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Emergency ekg

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https://www.readbyqxmd.com/read/29242010/heart-rate-variability-analysis-in-patients-who-have-bradycardia-presenting-to-the-emergency-department-with-chest-pain
#1
Jeffrey Tadashi Sakamoto, Nan Liu, Zhi Xiong Koh, Dagang Guo, Micah Liam Arthur Heldeweg, Janson Cheng Ji Ng, Marcus Eng Hock Ong
BACKGROUND: Heart rate variability (HRV) is a noninvasive method to measure the function of the autonomic nervous system. It has been used to risk stratify patients with undifferentiated chest pain in the emergency department (ED). However, bradycardia can have a modifying effect on HRV. OBJECTIVE: In this study, we aimed to determine how bradycardia affected HRV analysis in patients who presented with chest pain to the ED. METHODS: Adult patients presenting to the ED at Singapore General Hospital with chest pain were included in the study...
December 11, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29240666/induction-of-inflammation-in-vivo-by-electrocardiogram-sensor-operation-using-wireless-power-transmission
#2
Jin-Chul Heo, Beomjoon Kim, Yoon-Nyun Kim, Dae-Kwang Kim, Jong-Ha Lee
Prolonged monitoring by cardiac electrocardiogram (ECG) sensors is useful for patients with emergency heart conditions. However, implant monitoring systems are limited by lack of tissue biocompatibility. Here, we developed an implantable ECG sensor for real-time monitoring of ventricular fibrillation and evaluated its biocompatibility using an animal model. The implantable sensor comprised transplant sensors with two electrodes, a wireless power transmission system, and a monitoring system. The sensor was inserted into the subcutaneous tissue of the abdominal area and operated for 1 h/day for 5 days using a wireless power system...
December 14, 2017: Sensors
https://www.readbyqxmd.com/read/29233228/disease-and-non-battle-traumatic-injuries-evaluated-by-emergency-physicians-in-a-us-tertiary-combat-hospital
#3
Col S Vikhyat S Bebarta, Alejandra G Mora, Capt Patrick C Ng, Phillip E Mason, Andrew Muck, Maj Joseph K Maddry
Introduction Analysis of injuries during military operations has focused on those related to combat. Non-combat complaints have received less attention, despite the need for many troops to be evacuated for non-battle illnesses in Iraq. This study aims to further characterize the disease and non-battle injuries (DNBIs) seen at a tertiary combat hospital and to describe the types of procedures and medications used in the management of these cases. METHODS: In this observational study, patients were enrolled from a convenience sample with non-combat-related diseases and injuries who were evaluated in the emergency department (ED) of a US military tertiary hospital in Iraq from 2007-2008...
December 13, 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/29232768/modification-of-the-thrombolysis-in-myocardial-infarction-risk-score-for-patients-presenting-with-chest-pain-to-the-emergency-department
#4
Jaimi H Greenslade, Kimberly Chung, William A Parsonage, Tracey Hawkins, Martin Than, John W Pickering, Louise Cullen
OBJECTIVE: To develop a modified Thrombolysis in Myocardial Infarction (TIMI) score to effectively risk stratify patients presenting to the ED with chest pain. METHODS: A prospective observational study was conducted at two metropolitan EDs. Data were obtained during patient interview. The primary outcome was major adverse cardiovascular events (MACE) within 30 days of presentation. Two separate modifications of the TIMI score were developed. These scores were compared to the original TIMI in terms of the area under the receiver operating characteristic curve and diagnostic accuracy statistics (sensitivity, specificity, positive and negative predictive values)...
December 12, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29228515/aging-and-cardiometabolic-risk-in-european-hems-pilots-an-assessment-of-occupational-old-age-limits-as-a-regulatory-risk-management-strategy
#5
Hans Bauer, Dennis Nowak, Britta Herbig
Old-age limits are imposed in some occupations in an effort to ensure public safety. In aviation, the "Age 60 Rule" limits permissible flight operations conducted by pilots aged 60 and over. Using a retrospective cohort design, we assessed this rule's validity by comparing age-related change rates of cardiometabolic incapacitation risk markers in European helicopter emergency medical service (HEMS) pilots near age 60 with those in younger pilots. Specifically, individual clinical, laboratory, and electrocardiogram (ECG)-based risk markers and an overall cardiovascular event risk score were determined from aeromedical examination records of 66 German, Austrian, Polish, and Czech HEMS pilots (average follow-up 8...
December 11, 2017: Risk Analysis: An Official Publication of the Society for Risk Analysis
https://www.readbyqxmd.com/read/29221351/extracorporeal-membrane-oxygenation-system-as-a-bridge-to-reparative-surgery-in-ventricular-septal-defect-complicating-acute-inferoposterior-myocardial-infarction
#6
Jose Rozado, Isaac Pascual, Pablo Avanzas, Daniel Hernandez-Vaquero, Ruben Alvarez, Rocio Díaz, Beatriz Díaz, María Martín, Amelia Carro, Guillermo Muñiz, Jacobo Silva, Cesar Moris
Post-infarction ventricular septal defect (VSD) is a rare but potentially lethal complication of acute myocardial infarction. Medical management is usually futile, so definitive surgery remains the treatment of choice but the risk surgery is very high and the optimal timing for surgery is still under debate. A 55-year-old man with no previous medical history attended the emergency-room for 12 h evolution of oppressive chest pain and strong anginal pain 7 days ago. On physical examination, blood pressure was 96/70 mmHg, pansystolic murmur over left sternal border without pulmonary crackles...
September 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29218680/cardiovascular-profile-of-valbenazine-analysis-of-pooled-data-from-three-randomized-double-blind-placebo-controlled-trials
#7
Dao Thai-Cuarto, Christopher F O'Brien, Roland Jimenez, Grace S Liang, Joshua Burke
INTRODUCTION: Valbenazine is a novel vesicular monoamine transporter 2 inhibitor approved for the treatment of tardive dyskinesia in adults. OBJECTIVE: Using data from double-blind, placebo-controlled trials, analyses were conducted to evaluate the cardiovascular effects of once-daily valbenazine in patients with a psychiatric disorder who developed tardive dyskinesia after exposure to a dopamine-blocking medication. METHODS: Data were pooled from three 6-week, double-blind, placebo-controlled trials: KINECT (NCT01688037), KINECT 2 (NCT01733121), and KINECT 3 (NCT02274558)...
December 7, 2017: Drug Safety: An International Journal of Medical Toxicology and Drug Experience
https://www.readbyqxmd.com/read/29217178/factors-associated-with-advanced-cardiac-care-in-prehospital-chest-pain-patients
#8
Adam Frisch, Kenneth J Heidle, Stephanie O Frisch, Ashar Ata, Brandon Kramer, Caroline Colleran, Jestin N Carlson
INTRODUCTION: Many patients transported by emergency medical services (EMS) may require advanced cardiac care but do not have ST-segment elevation (STEMI) on the initial prehospital EKG. We sought to identify factors associated with the need for advanced cardiac care in undifferentiated EMS patients reporting chest pain in the absence of STEMI on EKG. METHODS: We performed a retrospective analysis of all adult patients, reporting atraumatic chest pain from a single EMS agency, presenting to a single, urban hospital over a 10-year period...
December 5, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29209787/-different-levels-of-experience-with-anesthetic-agents-of-german-emergency-physicians-results-of-an-online-survey
#9
A Luckscheiter, M Fischer, W Zink
BACKGROUND AND OBJECTIVE: In 2015 practice management guidelines on prehospital emergency anesthesia in adults were published in Germany. The aim of the present study was to evaluate whether emergency physicians follow these guidelines in daily practice and to assess their level of experience with the use of anesthetic agents. MATERIAL AND METHODS: In an online survey the way of induction of preclinical anesthesia (including preoxygenation time and applied monitoring techniques) was assessed with the help of virtual scenarios based on the guidelines...
December 5, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/29209491/a-3d-printed-sensor-for-monitoring-biosignals-in-small-animals
#10
Sung-Joon Cho, Donghak Byun, Tai-Seung Nam, Seok-Yong Choi, Byung-Geun Lee, Myeong-Kyu Kim, Sohee Kim
Although additive manufacturing technologies, also known as 3D printing, were first introduced in the 1980s, they have recently gained remarkable popularity owing to decreased costs. 3D printing has already emerged as a viable technology in many industries; in particular, it is a good replacement for microfabrication technology. Microfabrication technology usually requires expensive clean room equipment and skilled engineers; however, 3D printing can reduce both cost and time dramatically. Although 3D printing technology has started to emerge into microfabrication manufacturing and medical applications, it is typically limited to creating mechanical structures such as hip prosthesis or dental implants...
2017: Journal of Healthcare Engineering
https://www.readbyqxmd.com/read/29202148/behavioral-health-consult-ensuring-prompt-recognition-and-treatment-of-panic-disorder
#11
Eric H Berko, Gabriela Feier
Lorna D was seen by her primary care physician as follow-up to a visit she made to the emergency department (ED). The 37 year old had gone to the ED 4 times in the previous year. Each time she presented with tachycardia, dyspnea, nausea, numbness in her extremities, and a fear that she was having a heart attack. In spite of negative work-ups at each visit (electrocardiogram, cardiac enzymes, complete blood count, toxicology screen, Holter monitoring), Ms. D was terrified that the ED doctors were missing something...
December 2017: Journal of Family Practice
https://www.readbyqxmd.com/read/29197614/an-anatomical-and-physiological-basis-for-the-cardiovascular-autonomic-nervous-system-consequences-of-sport-related-brain-injury
#12
Michael F La Fountaine
Concussion is defined as a complex pathophysiological process affecting the brain that is induced by the application or transmission of traumatic biomechanical forces to the head. The result of the impact is the onset of transient symptoms that may be experienced for approximately 2weeks in most individuals. However, in some individuals, symptoms may not resolve and persist for a protracted period and a chronic injury ensues. Concussion symptoms are generally characterized by their emergence through changes in affect, cognition, or multi-sensory processes including the visual and vestibular systems...
November 29, 2017: International Journal of Psychophysiology
https://www.readbyqxmd.com/read/29191564/dynamic-st-segment-abnormality
#13
Elias B Hanna, Paul A LeLorier, D Luke Glancy
A 37-year-old man came to the emergency department because of several days of intermittent chest pain. An electrocardiogram (ECG) showed sinus rhythm, left atrial and left ventricular enlargement, and an early repolarization pattern. A second ECG recorded 10 minutes later was strikingly different, with ST-segment elevation and large upright T waves in the anterior precordial leads, interpreted as evidence of an ST-segment elevation myocardial infarction, and the cardiac catheterization team was activated. Closer inspection of the ECG, however, disclosed that the changes were because of intermittent ventricular pre-excitation of the Wolff-Parkinson-White type, and no electrocardiographic, echocardiographic, or serum markers of myocardial infarction were found...
November 2, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/29191490/prognosticating-clinical-prediction-scores-without-clinical-gestalt-for-patients-with-chest-pain-in-the-emergency-department
#14
Chin Pang Wong, Chun Tat Lui, Jonathan Gabriel Sung, Ho Lam, Hin Tat Fung, Ping Wa Yam
BACKGROUND: Assessment of patients with chest pain is a regular challenge in the emergency department (ED). Recent guidelines recommended quantitative assessment of ischemic risk by means of risk scores. OBJECTIVE: Our aim was to assess the performance of Thrombosis in Myocardial Infarction (TIMI); Global Registry of Acute Coronary Events (GRACE); history, electrocardiogram, age, risk factors, and troponin (HEART) scores; and the North America Chest Pain Rule (NACPR) without components of clinical gestalt in predicting 30-day major adverse cardiac events (MACE)...
November 27, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29190808/the-validity-of-linear-and-non-linear-heart-rate-metrics-as-workload-indicators-of-emergency-physicians
#15
Frederick Schneider, Jan Martin, Alexander Hapfelmeier, Denis Jordan, Gerhard Schneider, Christian M Schulz
BACKGROUND: It has been shown that linear and non-linear heart rate variability (HRV) metrics are suitable to assess workload of anesthetists administering anesthesia. In pre-hospital emergency care, these parameters have not yet been evaluated. We hypothesized that heart rate (HR) and HRV metrics discriminate between differing workload levels of an emergency physician. METHODS: Electrocardiograms were obtained from 13 emergency physicians. Mean HR, ten linear and seven non-linear HRV metrics were analyzed...
2017: PloS One
https://www.readbyqxmd.com/read/29189171/inappropriate-sinus-tachycardia
#16
Mohammed Ruzieh, Abdelmoniem Moustafa, Ebrahim Sabbagh, Mohammad M. Karim, Saima Karim
Definition and diagnosis: Inappropriate Sinus Tachycardia (IST) is a clinical syndrome characterized by a sinus heart rate inexplicably higher than one hundred beats per minute at rest that is associated with symptoms like palpitations, dyspnea or dizziness in the absence of primary causes of tachycardia. The diagnosis requires exclusion of other causes of tachycardia including medications/substances (such as anti-cholinergic, beta-blocker withdrawal, caffeine, and alcohol) or medical conditions (such as panic attacks, pulmonary embolism, fever, hyperthyroidism, hypovolemia, anemia, and pain)...
November 29, 2017: Current Cardiology Reviews
https://www.readbyqxmd.com/read/29189044/desvenlafaxine-versus-placebo-in-a-fluoxetine-referenced-study-of-children-and-adolescents-with-major-depressive-disorder
#17
Karen L Weihs, William Murphy, Richat Abbas, Deborah Chiles, Richard D England, Sara Ramaker, Dalia B Wajsbrot
OBJECTIVES: To evaluate the short-term efficacy and safety of desvenlafaxine (25-50 mg/d) compared with placebo in children and adolescents with major depressive disorder (MDD). METHODS: Outpatient children (7-11 years) and adolescents (12-17 years) who met DSM-IV-TR criteria for MDD and had screening and baseline Children's Depression Rating Scale-Revised (CDRS-R) total scores >40 were randomly assigned to 8-week treatment with placebo, desvenlafaxine (25, 35, or 50 mg/d based on baseline weight), or fluoxetine (20 mg/d)...
November 30, 2017: Journal of Child and Adolescent Psychopharmacology
https://www.readbyqxmd.com/read/29177620/revisiting-traumatic-cardiac-arrest-should-cpr-be-initiated
#18
Katie L Konesky, Weidun Alan Guo
OBJECTIVES: Traumatic cardiac arrest (TCA) represents a unique problem, and poses difficult challenges in the care of trauma patients. Although the literature has suggested that attempted resuscitation from TCA in trauma is futile and consumptive of medical and human resources, studies have recently demonstrated that the outcome of TCA is comparable cardiac arrest secondary to non-traumatic events. The objective of this study was to determine the incidence, predictors, and outcomes following TCA...
November 25, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29174184/competitive-interaction-between-chronic-obstructive-pulmonary-disease-and-cha2ds2-vasc-score-in-predicting-incident-atrial-fibrillation
#19
Maria Perticone, Angela Sciacqua, Giovanni Tripepi, Sofia Miceli, Salvatore Corrao, Giorgio Sesti, Francesco Perticone
BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality, and an emerging risk factor for atrial fibrillation (AF). CHADS2 and CHA2DS2-VASc scores are significantly associated with incident AF independently of other risk factors. The aim of this study was to demonstrate a possible interaction between COPD and CHA2DS2-VASc in predicting incident AF. METHODS: This observational prospective cohort study included 4322 Caucasians with cardiovascular risk factors, stratified by CHA2DS2-VASc score (>2 vs <2) and presence/absence of COPD...
November 20, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/29173681/cardiogenic-shock
#20
REVIEW
Semhar Z Tewelde, Stanley S Liu, Michael E Winters
Cardiogenic shock (CS) is a physiologic state in which cardiac pump function is inadequate to perfuse the tissues. If CS is not rapidly recognized and treated, tissue hypoperfusion can quickly lead to organ dysfunction and patient death. Evaluation of patients with suspected CS should include an electrocardiogram, chest radiograph, laboratory studies, and bedside echocardiogram. Initial resuscitation is directed toward restoring cardiac output and tissue perfusion. Mechanical circulatory support is indicated for patients with CS who do not respond to pharmacologic therapy...
February 2018: Cardiology Clinics
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