The Experts below are selected from a list of 222 Experts worldwide ranked by ideXlab platform
K Jennings - One of the best experts on this subject based on the ideXlab platform.
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Comparison of the value of novel rapid measurement of myoglobin, creatine kinase, and creatine kinase-MB with the Electrocardiogram for the diagnosis of acute myocardial infarction
Heart, 1994Co-Authors: S. J. Cross, Arthur Dickie, Stephen Walton, Paul H. Garthwaite, I. Ross, K JenningsAbstract:OBJECTIVE--To determine whether serum myoglobin, creatine kinase, and creatine kinase-MB measured at admission by rapid, compact, and easy to use automated quantitative analysers (results within 10 min) helped the early identification of acute myocardial infarction. The results were compared with the data obtained from the Electrocardiograms recorded at admission. DESIGN--A prospective study. SETTING--Coronary care unit. PATIENTS--94 consecutive patients with suspected myocardial infarction. Myocardial infarction was subsequently confirmed in 44 patients and excluded in 50. METHODS--All admission serum myoglobin, creatine kinase, and creatine kinase-MB were measured by clinical staff using analysers in the coronary care unit. An admission Electrocardiogram was obtained from all patients. RESULTS--The sensitivity, specificity, and predictive accuracy for diagnosing myocardial infarction were: Electrocardiogram 68%, 100%, and 85%; myoglobin 57%, 100%, and 80%; creatine kinase (threshold of 190 U/l) 34%, 98%, and 68%; creatine kinase-MB (threshold of 25 U/l) 43%, 100%, and 73%. When the electrocardiographic and myoglobin data were combined the sensitivity improved to 91%, diagnostic accuracy to 96%, with specificity of 100%. The results for the Electrocardiogram and creatine kinase-MB were 80%, 90%, 100% respectively and those for the Electrocardiogram with creatine kinase were 80%, 89%, 98% respectively. CONCLUSIONS--Admission myoglobin, creatine kinase, and creatine kinase-MB measurements were not as useful as the Electrocardiogram for the diagnosis of acute myocardial infarction. Combining the Electrocardiogram and myoglobin data substantially improved the sensitivity and predictive accuracy for the diagnosis of acute myocardial infarction.
Joel K. Kahn - One of the best experts on this subject based on the ideXlab platform.
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Inadvertent thrombolytic therapy for cardiovascular diseases masquerading as acute coronary thrombosis.
Clinical cardiology, 1993Co-Authors: Joel K. KahnAbstract:We report three cases of inadvertent thrombolytic administration to patients with cardiovascular diagnoses masquerading as acute coronary thrombosis presenting to tertiary care private hospital. Despite a final diagnosis of myocarditis, aortic dissection, and pericarditis, the initial presentation and Electrocardiogram were believed to indicate an acute myocardial infarction due to coronary thrombosis. Intravenous thrombolytic agents were administered early in their presentation. Cardiac catheterization in two of the patients revealed normal coronary arteriography and in the third patient confirmed an aortic dissection. The patient with an aortic dissection died while the other two recovered without adverse consequences of the thrombolytic agents. Prior reports of five patients, treated with intravenous thrombolytic agents for suspected coronary thrombosis, who proved to have a final diagnosis of pericarditis or aortic dissection are reviewed. Death or tamponade occurred in four of five. The consequences of inadvertently administering intravenous thrombolytic agents to patients with nonthrombolytic cardiac disorders can be serious. If the diagnosis of acute myocardial infarction due to coronary thrombosis is uncertain, serial Electrocardiograms, bedside echocardiography, or urgent cardiac catheterization may be appropriate before administering these agents.
S. J. Cross - One of the best experts on this subject based on the ideXlab platform.
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Comparison of the value of novel rapid measurement of myoglobin, creatine kinase, and creatine kinase-MB with the Electrocardiogram for the diagnosis of acute myocardial infarction
Heart, 1994Co-Authors: S. J. Cross, Arthur Dickie, Stephen Walton, Paul H. Garthwaite, I. Ross, K JenningsAbstract:OBJECTIVE--To determine whether serum myoglobin, creatine kinase, and creatine kinase-MB measured at admission by rapid, compact, and easy to use automated quantitative analysers (results within 10 min) helped the early identification of acute myocardial infarction. The results were compared with the data obtained from the Electrocardiograms recorded at admission. DESIGN--A prospective study. SETTING--Coronary care unit. PATIENTS--94 consecutive patients with suspected myocardial infarction. Myocardial infarction was subsequently confirmed in 44 patients and excluded in 50. METHODS--All admission serum myoglobin, creatine kinase, and creatine kinase-MB were measured by clinical staff using analysers in the coronary care unit. An admission Electrocardiogram was obtained from all patients. RESULTS--The sensitivity, specificity, and predictive accuracy for diagnosing myocardial infarction were: Electrocardiogram 68%, 100%, and 85%; myoglobin 57%, 100%, and 80%; creatine kinase (threshold of 190 U/l) 34%, 98%, and 68%; creatine kinase-MB (threshold of 25 U/l) 43%, 100%, and 73%. When the electrocardiographic and myoglobin data were combined the sensitivity improved to 91%, diagnostic accuracy to 96%, with specificity of 100%. The results for the Electrocardiogram and creatine kinase-MB were 80%, 90%, 100% respectively and those for the Electrocardiogram with creatine kinase were 80%, 89%, 98% respectively. CONCLUSIONS--Admission myoglobin, creatine kinase, and creatine kinase-MB measurements were not as useful as the Electrocardiogram for the diagnosis of acute myocardial infarction. Combining the Electrocardiogram and myoglobin data substantially improved the sensitivity and predictive accuracy for the diagnosis of acute myocardial infarction.
Cynthia M. Tracy - One of the best experts on this subject based on the ideXlab platform.
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The signal-averaged Electrocardiogram in predicting coronary artery disease.
American heart journal, 1991Co-Authors: Allen J. Solomon, Cynthia M. TracyAbstract:Abstract The ability to noninvasively detect coronary artery disease (CAD) in patients undergoing diagnostic cardiac catheterization was studied using a signal-averaged electrocardlogram. An initial study of 13 patients revealed that a QRS duration ≥100 msec, a root mean square voltage in the terminal 40 msec of the QRS 28 msec were suggestive of CAD. These parameters were then used prospectively to examine 40 consecutive patients with chest pain of undetermined etiology referred for cardiac catheterization. Patients with CAD had significantly longer filtered QRS and LAS durations and lower root mean square voltages compared with patients without CAD. The sensitivity, specificity, and positive predictive value of a single parameter ranged from 62% to 76%, 74% to 89%, and 75% to 87%, respectively. Thus the signal-averaged Electrocardiogram may be a useful tool in evaluating patients for the presence of CAD.
Marek Malik - One of the best experts on this subject based on the ideXlab platform.
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Automatic ectopic beat elimination in short-term heart rate variability measurement
Computer methods and programs in biomedicine, 2000Co-Authors: Burak Acar, Irina Savelieva, Harry Hemingway, Marek MalikAbstract:Our studies deal with fully automatic measurement of heart rate variability (HRV) in short term Electrocardiograms. Presently, all existing HRV analysis programs require user intervention for ectopic beat identification, especially of supraventricular ectopic beats (SVE). This makes the HRV measurement in large, e.g. epidemiological studies problematic. In this paper, we present a fully automatic algorithm for the discrimination of the ventricular (VE) and SVE ectopic beats from the normal QRS complexes suited for a reliable HRV analysis. The QRS identification is based on the template matching method. The ectopic beats are identified based on several morphological and timing properties of the Electrocardiogram (ECG) signal. The method incorporates several approaches and makes HRV analysis of large numbers of Electrocardiograms feasible. It uses the template matching for the basic morphology check of the QRS complex and the P-wave, the timing information to avoid unnecessary ectopic beat checks and to adjust thresholds and it also looks for a special QRS morphology, which is common in VEs. We used a testing set of 69 Electrocardiograms selected from a large number of recordings. The selected ECGs contained abnormalities including ectopic beats, right branch bundle block, respiratory arrhythmia, blocked atrial extrasystole, high amplitude and wide T-waves. The evaluation of our method showed a specificity of 0.99, supraventricular ectopic beat sensitivity of 0.99 and ventricular ectopic beat sensitivity of 0.98.
