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Background Descriptions of the effect of chemotherapy on all the electrocardiographic parameters in breast cancer women during chemotherapy are limited. Methods A retrospective and within-subject longitudinal study of the effect of chemotherapeutics and different chemotherapeutic regimens on electrocardiographic parameters was conducted in 948 breast cancer women who had completed chemotherapy with ECG recording at initial diagnosis and before each cycle of chemotherpy. Heart rate (HR), QRS interval, P-R interval, QRS axis, QT interval, QTc interval, and the incidence of QTc interval prolongation were analyzed. Age, body mass index (BMI), history of hypertension, diabetes, and coronary heart disease were also collected for further stratified study. Results Compared to initial diagnosis, changes in HR [74 (67, 82) bpm vs. 79 (73, 87)bpm], P-R interval [148 (136, 160) ms vs. 150 (138, 162) ms], QRS axis [41° (19.25°°, 60°) vs. 33° (15°, 53.75°)], QT interval [376 (358, 394) ms vs. 372 (354, 386) ms], QTc interval [417 (404, 431) ms vs. 426 (414, 436) ms], and incidence of QTc interval prolongation (9.6% vs. 15.8%) were all significant after chemotherapy, P  < 0.001. There were statistically differences in HR, QRS axis, QTc interval, and the incidence of QTc interval prolongation between initial diagnosis and prechemotherapy of the last cycle under different age strata (≤ 45 years, 45 ~ 55 years, ≥ 55 years), different BMI range groups (18.5–22.9 kg/m 2 , 23–24.9 kg/m 2 , and 25–29.9 kg/m 2 ), and even in patients without history of hypertension, diabetes, or coronary heart disease, respectively, P  < 0.05. Resting HR, QRS axis, and QTc interval between each cycle of TEC regimen were different, P  < 0.001. Resting HR and QTc interval between different cycles of EC-T(H) regimen were different, P  < 0.05. Compared to initial diagnosis, a longer QTc interval occurred from the third to the last cycle of TEC regimen, P  < 0.05. Only QTc interval before the fifth cycle of EC-T(H) regimen was statistically different from that at initial diagnosis, P  = 0.012. Conclusion Chemotherapy affects the ECG parameters of HR, P-R interval, QRS axis, QT interval, QTc interval, and QTc interval prolongation in early-stage breast cancer women during chemotherapy. Electrocardiographic parameters may be affected significantly by TEC regimen than by EC-T(H) or TC regimen. Trial registration Retrospectively registered.

Case Presentation: A 13-month-old child with past medical history of congenital adrenal insufficiency presented to the emergency department with vomiting and diarrhea. Initially the child was noticed to have bradycardia with normal blood pressure. An electrocardiogram (ECG) showed tall T waves, broad QRS complex, and widened PR interval suggestive of severe hyperkalemia. The initial blood gas showed potassium of 10.7 millimoles per liter. The patient was started on calcium gluconate with immediate resolution of ECG changes. Further management with insulin, dextrose, and sodium olystyrene sulfonate led to normal potassium levels. Discussion: Hyperkalemia is a life-threatening condition in children, especially in those with congenital adrenal insufficiency. The ECG showed different changes as the levels of serum potassium levels increased ranging from tall T waves, wide QRS complex, increased PR interval to arrythmias. Immediate treatment with calcium gluconate in such cases has significant cardioprotective effect. It is important to recognize the ECG changes manifested by changes in serum potassium levels. Our patient had classic ECG changes manifested in severe hyperkalemia.

A 48-year-old woman was found hanged in the bathroom. She was wearing a Holter monitor, which was later analysed by a cardiologist. During autopsy, findings congruent with atypical hanging were collected. The ECG showed a 20 s asystole and four minutes later bradycardia, which progressed to a second-degree AV-block Mobitz I, then Mobitz II, then to a third-degree AV-block. Finally, only P waves could be observed, before heart action ceased. This is one of few cases reporting ECG-changes during hanging and might give further insight into the complex pathophysiology of this type of death.

Background: COVID‐19 can involve the heart, which is associated with an increase in morbidity and mortality and can detected by electrocardiogram (ECG). So, in this study, we assess ECG changes in COVID‐19‐infected patients during hospitalization. Methods: In this study, we examined the ECGs of 474 patients with COVID‐19 positive at Birjand Vali‐Asr Hospital (east of Iran). All the ECGs were taken by a single device and interpreted by a cardiologist. Demographic information, past medical history, and severity of COVID disease (in terms of oxygen saturation, respiratory distress, and need for emergency care) were entered in the checklist. Data were entered into SPSS Version 22 and analyzed. A p value of ≤ 0.05 was considered as a significant level. Results: The patient’s mean age was 57.13 ± 18.7 years, and 55% of them were men; 428 (89.5%) patients survived and 49 (10.5%) died. About 78% of patients had abnormal ECG, which was higher in deceased patients significantly (91.8%, p = 0.03). Most frequent abnormalities include 40.3% of dysrhythmia (sinus tachycardia, atrial fibrillation, and sinus bradycardia), 30.1% of abnormal rate (tachycardia, bradycardia), and 30% of low‐voltage ECG. Statistical analysis showed that after multivariable logistic regression, tachycardia (OR = 2.65 [1.2–5.8]; p = 0.015) and ST‐segment elevation (OR = 2.9 [1.2–7.2]; p = 0.023) were directly related to the disease severity and mortality. Conclusion: ECG changes are very common in COVID‐19 patients, especially rate and rhythm changes. Tachycardia and ST segment elevation were associated with mortality. ECG changes are very common in COVID‐19 patients, especially changes in rate and rhythm. Tachycardia and ST segment elevation were associated with mortality. Since the ECG is a simple, cheap, and safe diagnostic method, it is necessary to take an initial ECG from the patient in acute upper respiratory infections such as COVID‐19, at least for patients with severe disease. In our study, the significant point was the presence of low voltage in ECG in one‐third of the patients with COVID‐19, which requires further research in this field.

Renal denervation (RDN) is an adjunct therapy for resistant hypertension, reducing blood pressure (BP) by inhibiting both afferent sensory and efferent sympathetic renal nerve activity. The resulting reduction in central sympathetic outflow including that directed toward the heart may beneficially impact cardiac remodeling, left ventricular hypertrophy (LVH) and atrial fibrillation (AF). RDN has been shown to reduce left ventricular mass and AF burden but long‐term data is sparse. Forty patients (72.5% male, 69.2 ± 9.6 years) underwent 12‐lead ECG at baseline prior to RDN and at a mean long‐term follow‐up (LTFU) of 8.3 ± 0.9 years post‐intervention. A 24‐h ambulatory blood pressure monitor (ABPM) was obtained at both time points. Cornell voltage indices were calculated at baseline and LTFU, then converted to left ventricular mass based on validated formulae accounting for sex. ECGs underwent cardiologist review for determination of AF at both time‐points. There was no difference in Cornell voltages or left ventricular mass index (LVMI) between baseline and long‐term follow‐up in neither males ( p  = 0.89) nor females ( p  = 0.91). BP lowering at LTFU was correlated with a more pronounced reduction in LVMI ( r  = 0.50, p  = 0.0011) No change was observed in the incidence of atrial fibrillation between baseline or long‐term follow‐up ( p  = 0.99). There was no reduction in mean Cornell voltage or LVMI across the cohort between baseline and long‐term follow‐up. However, changes in ambulatory systolic BP correlated with reduction in LVMI suggestive of an RDN‐induced BP dependent long‐term reduction in LVMI out to eight years post‐RDN.

We present a case of a 54-year-old male patient who was admitted to our Emergency Department (ED) with localized epigastric pain. Inflammation markers, ultrasound, and CT scan were inconsistent with an initial diagnosis of cholecystitis. However, there was additional evidence of cholecystolithiasis. The ECG showed new anterior biphasic T waves typical for a Wellens' type A ECG. Additionally, the patient had an intermittent left bundle branch block (LBBB). The diagnostic challenges in differentiating possible diagnoses will be described, to which in this case, were either acute cholecystitis or acute coronary syndrome (ACS). A laparoscopic study confirmed acute cholecystitis. Coronary angiography showed no pathological processes associated with ACS. ECG abnormalities were initially ongoing, but were no longer detectable during an 8month follow up assessment.

Background Aluminum phosphide (AlP) poisoning is a major cause of mortality, often presenting with non-specific symptoms that complicate diagnosis. Case A 19-year-old male presented with vomiting, abdominal pain, hypotension, and ECG abnormalities. He initially denied ingestion, delaying treatment. Despite supportive care, he progressed to cardiac arrest and death. Conclusion This case illustrates the diagnostic challenges of AlP poisoning and underscores the need for early suspicion and intervention to improve patient outcomes.

Extrinsic heart compression by gastrointestinal (GI) structures is an often underrecognized finding in clinical practice. It is potentially related to unpredictable clinical conditions, ranging from incidental detection in asymptomatic subjects, to deranging and potentially life‐threatening clinical manifestations. However, despite its potential clinical relevance, there is still no comprehensive analysis investigating the surrounding causes, clinical findings, and diagnostic imaging work‐up for this patient population. A narrative review with an extensive bibliographic search of the literature was performed using PubMed (MEDLINE), Embase, and Cochrane Central Databases up to December 31, 2023. Despite the broad spectrum of GI etiologies, clinical manifestations, and cardiac chamber involvement scenarios, physicians must be aware of such an uncommon condition, in order to provide timely diagnosis through a comprehensive imaging approach, avoid misleading interpretations, and determine the most appropriate decision‐making strategy.

Background Black rock, Kala Pathar or ParaPhenyleneDiamine (PPD), is an aromatic amine widely used as a hair dye ingredient and is also used in textile industries. However, when ingested, PPD is highly toxic resulting in angioneurotic edema, rhabdomyolysis, acute kidney injury, toxic hepatitis, and myocarditis with a high mortality rate. This study aimed to evaluate the incidence and outcome of laryngeal edema and rhabdomyolysis after ingestion of PPD. Patients and methods The current research was a cross-sectional study that was conducted at Aswan University Hospital, Aswan, Egypt, from December 2021 to December 2022. It consisted of 100 people who attempted suicide by ingesting black rock. All patients underwent general examinations and investigations, including complete blood count, urea, creatinine, creatine phospho kinase, alanine aminotransferase, aspartate aminotransferase, calcium, uric acid, phosphorus, urine analysis, and electrocardiography. Results The current study consisted of 15 males and 85 females; the most common presentation was stridor (88%) followed by muscle weakness (50%). Twelve percent of patients with stridor required tracheostomy while 14% required tracheal intubation. Regarding the complications of PPD ingestion, the incidence of hepatic injury was (97%) and acute kidney injury (14%) five of them required hemodialysis, with a mortality rate of 13%. Cardiac arrhythmias were noticed in the form of sinus tachycardia (24%), sinus bradycardia (3%), atrial fibrillation (5%), ventricular fibrillation (6%), and ventricular tachycardia (7%). Our study found a significant positive correlation between creatine phosphokinase, muscle weakness, and acute kidney injury ( P = 0.005). Whereas a significant positive correlation was noted between stridor, hospital stay, and mortality rate ( P = 0.000), ( P = 0.003), respectively. Moreover, a significant positive correlation was found between tracheotomy, mortality rate, and hospital stay ( P = 0.000). Conclusion PDD toxicity is more frequent in younger females. The intoxication from the black rock is increasingly used in suicide attempts and vital organs are usually affected especially the kidney, liver, and heart causing morbidity and mortality.