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253 results for

Wellens Syndrome

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241. Pediatrics, Intussusception (Overview)

In approximately 2-12% of children with intussusception, a surgical lead point is found. Occurrence of surgical lead points increases with age and indicates that the probability of nonoperative reduction is highly unlikely. Examples of lead points are as follows: Meckel diverticulum [ ] Enlarged mesenteric lymph node Benign or malignant tumors of the mesentery or of the intestine, including lymphoma, polyps, ganglioneuroma, [ ] and hamartomas associated with Peutz-Jeghers syndrome Mesenteric or duplication (...) % of patients with . Intussusception is assumed to be precipitated by the thick, inspissated stool material that adheres to the mucosa and acts as a lead point. Often, the course is indolent and chronic. Differential diagnosis includes distal intestinal obstruction syndrome and appendicitis. The majority of these patients require operative reduction. Other causes Electrolyte derangements associated with various medical conditions can produce aberrant intestinal motility, leading to enteroenteral

2014 eMedicine Emergency Medicine

242. Pediatrics, Intussusception (Follow-up)

of overnight observation usually is warranted before discharge. Therapeutic enema is of no value in patients with small bowel–to–small bowel intussusception, which usually occurs in older children who have other associated diseases (eg, HSP, hemophilia, Peutz-Jeghers syndrome, malignancies). Intussusception in the first month of life is rare. Most of these patients are found to have a surgical lead point; therefore, enemas are rarely successful and are potentially dangerous. Previous Next: Surgical (...) . J Pediatr Surg . 2008 Dec. 43(12):e21-3. . Soccorso G, Puls F, Richards C, Pringle H, Nour S. A ganglioneuroma of the sigmoid colon presenting as leading point of intussusception in a child: a case report. J Pediatr Surg . 2009 Jan. 44(1):e17-20. . Sanni RB, Nandiolo R, Coulibaly Diaoudia MT, Vodi L, Mobiot ML. Acute intussusception due to intestinal Kaposi's sarcoma in an infant. Afr J Paediatr Surg . 2009 Jul-Dec. 6(2):131. . Earl TM, Wellen JR, Anderson CD, et al. Small bowel obstruction

2014 eMedicine Emergency Medicine

243. Random Pearls 1

, palpitation at older age - VT more likely. Biphasic T-wave in V2-3 may indicates Wellen's syndrome. This is an indication of critical stenosis of proximal LAD. Stress test is not recommended. Fecal impaction (e.g. secondary to malignancies or with constipation) can surprisingly with spurious diarrhea. This can happen when the impacted feces liquefies at its margin and the patient mistaken this as diarrhea. Which size of the ureteric stones that can be predictably passed out spontaneously? 95% chance; 4

2013 Emergency Medicine Blog

244. <TextConstruct type="text" xmlns="">Subacute STEMI Masked by a Wide Complex</TextConstruct>

(abnormal, diagnostic of old or new MI). V4 still has biphasic T-waves. At this point, the troponin returned at 81 ng/ml and the cath lab was activated. A 70% ulcerated lesion with thrombus was found in the proximal LAD. Thrombus was suctioned and stent placed. Here is the post cath ECG: Finally we have a QRS that is of normal duration, and it has the classic biphasic T-waves of Wellens' syndrome, but is NOT Wellens'. Why? Because Wellens' syndrome has preservation of R-waves. Wellens' is a sentinel

2010 Dr Smith's ECG Blog

245. Evaluation of Asymptomatic Wolff-Parkinson-White EKG Morphology

, or conservative follow-up with clear instructions to report symptoms of SVT promptly would all be appropriate management options for this patient. References: 1. ACC/AHA/ESC Guidelines for the Management of Patients With: Supraventricular Arrhythmias: AV Reciprocating Tachycardia 2. Pappone et al. A Randomized Study of Prophylactic Catheter Ablation in Asymptomatic Patients with the Wolff-Parkinson-White Syndrome. NEJM 2003;349:1803-1811 3. Wellens et al. When to Perform Catheter Ablation in Asymptomatic (...) interval and a delta wave. The current prevalence of WPW on surface EKG is thought to be 0.15 to 0.25% in the general population. There is a 4-fold increase among family members of an affected patient (1). WPW syndrome is reserved for those patients with both EKG evidence of pre-excitation and tachyarrhythmia, most commonly A-V reentrant tachycardia (AVRT) accounting for 95% of associated tachycardia. Atrial fibrillation (AF) is a potentially life-threatening arrhythmia in patients with WPW syndrome

2008 Clinical Correlations

247. Resistin

, Fedak PW, Li RK, Weisel RD, Mickle DA (August 2003). "Resistin promotes endothelial cell activation: further evidence of adipokine-endothelial interaction". Circulation . 108 (6): 736–40. : . . Lu SC, Shieh WY, Chen CY, Hsu SC, Chen HL (October 2002). . FEBS Lett . 530 (1–3): 158–62. : . . Wellen KE, Hotamisligil GS (May 2005). . J. Clin. Invest . 115 (5): 1111–9. : . . . Wulster-Radcliffe MC, Ajuwon KM, Wang J, Christian JA, Spurlock ME (April 2004). "Adiponectin differentially regulates cytokines (...) with type 2 diabetes". Clin. Chim. Acta . 339 (1–2): 57–63. : . . McTernan PG, Fisher FM, Valsamakis G, et al. (December 2003). "Resistin and type 2 diabetes: regulation of resistin expression by insulin and rosiglitazone and the effects of recombinant resistin on lipid and glucose metabolism in human differentiated adipocytes". J. Clin. Endocrinol. Metab . 88 (12): 6098–106. : . . Tjokroprawiro A (2006). "New approach in the treatment of T2DM and metabolic syndrome (focus on a novel insulin sensitizer

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2012 Wikipedia

248. Electrocardiography

(Mobitz [Wenckebach] I and II) or complete AV block Right bundle Complete (RBBB) Left bundle Complete (LBBB) (LAFB) (LPFB) (LAFB plus LPFB) (LAFP plus FPFB plus RBBB) QT syndromes , genetic and drug-induced and Electrolytes disturbances and intoxication: Calcium: and Potassium: and Ischemia and infarction: (LAD occlusion) (LAD occlusion) and changes (heart attack) for ischemia with a Structural: and or S1Q3T3 (can be seen in ) Etymology [ ] An early commercial ECG device (1911) ECG from 1957 The word (...) August 2012 (PDF) . U.S. Federal Aviation Administration. 2006 . Retrieved 27 December 2013 . . MIT Technology Review . Retrieved 2019-04-01 . . Techcrunch . Retrieved 2018-08-25 . . Stanford Health Care . Retrieved 2019-04-01 . Schläpfer, J; Wellens, HJ (2017-08-29). . Journal of the American College of Cardiology . 70 (9): 1183–1192. : . Retrieved 2019-04-01 . Macfarlane, P.W.; Coleman (1995). (PDF) . Society for Cardiological Science and Technology . Retrieved 21 October 2017 . . Cables

2012 Wikipedia

249. Cardiac dysrhythmia

of bradycardia: , which manifests as PR prolongation , also known as or , also known as , also known as . First, second and third degree block also can occur at the level of the sinoatrial junction. This is referred to as typically manifesting with various degrees and patterns of . Sudden arrhythmic death syndrome [ ] (SADS), is a term used as part of sudden unexpected death syndrome to describe sudden due to brought on by an arrhythmia in the presence or absence of any structural heart disease on autopsy (...) produce a sustained abnormal circuit rhythm. As a sort of re-entry , vortices of excitation in the myocardium ( ) are considered to be the main mechanism of life-threatening cardiac arrhythmias. In particular, the is common in the thin walls of the atria, sometimes resulting in . Re-entry is also responsible for most , and dangerous . These types of re-entry circuits are different from syndromes, which utilize abnormal conduction pathways. Although from can be protective against arrhythmias, they can

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2012 Wikipedia

250. Integration of Continuous Glucose Monitoring Into a Bi-Hormonal Closed-Loop Artificial Pancreas for Automated Management Of Type 1 Diabetes

, proximal LAD critical stenosis (Wellen's sign), arrhythmia, tachycardia, and prolonged QT interval (> 440 ms) Congestive heart failure History of TIA or stroke Acute illness or exacerbation of chronic illness History of seizures History of pheochromocytoma (fractionated metanephrines will be tested in patients with history suggestive of pheochromocytoma) History of adrenal disease or tumor History of pancreatic tumor, including insulinoma History of impaired gastric motility or gastroparesis requiring (...) of allergy to aspirin or any history of aspirin intolerance, including Reye syndrome, or gastric ulcer or bleeding associated with salicylates Blood dyscrasia or bleeding diathesis, such as hemophilia, Von Willebrands disorder, and idiopathic thrombocytopenic purpura (ITP) Peptic ulcer Unable to perform 30 minutes of moderate exercise on a treadmill or exercise bicycle Unable or unwilling to discontinue dietary supplements for at least 2 weeks prior to each CRC admission History of celiac disease

2010 Clinical Trials

251. Repeat Wellens' Syndrome: Case Report of Critical Proximal Left Anterior Descending Artery Restenosis. (PubMed)

Repeat Wellens' Syndrome: Case Report of Critical Proximal Left Anterior Descending Artery Restenosis. We describe the case of a 40-year-old woman who presented to the Emergency Department with resolving chest pain. The initial electrocardiogram (ECG) showed biphasic T-waves in V2-V4, which was recognized as Wellens' syndrome, or acute coronary T-wave syndrome. Emergent cardiac catheterization revealed 95% stenosis of the previously placed stent in the proximal left anterior descending artery (...) (LAD). Review of her records from 3 years prior revealed similar ECG findings consistent with Wellens' syndrome, at which time a stent was placed for critical proximal LAD stenosis. We report this case to increase awareness of the T-wave abnormalities associated with Wellens' syndrome. There is significant morbidity and mortality that can occur in the absence of emergent coronary revascularization. This report of repeated Wellens' syndrome in the same patient demonstrates both types of precordial T

2008 Journal of Emergency Medicine

252. ACC/AHA/ESC 2006 Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death

of established heart disease . . . 756 2.1.2. Ventricular tachycardia and ventricular ?brillation during acute coronary syndromes 757 2.2. Sudden cardiac death 757 2.2.1. Incidence of sudden cardiac death. . . 757 2.2.2. Population subgroups and risk prediction 757 2.2.3. Time-dependent risk 757 2.2.4. Age, heredity, gender, and race 758 2.2.5. Risk pro?les and sudden cardiac death 758 3. Mechanisms and substrates 759 3.1. Substrate for ventricular arrhythmias 759 3.2. Mechanisms of sudden cardiac death 759 (...) with coronary heart diseases 765 5.3.2. Electrophysiological testing in patients with dilated cardiomyopathy 765 5.3.3. Electrophysiological testing in repolarization anomalies due to genetic arrhythmia syndromes 765 Long QTsyndrome . 765 Brugada syndrome . 765 Hypertrophic cardiomyopathy 765 Arrhythmogenic right ventricular cardiomyopathy. . 765 5.3.4. Electrophysiological testing in patients with out?ow tract ventricular tachycardia 765 5.3.5. Electrophysiological

2006 European Society of Cardiology

253. Electrocardiographic manifestations of Wellens' syndrome. (PubMed)

Electrocardiographic manifestations of Wellens' syndrome. Wellens' syndrome is a pattern of electrocardiographic T-wave changes associated with critical, proximal left anterior descending (LAD) artery stenosis. The syndrome is also referred to as LAD coronary T-wave syndrome. Syndrome criteria include T-wave changes plus a history of anginal chest pain without serum marker abnormalities; patients lack Q waves and significant ST-segment elevation; such patients show normal precordial R-wave (...) progression. The natural history of Wellens' syndrome is anterior wall acute myocardial infarction. The T-wave abnormalities are persistent and may remain in place for hours to weeks; the clinician likely will encounter these changes in the sensation-free patient. With definitive management of the stenosis, the changes resolve with normalization of the electrocardiogram. It is vital that the physician recognize these changes and the association with critical LAD obstruction and significant risk

2002 American Journal of Emergency Medicine

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