Podcasts about electrocardiogram

This episode covers: Cardiology This Week: A concise summary of recent studies AI and the future of the Electrocardiogram The heart in rheumatic disorders and autoimmune diseases Statistics Made Easy: Bayesian analysis Host: Susanna Price Guests: Carlos Aguiar, Paul Friedman, Maya Buch  Want to watch that episode? Go to: https://esc365.escardio.org/event/1801 Disclaimer: ESC TV Today is supported by Bristol Myers Squibb. This scientific content and opinions expressed in the programme have not been influenced in any way by its sponsor. This programme is intended for health care professionals only and is to be used for educational purposes. The European Society of Cardiology (ESC) does not aim to promote medicinal products nor devices. Any views or opinions expressed are the presenters' own and do not reflect the views of the ESC. Declarations of interests: Stephan Achenbach, Antonio Greco, Nicolle Kraenkel and Susanna Price have declared to have no potential conflicts of interest to report. Carlos Aguiar has declared to have potential conflicts of interest to report: personal fees for consultancy and/or speaker fees from Abbott, AbbVie, Alnylam, Amgen, AstraZeneca, Bayer, BiAL, Boehringer-Ingelheim, Daiichi-Sankyo, Ferrer, Gilead, GSK, Lilly, Novartis, Novo Nordisk, Pfizer, Sanofi, Servier, Takeda, Tecnimede. Maya Buch has declared to have potential conflicts of interest to report: grant/research support paid to University of Manchester from Gilead and Galapagos; consultant and/or speaker with funds paid to University of Manchester for AbbVie, Boehringer Ingelheim, CESAS Medical, Eli Lilly, Galapagos, Gilead Sciences, Medistream and Pfizer Inc; member of the Speakers' Bureau for AbbVie with funds paid to University of Manchester. Davide Capodanno has declared to have potential conflicts of interest to report: Bristol Myers Squibb, Daiichi Sankyo, Sanofi Aventis, Novo Nordisk, Terumo. Paul Friedman has declared to have potential conflicts of interest to report: co-inventor of AI ECG algorithms. Steffen Petersen has declared to have potential conflicts of interest to report: consultancy for Circle Cardiovascular Imaging Inc. Calgary, Alberta, Canada. Emma Svennberg has declared to have potential conflicts of interest to report: Abbott, Astra Zeneca, Bayer, Bristol-Myers, Squibb-Pfizer, Johnson & Johnson.

Darshan H. Brahmbhatt, Podcast Editor of JACC: Advances, discusses a recently published original research paper on Diagnostic Accuracy of Apple Watch Electrocardiogram for Atrial Fibrillation: A Systematic Review and Meta-Analysis

Sweeping U.S. tariffs on Canadian goods will be delayed for at least a month. A look at where Ontario's political leaders were on Monday. CKHA officials are encouraging those who have a family doctor to leave the Seasonal Care Clinic for those who don't. The Chatham-Kent Health Alliance has replaced some old, end-of-life equipment with two new Electrocardiogram stress testing systems. The municipalities of Chatham-Kent and Lakeshore are getting over $17M from the federal government to help create hundreds of new homes.

With Shinwan Kany, The University Medical Center Hamburg-Eppendorf, Hamburg - Germany, and Shaan Khurshid, Massachusetts General Hospital and Harvard Medical School - USA. Link to paper Link ton editorial

In this podcast, Dr. Valentin Fuster discusses a groundbreaking study on using artificial intelligence (AI) in electrocardiograms (ECGs) to assess left ventricular diastolic function and predict outcomes in patients with significant mitral regurgitation. The study demonstrates that AI-driven ECGs can offer comparable prognostic value to traditional echocardiography, identifying high-risk patients and potentially revolutionizing cardiovascular diagnostics, though challenges around sensitivity, specificity, and patient selection remain.

Darshan H. Brahmbhatt, Podcast Editor of JACC: Advances discusses a recently published original research paper on mortality risk stratification utilizing artificial intelligence electrocardiogram for hyperkalemia in cardiac ICU Patients.

Dr. Valentin Fuster evaluates a deep learning model designed to predict left and right ventricular dysfunction and dilation in congenital heart disease patients using ECG and CMR data. The research demonstrated that AI ECG can reliably identify significant cardiovascular issues, though future work should focus on refining thresholds and validating the model across diverse populations and healthcare settings.

Commentary by Dr. Candice Silversides

We're pumped to bring you this heart-stopping instalment of Join the Docs, where our intrepid hosts, the ever-eloquent Professor Jonathan Sackier and the delightfully droll Doctor Nigel Guest, discuss cardiac arrest. With their trademark blend of wit and wisdom, they dissect the causes of this heart-stopping phenomenon and the absolutely crucial role of CPR and defibrillators in ‘staying alive'.Anyone a football fan? Joining them is none other than the football legend Glenn Hoddle, who recounts his own tale of survival. Picture this: one minute, he's fine, the next, he's floored by a cardiac arrest, saved by the swift actions of a quick-thinking bystander with CPR magic in their hands. It's a story so gripping, you'll need to remind yourself to breathe!You can heart-ly believe your eyes! As our hosts expertly navigate the treacherous waters of cardiac troubles, they illuminate the stark differences between the sneak-attack of a cardiac arrest and the slow-burn drama of a heart attack. The Docs also introduce the catchy and life-saving mnemonic "5 H's and 5 T's," which sounds like a dance move but could actually help you save a life. You aorta listen!But what can you do? Professor Sackier and Doctor Guest, in their infinite jest, remind us that laughter might be the best medicine, but regular health check-ups are a close second. But it's not all in vein - The Docs champion the superhero potential in all of us through the power of CPR, turning each listener into a potential heart-throb hero.So, strap in for an episode that's equal parts educational, entertaining, and utterly exhilarating. Remember with Join the Docs, you're in for a heart-racing good time, and who knows? You might just learn to save a life.

Pour accéder à l'intégralité de ce podcast et écouter chaque semaine un nouvel épisode du Quart d'Heure Véto, c'est très simple, il vous suffit de vous abonner en cliquant sur ce lien : https://m.audiomeans.fr/s/S-yUNSBZSR Notes et références Bindi, F., Vezzosi, T., Sala, G. et al. Evaluation of a smartphone electrocardiograph in healthy foals and comparison to standard base-apex electrocardiography. Vet Res Commun 48, 1227–1232 (2024). https://doi.org/10.1007/s11259-023-10206-x Retrouvez toute la synthèse sur la fiche podcast juste ici : https://audmns.com/nvjJPhM Pour nous suivre : 1. Abonnez-vous à notre chaine pour profiter de l'intégralité des épisodes : Le Quart d'Heure Véto : décrypte et résume en moins de 15 min un article de biblio véto - Sur abonnement uniquement Le Véto du Mois : Partagez le temps d'une interview l'expérience de vétérinaires emblématiques de notre milieu, des rencontres conviviales, comme si nous étions dans votre salon au coin du feu. Podcasts bonus au fil des inspirations... 2. Le Scope Nous partageons avec vous nos dernières découvertes, inspirations, pistes de réflexion, nouveautés… À découvrir et utiliser dès maintenant, TOUT DE SUITE, dans votre quotidien de vétérinaire, de manager, de vie personnelle, de chef d'entreprise… Et tout cela en moins de 5 minutes top chrono un à 2 mardis par mois ! Je souhaite recevoir mon Scope : https://vetmasterclass.com/lescope/ 3. Contactez-nous, suivez-nous et donnez nous votre avis ! Des sujets que vous souhaiteriez approfondir, des références à partager, ou nous faire part de vos feed-backs : Abonnez-vous à notre chaine, donnez nous des étoiles, un commentaire et partagez autour de vous ! Sur notre site : https://vetmasterclass.com/ Sur Facebook : https://www.facebook.com/VmHorse Sur Instagram : https://www.instagram.com/vetmasterclass/ Sur YouTube : https://www.youtube.com/channel/UC18ovcWk9e-mFiTL34OQ03g Sur Linkedin : https://www.linkedin.com/company/vetmasterclass-horse/about/ Belle journée à tous, Et continuez à vivre votre métier avec Passion !

Deep-Learning Models for the Prognostication and Localization of Premature Ventricular Contractions Using a 12-Lead Electrocardiogram Guest: Guru G. Kowlgi, M.B.B.S. Host: Anthony H. Kashou, M.D.    In this episode, learners will understand what premature ventricular contractions are. They will learn to differentiate benign rom malignant PVCs, and understand which patients are at risk for PVC-cardiomyopathy. Furthermore, they will gain knowledge about the traditional and novel tools for risk-stratifying patients with PVCs, and how we manage these patients.   Topics Discussed What are PVCs and what are their clinical implications? When should we be concerned about a patient with PVCs? What are some of the tools we have to detect and localize high risk PVCs? How does AI help in this regard? What are the available treatment modalities for managing PVCs? Connect with Mayo Clinic's Cardiovascular Continuing Medical Education online at https://cveducation.mayo.edu or on Twitter @MayoClinicCV and @MayoCVservices. LinkedIn: Mayo Clinic Cardiovascular Services Cardiovascular Education App: The Mayo Clinic Cardiovascular CME App is an innovative educational platform that features cardiology-focused continuing medical education wherever and whenever you need it. Use this app to access other free content and browse upcoming courses. Download it for free in Apple or Google stores today! No CME credit offered for this episode. Podcast episode transcript found here.

Commentary by Dr. Candice Silversides

Commentary by Dr. Candice Silversides

Under ESC 2023 intervjuade vi Alexandra Måneheim, ST-läkare, Klinisk Fysiologi & Doktorand, Kardiovaskulär Epidemiologi, Lunds Universitet, om studien; How reliable are single day electrocardiogram measurements to detect excessive supraventricular ectopic activity. PP-ELI-SWE-2805

About Cardiomtics Cardiomatics offers cutting-edge, cloud AI-based digital analyses of data from Holter ECGs. The medical-grade system is based on accurate algorithms, ensuring high-quality and trusted outcomes. Healthcare providers can now quickly receive an easy-to-read report and benefit from smarter diagnoses and better workflows. As a reliable partner and digital health technologies developer, Cardiomatics cooperates with physicians, manufacturers, and providers of Holter devices globally. Read the Manuscript: https://www.cvdigitalhealthjournal.com/article/S2666-6936(23)00004-X/fulltext Follow the Journal: twitter.com/CVDH_journal

Dr. Pierre Elias sits down with Catherine Price to talk about how utilizing technologies like artificial intelligence and machine learning can help diagnose patients even before symptoms develop, and support doctors by freeing them up to focus on providing personalized care to their patients. They discuss navigating bias in both artificial intelligence and clinical care, and how new technology will improve the future of medicine. For more information visit nyp.org/Advances

Robert Harrington, MD and Jenine John, a cardiologist and machine learning research fellow discuss what you need to know about AI and ML in healthcare and where to find some helpful resources. This podcast is intended for healthcare professionals only. To read a transcript or to comment, visit: https://www.medscape.com/author/bob-harrington 'One Brave Idea' Recipient on Predicting Who Will Develop CAD https://www.medscape.com/viewarticle/874536 Multinational Federated Learning Approach to Train ECG and Echocardiogram Models for Hypertrophic Cardiomyopathy Detection https://doi.org/10.1161/circulationaha.121.058696 Application of Artificial Intelligence to the Electrocardiogram https://doi.org/10.1093/eurheartj/ehab649 Using Machine Learning to Detect Problems in ECG Data Collection https://www.cinc.org/archives/2011/pdf/0437.pdf Age and Sex Estimation Using Artificial Intelligence From Standard 12-Lead ECGs https://doi.org/10.1161/CIRCEP.119.007284 External Validation of a Widely Implemented Proprietary Sepsis Prediction Model in Hospitalized Patients http://jamanetwork.com/article.aspx?doi=10.1001/jamainternmed.2021.2626 Sepsis Predictor Tool Falls Short in Emergency Setting https://www.medscape.com/viewarticle/982534 Dissecting Racial Bias in an Algorithm Used to Manage the Health of Populations https://doi.org/10.1126/science.aax2342 Geographic Distribution of US Cohorts Used to Train Deep Learning Algorithms https://jamanetwork.com/journals/jama/fullarticle/2770833 Can Medical Algorithms Be Fair? Three Ethical Quandaries and One Dilemma https://doi.org/10.1136/bmjhci-2021-100445 Healthcare Machine Learning: Getting Started https://medium.com/@jeninej/healthcare-machine-learning-getting-started-761a7dbb63a2 What Clinicians Should Know About Healthcare AI, Part 1: Why Care About AI? https://medium.com/@jeninej/what-clinicians-should-know-about-healthcare-ai-part-1-why-care-about-ai-aba6a06f696d AI in Healthcare Specialization https://www.coursera.org/specializations/ai-healthcare You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine: https://www.medscape.com/features/public/machine Hear John Mandrola, MD's, summary and perspective on the top cardiology news each week, on This Week in Cardiology: https://www.medscape.com/twic Questions or feedback, please contact: news@medscape.net

In this episode, we review the high-yield topic of Electrocardiogram (ECG) from the Cardiovascular section. Follow Medbullets on social media: Facebook: www.facebook.com/medbullets Instagram: www.instagram.com/medbulletsofficial Twitter: www.twitter.com/medbullets --- Send in a voice message: https://anchor.fm/medbulletsstep1/message

Episode: 2430 How we equipped today's medical clinics in 1915.  Today, your doctor's office comes into being.

Computerized Left Ventricular Hypertrophy Detection Guest: Bob Farrell, Ph.D.   Hosts: Anthony H. Kashou, M.D. (@anthonykashoumd) When the heart in the human body's source to pump blood has decreased, it is referred to as the left ventricle. Furthermore, the hypertrophy or the heart's wall eventually loses its firmness, which leads to a higher risk of hypertension or high blood pressure. Often, the heart tends to lose its ability to pump blood. In addition, some signs to stay aware of are feeling fatigued, dizziness, fainting, and frequent chest pain. Patients affected by Left Ventricular Hypertrophy are more at risk of becoming diagnosed if they experience decreased or increased heart rhythm signals or congestive heart failure. Therefore, when the doctor recommends testing, an Electrocardiogram is used to record signals to test the heart rhythm and abnormalities. In addition, an MRI or Echocardiogram is used to test Computerized Left Ventricular Hypertrophy as well. Joining us today to discuss Computerized Left Ventricular Hypertrophy Detection is Bob Farrell, M.D., professor of medicine at Queen's University in Kingston, Ontario, Canada. Furthermore, Dr. Farrell is currently a member of the board of directors of the International Society of Computerized Electrocardiology. Specific topics discussed: With other modalities available to clinicians (e.g., echo, cardiac MR), is ECG still relevant in the discussion of LVH? You have recently made some updates in the GE “12SL” program related to LVH. What drove the changes that you made? Customer feedback, opaqueness of the criteria, ACC/AHA recommendations to manufacturers So what were the changes you made? How did you pick which of the many criteria out there to use and how important was it to explicitly list the positive criteria in the interpretation? You mentioned earlier that ECG-LVH is an entity in its own right and is associated with poorer outcomes. Can you talk about ECG-LVH and risk prediction, and how the changes you've made in the GE 12SL program aid in the risk prediction? Connect with Mayo Clinic's Cardiovascular Continuing Medical Education online at https://cveducation.mayo.edu or on Twitter @MayoClinicCV and @MayoCVservices. Facebook: MayoCVservices LinkedIn: Mayo Clinic Cardiovascular Services NEW Cardiovascular Education App: The Mayo Clinic Cardiovascular CME App is an innovative educational platform that features cardiology-focused continuing medical education wherever and whenever you need it. Use this app to access other free content and browse upcoming courses. Download it for free in Apple or Google stores today! No CME credit offered for this episode. Podcast episode transcript found here.

A new research paper was published in Aging (Aging-US) Volume 14, Issue 14, entitled, “Common electrocardiogram measures are not associated with telomere length.” Aging is accompanied by telomere shortening. Increased telomere shortening is considered a marker of premature aging. Cardiac aging results in the development of cardiac pathologies. Electrocardiogram (ECG) measures reflect cardiac excitation, conduction, and repolarization. ECG measures also prolong with aging and are associated with cardiac pathologies including atrial fibrillation. As premature prolongation of ECG measures is observed, researchers (Aenne S. von Falkenhausen, Rebecca Freudling, Melanie Waldenberger, Christian Gieger, Annette Peters, Martina Müller-Nurasyid, Stefan Kääb, and Moritz F. Sinner), from Ludwig-Maximilians-University Munich, Partner Site Munich Heart Alliance, German Research Center for Environmental Health, and Johannes Gutenberg University, hypothesized that such prolongation may be associated with telomere length. “We studied the large, community-based KORA F4 Study. Of 3,080 participants enrolled between 2006 and 2007 with detailed information on demographic, anthropometric, clinical, and ECG characteristics, 2,575 presented with available data on leukocyte telomere length.” Telomere length was determined by real-time quantitative PCR and expressed relative to a single copy gene. The researchers fitted multivariable adjusted linear regression models to associate the ECG measures RR-interval, PR-interval, QRS-duration, and heart rate corrected QTc with telomere length. In this cohort, the mean age was 54.9±12.9 years and 46.6% were men. Increased age was associated with shorter telomere length (p

Drs. Akhil Vaid and Lili Chan describe the findings of their study, "Automated Determination of Left Ventricular Function using Electrocardiogram Data in Patients on Maintenance Hemodialysis," on behalf of their colleagues.

Date: 5-17-22Name of podcast: Dr. PatientEpisode title and number:  6 How Doctoring Used to Be Episode summary:In the old days of medicine, doctors had more time and more freedom to practice their art as they saw fit. Nowadays many doctors are affiliated with big hospitals or groups, and have lost the freedom to design their day so to speak. Many don't have a say over how much time they get with patients, how billing works and more. In this story you'll hear a few stories about how things used to be, and also how those older healthcare providers see today's healthcare delivery.Guest(s): Anne Johnston, Dr. Jack Martin Key Terms:[08:30] EKG – short for Electrocardiogram, it's a test that looks at the electrical activity of your heart. [09:37] pacemaker – a device that's implanted into the chest to regulate your heartbeat and rate[10:05] – PVCs – Premature ventricular contraction, considered an “extra” heartbeat that originates in one of the lower chambers, ventricles, and leads to the feeling of fluttering or an extra heart beat[10:08] – pacemaker in situ – a pacemaker that's “in place”[10:54] – echocardiogram, basically an ultrasound of your heart, it checks how blood is pumping in all parts of your heart and the main vessels[29:28] – CME – Continuing Medical Education. Doctors need to log a certain number of hours per year to retain their medical license

Commentary by Dr. Shengxian Tu

Commentary by Dr. Sadeer Al-Kindi

Guests Arun Sridhar and Dr. Patrick Boyle sit down with host Dr. Hamid Ghanbari to discuss her recent paper on " Identifying risk of adverse outcomes in COVID-19 patients via artificial intelligence–powered analysis of 12-lead intake electrocardiogram" Read the paper here: https://www.cvdigitalhealthjournal.com/article/S2666-6936(21)00146-8/fulltext Read the journal: www.cvdigitalhealthjournal.com/ Follow the Journal: twitter.com/CVDH_journal

Join Dr. Peter Kotanko, MD, FASN Head of Biomedical Evidence Generation and Renal Research Institute, and Axel Loewe, PhD, Group Leader "Computational Cardiac Modeling" at Karlsruhe Institute of Technology (KIT) as they discuss the opportunities that the electrocardiogram (ECG) offers for the detection of electrolyte imbalances. The advantages of the ECG and the current state of the art of manual and automatic algorithms are summarized. A particular field of interest is the use of machine learning methods for an automatic classification or regression of electrolyte imbalances and concentrations, respectively.

Not Medical Advice or Opinion

In this episode, our guest is Atocha Calvo Santesmases. Atocha is an equine vet at  EquiTrain veterinarian clinic in Madrid.  What is an ECG and why should we perform ECGs on horses on a regular basis ? Here are the questions addressed in this episode.  Reed more on our website : www.seaverhorse.comHébergé par Ausha. Visitez ausha.co/politique-de-confidentialite pour plus d'informations.

Commentary by Dr. Valentin Fuster

In the first episode of To the Xth Degree, we will find a connection between the Electrocardiogram, a non-invasive measure of the heart’s electrical activity, and the Golden State Killer, a serial killer and rapist who was active in Northern and Southern California from 1973 to 1986.

This episode covers electrocardiogram signals!

Time for a heart check from Pastor Mitchell. Originally preached in the 2010 Tempe Bible Conference. Deu 8:1-11 NKJV - 1 "Every commandment which I command you today you must be careful to observe, that you may live and multiply, and go in and possess the land of which the LORD swore to your fathers. 2 "And you shall remember that the LORD your God led you all the way these forty years in the wilderness, to humble you [and] test you, to know what [was] in your heart, whether you would keep His commandments or not. 3 "So He humbled you, allowed you to hunger, and fed you with manna which you did not know nor did your fathers know, that He might make you know that man shall not live by bread alone; but man lives by every [word] that proceeds from the mouth of the LORD. 4 "Your garments did not wear out on you, nor did your foot swell these forty years. 5 "You should know in your heart that as a man chastens his son, [so] the LORD your God chastens you. 6 "Therefore you shall keep the commandments of the LORD your God, to walk in His ways and to fear Him. 7 "For the LORD your God is bringing you into a good land, a land of brooks of water, of fountains and springs, that flow out of valleys and hills; 8 "a land of wheat and barley, of vines and fig trees and pomegranates, a land of olive oil and honey; 9 "a land in which you will eat bread without scarcity, in which you will lack nothing; a land whose stones [are] iron and out of whose hills you can dig copper. 10 "When you have eaten and are full, then you shall bless the LORD your God for the good land which He has given you. 11 "Beware that you do not forget the LORD your God by not keeping His commandments, His judgments, and His statutes which I command you today, -- Join our bible reading plan: https://bible.com/p/21036256/5e69cf8f678bf7e81329c59d81a8a479 Want to receive text updates from our church? Send the keyword VBPH to 844-990-3380. Please let us know how this message has influenced you by connect with us using one of these options: Email: pastor@vbph.org Voicemail: https://anchor.fm/vbph-sermons/message Facebook: https://facebook.com/vbph.church Instagram: https://instagram.com/vbph.church Twitter: https://twitter.com/vbph_church Website: https://vbph.church Are you in Hampton Roads and want to visit our church? Come join us IRL: 1045 Lynnhaven Pkwy., Virginia Beach, VA 23452 Thanks for listening! Has this message been a blessing to you? Please consider giving a generous donation!

Welcome to Sports Med Res’ this week in review podcast where we highlight the news in sports medicine research from the week ending on July 10, 2020. This week’s podcast focused on electrocardiogram screening criteria among college athletes. * When Performing ECG Screenings, the Screening Criteria Matters * Consensus Recommendations on the Prehospital Care of the Injured Athlete With a Suspected Catastrophic Cervical Spine Injury * Position Statement of the Royal Spanish Football Federation for the Resumption of Football Activities After the COVID-19 Pandemic (June 2020) * American College of Sports Medicine Expert Consensus Statement to Update Recommendations for Screening, Staffing, and Emergency Policies to Prevent Cardiovascular Events at Health Fitness Facilities * Navigating Athletic Training Position Statements: The Strength of Recommendation Taxonomy System RSS Feed, Apple Podcasts, or Google Play Evidence-Based CEU Courses from Sports Med Res and Human Kinetics (3-10 EBP CEUs/course) The post Are You Positive About Your Pre-Participation Electrocardiogram Screening Criteria? appeared first on Sports Medicine Research.

AliveCor Kardia. AliveCor offers a great way to monitor your heart health with mobile EKG technology. What is an EKG? Let's discuss this with Doctor Garrett Ruth, a cardiologist. Host: Ant Pruitt Download or subscribe to this show at https://twit.tv/shows/hands-on-wellness Sponsor: casper.com/twit1 - promo code: TWIT1

AliveCor Kardia. AliveCor offers a great way to monitor your heart health with mobile EKG technology. What is an EKG?Let's discuss this with Doctor Garrett Ruth, a cardiologist. Host: Ant Pruitt Download or subscribe to this show at https://twit.tv/shows/hands-on-wellness Sponsor: casper.com/twit1 - promo code: TWIT1

AliveCor Kardia. AliveCor offers a great way to monitor your heart health with mobile EKG technology. What is an EKG?Let's discuss this with Doctor Garrett Ruth, a cardiologist. Host: Ant Pruitt Download or subscribe to this show at https://twit.tv/shows/hands-on-wellness Sponsor: casper.com/twit1 - promo code: TWIT1

AliveCor Kardia. AliveCor offers a great way to monitor your heart health with mobile EKG technology. What is an EKG?Let's discuss this with Doctor Garrett Ruth, a cardiologist. Host: Ant Pruitt Download or subscribe to this show at https://twit.tv/shows/hands-on-wellness Sponsor: casper.com/twit1 - promo code: TWIT1

AliveCor Kardia. AliveCor offers a great way to monitor your heart health with mobile EKG technology. What is an EKG?Let's discuss this with Doctor Garrett Ruth, a cardiologist. Host: Ant Pruitt Download or subscribe to this show at https://twit.tv/shows/hands-on-wellness Sponsor: casper.com/twit1 - promo code: TWIT1

AliveCor Kardia. AliveCor offers a great way to monitor your heart health with mobile EKG technology. What is an EKG?Let's discuss this with Doctor Garrett Ruth, a cardiologist. Host: Ant Pruitt Download or subscribe to this show at https://twit.tv/shows/hands-on-wellness Sponsor: casper.com/twit1 - promo code: TWIT1

Commentary by Dr. Valentin Fuster

To Your Health With Dr. Jim Morrow: Episode 16, The Complete Physical Exam, What it IS and What it ISN’T How often should you get a complete physical exam? What are the most important tests in a thorough physical exam, and which are unnecessary or a waste of money? Dr. Jim Morrow answers these questions […] The post To Your Health With Dr. Jim Morrow: Episode 16, The Complete Physical Exam, What it IS and What it ISN’T appeared first on Business RadioX ®.

Professor Jon Drezner is a family medicine physician from Seattle, USA with expertise in sports medicine and sports cardiology. He shares the new international criteria for electrocardiogram (ECG) interpretation in athletes - these lead to a lower false positive rate while maintaining sensitivity. He clearly defines the key changes and what to look out for on an ECG. You can access the International ECG Criteria paper below and also check out the conference Prof. Drezner is organising in Seattle 2-3 November 2017. International ECG Interpretation Criteria - http://bjsm.bmj.com/content/early/2017/03/03/bjsports-2016-097331. Conference: “Prevention of Sudden Cardiac Death in Athletes: Sports Cardiology for the Team Physician and Cardiology Consultant” - https://uw.cloud-cme.com/Ap2.aspx?EID=4649&P=5.

http://bit.ly/2rqzqUc

Myocardial infarction (MI) in children is uncommon, but underdiagnosed.  This is due to two main factors: the etiologies are varied; and the presenting symptoms are “atypical”. We need a mental metal detector!  Case examples Congenital Two main presentations of MI due to congenital lesions: novel and known.  The novel presentation is at risk for underdiagnosis, due to its uncommonness and vague, atypical symptoms.  There are usually some red flags with a careful H&P.  The known presentation is a child with a history of congenital heart disease, addressed by corrective or palliative surgery.  This child is at risk for expected complications, as well as overdiagnosis and iatrogenia.  Risk stratify, collaborate with specialists. The fussy, sweaty feeder: ALCAPA Anomalous Left Coronary Artery from the Pulmonary Artery (ALCAPA) is an example of what can go wrong during fetal development: any abnormality in the number, origin, course, or morphology of the coronary arteries can present as a neonate with sweating during feeds (steal syndrome), an infant in CHF, or an older child with failure to thrive or poor exercise tolerance. The stable child with chest pain: myocardial bridge Normal coronary arteries run along the epicardial surface of the heart, with projections into the myocardium.  If part of the artery’s course runs within the myocardium (i.e. the artery weaves into and/or out of the myocardium), then there is a myocardial bridge of the coronary artery.  With every systolic contraction, the artery is occluded.  Although a myocardial bridge may not cause symptoms (especially at distal portions), the area it supplies is at risk. With any minor trauma or exertion, demand may outpace supply, resulting in ischemia.  Diagnosis is made on coronary angiography. The unwell child post-cardiac surgery: Fontan problems The child with single ventricle physiology may have a Norwood procedure at birth (creation of a neoaorta, atrial septectomy, and Blalock-Taussig shunt), a Bidirectional Glenn procedure at 3-6 months (shunt removed, superior vena cava connected to pulmonary arteries), and a Fontan procedure at about 2-3 years of age (inferior vena cava blood flow is shunted into the pulmonary arteries). These children depend on their preload to run blood passively into the pulmonary circuit; afterload reduction is also important to compensate for a poor left ejection fraction, as well as to avoid the development of pulmonary hypertension.  They are typically on an anticoagulant (often aspirin), a diuretic (e.g. furosemide), and an afterload reduction agent (e.g. enalapril).  Any disturbance in volume status (hyper- or hypovolemia), anticoagulation, or afterload may cause myocardial strain or infarction.  Take the child s/p Fontan seriously and involve his specialists early with any concerns. Autoimmune The body’s inflammatory-mediated reaction to a real or perceived insult can cause short- and long-term cardiac sequelae.  Find out how well the underlying disease is controlled, and what complications the child has had in the past. The red, hot, crispy, flaky child: acute Kawasaki disease Kawasaki disease (KD) is an acute systemic vasculitis, diagnosed by the presence of fever for five or more days accompanied by four or more criteria:  bilateral conjunctival injection, mucositis, cervical lymphadenopathy, polymorphous rash, and palmar or sole desquamation.  The criteria may occur (and disappear) at any time during the illness. Infants are under double jeopardy with Kawasaki Disease.  They are more likely to have incomplete KD (i.e. not fulfill strict criteria) and if they have KD, they are more likely to suffer the dangerous consequences of aneurysm formation (chiefly coronary arteries, but also brain, kidney).  Have a low threshold for investigation. Treatment includes 2 g/kg/day IVIG and high-dose aspirin (30-50 mg/kg/day) acutely, then low-dose aspirin (5 mg/kg/day) for weeks to months.  Regular and long-term follow-up with Cardiology is required. The aftermath: sequelae of Kawasaki disease The family and child with a history of KD may have psychological trauma and continuous anxiety about the child’s risk of MI.  Approximately 4.7% of children who were promptly diagnosed and correctly treated will go on to have cardiac sequelae. Children who have no detected cardiac sequelae by 8 weeks, typically continue to be asymptomatic up to 20 years later.  Smaller aneurysms tend to regress over time, especially those < 6 mm. Thrombi may calcify, or the lumen may become stenotic due to myofibroblast proliferation.  Children with any coronary artery dilatation from KD should be followed indefinitely. Giant aneurysms (≥8 mm) connote the highest risk for MI.  Parents often are concerned about recurrence, and any subsequent fever can be distressing.  There is a low rate of recurrence for KD: approximately 2%.  Infants who have coronary aneurysms are at the highest risk for recurrence. The older child with vague chest complaints and hypercoagulability: Systemic Lupus Erythematosus and Anti-Phospholipid Syndrome Up to 15% of cases of SLE begin in childhood.  Adult criteria are used, with the caveat that the diagnosis of SLE in children can be challenging; many children only manifest a few of the criteria initially before going on to develop further systemic involvement. The Systemic Lupus International Collaborating Clinics (SLICC) revised the criteria in 2012.  The patient should have ≥4/17 clinical and/or immunologic criteria.  The clinical criteria are: acute cutaneous (malar); chronic cutaneous (discoid); oral; alopecia; synovitis; serositis; renal; neurologic; hemolytic anemia; leukopenia; or thrombocytopenia.  The immunologic criteria are: ANA; anti-dsDNA; anti-Sm; antiphospholipid; low complement; and/or Direct Coombs (in absence of hemolytic anemia).  At least one criterion should be clinical, and at least one should be immunologic.  Children with antiphospholipid syndrome (APS) may occur with or without SLE.  Patients are at risk for venous and arterial thrombi formation.  APS may also cause structural damage, such as valvular thickening and valvular nodes (Libman-Sacks endocarditis).  Mitral and aortic valves are at the highest risk. Although most children with chest pain will not have MI, those with comorbidities should be investigated carefully. Trauma Direct, blunt trauma to the chest can cause myocardial stunning, dysrhythmias, or an asymptomatic rise in Troponin I.  However, some children are at risk for disproportionate harm due to a previously unknown risk factor.  Clinically significant cardiac injury occurs in up to 20% of patients with non-penetrating thoracic trauma. The motor vehicle collision: blunt myocardial injury Direct trauma (steering wheel, airbag, seatbelt), especially in fast acceleration-deceleration injury, may cause compression of the heart between the sternum and the thoracic spine. Electrocardiography (ECG) should be performed on any patient with significant blunt chest injury.  A negative ECG is highly consistent with no significant blunt myocardial injury. Any patient with a new abnormality on ECG (dysrhythmia, heart block, or signs of ischemia) should be admitted for continuous ECG monitoring. Elevation in troponin is common, but not predicted.  A solitary elevated troponin without ECG abnormality is of unclear significance.  Author’s advice: obtain troponin testing if there is an abnormal ECG, more than fleeting suspicion of BCI, and/or the child will be admitted for monitoring. Hemodynamically labile children should be resuscitated and a stat transesophageal echocardiogram obtained. The high-velocity object: coronary artery dissection or thrombus Direct trauma (e.g. MVC, baseball, high-velocity soccer ball) may cause damage to the left anterior descending artery or left circumflex artery, at the highest risk due to their proximity to the chest wall.  Thrombosis and/or dissection may result, often presenting in a focal pattern of ischemia on the ECG. Echocardiography may reveal valvular damage related to the injury, as well as effusion and ejection fraction.  Since there is often a need to investigate the coronary anatomy, percutaneous coronary intervention (PCI) is recommended. The minor trauma with disproportionate complaint: myocardial bridge As mentioned in the congenital section (above), a known variation of a coronary artery’s course involves weaving in and out of the myocardium, creating a baseline risk for ischemia.  Even minor trauma in a child with a myocardial bridge may cause acute thrombus, or slow stenosis from resulting edema.  Unfortunately, the presence of myocardial bridging is often unknown at the time of injury.  Approximately 25% of the population may have myocardial bridging, based on autopsy studies. Take the child seriously who has disproportionate symptoms to what should be a minor injury. Hematologic Coagulopathic and thrombophilic states may predispose children to focal cardiac ischemia.  The best documented cormorbidity is sickle cell disease, although other pro-thrombotic conditions also put the child at risk. The child with sickle cell disease and chest pain: when it’s not acute chest syndrome Sickle cell disease (SCD) can affect any organ system, although the heart is traditionally considered a lower-risk target organ for direct sickling and ischemia.  The major cardiac morbidity in sickle cell is from strain, high-output failure and multiple, serial increases in myocardial demand, causing left ventricular hypertrophy and congestive heart failure. However, there is mounting evidence that acute myocardial ischemia in sickle cell disease may be underappreciated and/or attributed to other causes of chest pain. Other cardiac sequelae from SCD include pulmonary hypertension, left ventricular dysfunction, right ventricular dysfunction, and chronic iron overload. Evidence of myocardial ischemia/infarction in children with SCD has been demonstrated on single-photon emission computed tomography (SPECT) scan. The puffy faced child with chest pain: nephrotic syndrome hypercoagulability Children who suffer from nephrotic syndrome lose proteins that contribute to the coagulation cascade.  In addition, lipoprotein profiles are altered: there is a rise in the very low-density lipoproteins (LDL), contributing to accelerated atherosclerosis.  Typically nephrotic patients have normal levels of high-density lipoproteins (HDL), unless there is profuse proteinuria. Children with difficult-to-control nephrotic syndrome (typically steroid-resistant) may form accelerated plaques that rupture, causing focal MI, as early as school age. The previously well child now decompensated: undiagnosed thrombophilia Asymptomatic patent foramen ovale (PFO) is the cause of some cases of cryptogenic vascular disease, such as stroke and MI.  However, the presence of PFO alone does not connote higher risk.  When paired with an inherited or acquired thrombogenic condition, the venous thrombus may travel from the right-sided circulation to the left, causing distal ischemia.  Many of these cases are unknown until a complication arises. The chronically worried, now with a reason: hypercholesterolemia A family history of adult-onset hypercholesterolemia is not necessarily a risk factor for early complications in children, provided the child does not have the same acquired risk factors as adults (e.g. obesity, sedentary lifestyle, smoking, etc).  Parents may seek help in the ED for children with chest pain and no risk factors, but adult parents who have poor cholesterol profiles. The exception is the child with familial hypercholesterolemia, who is at risk for accelerated atherosclerosis and MI. Infectious Myocarditis has varied etiologies, including infectious, medications (chemotherapy agents), immunologic (rheumatologic, transplant rejection), toxins (arsenic, carbon monoxide, heavy metals such as iron or copper), or physical stress (electrical injury, heat illness, radiation). In children, the most common cause of myocarditis is infectious (viruses, protozoa, bacteria, fungal, parasites).  Of these, viral causes are the most common (adenovirus, enterovirus, echovirus, rubella, HHV6). The verbal child may complain of typical chest complaints, or may come in with flu-like illness and tachycardia or ill appearance out of proportion to presumed viral illness. The most common presenting features in children with myocarditis are: shortness of breath, vomiting, poor feeding, hepatomegaly, respiratory distress, and fever. The infant in shock after a ‘cold’: myocarditis Beware of the poor feeding, tachycardic, ill appearing infant who “has a cold” because everyone else around him has a ‘cold’.  That may very well be true, but any virus can be invasive with myocardial involvement.  Infants are only able to increase their cardiac output through increasing their heart rate; they cannot respond to increased demands through ionotropy.  Look for signs of acute heart failure, such as hepatomegaly, respiratory distress, and sacral edema. The child with tachycardia out of proportion to complaint: myocarditis The previously healthy child with “a bad flu” may simply be very symptomatic from influenza-like illness, or he may be developing myocarditis.  Look for chest pain and tachycardia out of proportion to presumed illness, and constant chest pain, not just associated with cough. The “pneumonia” with suspicious chest x-ray: myocarditis Acute heart failure may mimic viral pneumonia.  Look for disproportionate signs and symptoms. Toxins Younger children may get into others’ medications, be given dangerous home remedies, take drugs recreationally, have environmental exposures (heavy metals), suffer from a consequence of a comorbidity (iron or copper overload) or have adverse events from generally safe medications. The hyperactive boy with a hyperactive precordium: methylphenidate Attention deficit hyperactivity disorder (ADHD) is growing in rate of diagnosis and use of medications.  As the only medical diagnosis based on self-reported criteria, many children are given stimulants regardless of actual neurologic disorder; with a higher proportion of children exposed to stimulants, adverse effects are seen more commonly. Methylphenidate is related to amphetamine, and they both are dopaminergic drugs.  Their mechanisms of action are different, however.  Methylphenidate increases neuronal firing rate.  Methamphetamine reduces neuronal firing rate; cardiovascular sequelae such as MI and CHF are more common in chronic methamphetamine use. Although methylphenidate is typically well tolerated, risks include dysrhythmias such as ventricular tachycardia. The child with seizure disorder and chest pain: anti-epileptics Some anti-epileptic agents, such as carbamazepine, promote a poor lipid profile, leading to atherosclerosis and early MI.  Case reports include school-aged children on carbamazepine who have foamy cells in the coronary arteries, aorta, and vasa vasorum on autopsy.  It is unclear whether this is a strong association. The spice trader: synthetic cannabinoids Synthetic cannabinoids are notoriously difficult to regulate and study, as the manufacturers label them as “not for human consumption”.  Once reports surface of abuse of a certain compound, the formula is altered slightly and repackaged, often in a colorful or mysterious way that is attractive to teenagers. The misperceptions are: are a) synthetics are related to marijuana and therefore safe and b) marijuana is inherently “safe”. Both tend to steer unwitting teens to take these unknown entities.  Some suffer MI as a result. Exposure to tetrahydrocannabinol (THC) in high-potency marijuana has been linked to myocardial ischemia, ventricular tachycardia, and ventricular fibrillation.  Marijuana can increase the heart rate from 20-100%, depending on the amount ingested. K2 (“kush 2.0”) or Spice (Zohai, Genie, K3, Bliss, Nice, Black Mamba, fake weed, etc) is a mixture of plant leaves doused in synthetic chemicals, including cannabinoids and fertilizer (JWH-108), none of which are tested or safe for human consumption.  Synthetic cannabinoids have a higher affinity to cannabinoid receptors, conferring higher potency, and therefore worse adverse effects.  They are thought to be 100 to 800 times more potent as marijuana. Bath salts (Purple Wave, Zoom, Cloud Nine, etc) can be ingested, snorted, or injected.  They typically include some form of cathinone, such as mephedrone, similar to the substance found in the naturally occurring khat plant. Hallucinations, palpitations, tachycardia, MI, and dysrhythmias have been reported from their use as a recreational drug. Chest pain with marijuana, synthetic cannabinoid, or bath salt ingestion should be investigated and/or monitored. Riding that train: high on cocaine Cocaine is a well-known cause of acute MI in young people.  In addition to the direct stimulant causes acutely, such as hypertension, tachycardia, and impaired judgement (coingestions, risky behavior), chronic cocaine use has long-term sequelae.  Cocaine causes accelerated atherosclerosis.  That, in conjunction with arterial vasospasm and platelet activation, is a recipe for acute MI in the young. Cranky: methamphetamine Methamphetamine is a highly addictive stimulant that is relatively inexpensive and widely available.  Repeated use causes multiple psychiatric, personality, and neurologic changes.  Risky behavior, violence, and motor vehicle accidents are all linked to this drug.  Like cocaine, methamphetamine may cause fatal dysrhythmias, acute MI from demand ischemia, and long-term sequelae such as congestive heart failure. Summary Acute MI is a challenging presentation in children: Easily missed: uncommon and atypical Varied etiology Respect vague symptoms with a non-reassuring H&P Try to detect it: CATH IT! References Congenital AboulHosn JA et al. Fontan Operation and the Single Ventricle. Congenit Heart Dis. 2007; 2:2-11. Aliku TO et al. A case of anomalous origin of the left coronary artery presenting with acute myocardial infarction and cardiovascular collapse. African Health Sci. 2014; 14(1): 23-227. Andrews RE et al. Acute myocardial infarction as a cause of death in palliated hypoplastic left heart syndrome. Heart. 2004; 90:e17. Canale LS et al. Surgical treatment of anomalous coronary artery arising from the pulmonary artery. Interactive Cardiovascaulr and Thoracic Surgery. 2009; 8:67-69. Güvenç O et al. Correctable Cause of Dilated Cardiomyopathy in an Infant with Heart Failure: ALCAPA Syndrome. J Curr Pediatr. 2017; 15:47-50. Hastings RS et al. Embolic Myocardial Infarction in a Patient with a Fontan Circulation. World Journal for Pediatric Congenital Heart Surgery. 2014; 5(4)L631-634. Hoffman JIE et al. Electrocardiogram of Anomalous Left Coronary Artery From the Pulmonary Artery in Infants. Pediatr Cardiol. 2013; 34(3):489-491. Kei et al. Rare Case of Myocardial Infarction in a 19-Year-Old Caused by a Paradoxical Coronary Artery Embolism. Perm J.2015; 19(2):e107-e109. Liu Y, Miller BW. ALCAPA Presents in an Adult with Exercise Inlerance but Preserved Cardiac Function. Case Reports Cardiol. 2012; AID 471759. Möhlenkamp S et al. Update on Myocardial Bridging.Circulation. 2002;106:2616-2622. Murgan SJ et al. Acute myocardial infraction n the neonatal period. Cardiol Young. 2002; 12:411-413. Sieweke JT et al. Myocardial infarction in grown up patients with congenital heart disease: an emergening high-risk combination. International Journal of Cardiology. 2016; 203:138-140. Schwerzmann M et al. Anomalous Origin of the Left Coronary Artery From the Main Pulmonary Artery in Adults. Circulation. 2004; 110:e511-e513. Tomkewicz-Pajak L et al. Arterial stiffness in adult patients after Fontan procedure. Cardiovasculr Ultrasound. 2014; 12:15. Varghese MJ et al. The caveats in the diagnosis of anomalous origin of left coronary artery from pulmonary artery (ALCAPA). Images Paediatr Cardiol. 2010; 12(3): 3–8. Autoimmune Ayala et al. Acute Myocardial Infarction in a Child with Systemic Lupus Erythematosus and Antiphospholipid Syndrome. Turk J Rheumatol. 2009; 24:156-8. Nakano H et al. Clinical characteristics of myocardial infarction following Kawasaki disease: Report of 11 cases. J Pediatr. 1986; 108(2):198-203. Pongratz G et al. Myocardial infarction in an adult resulting from coronary aneurysms previously documented in childhood after an acute episode of Kawasaki’s disease. European Heart J. 1994. 15:1002-1004. Newburger JW et al.  Diagnosis, Treatment, and Long-Term Management of Kawasaki Disease. A Statement for Health Professionals From the Committee on Rheumatic Fever, Endocarditis and Kawasaki Disease, Council on Cardiovascular Disease in the Young, American Heart Association. Circulation. 2004;110:2747-2771. Son MB et al. Kawaski Disease. Pediatr Rev. 2013; 34(4). Yuan S. Cardiac surgical procedures for the coronary sequelae of Kawasaki disease. Libyan J Med. 2012; 7:19796. Trauma Abdolrahim SA et al. Acute Myocardial Infarction Following Blunt Chest Trauma and Coronary Artery Dissection. J Clin Diagnost Res. 2016; 10(6):14-15. Galiuto L et al. Post-traumatic myocardial infarction with hemorrhage and microvascular damage in a child with myocardial bridge: is coronary anatomy actor or bystander. Signa Vitae. 2013; 8(2):61-63. Janella BL et al. Acute Myocardial Infarction related to Blunt Thoracic Trauma. Arq Bras Cardiol. 2006; 87:e168-e171. Liu X et al. Acute myocardial infarction in a child with myocardial bridge World J Emerg Med. 2011; 2(1):70-72. Long WA et al. Childhood Traumatic Infarction Causing Left Ventricular Aneurysm: Diagnosis by Two-Dimensional Echocardiography. JACC. 1985; 5(6):1478-83. Smith S. Right Bundle Branch Block after Blunt Trauma: A Tragic Case. [Blog Post] July 22, 2012. Retrievable at: http://hqmeded-ecg.blogspot.com/2012/07/right-bundle-branch-block-after-blunt.html. Hematologic Carano N et al. Acute Myocardial Infarction in a Child: Possible Pathogenic Role of Patent Foramen Ovale Associated with Heritable Thrombophilia. Pediatr. 2004; 114(2):255-258.      Chacko P et al. Myocardial Infarction in Sickle Cell Disease. J Cardiovascl Transl Res. 2013; 6(5):752-761. De Montalembert M et al. Myocardial ischaemia in children with sickle cell disease. Arch Dis Child. 2004; 89:359-362. Gladwin MT et al. Cardiovascular Abnormalities in Sickle Cell Disease. JACC. 2012; 59(13):1123-1133. Osula S et al. Acute myocardial infarction in young adults: causes and management. Postgrad Med J. 2002; 78:27-30. Silva JMP et al. Premature acute myocardial infarction in a child with nephrotic syndrome. Pediatr Nephrol. 2002; 17:169-172. Suryawanshi SP. Myocardial infarction in children: Two interesting cases. Ann Pediatr Cardiol. 2011 Jan-Jun; 4(1): 81–83. Infectious Cunningham R et al. Viral myocarditis Presenting with Seizure and Electrocardiographic Findings of Acute Myocardial Infarction in a 14-Month-Old Child. Ann Emerg Med. 2000; 35(6):618-622. De Vettten L et al. Neonatal Myocardial Infarction or Myocarditis? Pediatr Cardiol. 2011; 32:492-497. Durani Y et al. Pediatric myocarditis: presenting clinical characteristics. Am J Emerg Med. 2009; 27:942-947. Erden I et al. Acute myocarditis mimicking acute myocardial infarction associated with pandemic 2009 (H1N1) influenza virus. Cardiol J. 2011; 552-555. Hover MH et al. Acute Myocarditis Simulating Myocardial Infarction in a Child. Pediatr. 1191; 87(2):250-252. Lachant D et al. Meningococcemia Presenting as a Myocardial Infarction. Case Reports in Critical Care. 2015; AID 953826. Laissy JP et al. Differentating Myocardial Infarction from Myocarditis. Radiology. 2005; 237(1):75-82. Miranda CH et al. Evaluation of Cardiac Involvement During Dengue Viral Infection. CID. 2013; 57:812-819. Rettig JS et al. Myocarditis in Children Requiring Critical Care Transport. In:  "Diagnosis and Treatment of Myocarditis", Milei J, Ambrosio G (Eds). DOI: 10.5772/56177. Toxins De Chadarévian JP et al. Epilepsy, Atherosclerosis, Myocardial Infarction, and Carbamazepine. J Child Neurol. 2003; 18(2):150-151. McIlroy G et al. Acute myocardial infarction, associated with the use of a synthetic adamantly-canabinoid: a case report. BMC Pharmacology and Toxicology. 2016; 17:2. Mir A et al. Myocardial Infarction Associated with Use of the Synthetic Cannabinoid K2. Pediatr. 2011; 128(6):1-6 Munk K et al. Cardiac Arrest following a Myocardial Infarction in a Child Treated with Methylphenidate. Case Reports Pediatr. 2015; AID 905097. Rezkalla SH et al. Cocaine-Induced Acte Mycardial Infarction. Clin Med Res. 2007; 5(3):172-176. Schelleman H et al. Methylphenidate and risk of serious cardiovascular events in adults. Am J Psychiatry. 2012 Feb;169(2):178-85. Sheridan J et al. Injury associated with methamphetamine use: a review of the literature. Harm Reduction Journal, 2006; 3(14):1-18. Stiefel G et al. Cardiovascular effects of methylphenidate, amphetamines and atomoxetine in the treatment of attention-deficit hyperactivity disorder. Drug Saf. 2010 Oct 1;33(10):821-42.   This post and podcast are dedicated to Edwin Leap, MD for his sanity and humanity in the practice of Emergency Medicine.  Thank you, Dr Leap for all that you do.

Serial measurements of high-sensitivity troponin are used to rule out acute myocardial infarction (AMI) with an assay specific cutoff at the 99th percentile.

Dr. Stephen D. Clements, Jr. The Electrocardiogram and Decision Making in Cardiology. Recorded 2015-02-23.

MIT researchers are developing energy-efficient microchips that could operate within wearable or implantable devices that monitor medical patient for health problems.

The heart’s electric currents have been known for one hundred years, but three-quarters of a century later, the ECG is still giving up its secrets. Buchman explains the basic ECG signal and its relationship with the function of the human heart. He then turns to complex systems science to discover hidden structure within the ECG. These lie in frequencies (akin to musical tones); in variability (akin to the change in directions of a walker choosing not-quite-random steps); and in network design (akin to adding/losing elements of a power grid). Finally, he explores the ways in which the ECG might point towards the existence of fundamental laws of biology. Armed with these fundamental laws, we ask how complex systems science might allow us to guide care in the intensive care unit.