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EMERGENCY ECG

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https://www.readbyqxmd.com/read/27899069/gastric-dilatation-and-intestinal-obstruction-mimicking-acute-coronary-syndrome-with-dynamic-electrocardiographic-changes
#1
H M M T B Herath, Anne Thushara Matthias, B S D P Keragala, W A E Udeshika, Aruna Kulatunga
BACKGROUND: ST elevation myocardial infarction is a medical emergency and the electrocardiogram is a part of the mainstay in the initial diagnosis. A variety of non-cardiac conditions have been known to mimic the electrocardiographic changes seen in acute coronary syndrome. We present a patient presenting with acute partial intestinal obstruction causing gastric distension and intestinal dilatation who also had dynamic electrocardiographic changes, mimicking anterior ST elevation myocardial infarction...
November 29, 2016: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/27895451/non-cardiogenic-pulmonary-edema-rhabdomyolysis-and-myocardial-injury-following-heroin-inhalation-a-case-report
#2
G Bazoukis, A Spiliopoulou, K Mourouzis, P Grigoropoulou, A Yalouris
BACKGROUND: Heroin use by non-injecting routes of administration (snorting, swallowing, "chasing the dragon") is considered to be safer but is not risk-free for fatal overdose or serious side effects. We report the case of an adolescent who was transferred unconscious to the emergency department after heroin inhalation. Description of the case: A 17-year-old male was transferred to the emergency department unconscious (Glasgow coma scale: 6/15) after heroin inhalation. He was treated with non-rebreather mask and intravenous infusion of naloxone with gradual improvement of consciousness and arterial blood gasses...
January 2016: Hippokratia
https://www.readbyqxmd.com/read/27884575/brugada-pattern-caused-by-a-flecainide-overdose
#3
Elena Tessitore, Majd Ramlawi, Olivier Tobler, Henri Sunthorn
BACKGROUND: Brugada pattern can be found on the electrocardiogram (ECG) of patients with altered mental status, usually with fever or drug intoxication. Diagnosis remains challenging, because the ECG changes are dynamic and variable. In addition, triggers are not always clearly identified. In patients with atrial fibrillation (AF), the use of class IC antidysrhythmic drugs can unmask a Brugada pattern on the ECG, especially if combined with other medications acting on sodium channels...
November 21, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27877193/a-combined-linkage-and-exome-sequencing-analysis-for-electrocardiogram-parameters-in-the-erasmus-rucphen-family-study
#4
Claudia T Silva, Irina V Zorkoltseva, Najaf Amin, Ayşe Demirkan, Elisabeth M van Leeuwen, Jan A Kors, Marten van den Berg, Bruno H Stricker, André G Uitterlinden, Anatoly V Kirichenko, Jacqueline C M Witteman, Rob Willemsen, Ben A Oostra, Tatiana I Axenovich, Cornelia M van Duijn, Aaron Isaacs
Electrocardiogram (ECG) measurements play a key role in the diagnosis and prediction of cardiac arrhythmias and sudden cardiac death. ECG parameters, such as the PR, QRS, and QT intervals, are known to be heritable and genome-wide association studies of these phenotypes have been successful in identifying common variants; however, a large proportion of the genetic variability of these traits remains to be elucidated. The aim of this study was to discover loci potentially harboring rare variants utilizing variance component linkage analysis in 1547 individuals from a large family-based study, the Erasmus Rucphen Family Study (ERF)...
2016: Frontiers in Genetics
https://www.readbyqxmd.com/read/27869048/efficacy-safety-and-tolerability-of-vortioxetine-for-the-treatment-of-major-depressive-disorder-in-patients-aged-55-years-or-older
#5
George G Nomikos, Dapo Tomori, Wei Zhong, John Affinito, William Palo
OBJECTIVE: These post hoc analyses evaluate the efficacy, safety, and tolerability of vortioxetine versus placebo in patients aged ≥55 years with major depressive disorder (MDD). METHODS: Study-level efficacy data from 12 short-term, fixed-dose, randomized, placebo-controlled trials of vortioxetine 5-20 mg/day were assessed using a random-effects meta-analysis. Adverse events (AEs), vital signs, ECG values, liver enzymes, and body weight were pooled from the same studies...
November 21, 2016: CNS Spectrums
https://www.readbyqxmd.com/read/27863892/pericarditis-mimicking-brugada-syndrome-a-case-report
#6
Manuel Monti, Giulia Olivi, Francesca Francavilla, Francesco Borgognoni
INTRODUCTION: Brugada syndrome (BrS) is a genetic heart disorder due to alteration of the ion channels function that causes an impaired in the cardiac conduction system. It is characterized by an abnormal electrocardiogram pattern and may be complicated by malignant ventricular arrhythmias. Pericarditis is an inflammation of the pericardium and 90% of isolated cases of acute pericarditis are idiopathic or viral. Acute pericarditis may appears with chest pain, fever, pericardial friction rub, and cardiac tamponade...
November 9, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27858506/causes-of-prehospital-misinterpretations-of-st-elevation-myocardial-infarction
#7
Nichole Bosson, Stephen Sanko, Ronald E Stickney, James Niemann, William J French, James G Jollis, Michael C Kontos, Tyson G Taylor, Peter W Macfarlane, Richard Tadeo, William Koenig, Marc Eckstein
OBJECTIVES: To determine the causes of software misinterpretation of ST elevation myocardial infarction (STEMI) compared to clinically identified STEMI to identify opportunities to improve prehospital STEMI identification. METHODS: We compared ECGs acquired from July 2011 through June 2012 using the LIFEPAK 15 on adult patients transported by the Los Angeles Fire Department. Cases included patients ≥18 years who received a prehospital ECG. Software interpretation of the ECG (STEMI or not) was compared with data in the regional EMS registry to classify the interpretation as true positive (TP), true negative (TN), false positive (FP), or false negative (FN)...
November 18, 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27832957/the-physio-toolbox-for-modeling-physiological-noise-in-fmri-data
#8
Lars Kasper, Steffen Bollmann, Andreea O Diaconescu, Chloe Hutton, Jakob Heinzle, Sandra Iglesias, Tobias U Hauser, Miriam Sebold, Zina-Mary Manjaly, Klaas P Pruessmann, Klaas E Stephan
BACKGROUND: Physiological noise is one of the major confounds for fMRI. A common class of correction METHODS: model noise from peripheral measures, such as ECGs or pneumatic belts. However, physiological noise correction has not emerged as a standard preprocessing step for fMRI data yet due to: (1) the varying data quality of physiological recordings, (2) non-standardized peripheral data formats and (3) the lack of full automatization of processing and modeling physiology, required for large-cohort studies...
November 7, 2016: Journal of Neuroscience Methods
https://www.readbyqxmd.com/read/27816333/ischemic-stroke-due-to-hypoperfusion-in-a-patient-with-a-previously-unrecognized-danon-disease
#9
Marco Marino, Olimpia Musumeci, Giuseppe Paleologo, Maria Cucinotta, Alba Migliorato, Carmelo Rodolico, Antonio Toscano
Danon disease, an X-linked multisystemic disorder, is due to deficiency of Lysosome-Associated Membrane Protein 2 (LAMP2). It is usually characterized by hypertrophic cardiomyopathy, mental retardation and skeletal myopathy, sometimes also with atypical features. A 20-year-old man with cognitive impairment was admitted to the Emergency Room because of a sudden chest pain. ECG showed Wolff-Parkinson-White syndrome; echocardiography revealed hypertrophic cardiomyopathy, and, shortly after, he experienced a cardiac arrest followed by an occipital ischemic stroke...
October 5, 2016: Neuromuscular Disorders: NMD
https://www.readbyqxmd.com/read/27807020/miliary-tuberculosis-in-an-immunocompetent-male-with-a-fatal-outcome
#10
Louise Dunphy, Elizabeth Keating, T Parke
A man aged 33 years, born in Nepal, but resident in the UK for 7 years presented to the emergency department with a 4-day history of general malaise, fever (temperature 38.6°C) and a non-productive cough. His medical history was unremarkable and no high-risk behaviour was identified. Clinical examination confirmed decreased air entry bilaterally with bibasal crackles. He was tachycardic, with a heart rate of 120 bpm. Further investigation with a 12-lead ECG confirmed supraventricular tachycardia (SVT) which was terminated with vagal manoeuvres...
November 2, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27797440/the-association-of-electrocardiographic-abnormalities-and-major-adverse-cardiac-events-in-emergency-patients-with-chest-pain
#11
Thomas Knowlman, Jaimi H Greenslade, William Parsonage, Tracey Hawkins, Lorcan Ruane, Paul Martin, Sandhir Prasad, Daniel Lancini, Louise Cullen
OBJECTIVES: The electrocardiograph (ECG) is an essential tool in initial management and risk stratification of patients with suspected acute coronary syndrome (ACS). A six-point reporting criterion has been proposed to facilitate standardized clinical assessment of patients presenting to the emergency department (ED) with suspected ACS. We set out to evaluate the efficacy of these criteria in identifying patients with major adverse cardiac events (MACE), Type 1 myocardial infarction (T1MI), Type 2 myocardial infarction (T2MI), and one-year mortality in a cohort of emergency patients with chest pain...
October 31, 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/27796707/comparison-of-clinical-based-and-ecg-based-triage-of-acute-chest-pain-in-the-emergency-department
#12
Melanie Dechamps, Diego Castanares-Zapatero, Patrick Vanden Berghe, Philippe Meert, Alessandro Manara
In the Emergency Department, chest pain triage systems are based on either clinical features or ECG recording. In this prospective, single-center, observational study, we aimed to compare the diagnostic performance of these triage systems in distinguishing acute coronary syndromes (ACS) from diseases of mild severity. Patients were sorted into the triage systems based on collected data at admission and on a systematic 12-lead ECG performed at triage. The final diagnosis was determined after a 30-day follow-up...
October 28, 2016: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/27780740/comparative-performance-assessment-of-commercially-available-automatic-external-defibrillators-a-simulation-and-real-life-measurement-study-of-hands-off-time
#13
Simone Savastano, Vincenzo Vanni, Roman Burkart, Maurizio Raimondi, Fabrizio Canevari, Simone Molinari, Enrico Baldi, Aurora I Danza, Maria Luce Caputo, Romano Mauri, Francois Regoli, Giulio Conte, Claudio Benvenuti, Angelo Auricchio
PURPOSE: Early and good quality cardiopulmonary resuscitation (CPR) and the use of automated external defibrillators (AEDs) improve cardiac arrest patients' survival. However, AED peri- and post-shock/analysis pauses may reduce CPR effectiveness. METHODS: The time performance of 12 different commercially available AEDs was tested in a manikin based scenario; then the AEDs recordings from the same tested models following the clinical use both in Pavia and Ticino were analyzed to evaluate the post-shock and post-analysis time...
October 22, 2016: Resuscitation
https://www.readbyqxmd.com/read/27778147/effects-of-acute-carbon-monoxide-poisoning-on-ecg-and-echocardiographic-parameters-in-children
#14
Abdullah Ozyurt, Derya Karpuz, Aydin Yucel, Mehtap Durukan Tosun, Ayse Esin Kibar, Olgu Hallioglu
The aim of the current study is to investigate the effects of CO (carbon monoxide) on the cardiovascular system via electrocardiographic, echocardiographic and biochemical findings in children. This prospective study included 22 children with CO poisoning and 24 healthy children as a control group. The CO-intoxicated children were evaluated via electrocardiography and echocardiography 1 h after admission to the emergency department and daily until their discharge from the hospital. Blood gasses, complete blood account, troponin I and creatinine kinase-MB(CK-MB) were assessed daily...
October 24, 2016: Cardiovascular Toxicology
https://www.readbyqxmd.com/read/27776642/type-a-aortic-dissection-are-there-ct-signs-suggestive-of-valvular-involvement
#15
Alexandra Platon, Stephane Bernard, Nils Perrin, Nicolas Murith, Gregor John, Thomas Perneger, Olivier T Rutschmann, Pierre-Alexandre Poletti
AIM: To identify the predictive signs of aortic valve involvement on the non-electrocardiogram (ECG)-gated admission computed tomography (CT) of patients with Type A aortic dissection (AD) according to the Stanford classification. MATERIALS AND METHODS: We retrospectively analyzed the non-ECG-gated CT examinations of patients admitted to the emergency department who underwent surgery for Type A AD over a period of 4 years. The diameter of the following structures was calculated as the mean of the smallest and largest diameters (mm) measured in two different planes: aortic annulus, sinus of Valsalva, sinotubular junction, and proximal ascending aorta...
November 2016: European Journal of Radiology
https://www.readbyqxmd.com/read/27769754/long-term-prognostic-value-of-a-negative-work-up-for-acute-coronary-disease-in-emergency-department-chest-pain-patients-without-known-coronary-artery-disease-a-cohort-study
#16
Anne-Maree Kelly, Sharon Klim
BACKGROUND: To determine the rate of all cause and cardiac death, new myocardial infarction (MI) or coronary revascularisation at over three years from index visit in emergency department chest pain patients without known coronary artery disease (CAD) at index presentation who had a negative electrocardiogram (ECG) and biomarker workup for acute coronary syndrome (ACS). METHODS: An unplanned sub-study of a prospective observational study of consecutive adult patients presenting to the ED with atraumatic chest pain (or equivalents)...
September 13, 2016: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/27765481/cost-analysis-of-the-history-ecg-age-risk-factors-and-initial-troponin-heart-pathway-randomized-control-trial
#17
Robert F Riley, Chadwick D Miller, Gregory B Russell, Erin N Harper, Brian C Hiestand, James W Hoekstra, Cedric W Lefebvre, Bret A Nicks, David M Cline, Kim L Askew, Simon A Mahler
INTRODUCTION: The HEART Pathway is a diagnostic protocol designed to identify low-risk patients presenting to the emergency department with chest pain that are safe for early discharge. This protocol has been shown to significantly decrease health care resource utilization compared with usual care. However, the impact of the HEART Pathway on the cost of care has yet to be reported. METHODS AND RESULTS: We performed a cost analysis of patients enrolled in the HEART Pathway trial, which randomized participants to either usual care or the HEART Pathway protocol...
October 5, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27765299/prognostic-value-of-coronary-artery-calcium-score-in-acute-chest-pain-patients-without-known-coronary-artery-disease-systematic-review-and-meta-analysis
#18
REVIEW
Kongkiat Chaikriangkrai, Ghanshyam Palamaner Subash Shantha, Hye Yeon Jhun, Patompong Ungprasert, Gardar Sigurdsson, Faisal Nabi, John J Mahmarian, Su Min Chang
STUDY OBJECTIVE: Coronary artery calcium score (CACS) is a well-established test for risk stratifying asymptomatic patients. Recent studies also indicate that CACS may accurately risk stratify stable patients presenting to the emergency department (ED) with acute chest pain; however, many were underpowered. The purpose of this systematic review and meta-analysis is to evaluate the prognostic value and accuracy of a zero (normal) CACS for identifying patients at acceptable low risk for future cardiovascular events who might be safely discharged home from the ED...
December 2016: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/27761167/genetics-of-brugada-syndrome
#19
Jyh-Ming Jimmy Juang, Minoru Horie
In 1992, the Brugada syndrome (BrS) was recognized as a disease responsible for sudden cardiac death, characterized by a right bundle-branch block with ST segment elevation in the leads V1 and V2. This syndrome is highly associated with sudden cardiac death, especially in young males. BrS is currently diagnosed in patients with ST-segment elevation showing type 1 morphology ≥ 2 mm in ≥1 leads among the right precordial leads V1 or V2 positioned in the 2nd, 3rd, or 4th intercostal space, and occurring either spontaneously or after a provocative drug test by the intravenous administration of Class I antiarrhythmic drugs...
October 2016: Journal of Arrhythmia
https://www.readbyqxmd.com/read/27759433/emergency-physician-accuracy-in-interpreting-electrocardiograms-with-potential-st-segment-elevation-myocardial-infarction-is-it-enough
#20
Giacomo Veronese, Federico Germini, Stella Ingrassia, Ombretta Cutuli, Valeria Donati, Luca Bonacchini, Maura Marcucci, Andrea Fabbri
BACKGROUND: Electrocardiogram (ECG) interpretation is widely performed by emergency physicians. We aimed to determine the accuracy of interpretation of potential ST-segment elevation myocardial infarction (STEMI) ECGs by emergency physicians. METHODS: Thirty-six ECGs resulted in putative STEMI diagnoses were selected. Participants were asked to focus on whether or not the ECG in question met the diagnostic criteria for an acutely blocked coronary artery causing a STEMI...
October 19, 2016: Acute Cardiac Care
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