Electrocardiographic Findings Suggestive of Cardiomyopathy: What to Look for and What to Do Next.

Electrocardiographic findings suggestive of cardiomyopathy: what to look for and what to do next.

Curr Sports Med Rep. 2013 Mar; 12(2): 77-85
Pelto H, Owens D, Drezner J

Cardiomyopathies are the leading cause of sudden cardiac death in young athletes. The electrocardiogram (ECG) is utilized as a first-line screening and diagnostic tool for detecting conditions associated with sudden death. Fundamental to the appropriate evaluation of athletes undergoing ECG is an understanding of what ECG findings are abnormal and may suggest the presence of a pathologic cardiac disorder. Multiple findings such as T-wave inversion, ST-segment depression, and pathologic Q waves are present in patients with cardiomyopathy. This article reviews the ECG findings in the four most common cardiomyopathies afflicting young athletes – hypertrophic cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy, left ventricular noncompaction, and idiopathic dilated cardiomyopathy. ECG changes resulting from physiologic cardiac adaptation to regular exercise (athlete’s heart) are presented also. This article provides a framework for distinguishing normal from abnormal ECG findings and outlines appropriate steps for further evaluation of ECG abnormalities in athletes suspected of having a cardiomyopathy. HubMed – depression


Insights into the mechanism for gold catalysis: behaviour of gold(i) amide complexes in solution.

Dalton Trans. 2013 Mar 11;
Bobin M, Day IJ, Roe SM, Viseux EM

We report the synthesis and activity of new mononuclear and dinuclear gold amide complexes . The dinuclear complexes and were characterised by single crystal X-ray analysis. We also report solution NMR and freezing point depression experiments to rationalise their behaviour in solution and question the de-ligation process invoked in gold catalysis. HubMed – depression



J Cardiopulm Rehabil Prev. 2013 Mar 8;
Murphy B, Rogerson M, Worcester M, Elliott P, Higgins R, Le Grande M, Turner A, Goble A

PURPOSE:: Research demonstrates that depression at the time of a cardiac event predicts early mortality. However, the best time for depression screening is unknown. We investigated the prognostic importance of inhospital and 2-month depressive symptoms in predicting 12-year mortality in female cardiac patients. METHODS:: A consecutive series of 170 women admitted to hospital after acute myocardial infarction or for coronary artery bypass graft surgery completed the Hospital Anxiety and Depression Scale inhospital and 2 months later. Hospital Anxiety and Depression Scale’s depression subscale scores of 4 to 7 were classified as “mild” depressive symptoms and 8+ as “moderate/severe” depressive symptoms. Mortality was tracked through the Australian National Death Index and other sources. RESULTS:: One hundred sixty-three (96%) of the 170 women were successfully tracked after 12 years. Of these women, 136 (83%) completed the depression subscale of the Hospital Anxiety and Depression Scale at both assessments and were included in the analyses. Over 12 years, 45 (33%) women died. Using logistic regression and controlling for age, disease severity, and diabetes, mild inhospital depression predicted mortality (P = .02), whereas moderate/severe inhospital depression did not (P = .14). At 2 months, moderate/severe depression predicted mortality (P = .05), whereas mild depression did not (P = .09). Half the patients (49%) changed depression class by the 2-month assessment. The death rate was highest (64%) in those whose mild inhospital depressive symptoms increased to moderate/severe and lowest (14%) in those whose moderate/severe inhospital symptoms remitted. CONCLUSIONS:: Mild inhospital depression and moderate/severe 2-month depression were predictive of 12-year deaths. The findings suggest a prognostic benefit in undertaking repeat depression screening 2 months after an acute cardiac event. HubMed – depression


Characteristics and prognosis in patients with false-positive ST-elevation myocardial infarction in the ED.

Am J Emerg Med. 2013 Mar 8;
Chung SL, Lei MH, Chen CC, Hsu YC, Yang CC

BACKGROUND: There are several causes of ST-segment elevation (STE) besides acute myocardial infarction (MI). OBJECTIVES: We design this study to determine the prevalence, etiology, clinical manifestation, electrocardiographic characteristics, and outcome in patients with false-positive STEMI. METHODS: This is a retrospective case-control study design. At our emergency department, 297 patients who underwent emergent coronary angiography for suspected STEMI were enrolled from January 2004 to December 2010. RESULTS: Of the 297 patients who underwent coronary angiography, 31 patients (10.4%) did not have a clear culprit coronary lesion and were classified as false-positive STEMI. False-positive STEMI patients had a lower incidence of typical chest pain or chest tightness (58.1% vs 87.6%, P < .001). Inferior STE occurred significantly more often in the patients with true-positive STEMI (49.6% vs 25.8%, P = .012), and diffuse STE, more often in the patients with false-positive STEMI (19.4% vs 0.38%, P = .001). Total height of STE was lower in false-positive STEMI patients (7.5 ± 4.9 vs 10.9 ± 7.9 mm, P = .002) if excluding 5 patients of marked STE just after cardiopulmonary resuscitation. Concave STE and no reciprocal ST-segment depression occurred more often in false-positive STEMI patients (51.6% vs 24.1%, P = .001; 64.5% vs 19.2%, P < .001). There was no significant difference of in-hospital major adverse events in the patients with false-positive and true-positive STEMI. CONCLUSIONS: The diagnosis of false-positive STEMI is not uncommon. Detailed clinical evaluation and electrocardiogram interpretation may avoid partly unnecessary catheterization laboratory activation. HubMed – depression