Continous medical discussion: the ECG blog ECG A deep learning ECG biomarker for sudden cardiac death: what the new Nature study shows Low risk (blue…

…the medical record, prior device interrogation, and, when necessary, chest radiography. A chest radiograph can help identify the device and lead configuration when records are…

…chest pain patients An ECG must be performed on all patients seeking medical attention due to chest discomfort or other symptoms that may be caused…

…Medical conditions Category Condition Congenital conditions Jervell and Lange Nielsen syndrome Romano Ward syndrome Idiopathic congenital long QT syndrome (LQTS) Metabolic disorders Hypokalemia Hypomagnesemia Hypocalcemia…

…Document the restart date in the medical record. Sources ESC Guidelines for the management of atrial fibrillation. Internetmedicin, DOACs, measures in bleeding and medical procedures…

Continous medical discussion: the ECG blog ECG Early repolarization pattern: confused J points, notches and slurs I once had the privilige of attending a lecture…

Continous medical discussion: the ECG blog Myocardial ischemia and infarction Myocardial ischemia The definition of ischemia may appear trivial but it is actually a very…

Continous medical discussion: the ECG blog ECG The best ECG book is not the one making it simple In the thrilling and ever evolving field…

Arrhythmias and arrhythmology Continous medical discussion: the ECG blog Genetic and miscellaneous conditions A novel potentially life threatening cardiac arrhythmia syndrome identified with ECG The…

Cardiology Continous medical discussion: the ECG blog Infectious diseases Cardiovascular effects of COVID 19 Coronavirus disease 2019 (COVID 19) has caused a global public health…

Cardiology Continous medical discussion: the ECG blog Coronary artery disease: On LDL cholesterol, dietary fat & statins You are probably aware that ischemic heart disease, also…

Cardiology Continous medical discussion: the ECG blog Endocrinology & metabolism Cardiovascular medicine is currently witnessing a paradigm shift. For decades, the management of type 2 diabetes…

ECG The artificial pacemaker is one of the great medical inventions of the 20th century. Cardiac pacing has evolved from a hazardous experiment in the…

CPR Hearts too good to die In 1961 the Journal of the American Medical Association (JAMA) published an article titled Hearts too good to die…

…interpreted as specialist investigations. Both fail more often for practical than for medical reasons: the cuff is in the wrong place, the electrodes come off…

…begins in parallel with the diagnostic work up. Obtain an interpretable 12 lead ECG within 10 minutes of first medical contact, attach continuous rhythm monitoring…

…body weight in kilograms by the square of height in meters. BMI is relevant for medical prognostication as it serves as a quick, low cost…

…Initial diagnosis of STEMI ECG Management Recommendation Level of evidence A 12 lead ECG should be interpreted immediately (within 10 minutes) at first medical contact…

…education, psychosocial support, vocational guidance, medical surveillance, and appropriate pharmacological treatment. After myocardial infarction, rehabilitation aims to: Restore and improve functional capacity Reduce disability and…

…events after coronary angiography, percutaneous coronary intervention (PCI), or medical management. The standard post ACS regimen is DAPT for 12 months, generally consisting of low…

…practice guidelines for emergency medicine (and prehospital medicine). This is high quality medical education simply. Life in the Fast Lane Australian site with one of…

…to established reversible myocardial ischaemia in either of two settings: Obstructive coronary artery disease (CAD) that cannot be controlled despite escalation of antianginal medical therapy…

…AV block 1, 2 & 3) Evaluation of patients with suspected AV blocks requires a thorough medical history (with emphasis on causes of AV blocks; please…

…acidosis , that is, a pH below 7.35 and a PaCO₂ above 6.0 kPa despite optimal medical treatment with bronchodilators, steroids and controlled oxygen…

…Delirium is common but often missed. On medical and geriatric wards a substantial proportion of older patients are affected, and the incidence is particularly high…

…the only absolute indication, and always urgent. A large pericardial effusion with symptoms despite medical treatment. Diagnostic drainage in suspected purulent pericarditis, tuberculosis or malignancy…

…generally tolerate ischaemia for approximately 4–6 hours, making ALI a medical emergency in which prompt recognition, specialist assessment and restoration of perfusion are essential…

…to exercise Detection of exercise induced arrhythmias Identification of exercise related ST segment changes Prognostic and risk stratification information Assessment of response to selected medical…

…not reverse coronary atherosclerosis. Long term benefit therefore depends on the integration of revascularisation with guideline directed medical therapy and secondary prevention. Clinical Presentation and…

…should influence the urgency of management: Recurrent or ongoing chest pain despite medical treatment Acute heart failure presumed to result from ongoing myocardial ischaemia Haemodynamic…

…underlying coronary atherosclerotic process. Their clinical effects therefore occur within the broader framework of guideline directed medical therapy and secondary prevention. PCI treats focal stenotic…

…or chest pain equivalent symptoms. The ECG assessment remains necessary even when symptoms have improved by the time of medical evaluation, because transient or evolving…

…symptoms, or medical histories should undergo appropriate screening for secondary hypertension. The initial clinical assessment should establish: Whether hypertension is genuinely present Factors that may…

…myocardial injury is strongly influenced by total ischaemic time. This interval includes: The time from symptom onset to recognition and seeking medical assistance. Prehospital assessment…

…In out of hospital cardiac arrest (OHCA) the initial rhythm is recorded by the EMS (emergency medical service) team upon their arrival at the scene…

…arrest with a separate category for cardiac etiologies. Cause Definition Medical cause Includes cardiac arrest caused by heart disease, other medical conditions (pulmonary embolism, bleeding…

…includes surgery, catheter interventions, and medical therapies. Adults with congenital heart disease are mostly managed in GUCH clinics (Grown Up Congenital Heart disease). Prevalence of…

…HFimpEF). HFimpEF refers to patients with a historical baseline LVEF ≤40% that has subsequently improved to 40% under guideline directed medical therapy (GDMT). These patients…

…Data from the TRED HF trial demonstrated that withdrawal of guideline directed medical therapy (GDMT) in these patients leads to a high rate of relapse…

…80 years. This was expressed in 1961 by Beck et al in the Journal of American Medical Association (JAMA): [...] Of every 10 such victims, the…

…EMTs, nurses and physicians in the emergency medical system (EMS), as well as the hospital cardiac arrest team (CAT) and intensive care units and other…

…management Medical therapies do not alter disease progression. Diuretics may be used for symptom relief. Surgical repair or valve replacement is considered when medical therapy…

…of medical suitability is made by the transplant team. Never rule out a possible donor on your own on grounds of age or medical history…

…of ventricular tachycardia (VT). ECG showing polymorphic ventricular tachycardia degenerating into ventricular fibrillation. By Bagnall et al: BMC Medical Genetics 15 (2014): 99. Polymorphic vent

…lower back or scrotum. Aneurysmal pain is clinically important because it may herald rupture and constitutes a medical emergency. Rupture may occur without preceding symptoms…

…Due to the risk of airway compromise, it represents a medical emergency. Evaluation and Physical Examination The evaluation of chronic cough in a patient taking…

…safety and efficacy of an approach based on starting and titrating oral medical therapy for heart failure within 2 days before anticipated hospital discharge and…

…initiation and after each adjustment. Persistent symptoms despite appropriately titrated medical therapy should prompt consideration of coronary angiography and possible revascularization. Revascularization may be selected…

…Patients with suggestive symptoms, signs or a medical history indicating possible secondary hypertension should undergo appropriate screening for an underlying secondary cause. Evaluation and physical…

…delayed, or selectively after initial medical treatment. The presence of ST segment changes or a positive troponin assay identifies patients in whom an invasive strategy…

…compatible with HeFH. Evaluation and physical examination Assessment begins with systematic lipid screening and a careful clinical, medical, social and multigenerational family history. The evaluation…

…The initial evaluation includes: Targeted medical history Physical examination Vital sign assessment 12 lead ECG Initial hs cTn measurement Continuous cardiac monitoring The source material…

…However, randomized evidence has not shown a reduction in mortality or myocardial infarction with routine CTO PCI compared with medical therapy. Clinical presentation and symptoms…

…angiography may be appropriate, particularly when symptoms are severe, refractory to guideline directed medical therapy, occur at a low level of exertion, or are associated…

…vigorous physical exercise, emotional stress, or a medical or surgical illness is present before the event. Although STEMI may occur at any time, circadian variations…

…precipitants include vigorous physical activity, emotional stress, and an intercurrent medical or surgical illness. Events may occur at any time, although clustering in the morning…

…to a hospital with 24/7 PCI capability, bypassing non PCI hospitals. A regional network should link emergency medical services, non PCI hospitals, PCI centres…

…be defined before revascularization Residual ischaemia must be assessed after initiation of medical treatment LV function requires evaluation in the setting of suspected ischaemia or…

…of ventricular tachycardia (VT). ECG showing polymorphic ventricular tachycardia degenerating into ventricular fibrillation. By Bagnall et al: BMC Medical Genetics 15 (2014): 99. Polymorphic vent