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https://www.readbyqxmd.com/read/28057896/out-of-hospital-cardiac-arrest-in-hong-kong-a-territory-wide-study
#1
K L Fan, L P Leung, Y C Siu
INTRODUCTION: Out-of-hospital cardiac arrest is a global health care problem. Like other cities in the world, Hong Kong faces the impact of such events. This study is the first territory-wide investigation of the epidemiology and outcomes of out-of-hospital cardiac arrest in Hong Kong. It is hoped that the findings can improve survival of patients with cardiac arrest. METHODS: This study was a retrospective analysis of the prospectively collected data on out-of-hospital cardiac arrest managed by the emergency medical service from 1 August 2012 to 31 July 2013...
January 6, 2017: Hong Kong Medical Journal, Xianggang Yi Xue za Zhi
https://www.readbyqxmd.com/read/28055996/-syncope-electrocardiogram-and-autonomic-function-tests
#2
William Uribe, Adrián Baranchuk, Federico Botero
Syncope represents one of the most frequent reasons for consultation in the emergency department. A proper identification will allow a precise etiologic approach and the optimization of delivery of health resources.
Once knowing the classification of syncope; it is the clinical interrogatory what enables to discriminate which of these patients present with a neurogenic mediated syncope or a cardiac mediated syncope. The use of diagnostic methods such as the tilt test, will clarify what type of neurally mediated syncope predominates in the patient...
December 23, 2016: Medwave
https://www.readbyqxmd.com/read/28045691/ecg-of-the-month-wide-qrs-tachycardias
#3
D Luke Glancy, Theresa A Mills
A 61-year-old man came from out of state to attend a football game. He felt well during the game, but when he stood up to leave, he became dizzy and dyspneic. The symptoms lasted 15 to 20 minutes, and when the paramedics arrived, they diagnosed an idioventricular rhythm and brought the patient to the emergency department where a 12-lead electrocardiogram (ECG) was recorded (Figure 1).
November 2016: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28034683/predictors-of-late-reperfusion-in-stemi-patients-undergoing-primary-angioplasty-impact-of-the-place-of-first-medical-contact
#4
Antoni Carol Ruiz, Josep Masip Utset, Albert Ariza Solé
INTRODUCTION AND OBJECTIVES: The benefit of primary angioplasty may be reduced if there are delays to reperfusion. Identification of the variables associated with these delays could improve health care. METHODS: Analysis of the Codi Infart registry of Catalonia and of the time to angioplasty depending on the place of first medical contact. RESULTS: In 3832 patients analyzed, first medical contact took place in primary care centers in 18% and in hospitals without a catheterization laboratory in 37%...
December 26, 2016: Revista Española de Cardiología
https://www.readbyqxmd.com/read/28034568/efficacy-and-safety-of-balloon-pulmonary-angioplasty-for-chronic-thromboembolic-pulmonary-hypertension-guided-by-cone-beam-computed-tomography-and-electrocardiogram-gated-area-detector-computed-tomography
#5
Takeshi Ogo, Tetsuya Fukuda, Akihiro Tsuji, Shigefumi Fukui, Jin Ueda, Yoshihiro Sanda, Yoshiaki Morita, Ryotaro Asano, Nao Konagai, Satoshi Yasuda
BACKGROUND: Chronic thromboembolic pulmonary hypertension (CTEPH) is a disease characterized by chronic obstructive thrombus and pulmonary hypertension. Balloon pulmonary angioplasty (BPA), an emerging alternative catheter-based treatment for inoperable patients with CTEPH, has not yet been standardised, especially for lesion assessment in distal pulmonary arteries. Recent advancement in computed tomography enables distal CTEPH lesions to be visualized. METHODS: We retrospectively studied 80 consecutive patients with inoperable CTEPH who received BPA guided by cone-beam computed tomography (CT) (CBCT) or electrocardiogram (ECG)-gated area detector CT (ADCT) for target lesion assessment...
December 21, 2016: European Journal of Radiology
https://www.readbyqxmd.com/read/28017935/neural-networks-as-a-tool-to-predict-syncope-risk-in-the-emergency-department
#6
Giorgio Costantino, Greta Falavigna, Monica Solbiati, Ivo Casagranda, Benjamin C Sun, Shamai A Grossman, James V Quinn, Matthew J Reed, Andrea Ungar, Nicola Montano, Raffaello Furlan, Roberto Ippoliti
AIMS: There is no universally accepted tool for the risk stratification of syncope patients in the Emergency Department. The aim of this study was to investigate the short-term predictive accuracy of an artificial neural network (ANN) in stratifying the risk in this patient group. METHODS AND RESULTS: We analysed individual level data from three prospective studies, with a cumulative sample size of 1844 subjects. Each dataset was reanalysed to reduce the heterogeneity among studies defining abnormal electrocardiogram (ECG) and serious outcomes according to a previous consensus...
December 25, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28017302/cardiodynamicsgram-as-a-new-diagnostic-tool-in-coronary-artery-disease-patients-with-nondiagnostic-electrocardiograms
#7
Muqing Deng, Min Tang, Cong Wang, Liang Shan, Linfeng Zhang, Jingtao Zhang, Weiming Wu, Ling Xia
Cardiodynamicsgram (CDG) has emerged recently as a noninvasive spatiotemporal electrocardiographic method for subtle cardiac dynamics information analysis within electrocardiogram (ECG). This study sought to evaluate the clinical utility of CDG for early coronary artery disease (CAD) detection in suspected patients with CAD presenting with nondiagnostic ECGs. A total of 421 suspected patients with CAD presenting with nondiagnostic ECG were enrolled. Standard 12-lead ECG and CDG were performed simultaneously, 1 day before invasive coronary angiography...
December 2, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/27999038/pharmacokinetics-and-tolerability-of-abx464-a-novel-first-in-class-compound-to-treat-hiv-infection-in-healthy-hiv-uninfected-subjects
#8
Didier Scherrer, Regine Rouzier, P Noel Barrett, Jean-Marc Steens, Paul Gineste, Robert L Murphy, Jamal Tazi, Hartmut J Ehrlich
BACKGROUND: An anti-HIV compound (ABX464) has been developed with a novel mechanism of activity in that it blocks viral gene expression in cells that are already infected. OBJECTIVES: A first-in-man study was conducted to determine the pharmacokinetic and safety profiles of ABX464. This was carried out as an open label, parallel group, single ascending dose, exploratory study. METHODS: Twenty-four male subjects in good health without HIV infection, aged from 18 to 55 years old, with BMIs of 18-27 kg/m(2) were included...
December 20, 2016: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/27998614/the-de-winter-electrocardiographic-pattern-of-proximal-left-anterior-descending-occlusion
#9
Wei Yang, Hongzhou Liu, Minjie Zhu, Zizheng Song
Prompt recognition of electrocardiographic signs of acute left anterior descending (LAD) occlusion is essential for timely restoration of flow. However, some patients may present with atypical electrocardiographic signs, and early diagnosis of these patients may constitute a clinical challenge. Here, we report two cases presenting with an atypical electrocardiographic manifestation despite angiographically confirmed acute thrombotic occlusion of proximal LAD. These cases highlight the importance of recognizing the de Winter electrocardiogram pattern in cases of suspected acute myocardial infarction (AMI)...
December 16, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27998300/is-increased-positive-end-expiratory-pressure-the-culprit-autoresuscitation-in-a-44-year-old-man-after-prolonged-cardiopulmonary-resuscitation-a-case-report
#10
Henning Hagmann, Katrin Oelmann, Robert Stangl, Guido Michels
BACKGROUND: The phenomenon of autoresuscitation is rare, yet it is known to most emergency physicians. However, the pathophysiology of the delayed return of spontaneous circulation remains enigmatic. Among other causes hyperinflation of the lungs and excessively high positive end-expiratory pressure have been suggested, but reports including cardiopulmonary monitoring during cardiopulmonary resuscitation are scarce to support this hypothesis. CASE PRESENTATION: We report a case of autoresuscitation in a 44-year-old white man after 80 minutes of advanced cardiac life support accompanied by continuous capnometry and repeated evaluation by ultrasound and echocardiography...
December 20, 2016: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/27997286/kounis-syndrome-following-canned-tuna-fish-ingestion
#11
Luisa De Gennaro, Natale Daniele Brunetti, Nicola Locuratolo, Massimo Ruggiero, Manuela Resta, Giuseppe Diaferia, Michele Rana, Pasquale Caldarola
Kounis syndrome (KS) is a complex of cardiovascular symptoms and signs following either allergy or hypersensitivity and anaphylactic or anaphylactoid insults. We report the case of 57-year-old man, with hypertension and history of allergy, referred for facial rash and palpitations appeared after consumption of canned tuna fish. Suddenly, the patient collapsed: electrocardiogram showed ST-elevation in inferior leads. The patient was transferred from the spoke emergency room for coronary angio, which did not show any sign of coronary atherosclerosis...
December 20, 2016: Acta Clinica Belgica
https://www.readbyqxmd.com/read/27993292/long-term-general-and-cardiovascular-safety-of-tiotropium-olodaterol-in-patients-with-moderate-to-very-severe-chronic-obstructive-pulmonary-disease
#12
Roland Buhl, Sheldon Magder, Ulrich Bothner, Kay Tetzlaff, Florian Voß, Lazaro Loaiza, Claus F Vogelmeier, Lorcan McGarvey
BACKGROUND: Long-term safety, particularly cardiovascular safety, is of special interest in maintenance treatment of chronic obstructive pulmonary disease (COPD) with long-acting β2-agonists and long-acting muscarinic antagonists, given potential cardiovascular effects. METHODS: Two 52-week Phase III trials (TONADO(®)) investigated tiotropium/olodaterol (5/5 and 2.5/5 μg) versus tiotropium 2.5, 5 μg and olodaterol 5 μg. In a pre-specified safety analysis, investigator-reported treatment-emergent adverse events (AEs), electrocardiogram and laboratory data were pooled...
January 2017: Respiratory Medicine
https://www.readbyqxmd.com/read/27989256/junctional-tachycardia-in-a-child-with-non-rheumatic-fever-streptococcal-pharyngitis
#13
Neha Bansal, Peter P Karpawich, Chenni S Sriram
Accelerated junctional rhythm has been reported in children in the setting of acute rheumatic fever; however, we describe a hitherto unreported case of isolated junctional tachycardia in a child with streptococcal pharyngitis, not meeting revised Jones criteria for rheumatic fever. A previously healthy, 9-year-old girl presented to the emergency department with complaints of sore throat, low-grade fever, and intermittent chest pain. She was found to have a positive rapid streptococcal antigen test. The initial electrocardiogram showed junctional tachycardia with atrioventricular dissociation in addition to prolonged and aberrant atrioventricular conduction...
December 19, 2016: Cardiology in the Young
https://www.readbyqxmd.com/read/27988446/a-novel-variant-in-ryr2-causes-familiar-catecholaminergic-polymorphic-ventricular-tachycardia
#14
Cristina Bosch, Oscar Campuzano, Georgia Sarquella-Brugada, Sergi Cesar, Alexandra Perez-Serra, Monica Coll, Irene Mademont, Jesus Mates, Bernat Del Olmo, Anna Iglesias, Josep Brugada, Volker Petersen, Ramon Brugada
Catecholaminergic polymorphic ventricular tachycardia is a rare familial arrhythmogenic disease. It usually occurs in juvenile patients with a structurally normal heart and causes exercise-emotion triggered syncope and sudden cardiac death. The main gene associated with catecholaminergic polymorphic ventricular tachycardia is RyR2, encoding the cardiac ryanodine receptor protein which is involved in calcium homeostasis. After the identification of a 16 year-old man presenting with exercise-induced sudden cardiac death, clinically diagnosed as catecholaminergic polymorphic ventricular tachycardia, we collected the family information and performed a comprehensive genetic analysis using Next Generation Sequencing technology...
December 9, 2016: Forensic Science International
https://www.readbyqxmd.com/read/27987279/falsely-elevated-troponin-rare-occurrence-or-future-problem
#15
James Nguyen, Rosy Thachil, Neil Vyas, Thomas Marino
INTRODUCTION: Troponins are known to be released in response to cardiac damage and therefore are the biomarkers of choice for the early diagnosis of acute myocardial infarction (AMI), improving outcome in patients presenting with chest pain. However, false results can occur due to interference from other substances in the blood. CASE: A 52-year-old male with a past medical history of alcohol abuse, hypertension, and coronary artery bypass graft at age 34 with normal stress test 2 years before presented to the emergency department (ED) complaining of 1 day of non-exertional chest pain with radiation to the neck and left arm...
2016: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/27981367/-cardiac-causes-of-chest-pain
#16
C Wächter, B Markus, B Schieffer
Because of the life-threatening character and a high prevalence in emergency rooms, cardiac causes are important differential diagnoses of acute chest pain with the need for rapid clarification. In this context the working diagnosis "acute coronary syndrome" (ACS) plays a major role. In a synopsis of the clinical presentation, medical history, electrocardiogram and analysis of cardiac biomarkers, ST-segment elevation myocardial infarction (STEMI), non-ST-segment elevation myocardial infarction (NSTEMI) and unstable angina pectoris can be specified as entities of ACS...
December 15, 2016: Der Internist
https://www.readbyqxmd.com/read/27979041/acute-cardioversion-vs-a-wait-and-see-approach-for-recent-onset-symptomatic-atrial-fibrillation-in-the-emergency-department-rationale-and-design-of-the-randomized-acwas-trial
#17
Elton Dudink, Brigitte Essers, Wouter Holvoet, Bob Weijs, Justin Luermans, Hemanth Ramanna, Anho Liem, Jurren van Opstal, Lukas Dekker, Vincent van Dijk, Timo Lenderink, Otto Kamp, Lennert Kulker, Michiel Rienstra, Bas Kietselaer, Marco Alings, Jos Widdershoven, Joan Meeder, Martin Prins, Isabelle van Gelder, Harry Crijns
BACKGROUND: Current standard of care for patients with recent-onset atrial fibrillation (AF) in the emergency department aims at urgent restoration of sinus rhythm, although paroxysmal AF is a condition that resolves spontaneously within 24 hours in more than 70% of the cases. A wait-and-see approach with rate-control medication only and when needed cardioversion within 48 hours of onset of symptoms is hypothesized to be noninferior, safe, and cost-effective as compared with current standard of care and to lead to a higher quality of life...
January 2017: American Heart Journal
https://www.readbyqxmd.com/read/27977016/heart-sounds-at-home-feasibility-of-an-ambulatory-fetal-heart-rhythm-surveillance-program-for-anti-ssa-positive-pregnancies
#18
B F Cuneo, A J Moon-Grady, S-E Sonesson, S Levasseur, L Hornberger, M T Donofrio, A Krishnan, A Szwast, L Howley, D W Benson, E Jaeggi
OBJECTIVE: Fetuses exposed to anti-SSA (Sjögren's) antibodies are at risk of developing irreversible complete atrioventricular block (CAVB), resulting in death or permanent cardiac pacing. Anti-inflammatory treatment during the transition period from normal heart rhythm (fetal heart rhythm (FHR)) to CAVB (emergent CAVB) can restore sinus rhythm, but detection of emergent CAVB is challenging, because it can develop in ⩽24 h. We tested the feasibility of a new technique that relies on home FHR monitoring by the mother, to surveil for emergent CAVB...
December 15, 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/27955984/lower-extremity-weakness-in-a-teenager-due-to-thyrotoxic-periodic-paralysis
#19
Matthew D Thornton
BACKGROUND: Thyrotoxic hypokalemic paralysis is the hallmark of thyrotoxic periodic paralysis (TPP). TPP is a potentially deadly complication of hyperthyroidism that occurs because of rapid and dramatic intracellular shift of potassium. This transference results in severe hypokalemia and clinically manifests itself as muscle weakness or paralysis. This condition predominantly affects males of Asian descent, and its presentation can range from mild to severe, as seen in our case. CASE REPORT: We present the case of a 15-year-old Asian-American male who presented to a tertiary-care pediatric emergency department complaining of generalized weakness and flaccid paralysis of his lower extremities...
December 9, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27951539/wellens-syndrome-with-syncope-but-not-chest-pain
#20
Omar Z Yasin, Alberto Rubio-Tapia, Maurice E Sarano
We report the case of a woman in her 70s presenting to the emergency department with syncope, troponemia, and an electrocardiogram with deep symmetric T-wave inversions in V2 and V3 and prolonged QTc. Her presentation was concerning for acute coronary syndrome, Wellens syndrome in particular, given the elevated troponin levels, lack of ST segment changes, and characteristic T-wave findings. The diagnosis was confirmed with angiography that showed a critical left anterior descending (LAD) artery occlusion. Since myocardial infarction does not typically present with syncope, we explored the differential diagnoses for T-wave inversions, which include electrolyte abnormalities, medications, intracranial hemorrhage, pulmonary embolism, and other cardiac diseases that were ruled out in our patient...
December 13, 2016: Cardiology
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