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EMERGENCY ECG

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https://www.readbyqxmd.com/read/28333976/early-diagnosis-of-acute-myocardial-infarction-using-high-sensitivity-troponin-i
#1
Johannes Tobias Neumann, Nils Arne Sörensen, Francisco Ojeda, Thomas Renné, Renate B Schnabel, Tanja Zeller, Mahir Karakas, Stefan Blankenberg, Dirk Westermann
OBJECTIVE: There is a clinical need for early and accurate diagnosis of acute myocardial infarction (AMI). Current European Society of Cardiology (ESC) guidelines recommend diagnosis of non-ST-elevation AMI based on serial troponin measurements. We aimed to challenge the ESC guidelines using 1) a high-sensitivity troponin I (hs-TnI) baseline cutoff, 2) an absolute hs-TnI change after 1 hour and 3) additional application of an ischemic ECG. METHODS: 1,516 patients with suspected AMI presenting to the emergency department were included...
2017: PloS One
https://www.readbyqxmd.com/read/28329355/international-recommendations-for-electrocardiographic-interpretation-in-athletes
#2
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/28328689/adult-chest-pain-in-the-pediatric-emergency-department-treatment-and-timeliness-from-door-in-to-door-out
#3
Jeffrey H Sacks, Peter B Flueckiger, Philip R Spandorfer, William T Mahle, Brian E Costello
OBJECTIVES: The American College of Cardiology Foundation/American Heart Association guidelines for acute coronary syndrome (ACS) recommend immediate aspirin (ASA) administration, an electrocardiogram (ECG) in less than 10 minutes, and a door-in to door-out (DIDO) time less than 30 minutes for interfacility transfer. We sought to determine if compliance is hindered when adults with suspected ACS present to pediatric facilities. METHODS: Visits to the 2 tertiary care emergency departments of a pediatric healthcare system using an adult chest pain protocol were examined from October 2006 to September 2012...
March 21, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28323905/elevated-plasma-levels-of-cardiac-troponin-i-predict-left-ventricular-systolic-dysfunction-in-patients-with-myotonic-dystrophy-type-1-a-multicentre-cohort-follow-up-study
#4
Mark J Hamilton, Yvonne Robb, Sarah Cumming, Helen Gregory, Alexis Duncan, Monika Rahman, Anne McKeown, Catherine McWilliam, John Dean, Alison Wilcox, Maria E Farrugia, Anneli Cooper, Josephine McGhie, Berit Adam, Richard Petty, Cheryl Longman, Iain Findlay, Alan Japp, Darren G Monckton, Martin A Denvir
OBJECTIVE: High sensitivity plasma cardiac troponin-I (cTnI) is emerging as a strong predictor of cardiac events in a variety of settings. We have explored its utility in patients with myotonic dystrophy type 1 (DM1). METHODS: 117 patients with DM1 were recruited from routine outpatient clinics across three health boards. A single measurement of cTnI was made using the ARCHITECT STAT Troponin I assay. Demographic, ECG, echocardiographic and other clinical data were obtained from electronic medical records...
2017: PloS One
https://www.readbyqxmd.com/read/28304194/out-of-hospital-cardiac-arrest-survivors-sent-for-emergency-angiography-a-clinical-score-for-predicting-acute-myocardial-infarction
#5
Floriane Zeyons, Laurence Jesel, Olivier Morel, Hélène Kremer, Nathan Messas, Sebastien Hess, Ulun Crimizade, Philippe Reydel, Laurent Tritsch, Patrick Ohlmann
BACKGROUND: Out-of-hospital cardiac arrest (OHCA) remains a major public health issue. Emergency coronary angiography and percutaneous coronary intervention might improve survival, especially when cardiac arrest is caused by acute myocardial infarction (AMI). However, identifying patients with AMI after OHCA remains challenging. The aim of this study was to determine the clinical and ECG criteria in OHCA that may help to identify better the patients with AMI. METHODS: Consecutive OHCA patients who underwent emergency coronary angiography in our centre between 2009 and 2013 were included in this retrospective single-centre observational study...
March 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28294866/-treatment-of-patients-with-stable-ischemic-heart-disease-in-real-clinical-practice-in-russia-the-choice-2-program
#6
G Glezer M, On Behalf Of The Choice-Study Participants On Behalf Of The Choice-Study Participants
OBJECTIVE: in the framework of an open post-marketing observational national program CHOICE-2 to assess correspondence between recommendations for management of patients with stable angina and actual clinical practice, as well as to assess effect of treatment with cytoprotector trimetazidine on clinical course of the disease. MATERIAL AND METHODS: Participating physicians (n=185 from 46 regions of Russian Federation) recruited 896 patients with ischemic heart disease (IHD)...
May 2016: Kardiologiia
https://www.readbyqxmd.com/read/28290845/-assessment-of-efficiency-of-medicamentous-therapy-in-correction-of-structurally-functional-changes-of-the-cardiac-muscle-at-patients-with-arterial-hypertension-in-combination-with-bronchial-asthma
#7
E I Tarlovskaya, A A Odegova
BACKGROUND: Bronchial asthma (BA) is a serious problem. It was found that the frequency of arterial hypertension (AH) detection in patients with asthma is about 30 %. At patients practically all types of violations of a warm rhythm meet a bronkhoobstruktivny syndrome. Emergence of rather new preparations - If-blockers, opens new opportunities in correction of heart rate (HR) and a cardioprotection at a combination of AH and BA. AIM: To assess therapy diltiazem-retard and ivabradine on structurally functional changes of a cardiac muscle and HR at patients with AH in combination with BA...
June 2016: Kardiologiia
https://www.readbyqxmd.com/read/28290164/risk-factors-for-permanent-pacemaker-after-implantation-of-surgical-or-percutaneous-self-expanding-aortic-prostheses
#8
Emmanuel Villa, Alberto Clerici, Antonio Messina, Luca Testa, Francesco Bedogni, Andrea Moneta, Francesco Donatelli, Giovanni Troise
BACKGROUND: The use of transcatheter aortic valve implantation (TAVI) following the introduction of Nitinol autoexpandable devices has spread rapidly during recent years. In addition, cardiac surgery has been revolutionized due to the use of Nitinol-based sutureless prostheses for aortic valve replacement (AVR). During the same period, however, permanent pacemaker (PPM) implantation has emerged as a frequent complication. The study aim was to identify the risk factors of PPM following the implantation of a Nitinol self-expanding prosthesis (for AVR or TAVI)...
November 2016: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28285882/effect-of-altering-the-intervals-between-consecutive-superovulatory-doses-of-porcine-follicle-stimulating-hormone-on-ovarian-responses-and-embryo-yields-in-anestrous-ewes
#9
P M Bartlewski, M Murawski, T Schwarz, M E F Oliveira
The effect of varying intervals between successive gonadotropin injections on the superovulatory outcomes in anestrous Rideau Arcott ewes superstimulated for ovarian follicular development with multiple doses of porcine FSH (pFSH) was evaluated in a single study. Twenty-five animals received six (1×2.5ml and 5×1.25ml) injections of Folltropin(®)-V given at 0800 and 1600h or at 0800 and 2000h in Group 1 (n=9) or Group 2 (n=16), respectively. An i.m. injection of 500 IU of equine chorionic gonadotropin (eCG; Folligon(®)) was given concurrently with the first pFSH dose...
March 6, 2017: Animal Reproduction Science
https://www.readbyqxmd.com/read/28283339/prinzmetal-angina-coronary-vasospasm-associated-with-5-fluorouracil-chemotherapy
#10
Maxim Ben-Yakov, Amal Mattu, William J Brady, Sarah B Dubbs
Several chemotherapeutic agents are known to be cardiotoxic. One of them, 5-fluorouracil (5-FU), has been associated with coronary ischemia and reversible vasospasm. In this report, we describe a 54-year-old man with rectal cancer who developed chest pain during 5-FU infusion. His initial electrocardiogram (ECG), obtained while he was experiencing chest pain, showed hyperacute T waves in the anterolateral leads. Those waves disappeared along with the chest pain after administration of sublingual nitroglycerine...
March 1, 2017: American Journal of Emergency Medicine
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
#11
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/28278167/superior-success-rate-of-intracavitary-electrocardiogram-guidance-for-peripherally-inserted-central-catheter-placement-in-patients-with-cancer-a-randomized-open-label-controlled-multicenter-study
#12
Ling Yuan, Rongmei Li, Aifeng Meng, Yuling Feng, Xiancui Wu, Yiqun Yang, Ping Chen, Zhenzhu Qiu, Jing Qi, Chuanying Chen, Jia Wei, Minyi Qin, Weiwei Kong, Xiangyu Chen, Wei Xu
BACKGROUND: Intracavitary electrocardiogram (IC ECG) guidance emerges as a new technique for peripherally inserted central catheters (PICCs) placement and demonstrates many potential advantages in recent observational studies. AIMS: To determine whether IC ECG-guided PICCs provide more accurate positioning of catheter tips compared to conventional anatomical landmarks in patients with cancer undergoing chemotherapy. METHODS: In this multicenter, open-label, randomized controlled study (ClinicalTrials...
2017: PloS One
https://www.readbyqxmd.com/read/28274542/hypokalemia-in-women-and-methadone-therapy-are-the-strongest-non-cardiologic-factors-associated-with-qt-prolongation-in-an-emergency-department-setting
#13
Keith A Marill, Emily S Miller
BACKGROUND: Our primary objective was to determine the adjusted quantitative associations of clinical predictors with QT prolongation, a defining cause of Torsades de Pointes (TdP). METHODS: A retrospective cohort study was performed on consecutive emergency department patients identified by ECG acquisition date, and heart rate corrected QT (QTc) and QRS durations. QTc was modeled as a function of clinical predictors with multiple linear regression. RESULTS: 1010 patients were included...
February 10, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/28271382/maximal-tachycardia-and-high-cardiac-strain-during-night-shifts-of-emergency-physicians
#14
Frédéric Dutheil, Fouad Marhar, Gil Boudet, Christophe Perrier, Geraldine Naughton, Alain Chamoux, Pascal Huguet, Martial Mermillod, Foued Saâdaoui, Farès Moustafa, Jeannot Schmidt
PURPOSE: To compare tachycardia and cardiac strain between 24-hour shifts (24hS) and 14-hour night shifts (14hS) in emergency physicians (EPs), and to investigate key factors influencing tachycardia and cardiac strain. METHODS: We monitored heart rate (HR) with Holter-ECG in a shift-randomized trial comparing a 24hS, a 14hS, and a control day, within a potential for 19 EPs. We also measured 24-h HR the third day (D3) after both shifts. We measured perceived stress by visual analog scale and the number of life-and-death emergencies...
March 7, 2017: International Archives of Occupational and Environmental Health
https://www.readbyqxmd.com/read/28269310/driver-drowsiness-detection-using-the-in-ear-eeg
#15
Taeho Hwang, Miyoung Kim, Seunghyeok Hong, Kwang Suk Park
Driver drowsiness monitoring is one of the most demanded technologies for active prevention of severe road accidents. Electroencephalogram (EEG) and several peripheral signals have been suggested for the drowsiness monitoring. However, each type of signal has partial limitations in terms of either convenience or accuracy. Recent emerged concept of in-ear EEG raises expectations due to reduced obtrusiveness. It is yet unclear whether the in-ear EEG is effective enough for drowsiness detection in comparison with on-scalp EEG or peripheral signals...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28268118/the-role-of-early-focused-cardiac-ultrasound-in-a-not-so-typical-presentation-of-takotsubo-cardiomyopathy-a-case-report
#16
Jithin G Varghese, Qurat-Ul-Ain Jelani, Stuart Zarich, Brooks Walsh
BACKGROUND: Focused cardiac ultrasound (FoCUS) can be extremely helpful in identifying unexpected diagnoses that can significantly alter treatment options. The diagnosis of Takotsubo cardiomyopathy (TCM) may be difficult to identify. CASE REPORT: We describe a 47-year-old woman who presented to the emergency department (ED) with atypical features of TCM. Her clinical features included being a premenopausal woman with mild chest pain with a lack of identifiable emotional or physical stressors or significant electrocardiographic changes...
March 3, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28261908/acute-coronary-syndrome-screening-and-diagnostic-practice-variation
#17
Maame Yaa A B Maya Yiadom, Xulei Liu, Conor M McWade, Dandan Liu, Alan B Storrow
BACKGROUND: In the absence of the existing acute coronary syndrome guidelines directing the clinical practice implementation of ED screening and diagnosis, there is variable screening and diagnostic clinical practice across ED facilities. This practice diversity may be warranted. Understanding the variability may identify opportunities for more consistent practice. METHODS: This is a cross-sectional clinical practice epidemiology study with the emergency department (ED) as the unit of analysis characterizing variability in the acute coronary syndrome (ACS) evaluation across 62 diverse EDs...
March 6, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28258297/-prehospital-analgesia-by-emergency-physicians-and-paramedics-comparison-of-effectiveness
#18
B Schempf, S Casu, D Häske
BACKGROUND: In some German emergency medical service districts, analgesia is performed by paramedics without support of emergency physicians on scene. With regard to safety and effectiveness, paramedics should not be overshadowed by emergency physicians. OBJECTIVES: Is prehospital analgesia performed by paramedics under medical supervision or emergency physicians comparable regarding processes and effectiveness in the case of isolated limb injury? MATERIAL AND METHODS: As a retrospective analysis of patients with isolated limb injury, analgesia performed by paramedics and by emergency physicians was analyzed...
March 3, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28258178/international-criteria-for-electrocardiographic-interpretation-in-athletes
#19
Jonathan A Drezner, Sanjay Sharma, 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...
March 3, 2017: British Journal of Sports Medicine
https://www.readbyqxmd.com/read/28256386/-reliability-study-on-the-interpretation-of-electrocardiograms-by-general-practitioners-and-trainees
#20
F J Alonso Moreno, R Orueta Sánchez, A Segura Fragoso, A I Rabadán Velasco, L Luna Del Pozo, A Villarín Castro, M Baquero Alonso, L Rodríguez Padial
OBJECTIVE: To determine the reliability of the interpretation of electrocardiograms (ECG) by general practitioners and those in training by making a comparison with the interpretation made by the cardiologist. MATERIAL AND METHODS: An observational study was conducted that included general practitioners working in the Toledo Health Area, physicians during their training in Family and Community Medicine, and cardiologists in their first 3 years of specialist training (R1-R3)...
February 27, 2017: Semergen
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