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David H Spodick

Publications and source records attributed to David H Spodick.

At least 55 records · Page 3Linked to original sources
PubMed2005

Electrocardiographic T- and U-wave discordance.

BACKGROUND: Abundant information has been reported regarding the U wave, which almost entirely has been focused on U waves in isolation. There has been little investigation of discordant T and U waves. METHODS: Of 18,750 consecutively recorded electrocardiograms, 143 patients were categorized resulting in three groups. Group A: 53 patients with negative T waves and positive U waves (Type I Discordance); Group B: 26 patients with positive T waves and negative U waves (Type II Discordance); and Group C: 63 patients with negative T and negative U waves. Each patient's chart was reviewed for relevant clinical, laboratory, and medical history. RESULTS: Coronary disease was slightly more common in Group A (64%) than in Group B (46%) (P = 0.174; ns). Coronary disease in Group C was extremely common (88%; P <0.001). Hypertension in the two discordant groups was similar: Group A (60%) versus Group B (58%) (P = ns), Group C was significantly higher (88%) (P <0.001). Left ventricular hypertrophy was 49% in Group A and 58% in Group B (P = ns), but Group C was significantly higher at 70% (P = 0.038). CONCLUSIONS: This appears to be the first investigation of the associations of discordant T and U waves. We found that the significance of any U wave is not independent of their respective T wave. In addition, we propose that the U wave not be analyzed in isolation, but rather with respect to its T wave.

Aged↗
PubMed2005

Correlation of left atrial size with p-wave duration in interatrial block.

BACKGROUND: Interatrial block (IAB) [P-wave duration > or = 110 ms] is associated with left atrial (LA) enlargement (LAE) and pathophysiologic derangements that result in atrial tachyarrhythmias, LA electromechanical dysfunction, and embolism. However, there has been no study addressing the direct correlation of P-wave duration in IAB and LAE. METHODS: One hundred eighty-one consecutive patients who were admitted to a tertiary care teaching hospital over 5 consecutive days were screened for past transthoracic echocardiogram evaluations and were then matched with ECGs done within 10 days of these echocardiographic investigations. ECGs were evaluated for presence of IAB, and patients were subsequently classified into two groups: control patients and patients with IAB. Patients were also matched for common comorbidities. Mean, SD of age, Pearson correlation coefficient (r), p values, and multivariate and linear regression analyses were analyzed for the investigated variables of LA size, left ventricular hypertrophy (LVH), posterior wall thickness, septal thickness, and P-wave duration. RESULTS: From the sample (n = 66; mean age +/- SD, 71.3 +/- 13.7; female gender, 48.5%), the mean LA size in the control group was 36.7 +/- 4.01 mm and for the group of patients with IAB (n = 38) was 42.2 +/- 7.25 mm (p = 0.004). Linear regression analysis revealed that P-wave duration was significantly correlated with LA size (p = 0.0002, r = 0.606). CONCLUSIONS: Degree of conduction delay in IAB (P-wave duration) is an independent, direct correlate of LAE, and the regression equation (LA size [in millimeters] = 2.47 +/- 0.29 x P-wave duration [in milliseconds]) could be used to estimate LAE.

Aged↗
PubMed2004

Repetitive yawning associated with cardiac tamponade.

Yawning occurs frequently in daily life and is often attributed to boredom and fatigue. Rarely, it may be a symptom of serious underlying medical illness, primarily involving the central nervous system. We report a case of acute cardiac tamponade resulting from a large, malignant pericardial effusion. The patient manifested striking repetitive yawning that resolved immediately after pericardial drainage. An association between repetitive yawning and acute cardiac tamponade has not been previously described.

Carcinoma, Non-Small-Cell Lung↗