We present a case of pacing-induced cardiomyopathy. The patient presented with clinical symptoms of dyspnea, leg swelling, and orthopnea several months after a dual-chambered pacemaker was placed for third-degree heart block. The echocardiogram demonstrated a depressed ejection fraction. Coronary angiography was performed, which showed widely patent vessels. Single- and dual-chambered pacemakers create ventricular dyssynchrony, which in turn can cause structural, molecular changes leading to cardiomyopathy. With early intervention of biventricular pacemaker replacement, these changes can be reversible; thus, a timely diagnosis and awareness is warranted.
Although the mean intubation times between the groups were not significantly different, the overall success rate was significantly higher in the standard uniform group when compared with PPE group. The perceived difficulty rating was also noted to be significantly higher in the PPE group when compared with the standard uniform group.
I present Modern Symbolic Logic, an introductory philosophy course in first-order logic, as a blended course. A blended course integrates online video learning with in-class activities, out of class supports, and deliverables into a cohesive and mutually supporting package. Blended courses are an enhancement on hybrid courses, which focus on online video learning but not on the additional supports needed for an effective learning experience. This paper has two central aims. The first is to present a blended course in action in order to address a need in the literature for detailed reports of blended classes. The second is to advance an iterative approach to blended course design that significantly lowers the bar of entry for instructions hoping to create a blended course.
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