scholarly journals Clinical evaluation and diagnostic yield following evaluation of abnormal pulse detected using Apple Watch

2020 ◽  
Vol 27 (9) ◽  
pp. 1359-1363
Author(s):  
Kirk D Wyatt ◽  
Lisa R Poole ◽  
Aidan F Mullan ◽  
Stephen L Kopecky ◽  
Heather A Heaton
Keyword(s):  
Atrial Fibrillation ◽  
Diagnostic Yield ◽  
Unintended Consequences ◽  
Clinical Documentation ◽  
Healthcare Resources ◽  
Pulse Detection ◽  
X Ray ◽  
Holter Monitor ◽  
Chest X Ray ◽  
Cardiovascular Diagnosis

Abstract Objective The study sought to characterize the evaluation of patients who present following detection of an abnormal pulse using Apple Watch. Materials and Methods We conducted a retrospective review of patients evaluated for abnormal pulse detected using Apple Watch over a 4-month period. Results Among 264 included patients, clinical documentation for 41 (15.5%) explicitly noted an abnormal pulse alert. Preexisting atrial fibrillation was noted in 58 (22.0%). Most commonly performed testing included 12-lead echocardiography (n = 158; 59.8%), Holter monitor (n = 77; 29.2%), and chest x-ray (n = 64; 24.2%). A clinically actionable cardiovascular diagnosis of interest was established in only 30 (11.4%) patients, including 6 of 41 (15%) patients who received an explicit alert. Discussion False positive screening results may lead to overutilization of healthcare resources. Conclusions The Food and Drug Administration and Apple should consider the unintended consequences of widespread screening for asymptomatic (“silent”) atrial fibrillation and use of the Apple Watch abnormal pulse detection functionality by populations in whom the device has not been adequately studied.

Amiodarone – induced pulmonary nodules mimiking metastatic lung disease – investigation by somatostatin radio peptide scaning

2005 ◽  
Vol 4 (2) ◽  
pp. 63-65
Author(s):  
Veronica Varney ◽  
◽  
Mary Warren ◽  
M Palmer ◽  
◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Sinus Rhythm ◽  
Pulmonary Nodules ◽  
Alcoholic Cardiomyopathy ◽  
X Ray ◽  
The Past ◽  
Previous Diagnosis ◽  
Metastatic Lung ◽  
Chest X Ray ◽  
200Mg Daily

A 61 year old former paramedic presented to A&E complaining of palpitations. He was found to be in atrial fibrillation, which reverted spontaneously to sinus rhythm. A chest x-ray taken at that time showed multiple pulmonary nodules consistent with metastatic malignancy (Figure 1). In the past he had been treated with amiodarone 200mg daily for 6 years following a previous diagnosis of atrial fibrillation, which had been attributed to alcoholic cardiomyopathy. He had discontinued the drug 8 months earlier, after selfdiagnosing hypotension and bradycardia. A previous chest X-ray, taken before starting amiodarone, was normal.

scholarly journals The Diagnostic Yield and Clinical Impact of a Chest X-Ray after Percutaneous Dilatational Tracheostomy: A Prospective Cohort Study

2007 ◽  
Vol 35 (3) ◽  
pp. 393-397 ◽  
Author(s):  
S. H. Haddad ◽  
A. S. Aldawood ◽  
Y. M. Arabi
Keyword(s):  
Diagnostic Yield ◽  
Perioperative Complications ◽  
Percutaneous Dilatational Tracheostomy ◽  
Chest Physiotherapy ◽  
Radiographic Findings ◽  
X Ray ◽  
Dilatational Tracheostomy ◽  
New Finding ◽  
Chest X Ray ◽  
Tube Malposition

A chest X-ray (CXR) is routinely performed after percutaneous dilatational tracheostomy (PDT). The purpose of this study was to evaluate the diagnostic yield of routine CXR following PDT and its impact on patient management and to identify predictors of post-PDT CXR changes. Two-hundred-and-thirty-nine patients who underwent PDT in a 21-bed intensive care unit were included prospectively in the study. The following data were collected: patient demographics, APACHE III scores, pre-PDT FiO2 and PEEP, PDT technique, perioperative complications and the use of bronchoscopic guidance. We compared post-PDT CXR with the last pre-PDT CXR. We documented any post-PDT new radiographic findings including atelectasis, pneumothorax, pneumomediastinum, surgical emphysema, pulmonary infiltrates or tracheostomy tube malposition. We also recorded management modifications based on post-PDT radiographic changes, including increased PEEP, chest physiotherapy, therapeutic bronchoscopy or chest tube insertion. Atelectasis was the only new finding detected on post-PDT CXRs of 24 (10%) patients. The new radiographic findings resulted in a total of 14 modifications of management in 10 (4%) patients including increased PEEP in six, chest physiotherapy in six and bronchoscopy in two patients. Trauma and pre-PDT PEEP >5 cmH2O were independent predictors of post-PDT CXR changes. Routine CXR following PDT has a low diagnostic yield, detecting mainly atelectasis and leading to a change in the management in only a minority of patients. Routine CXR after apparently uncomplicated PDT performed by an experienced operator may not be necessary and selective use may improve its diagnostic yield. Further studies are required to validate the safety of selective versus routine post-PDT CXR.

scholarly journals Early chest X-ray in persons with presumptive tuberculosis increases Xpert® MTB/RIF diagnostic yield and efficiency

2020 ◽  
Vol 10 (1) ◽  
pp. 17-20
Author(s):  
Z. Nadiah ◽  
R. C. Koesoemadinata ◽  
S. M. McAllister ◽  
G. Putriyani ◽  
L. Chaidir ◽  
...  
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Diagnostic Yield ◽  
Content Type ◽  
X Ray ◽  
Acid Fast Bacilli ◽  
Number Needed To Screen ◽  
Sputum Microscopy ◽  
Chest X Ray

Adult presumptive tuberculosis (TB) patients (n = 1690) were screened for TB using a questionnaire, chest X-ray (CXR) and sputum microscopy for acid-fast bacilli (AFB); <named-content content-type="genus-species">Mycobacterium tuberculosis</named-content> culture was performed for 74% of the patients and Xpert® MTB/RIF was done for 17.2%. Among patients recruited, 943 (55.8%) were diagnosed with TB, of whom 870 (92.3%) were bacteriologically confirmed and 73 (7.7%) were clinically diagnosed on the basis of CXR. Using CXR prior to culture or Xpert testing reduces the number needed to screen from 7.6 to 5.0. Using CXR to triage for culture or Xpert testing reduces the number of missed cases and increases the efficiency of culture and Xpert testing.

scholarly journals Intracardiac Migration of the Ureteral Double-J Stent during Percutaneous Nephrolithotomy

Medicina ◽  
2021 ◽  
Vol 57 (9) ◽  
pp. 939
Author(s):  
Chun-Kai Chang ◽  
Yi-Hsuan Wu ◽  
Ming-Chen Paul Shih ◽  
Jiun-Hung Geng
Keyword(s):  
Atrial Fibrillation ◽  
Blood Pressure ◽  
Percutaneous Nephrolithotomy ◽  
Renal Stones ◽  
X Ray ◽  
One Stage ◽  
Medical Issues ◽  
Double J Stent ◽  
Chest X Ray ◽  
To Receive

The complications of percutaneous nephrolithotomy (PNL) include hemorrhage, damage to adjuvant organs, and other medical issues, although intracardiac migration of ureteral double-J stent has never been found during PNL and delaying the diagnosis might cause mortality. We report the case of a 60-year-old male who was admitted to receive one-stage PNL for right renal stones. During operation, an unexpected atrial fibrillation with a drop in blood pressure was suddenly encountered and the chest X-ray subsequently showed that the ureteral double-J had penetrated deep into the heart. Emergent endovascular intervention was performed to remove the stent and the patient was uneventfully discharged 2 days later.

scholarly journals Atrial fibrillation following electric shock requiring cardioversion

2016 ◽  
Vol 13 (1) ◽  
pp. 31-34
Author(s):  
Navaraj Paudel ◽  
V. M. Alurkar ◽  
Ramchandra Kafle ◽  
Subash Sapkota
Keyword(s):  
Atrial Fibrillation ◽  
Electric Shock ◽  
Atrial Arrhythmias ◽  
Normal Pattern ◽  
Initial Attempt ◽  
Electrical Shock ◽  
X Ray ◽  
Chest X Ray ◽  
Pharmacological Cardioversion ◽  
Injury Falls

Cardiac arrhythmias following electrical injury falls in a minority. Atrial arrhythmias including atrial fibrillation secondary to electrical shock are even more uncommon. This is a case report of AF requiring pharmacological cardioversion on a 41 year old female following an electrical shock. Initial attempt of electrical cardioversion had failed. Successful pharmacological cardioversion was achieved after 6 hours of amiodarone infusion (12-13 hours after the electric shock). Baseline electrocardiography showed normal pattern post cardioversion. Serum cardiac specific markers, electrolytes, thyroid function, chest x-ray and echocardiographic reports were all within normal limits.Nepalese Heart Journal 2016; 13(1): 31-34

Implementing upfront mobile digital chest x-ray for tuberculosis diagnosis in India—feasibility and benefits

2020 ◽  
Vol 114 (7) ◽  
pp. 499-505
Author(s):  
Bornali Datta ◽  
Ashish Prakash ◽  
David Ford ◽  
Jaya Prasad Tripathy ◽  
Pinky Goyal ◽  
...  
Keyword(s):  
Diagnostic Yield ◽  
Control Program ◽  
Diagnostic Algorithm ◽  
High Yield ◽  
Systematic Screening ◽  
X Ray ◽  
Sputum Microscopy ◽  
Digital Chest ◽  
Chest X Ray ◽  
Smear Negative

Abstract Background The Tuberculosis (TB) Control Program in India changed the TB diagnostic algorithm and recommended sputum testing and chest x-ray (CXR) for presumptive TB up front. There is no experience of testing this algorithm in routine field settings. Methods In a public–private partnership (PPP), a private hospital provided mobile digital CXR services (mounted on a van) to complement the existing diagnostic services of sputum microscopy and GeneXpert testing. All presumptive TB patients (cough &gt;2 weeks) underwent CXR and sputum microscopy, and GeneXpert testing if eligible (smear-negative CXR suggestive of TB). Results All 2973 presumptive TB patients underwent CXR and sputum microscopy; 471 (15.8%) had abnormal CXR findings suggestive of TB, 129 (4.3%) were smear positive and 17 were extrapulmonary TB. Of the remaining 325 with smear-negative and CXR suggestive of TB, 147 (45.2%) underwent GeneXpert testing, yielding 32 positives (21.8%). Of the remaining 178 with no GeneXpert test done, 106 (60.0%) had CXR definitely suggesting TB (clinically diagnosed TB). Thus a total of 284 cases of TB (161 microbiologically confirmed, 106 clinically diagnosed, 17 extrapulmonary TB) were identified, giving a potential diagnostic yield of 19.6%. Conclusions Systematic screening with mobile digital X-ray service via a PPP model integrated into the national program is feasible and scalable with a high yield.

scholarly journals Giant Intrapericardial bronchogenic cyst associated with congestive heart failure and atrial fibrillation: a case report

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Javier Maldonado Escalante ◽  
German Molina ◽  
Francisco Mauricio Rincón ◽  
Lina M. Acosta Buitrago ◽  
Carlos J. Perez Rivera
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Differential Diagnosis ◽  
Bronchogenic Cyst ◽  
De Novo ◽  
Case Presentation ◽  
X Ray ◽  
Abnormal Chest ◽  
Chest X Ray ◽  
Bronchogenic Cysts

Abstract Background Large intracardiac bronchogenic cysts are rare mediastinal masses. However, they must always be considered in the differential diagnosis of heart failure with abnormal chest X-ray. Case presentation We present a 60-year-old female patient with de novo atrial fibrillation, heart failure and a very large intrapericardial mass. The patient underwent successful surgical resection, with pathological findings confirming a bronchogenic cyst. Conclusions Large bronchogenic cysts located intrapericardially are very rare. However, they should be included in the differential diagnosis of patients presenting with atrial fibrillation and heart failure with abnormal radiologic studies.

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