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ECG clinical cases

Fanhao Ye, Wenbing Jiang, Yi Wang, Wei Lin, Hao Chen, Binglin Pan
RATIONALE: Amiodarone, a broad-spectrum antiarrhythmic drug, is widely used for the clinical treatment of tachyarrhythmias because of its safety and efficacy. PATIENT CONCERNS: A 30-year-old woman presented with known paroxysmal atrial tachycardia and severe preeclampsia. Two days before admission, she had given birth to twins. She described her symptoms as a sudden palpitation at 10:20 accompanied by chest tightness and shortness of breath. DIAGNOSIS: Cardiac arrhythmia and acute left heart failure...
February 2019: Medicine (Baltimore)
Demetris Yannopoulos, Jason A Bartos, Tom P Aufderheide, Clifton W Callaway, Rajat Deo, Santiago Garcia, Henry R Halperin, Karl B Kern, Peter J Kudenchuk, Robert W Neumar, Ganesh Raveendran
Coronary artery disease is prevalent in different causes of out-of-hospital cardiac arrest (OHCA), especially in individuals presenting with shockable rhythms of ventricular fibrillation/pulseless ventricular tachycardia (VF/pVT). The purpose of this report is to review the known prevalence and potential importance of coronary artery disease in patients with OHCA and to describe the emerging paradigm of treatment with advanced perfusion/reperfusion techniques and their potential benefits on the basis of available evidence...
February 14, 2019: Circulation
Harel Gilutz, Sevatlana Shindel, Ilana Shoham-Vardi
BACKGROUND: Adherence to guidelines for the initial treatment of ST-Segment Elevation Myocardial Infarction has been thoroughly studied, whereas the study of emergency department (ED) adherence to guidelines for Non-ST-Segment Elevation Myocardial Infarction-Acute Coronary Syndrome (NSTEMI-ACS) has been much scarcer. The recommended guidelines for the initial prompt workup and treatment of NSTEMI-ACS remains a challenge. AIM: We studied adherence to guidelines for NSTEMI in the ED...
March 2019: Critical Pathways in Cardiology
Hai-Di Wu, Hong-Yan Cao, Zi-Kai Song, Shuo Yang, Ming-Long Tang, Yang Liu, Ling Qin
BACKGROUND: Rivaroxaban is a non-vitamin K antagonist oral anticoagulant that does not require coagulation monitoring based on current recommendations. Our goal is to explore whether routine coagulation monitoring should not be required for all patients receiving oral rivaroxaban, what relationship between routine coagulation abnormalities and bleeding, and how to deal with the above clinical situations through our case and review of the literature. CASE SUMMARY: We report a 67-year-old woman with a history of atrial fibrillation who presented to the hospital with worsening dyspnea and cough...
February 6, 2019: World Journal of Clinical Cases
Hua He, XiaoDong Li, BingBing Ke, Zhuo Chen, FuSheng Han, YuJie Zeng
PURPOSE: To determine whether the midrange ejection fraction (mrEF) is associated with increased risk of deterioration of cardiac function (DCF) after dual chamber permanent pacemaker (PPM) implantation. METHODS: We performed a prospective cohort study of relevance in patients with EF ≥ 40% and indications for PPMs. Patient characteristics were recorded at baseline and 1 day, 1 month, 3 months, and 6 months after PPM implantation with leads placed in the right ventricular apex...
February 9, 2019: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Peng Yue, Kaiyu Zhou, Yimin Hua, Jie Fang, Yifei Li
RATIONALE: Hemoptysis or hematemesis is a common clinical symptom in adults, but is unusually to be observed in children. Hemoptysis can occur with circulatory diseases, injuries, several types of systemic diseases, or systemic factors including factitious disorder (FD), which is difficult to be diagnosed. Here, we report a case of hemoptysis caused by FD to provide a diagnostic flow chart for such kind of disease. PATIENT CONCERNS: An 11-year-old female patient had a history of hemoptysis or hematemesis for 6 months and suffered with paroxysmal syncope for a month...
February 2019: Medicine (Baltimore)
Panteleimon E Papakonstantinou, Emmanuel N Simantirakis
Although atrial fibrillation (AF) is an arrhythmia with a variable clinical profile (symptomatic and asymptomatic episodes), the first symptomatic episode leads to its initial diagnosis in most cases. Nowadays, continuous and remote long- term cardiac rhythm monitoring is feasible by the use of implantable loop recorders. The data concerning the AF recurrences and progression after the first ECG- documented clinical AF episode demonstrates that a high percentage of patients may not suffer any other AF recurrence, or may present a low recurrence rate of the arrhythmia in the future...
February 5, 2019: Minerva Cardioangiologica
Alessandro Tonacci, Lucia Billeci, Francesco Sansone, Antonella Masci, Anna Paola Pala, Claudio Domenici, Raffaele Conte
Background and objectives: Smartphones are playing a pivotal role in everyday life, due to the opportunity they grant in terms of simplifying communication, entertainment, education and many other daily activities. Against such positive characteristics, smartphone interaction can result, in particular cases, in dangerous smartphone addiction patterns, possibly leading to several long-term detrimental psychophysiological conditions. Therefore, this pilot aims at assessing the feasibility of using an innovative approach, based on unobtrusive wearable sensors, used for the first time in this specific topic, and psychological questionnaires, to investigate the links between stress and emotions in a group of young, nonaddicted individuals performing smartphone interaction...
February 4, 2019: Medicina
Giuseppe D Sanna, Giuseppe Nusdeo, Maria Rita Piras, Antonietta Forteleoni, Maria Rita Murru, Pier Sergio Saba, Simone Dore, Giovanni Sotgiu, Guido Parodi, Antonello Ganau
OBJECTIVES: This case control study sought to assess the presence and characteristics of cardiac abnormalities in patients with Alzheimer disease (AD). BACKGROUND: Protein misfolding is involved in the pathophysiology of neurodegenerative disorders such as AD. Recently, amyloid-beta (Aβ) aggregates were identified within the cardiomyocytes and interstitium of patients with AD, suggesting that Aβ oligomers may reach and damage the heart. METHODS: The authors studied 32 patients with AD and 34 controls matched by age and sex, all of whom were free from cardiac or systemic diseases...
February 2019: JACC. Heart Failure
Julien Le Roy, Hélène Vernhet Kovacsik, Hamid Zarqane, Marie Vincenti, Hamouda Abassi, Kathleen Lavastre, Thibault Mura, Alain Lacampagne, Pascal Amedro
BACKGROUND: The use of coronary computed tomography (CT) angiography in children with coronary artery anomalies is increasing. However, it remains technically demanding and the need to adapt acquisition parameters to a patient's cardiac characteristics has not yet been addressed. The aim of the study was to prospectively assess the feasibility of personalized multiphasic coronary CT angiography for pediatric patients. METHODS: Fifty pediatric patients (mean age 6...
February 2019: Circulation. Cardiovascular Imaging
Seher Çatalkaya Demir, Erdem Demir, Sibel Çatalkaya
Background . Though several studies about prevalence, etiology, clinical characteristics, preceding events, clinical management, and outcome of Tako-Tsubo cardiomyopathy (TTC) exist, the current knowledge of TTC remains limited. Objective . In 2006, TTC was classified among the acquired forms of cardiomyopathy. On the basis of pathophysiological implications, we analyzed whether the presence of ST-segment elevation in lead -aVR (i.e., ST-segment depression in aVR) and the simultaneous absence of ST-segment elevation in lead V1 allow a reliable differentiation of TTC from acute anterior ST-segment elevation myocardial infarction (STEMI)...
January 30, 2019: Biomolecules
Savvy Nandal, Anastasia Castles, Muhammad Asrar Ul Haq, William van Gaal
Takotsubo cardiomyopathy (TC) is acute stress-induced cardiomyopathy with characteristic transient wall motion abnormalities. TC has a clinical presentation similar to an acute coronary syndrome, including chest pain or dyspnoea, ECG changes and elevated cardiac enzymes. TC often occurs after emotional stress. There are approximately 50 TC cases reported related to seizure activity, and our review revealed 15 articles which were associated with status epilepticus. This condition can be a serious complication of seizures...
January 29, 2019: BMJ Case Reports
Sara Schukraft, Marco Mancinetti, Daniel Hayoz, Yannick Faucherre, Stéphane Cook, Diego Arroyo, Serban Puricel
BACKGROUND/RATIONALE: Atrial fibrillation (AF) is frequent and causes great morbidity in the aging population. While initial events may be symptomatic, many patients have silent AF and are at risk of ischemic embolic complications. Timely detection of asymptomatic patients is paramount. The HECTO-AF trial aims to investigate the efficacy of an electrocardiogram (ECG) handheld device for the detection of AF in patients in hospital without a prior diagnosis of AF. METHODS/DESIGN: The "Handheld ECG tracking of in-hospital atrial fibrillation" (HECTO-AF) study is a single-center, open-label, randomized controlled trial...
January 30, 2019: Trials
Christian Funck-Brentano, Nouhoum Ouologuem, Stephan Duparc, Mathieu Felices, Sodiomon B Sirima, Issaka Sagara, Issiaka Soulama, Jean-Bosco Ouedraogo, Abdoul H Beavogui, Isabelle Borghini-Fuhrer, Yasmin Khan, Abdoulaye A Djimdé, Pascal Voiriot
Several antimalarial drugs are known to prolong ventricular repolarization as evidenced by QT/QTc interval prolongation. This can lead to Torsades de Pointes, a potentially lethal ventricular arrhythmia. Whether this is the case with artemisinin-based combination therapies (ACTs) remains uncertain. Assessment of the extent of QTc prolongation with antimalarials is hampered by important variations of heart rate during malaria crises and previous studies have reported highly variable values of QTc prolongations with ACTs...
January 29, 2019: Scientific Reports
M Piels, T Faes, J Vainer
BACKGROUND: Obstructive coronary artery disease is found in approximately 97% of patients presenting with ST-elevation myocardial infarction and 92% of patients with non ST-elevation myocardial infarction (Bainey KR, Welsh RC, Alemayehu W, Westerhout CM, Traboulsi D, Anderson T, et al. Int J Cardiol 264: 12-17, 2018). Recent studies showed that myocardial infarction without obstructive coronary atherosclerosis (MINOCA) is also associated with a long-term risk of adverse events (Bainey KR, Welsh RC, Alemayehu W, Westerhout CM, Traboulsi D, Anderson T, et al...
January 29, 2019: BMC Cardiovascular Disorders
Y Zhang, X M Li, H Jiang, F Q Zhang, Y Q Jin, H J Liu, H Y Ge
Objective: To investigate the clinical features and results of treatment for right atrial appendage aneurysms complicated by atrial tachyarrhythmias in children. Methods: This retrospective study included three children with right atrial appendage aneurysm complicated by atrial tachyarrhythmias (aged 1.0 to 5.3 years, weight 10 to 17.1 kg) who were hospitalized at the Pediatric Cardiology Department (Heart Center) of the First Hospital of Tsinghua University (Beijing Huaxin Hospital) during the period from January 2016 through April 2018...
February 2, 2019: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
Renata Mazur, Małgorzata Buksińska-Lisik, Artur Mamcarz
Patients with severe diabetic acidosis may present varying electrocardiography (ECG) abnormalities including ST-segment elevation. The authors described a case of 70-year-old type 2 diabetic woman hospitalized due to ST elevation myocardial infarction and serious metabolic disorders. According to the clinical presentation, the ECG abnormalities and the significant rise in myocardial necrosis biomarkers the patient was diagnosed with myocardial infarction and received a typical pharmacological treatment. In the autopsy, no signs of myocardial infarction and no significant stenoses in the coronary arteries were found, while the features of acute upper gastrointestinal bleeding were observed...
December 28, 2018: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
Dilpreet Singh, Idrees Suliman, Iryna Chyshkevych, Nemer Dabage
BACKGROUND Acute chest pain is a common presentation in emergency departments worldwide. Ruling out acute coronary syndrome is essential in ensuring patient safety. Workup includes electrocardiogram (ECG) and cardiac biomarkers. Wellens syndrome is characterized by a history of chest pain, normal or minimally elevated biomarkers, no STEMI/Q-waves, and specific ECG changes. These changes consist of biphasic T waves in lead V2 and V3 or deep symmetrically inverted T waves in leads V1-V4. CASE REPORT A 55-year-old male presented to the emergency department with acute chest pain in a background of active smoking, hypertension, and hyperlipidemia...
January 28, 2019: American Journal of Case Reports
Christian A Barrera, Hansel J Otero, Ammie M White, David Saul, David M Biko
Assess image quality and radiation dose of ECG-triggered High-Pitch Dual-Source CTA for the evaluation central vascular stents in children. We included all children ≤ 21 years old with one or more central vascular stents and available prospective ECG-triggered High-Pitch Dual-Source CTA performed at our institution between January 2015 and August 2017. Demographic and scanner information was retrieved. Two board-certified pediatric radiologists blinded to the clinical data, independently reviewed and scored each case using a four-point quality score...
January 25, 2019: International Journal of Cardiovascular Imaging
S Blankenberg, T Wittlinger, B Nowak, H-J Rupprecht
Elevation of cardiac troponins above the 99th percentile of a healthy reference population is established as a marker for myocardial cell damage and is crucial for the diagnosis of myocardial infarction. In addition, corresponding clinical evidence of acute myocardial ischemia i.e. symptoms, changes in the electrocardiogram (ECG), wall motion abnormalities or suggestive angiographic findings are required for the diagnosis of myocardial infarction. Using modern highly sensitive assays myocardial infarction can be detected more frequently and earlier...
January 24, 2019: Herz
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