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https://www.readbyqxmd.com/read/28515827/transient-left-bundle-branch-block-due-to-severe-hyperkalemia
#1
Kishore Kumar, Madhavi Biyyam, Amandeep Singh, Bharat Bajantri, Hassan Tariq, Suresh Kumar Nayudu, Sridhar Chilimuri
Hyperkalemia is a potentially life-threatening electrolyte imbalance that can lead to sudden death from cardiac arrhythmias and asystole. We present a case of transient left bundle branch block pattern on an electrocardiogram (ECG) secondary to hyperkalemia in a patient with history of end-stage renal disease. A 52-year-old man presented to the emergency room (ER) with chief complaints of weakness and lethargy after missing his regularly scheduled session of hemodialysis. A 12-lead ECG in the ER showed sinus tachycardia at 118 beats/min, wide QRS complexes, peaked T waves and left bundle branch block-like pattern...
April 2017: Cardiology Research
https://www.readbyqxmd.com/read/28515824/cardiogenic-shock-acute-severe-mitral-regurgitation-and-complete-heart-block-after-cavo-tricuspid-isthmus-atrial-flutter-ablation
#2
Thein Tun Aung, Edward Samuel Roberto, Kevin D Kravitz
Radiofrequency (RF) ablation is the first-line management of cavo-tricuspid isthmus dependent atrial flutter. It has been performed with 95% success rate. Adverse events are very rare. We report the first case of acute severe mitral regurgitation (MR) and complete heart block developed after successful atrial flutter ablation. A 62-year-old female with mild MR presented with palpitations. Surface electrocardiogram was suggestive of isthmus dependent atrial flutter. A duodecapolar mapping catheter showed an atrial flutter with cycle length of 280 ms...
April 2017: Cardiology Research
https://www.readbyqxmd.com/read/28515106/direct-comparison-of-2-rule-out-strategies-for-acute-myocardial-infarction-2-h-accelerated-diagnostic-protocol-vs-2-h-algorithm
#3
Karin Wildi, Louise Cullen, Raphael Twerenbold, Jaimi H Greenslade, William Parsonage, Jasper Boeddinghaus, Thomas Nestelberger, Zaid Sabti, Maria Rubini-Giménez, Christian Puelacher, Janosch Cupa, Lukas Schumacher, Patrick Badertscher, Karin Grimm, Nikola Kozhuharov, Claudia Stelzig, Michael Freese, Katharina Rentsch, Jens Lohrmann, Wanda Kloos, Andreas Buser, Tobias Reichlin, John Pickering, Martin Than, Christian Mueller
BACKGROUND: We compared 2 high-sensitivity cardiac troponin (hs-cTn)-based 2-h strategies in patients presenting with suspected acute myocardial infarction (AMI) to the emergency department (ED): the 2-h accelerated diagnostic protocol (2h-ADP) combining hs-cTn, electrocardiogram, and a risk score, and the 2-h algorithm exclusively based on hs-cTn concentrations and their absolute changes. METHODS: Analyses were performed in 2 independent diagnostic cohorts [European Advantageous Predictors of Acute Coronary Syndrome Evaluation (APACE) study, Australian-New Zealand 2-h Accelerated Diagnostic Protocol to Assess patients with chest Pain symptoms using contemporary Troponins as the only biomarker (ADAPT) study] employing hs-cTnT (Elecsys) and hs-cTnI (Architect)...
May 17, 2017: Clinical Chemistry
https://www.readbyqxmd.com/read/28506854/long-term-safety-and-efficacy-of-solifenacin-in-children-and-adolescents-with-overactive-bladder
#4
Donald Newgreen, Brigitte Bosman, Adriana Hollestein-Havelaar, Ellen Dahler, Robin Besuyen, Robert Snijder, Will Sawyer, Søren Rittig, Stéphane Bolduc
PURPOSE: To evaluate long-term safety and efficacy of once-daily oral solifenacin suspension in children (aged 5-<12 years) and adolescents (aged 12-<18 years) with overactive bladder. MATERIALS AND METHODS: 40-week, open-label extension of a 12-week double-blind, placebo-controlled trial. OUTCOME MEASURES: incidence and severity of adverse events (primary endpoint), laboratory variables, vital signs, 12-lead electrocardiogram, post-void residual volume, change from baseline to end of treatment in: mean number of micturitions and incontinence episodes/24 hours, number of incontinence-free days/7 days, number of grade 3 or 4 urgency episodes/24 hours (adolescents only)...
May 12, 2017: Journal of Urology
https://www.readbyqxmd.com/read/28506591/early-echocardiography-has-a-low-yield-in-patients-with-transient-ischemic-attack
#5
Elie Harmouche, Ghada A Mahmoud, Michael Ross, Jason Hockenberry, Robin Dharia, Fadi Nahab
STUDY OBJECTIVE: Current guidelines recommend patients presenting with transient ischemic attack (TIA) undergo echocardiography to evaluate for a cardiac source. However, echocardiography is not available daily at many centers. We assessed the yield from early transthoracic echocardiography (TTE) in consecutive patients with TIA evaluated in an emergency department observation unit (EDOU) protocol. METHODS: This observational cohort study took place in an academic medical center from January 1, 2011 to July 31, 2013...
May 11, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28497506/left-ventricular-obstruction-caused-by-a-large-hiatal-hernia
#6
Kenji Harada, Ushio Tamura, Chiyo Ichimiya, Naho Terada, Yasuhiro Yokoyama, Norihito Kageyama, Akira Hirono, Yuya Hiroshima, Takeshi Omura, Hirofumi Yamamoto, Hiroyuki Fujinaga
A 76-year-old man was admitted to our emergency department owing to chest pain, which started immediately after lunch. Although electrocardiogram revealed ST-segment elevation with hyperacute T-wave changes in the anterior lead tracings, emergency coronary angiography revealed normal coronary arteries. Echocardiography revealed left ventricular (LV) compression with left ventricular obstruction (LVO) caused by an echogenic mass. Computed tomography clearly revealed compression of both left atrial (LA) and LV by a large hiatal hernia...
May 12, 2017: Echocardiography
https://www.readbyqxmd.com/read/28494415/studies-on-curative-efficacy-of-monoterpene-eugenol-on-anti-leukemic-drug-arsenic-trioxide-induced-cardiotoxicity
#7
Prakash Binu, Nellikunnath Priya, Surendran Abhilash, Radhakrishnan Chandraprabha Vineetha, Raveendran Harikumaran Nair
BACKGROUND: Arsenic trioxide (As2O3) is emerging as a frontline agent for the treatment of acute promyelocytic leukemia (APL) but the therapeutic application is limited by its toxicity. QT prolongation, torsades de pointes and sudden cardiac death have been implicated in the As2O3 therapy. So eugenol is a monoterpene compound is well known for its antioxidant properties and protective effect on the cardiovascular system. OBJECTIVE: In this study, the cardioprotective effect of eugenol on cardiac electrical conductivity, tissue electrolytes, myocardial markers, antioxidant system, lipid peroxidation and nitric oxide production was investigated in male Wistar rats treated with arsenic trioxide...
May 7, 2017: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
https://www.readbyqxmd.com/read/28483037/effect-of-the-4-h-target-on-time-to-ecg
#8
James A Hughes, C J Cabilan, Caitlin Young, Andrew Staib
Objectives The aim of this study was to assess the relationship between compliance with time-based Emergency Department (ED) targets (known as NEAT) and the time taken to collect an electrocardiogram (TTE) in patients presenting with chest pain.Methods This was a pilot descriptive retrospective cohort study completed in a large inner city tertiary ED. Patients who presented with active or recent chest pain between July 2014 and June 2015 were eligible for inclusion. Pregnant patients, inter-hospital transfers, and traumatic chest pain were excluded...
May 9, 2017: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/28482930/fatal-monomorphic-ventricular-tachycardia-in-a-semi-urban-setting-in-cameroon-a-case-report
#9
Clovis Nkoke, Engelbert Bain Luchuo, Laetitia Dikoume
BACKGROUND: Ventricular tachycardia is a life threatening cardiac arrhythmia. It needs management with defibrillation, without which, immediate death may occur. CASE PRESENTATION: A 66 year old black African patient with a 2 year history of hypertension was admitted to the emergency department of the Buea Regional hospital, a semi-urban setting in Cameroon, after presenting with syncope while in church. The wife described a similar episode 2 weeks prior without any further evaluation...
May 8, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28479090/electrocardiogram-training-for-residents-a-curriculum-based-on-facebook-and-twitter
#10
Stanley S Liu, Sammy Zakaria, Dhananjay Vaidya, Mukta C Srivastava
BACKGROUND: We studied whether social media applications can serve as effective educational tools for teaching electrocardiogram (ECG) interpretation to medical residents. METHODS: 39 emergency, family, and internal medicine residents participated in the 33-week "ECG of the Week" curriculum via Facebook and Twitter. ECG skill was assessed before and after the study with a 10-ECG quiz. Outcomes of interest included predictors of participant response rates and post-study quiz performance...
April 22, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/28463019/fatal-cardiac-glycoside-poisoning-due-to-mistaking-foxglove-for-comfrey
#11
I-Lin Wu, Jiun-Hao Yu, Chih-Chuan Lin, Chen-June Seak, Kent R Olson, Hsien-Yi Chen
CONTEXT: Accidental ingestion of foxglove (Digitalis purpurea) can cause significant cardiac toxicity. We report a patient who ingested foxglove mistaking it for comfrey and developed refractory ventricular arrhythmias. The patient died despite treatment with digoxin-specific antibody fragments (DSFab) and veno-arterial extracorporeal membrane oxygenation (VA-ECMO). CASE DETAILS: A 55-year-old woman presented to the emergency department with nausea, vomiting and generalized weakness eight hours after drinking "comfrey" tea...
May 2, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28460856/longterm-prognosis-of-low-risk-women-presenting-to-the-emergency-department-with-chest-pain
#12
Moneer Eddin, Sandhya Venugopal, Brittany Chatterton, Angela Thinda, Ezra A Amsterdam
BACKGROUND: Prognosis of low risk women presenting to the emergency department with chest pain has not been clarified. We assessed early and longterm outcomes of such patients and determined the need for predischarge testing METHODS: Retrospective assessment of consecutive low risk women presenting to the ED with chest pain evaluated in a chest pain unit (CPU). Criteria of low risk: age ≤51 yr, no history of cardiovascular disease, diabetes or smoking, negative initial electrocardiogram (ECG), and cardiac troponin...
April 28, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28457342/outcome-after-coronary-bypass-grafting-for-coronary-complications-following-coronary-angiography
#13
Ingo Slottosch, Oliver Liakopoulos, Elmar Kuhn, Antje-Christin Deppe, Maximilian Scherner, Navid Mader, Yeong-Hoon Choi, Thorsten Wahlers
BACKGROUND: Coronary complications during coronary angiography or intervention (percutaneous coronary intervention [PCI]) are uncommon. However, PCI-related coronary artery perforation, dissection, or acute occlusion frequently result in myocardial ischemia followed by hemodynamic instability and need of urgent coronary artery bypass grafting (coronary artery bypass grafting [CABG]). This single-center study aimed to investigate clinical outcomes of patients undergoing urgent CABG after life-threatening PCI complications...
April 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28451088/the-association-of-right-coronary-artery-conus-branch-size-and-course-with-st-segment-elevation-of-right-precordial-leads-and-clinical-outcome-of-acute-anterior-myocardial-infarction
#14
Samad Ghaffari, Mohammadreza Taban Sadeghi, Mohammad Hossein Sayyadi
Introduction: Coronary artery disease is the leading cause of death worldwide and electrocardiogram (ECG) is a reliable diagnostic tool to determine a myocardial infarction. The present study tried to compare the relationship between the ECG findings and angiographic findings in patients with acute anterior myocardial infarction. Methods: Seventy-four patients with acute anterior ST elevation myocardial infarction (Ant- STEMI) presenting to the emergency room in the first 12 hours after the onset of symptoms were studied...
2017: Journal of Cardiovascular and Thoracic Research
https://www.readbyqxmd.com/read/28445305/a-case-report-of-painless-type-a-aortic-dissection-with-intermittent-convulsive-syncope-as-initial-presentation
#15
Chun-Hsien Chen, Kuan-Ting Liu
RATIONALE: The initial presenting symptoms and signs of acute aortic dissection are so diverse that it makes early and accurate diagnosis arduous. Painless and convulsive syncope due to cardiac arrhythmia were not typical presentations of acute aortic dissection. PATIENT CONCERNS: A 61-year-old male presenting with transient consciousness loss and suspected seizure attack was sent to emergency room (ER) by ambulance. Consciousness loss accompanying with upward gaze and limb convulsion was noted in ER, and electrocardiogram monitor recorded a transient cardiac asystole then spontaneous recovery of sinus rhythm...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28437795/effect-of-using-the-heart-score-in-patients-with-chest-pain-in-the-emergency-department-a-stepped-wedge-cluster-randomized-trial
#16
Judith M Poldervaart, Johannes B Reitsma, Barbra E Backus, Hendrik Koffijberg, Rolf F Veldkamp, Monique E Ten Haaf, Yolande Appelman, Herman F J Mannaerts, Jan-Melle van Dantzig, Madelon van den Heuvel, Mohamed El Farissi, Bernard J W M Rensing, Nicolette M S K J Ernst, Ineke M C Dekker, Frank R den Hartog, Thomas Oosterhof, Ghizelda R Lagerweij, Eugene M Buijs, Maarten W J van Hessen, Marcel A J Landman, Roland R J van Kimmenade, Luc Cozijnsen, Jeroen J J Bucx, Clara E E van Ofwegen-Hanekamp, Maarten-Jan Cramer, A Jacob Six, Pieter A Doevendans, Arno W Hoes
Background: The HEART (History, Electrocardiogram, Age, Risk factors, and initial Troponin) score is an easy-to-apply instrument to stratify patients with chest pain according to their short-term risk for major adverse cardiac events (MACEs), but its effect on daily practice is unknown. Objective: To measure the effect of use of the HEART score on patient outcomes and use of health care resources. Design: Stepped-wedge, cluster randomized trial...
May 16, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28427736/interactions-between-reciprocal-st-segment-downsloping-during-st-elevated-myocardial-infarction-and-global-cardiac-perfusion-and-functional-abnormalities
#17
Riccardo Liga, Enrico Orsini, Paolo Caravelli, Marco De Carlo, Anna Sonia Petronio, Mario Marzilli
Reciprocal ST-segment downsloping on electrocardiogram is a frequent finding during ST-elevated myocardial infarction (STEMI), but its etiology is still disputed. We sought to evaluate the relation between reciprocal ST-segment downsloping during STEMI and major cardiac perfusion and functional parameters. One hundred eighty-five patients with STEMI underwent emergency coronary angiography. The presence of reciprocal ST-segment downsloping was assessed. At coronary angiography, the corrected TIMI frame count (cTFC) was computed both on culprit and remote vessels and the occurrence of "no/slow reflow" phenomenon after percutaneous coronary intervention (PCI) identified...
March 29, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28427082/perioperative-outcomes-and-safety-of-atrial-fibrillation-catheter-ablation-in-octogenarians-a-retrospective-study-and-review-of-the-benefits-of-rhythm-control
#18
Stephanie Hakimian, Juan C Camacho, Edwin Grajeda Silvestri, Farid AbdelMalak, Elie Donath, Robert Chait
OBJECTIVES: Catheter ablation for rhythm control has emerged as a successful therapeutic option for the treatment of atrial fibrillation (AF), though it has not been well studied in octogenarians. This study evaluates its safety in octogenarians in a community hospital and reviews the benefits of rhythm control. METHODS: Among 1,592 patients undergoing AF ablation, 84 octogenarian were identified. The primary outcome was normal sinus rhythm (NSR) on electrocardiogram at discharge...
April 21, 2017: Cardiology
https://www.readbyqxmd.com/read/28420263/an-unusual-cause-of-frequent-sudden-transient-unexplained-falls-and-new-onset-status-epilepticus-case-report-and-mini-review
#19
Dinesh Singh, Alford Dyer, Sherry Gu, Patrick McCarville, Annie Hess, Olugbenga Akingbola, Jane El-Dahr, Stephen Nelson
We report a 14-year old adolescent Caucasian female, who presented with frequent, sudden, transient, and unexplained falls leading to multiple serious injuries to her head and extremities requiring several visits to the emergency department. She was evaluated numerous times and imaging studies, echocardiogram, electrocardiogram, and electroencephalogram studies were all normal. She eventually presented to outside emergency department with dystonic posturing and status epilepticus and was transferred to our pediatric intensive care unit for further management...
April 1, 2017: Clinical Pediatrics
https://www.readbyqxmd.com/read/28419650/cardiovascular-safety-in-refractory-incontinent-patients-with-overactive-bladder-receiving-add-on-mirabegron-therapy-to-solifenacin-beside
#20
Marcus J Drake, Scott MacDiarmid, Christopher R Chapple, Adil Esen, Stavros Athanasiou, Javier Cambronero Santos, David Mitcheson, Sender Herschorn, Emad Siddiqui, Moses Huang, Matthias Stoelzel
AIMS/OBJECTIVES: In the BESIDE study, combination therapy (antimuscarinic [solifenacin] and β3 -adrenoceptor agonist [mirabegron]) improved efficacy over solifenacin monotherapy without exacerbating anticholinergic side effects in overactive bladder (OAB) patients; however, a potential synergistic effect on the cardiovascular (CV) system requires investigation. METHODS: OAB patients remaining incontinent despite daily solifenacin 5 mg during 4-week single-blind run-in, were randomised 1:1:1 to double-blind daily combination (solifenacin 5 mg/mirabegron 25 mg, increasing to 50 mg after week 4), solifenacin 5 or 10 mg for 12 weeks...
April 16, 2017: International Journal of Clinical Practice
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