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Related Concept Videos

Pulse rhythm01:30

Pulse rhythm

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Pulse rhythm refers to the pattern of pulsations within specific intervals, offering valuable insights into the regularity or irregularity of the heart's beats as observed through the pattern of pulsation within specific intervals. A regular pulse exhibits a consistent heart rate with uniform waveforms and pulsation force, variations of which can be classified as normal, weak, or bounding.
Conversely, an irregular pulse pattern is termed dysrhythmia, stemming from disruptions in cardiac...
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ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias01:25

ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias

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Arrhythmia is a condition characterized by an irregular heart rhythm, with ECG changes that differ based on its origin and nature. The types of arrhythmias discussed below include atrial, junctional, and ventricular arrhythmias.Atrial ArrhythmiasPremature Atrial Complexes (PACs): PACs are early atrial beats caused by stress, caffeine, alcohol, electrolyte imbalances, hypoxia, hyperthyroidism, or certain medications (e.g., bronchodilators and decongestants). The ECG shows early P waves with an...
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Ischemic Heart Disease: Overview01:17

Ischemic Heart Disease: Overview

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Ischemic heart disease occurs when the heart's blood supply dwindles, causing an ominous lack of oxygen and nutrients. This deficiency, stemming from reduced or obstructed blood flow, spells danger, leading to heart muscle damage and dysfunction.
Atherosclerosis, the primary malefactor, orchestrates this dangerous condition. It manifests as the accumulation of fatty deposits, akin to insidious plaques, within arterial walls. As time elapses, these plaques metamorphose, hardening and...
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Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations01:19

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The pathophysiology of Acute Coronary Syndrome [ACD] involves several key processes:The main underlying cause of ACD is atherosclerosis, a chronic inflammatory disease characterized by the buildup of lipid-laden plaques within the coronary arteries.As the atherosclerotic plaque grows in the coronary artery, it may become unstable due to the formation of a lipid-rich core and a thin fibrous cap. Inflammatory cells within the plaque, such as macrophages, secrete enzymes that degrade the...
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Acute Coronary Syndrome III: Diagnostic Studies01:30

Acute Coronary Syndrome III: Diagnostic Studies

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Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
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Related Experiment Video

Updated: Jul 31, 2025

A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis
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Recurrent Transient Ischemic Attacks in a Patient with Multiple Pacemaker Leads.

Thinzar Shwe1, Aneeqa Javed2, Ravi Patel2

  • 1Cardiology Department, Staten Island University Hospital, New York, NY, USA.

The Journal of Innovations in Cardiac Rhythm Management
|May 5, 2023
PubMed
Summary
This summary is machine-generated.

Venous complications from pacemaker leads, like superior vena cava (SVC) syndrome, can cause rare but serious issues. This case highlights unusual collateral circulation leading to transient ischemic attacks.

Keywords:
Pacemaker leadspermanent pacemakersuperior vena cava syndrometransient ischemic attack

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Area of Science:

  • Cardiology
  • Vascular Surgery
  • Neurology

Background:

  • Transvenous implantation of pacemakers and defibrillators can lead to venous complications such as stenosis and thrombosis.
  • Superior vena cava (SVC) syndrome is a recognized, though uncommon, complication, with reported incidences ranging from 1 in 3,100 to 1 in 650 patients.
  • The azygos-hemiazygos venous system is the most frequently observed collateral pathway in such cases.

Observation:

  • A 71-year-old female presented with stroke-like symptoms during an echocardiogram with agitated saline injection.
  • The patient had multiple pacemaker leads causing brachiocephalic and SVC obstruction.
  • An unusual venous collateral circulation was identified as the cause of the symptoms.

Findings:

  • The patient developed extensive collaterals between the brachiocephalic and subclavian veins, and bilateral pulmonary veins.
  • Injected air bubbles traversed this collateral network, reaching the left heart and cerebrovascular system.
  • This resulted in transient ischemic attacks, which resolved as the bubbles dissipated.

Implications:

  • This case presents a unique clinical scenario of pacemaker-induced venous obstruction leading to paradoxical embolism.
  • It underscores the importance of recognizing rare collateral pathways in patients with indwelling cardiac devices.
  • Regular device follow-up appointments are crucial for monitoring potential venous stenosis and SVC syndrome.