ABSTRACT
The predictability as to a positive or negative outcome of treadmill exercise stress testing in 341 consecutively studied patients referred for diagnostic purposes is presented. A clinical decision as to the result was derived by asking 2 simple questions and reviewing the pretest ECG. Additional clinical logistics included the type of physician ordering the study, smoking history, symptoms, and basic patient history. The predictable accuracy was 77.7% for the total patient group and 81.5% when the questionable cases (reflecting a neutral or ambivalent cardiologist's opinion) were eliminated.
Subject(s)
Electrocardiography , Exercise Test , Adult , Female , Humans , Male , Middle Aged , Predictive Value of Tests , SmokingSubject(s)
Cervical Vertebrae , Chest Pain/etiology , Electrocardiography , Head Movements , Intervertebral Disc Displacement/complications , Neck , Acute Disease , Adult , Angina Pectoris/diagnosis , Chest Pain/diagnosis , Diagnosis, Differential , Humans , Intervertebral Disc Displacement/diagnosis , MaleABSTRACT
Industrial exposure to nitrates is known to produce acute and chronic effects on the cardiovascular system. A case of acute inferior myocardial infarction in a young, otherwise healthy, white male that occurred during the usual weekend withdrawal period is presented.
Subject(s)
Coronary Vasospasm/chemically induced , Myocardial Infarction/etiology , Nitroglycerin/adverse effects , Occupational Exposure , Substance Withdrawal Syndrome , Adult , Humans , Male , OccupationsSubject(s)
Hypoglycemic Agents/poisoning , Insulin/poisoning , Myocardial Infarction/chemically induced , Animals , Blood Glucose/metabolism , Diagnosis, Differential , Female , Humans , Hyperinsulinism/blood , Hyperinsulinism/chemically induced , Hypoglycemic Agents/toxicity , Insulin/toxicity , Myocardial Infarction/diagnosis , RatsABSTRACT
Ketorolac is a nonsteroidal antiinflammatory drug that has been used as a postoperative analgesic since its introduction in the US in 1990. Although hemorrhagic side effects secondary to its use have been consistently described in the medical literature, its attendant complications have been commonly unappreciated by the medical profession. Two catastrophic, near-fatal, hemorrhagic postoperative events are described in which the use of ketorolac was unquestionably contraindicated.
Subject(s)
Analgesics/adverse effects , Anti-Inflammatory Agents, Non-Steroidal/adverse effects , Ketorolac Tromethamine/adverse effects , Postoperative Hemorrhage/chemically induced , Adult , Analgesics/administration & dosage , Anti-Inflammatory Agents, Non-Steroidal/administration & dosage , Female , Humans , Ketorolac Tromethamine/administration & dosage , Male , Middle Aged , Pain, Postoperative/drug therapySubject(s)
Bronchoscopy , Coronary Vasospasm/etiology , Heart Arrest/etiology , Malignant Carcinoid Syndrome/diagnosis , Adolescent , Diagnosis, Differential , Female , Humans , Male , Malignant Carcinoid Syndrome/complications , Malignant Carcinoid Syndrome/therapy , Middle Aged , Resuscitation , Risk FactorsSubject(s)
Anti-Arrhythmia Agents/adverse effects , Atrial Fibrillation/drug therapy , Diarrhea/chemically induced , Quinidine/adverse effects , Aged , Aged, 80 and over , Antidiarrheals/administration & dosage , Atrial Fibrillation/complications , Cholestyramine Resin/administration & dosage , Diarrhea/drug therapy , HumansABSTRACT
A review of 6938 computer-generated electrocardiogram interpretations was undertaken by a single cardiologist. The computer-assisted program correctly interpreted 51.6% of the tracings. One or more corrections were necessary in 48.4%. The greatest number of incorrect interpretations involved repolarization (T wave) abnormalities, followed by ST segment changes. It is mandatory that computer-generated ECG interpretations be reviewed by an experienced electrocardiographer. Reliance on nonreviewed ECG interpretations may result in incorrect diagnoses that could lead to inappropriate management decisions.
Subject(s)
Electrocardiography/standards , Signal Processing, Computer-Assisted/instrumentation , Diagnostic Errors , Electrocardiography/instrumentation , Electrocardiography/statistics & numerical data , Equipment Failure Analysis/statistics & numerical data , Humans , Prospective StudiesSubject(s)
Contusions/diagnosis , Heart Injuries/diagnosis , Myocardial Infarction/diagnosis , Biomarkers/analysis , Contusions/diagnostic imaging , Contusions/enzymology , Coronary Vessels/injuries , Creatine Kinase/analysis , Diagnosis, Differential , Echocardiography , Echocardiography, Transesophageal , Electrocardiography , Heart Injuries/diagnostic imaging , Heart Injuries/enzymology , Humans , Isoenzymes , Myocardial Infarction/diagnostic imaging , Myocardial Infarction/enzymology , Radionuclide Imaging , Sensitivity and Specificity , Troponin/analysis , Troponin I/analysis , Troponin TABSTRACT
The effective use of quinidine as an antiarrhythmic agent is frequently curtailed by one of its most common side effects-relentless diarrhea. Seven patients are described in whom diarrhea was quickly and completely controlled by the use of cholestyramine resin. To date, this is the only therapy reported to be effective for this purpose. It has proven to be safe, well tolerated, and continuously effective in these cases.
