Easily Neglected Manifestations in Electrocardiogram in the Prone Position

Abstract

This case report describes a patient in their 70s with chronic obstructive pulmonary disease and hypertension who presented with a 2-day history of cough, expectoration, and shortness of breath.

Discrepancies in Estimating Excess Death by Political Party Affiliation During the COVID-19 Pandemic

“…In Florida, Republicans have controlled all branches of state government since 1999, but Democrats retained an overall edge in partisan registration until 2021. 5 The authors used distinct measures across states to operationalize political party affiliation, 1 which exacerbates the conflation of partisanship and ideology. For Ohio, they included individuals who voted in a party's primary election, suggesting ideological alignment with that party.…”

“…Researchers must be cognizant of variation in how states report political party affiliation when attempting to extend this study's important results. 1 Patrick O'Mahen, PhD To the Editor Wallace et al 1 claim excess mortality among Republican-vs Democratic-affiliated voters. We see 5 limitations.…”

“…Second, the authors' analysis is of approximately 500 000 of approximately 31 million combined residents of these states, 1 or approximately 2%. This introduces the problem that differences in excess mortality may represent network effects-or patterns of spread in specific communities-and not fundamental differences in modifiable health outcomes by political preference.…”

Electrocardiogram Recording in the Prone Position

“…To the Editor When patients are prone, it is common to perform an electrocardiogram (ECG) by placing the precordial electrodes on the patient’s back, which transposes the usual location of the precordial electrodes to the dorsum (anatomical mirror). The case reported by Zhang et al shows that a substantial anterior ST elevation can go unnoticed in the ECG recorded this way. In another article, based on a case series of 100 patients, Chieng et al demonstrated the limited diagnostic capacity of the ECG obtained in this way, and specifically, showed this method is “unreliable for the detection of anterior myocardial injury.”…”

Electrocardiogram Recording in the Prone Position—Reply

“…In Reply We would like to express our gratitude to Cobos Gil et al for their thought-provoking and insightful comments on our case report, which discussed how anterior leads ST-segment elevation might be missed on the findings of an electrocardiogram (ECG) recorded in the commonly used prone position. Their comments addressed a new prone ECG acquisition method based on the concept of the mirror image electrocardiogram reported by Kors and van Herpen .…”