu Lin, Yining Wang, Yan Yi, Jian Cao, Lingyan Kong, Hao Qian, Hongzhi Zhang, Wei Wu, Yun Wang, Zhengyu Jin
Objective To evaluate the feasibility of a low-dose one-stop-shop cardiac CT imaging protocol with third-generation dual-source CT (DSCT). Methods Totally 23 coronary artery disease (CAD) patients were prospectively enrolled between March to September in 2016. All patients underwent an ATP stress dynamic myocardial perfusion imaging (MPI) (data acquired prospectively ECG-triggered during end systole by table shuttle mode in 32 seconds) at 70 kV combined with prospectively ECG-triggered high-pitch coronary artery angiography (CCTA) on a third-generation DSCT system...
February 20, 2017: Zhongguo Yi Xue Ke Xue Yuan Xue Bao. Acta Academiae Medicinae Sinicae
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