Sunday, December 4, 2011

What is the Ashman's phenomenon

One of the core competencies of hospitalists is the appropriate and accurate interpretation of electrocardiograms (ECG). Of course, we are Internal Medicine or Pediatrics (or both) specialists and not Cardiologists.

The ECG interpretation requires skill, close observation, excellent knowledge of the vectorial conduction of electricity in the heart, and most importantly, lots of practice and seeing multiple ECG's. In addition having the mentorship of senior Cardiologists with experience is paramount.

I had a case in the pre-operative clinic (IMPACT - Internal Medicine Preoperative Assessment, Consult and Treatment) at the Cleveland Clinic, and as part of the routine evaluation an ECG was obtained. She did have Atrial fibrillation , however some unexpected presumed premature ventricular contractions.

Further investigation on this electrocardiographic phenomena let us reassure our surgeons team and have the patient undergo surgery safely.

Read here our report in the Cleveland Clinic Journal of Medicine December 1 issue.

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