Atrial fibrillation

Fake Atrial Fibrillation — A Growing Patient-Safety Issue

Fake atrial fibrillation (AF) is a growing problem. This is when the computer-reading on an ECG calls the rhythm AF, but it is not AF. When the doctor does not recognize the faulty read, the patient is misdiagnosed. Here are three pictures from the last month. (I have a stack of these.) Notice the computer-read […]

Athletic heart General Cardiology General Medicine

New Trials and Fibrillations post is up

It’s entitled: More on ECG screening to prevent sudden death in the young: On risk, the Italian experience and notes from the real world. Here’s the lead in… Earlier this week, I wrote about one of my favorite topics in medicine: the ECG. This 12-pronged view of cardiac vectors catapulted my interest in the human […]

Athletic heart Exercise General Medicine

The NY Times gets it wrong on ECG screening of young athletes

When a news source as powerful as The NY Times publishes an article about sudden cardiac death in young people, one expects accurate information. It’s far too important a topic to write about imprecisely. This piece, entitled Should Young Athletes Be Screened for Heart Risk, included numerous inaccuracies and failed to tell important facts about […]

Athletic heart Cycling Wed Exercise

CW: The ECG of an athlete

It may seem a little formal to say this, but I would like to start by stating my goals for today’s post: Introduce the concept of the athletic heart; Touch upon the notion of sudden death of the athlete; Explain what an ECG really is, and how it may help diagnose heart disease; Review a […]

Athletic heart Doctoring General Cardiology General Medicine Health Care Reform

A five-minute cardiac screen for athletes?

It’s heart-wrenching when young athletes die of sudden cardiac death (SCD). This week, the death of Wes Leonard, a Michigan high school star athlete, was especially poignant since he collapsed right after hitting the game-winning shot.  This sort of tragedy occurs about one hundred times each year in America. That’s a lot of sadness. The […]

Atrial fibrillation ICD/Pacemaker

ECG Quiz: Drug-induced torsades de pointes

As the commenters correctly pointed out, this Sunday’s case involving the patient with recurrent syncope is indeed polymorphic ventricular tachycardia–aptly named torsades de pointes (‘twisting of the points’).  TDP is associated with prolongation of the QT interval, and pause-dependent PVCs (and VT).  A serious malady indeed. ICD evaluation showed hundreds of these episodes The initial ECG strengthened […]

General Cardiology General Medicine

ECG Quiz…

This one fell in the bucket: “John, you had better go check this out.” The septuagenerian presented to the emergency department because of repeated bouts of syncope. (Syncope is medical speak for temporary loss of consciousness.)  As Indiana electrophysiology fellows, we had two categories of passing out: “he passed out…cold,” or “he passed out…stone cold.” […]

Athletic heart Cycling Stuff Health Care Reform Knowledge

The feasibility of routine ECG screening of athletes?

Sudden death in a young athlete is surely a tragic event.  Sadly, many of the afflicted had an underlying undiagnosed heart anomaly that might have been detected with a screening ECG. On the surface, the idea seems so simple: just add an ECG to the routine pre-sport’s history and physical exam.  ECGs are painless, non-invasive […]

General Cardiology General Medicine

What is going on here?

A first for me: a clinical quiz. The patient has had seventy birthdays. He presents with shortness of breath and constant chest pressure. These symptoms began abruptly 24 hours before presenting.  He describes feeling “dreadful.” Past history is remarkable for an implanted device 8 years ago. A thorough physical exam is… you guessed it…normal. Here […]

Doctoring Health Care Health Care Reform

Saving lives with a 25 dollar painless test…

In the era of expensive and technologically advanced tests like MRI, CT and PET scans, how could a 25 dollar ECG save many lives?  A recent study on the merits of adding a screening ECG to the routine screening of young athletes has created a stir, with many words written in the lay press. For […]

General Cardiology General Medicine ICD/Pacemaker

A malignant arrhythmia from an antibiotic? Lessons to be had…

What can an interesting case of a simple infection which nearly led to sudden cardiac death teach us about health care, health care reform and our ways of knowing? Dr Wes’ blog recently described a post from a geriatrics (specialist in the care of the elderly) doctor that highlighted the challenges of caring for the […]