Background: Electrocardiogram (ECG) is a non-invasive test which can provide clue for the presence of cardiac diseases. Simple, handheld devices, sufficiently miniaturized are useful for a widespread use. New devices, however, need to be compared with the standard ones for their performance in the real-world practice. Here in we report clinical utility of a handheld device.Methods: KardioscreenTM is a mobile and handheld device. It’s been approved for safety and performance standards and it has been certified for ‘Conformite Europeenne’ (CE). Using this device, a comparative blinded study with a conventional and commercially available standard 12 lead ECG machine was one. 604 ECGs recorded from 302 patients with various clinical disorders were coded and analyzed by two blinded observers. A third cardiologist adjudicated the reports. The reports were then correlated for the ECG patterns generated and with the clinical diagnosis. Computer generated measurements of various durations and intervals were also analyzed and compared. Regression analysis was used to compare the values. SPSS 21 software was used to analyze the data.Results: Kardioscreen device could provide recordings to diagnose including ST elevation (99%), non-ST elevation myocardial infarction (94.1%), chamber-hypertrophy (87%), conduction blocks (99%), and arrhythmias (96.4%), with good correlations with the comparator for pattern recognition. Also, computer generated measurements were significantly correlated with the comparator (R=0.96 for HR, R=0.82 for QRSd, R=0.86 for QT/QTc, R=0.76 for PR).Conclusions: The Kardioscreen device is a reliable tool for electrocardiographic diagnosis of common clinical cardiac disorders.

Actinomycosis is an indolent, slowly progressive bacterial infection prevalent in tropical countries, commonly affecting cervicofacial, thoracic, abdominal, or pelvic regions. With early diagnosis and appropriate therapy, the prognosis is excellent. However, late presentation and widespread dissemination can be fatal. This paper reports a rare case of disseminated actinomycosis with fatal cardiac involvement. ( Level of Difficulty: Intermediate. )

Normally in the right ventricular (RV) paced rhythm, the electrocardiogram pattern will be of left bundle branch block (LBBB) pattern. A small percentage of patients can have right bundle branch block (RBBB) pattern in uncomplicated RV pacing. We are reporting here a rare occurrence of a new-onset RBBB in an RV paced patient which was coinciding with the onset of takotsubo cardiomyopathy following pulse generator re-implantation procedure.

Tuberous sclerosis complex is an autosomal dominant condition with variable penetrance. It is characterized by tuberose deposits in various organ systems. Although clinical features predominate neurocutaneous manifestations, cardiac, kidney, and lung involvement are common. Cardiac involvement is marked by the presence of multiple rhabdomyomas and in some cases arrhythmias. In the absence of symptoms, rhabdomyomas require no specific treatment. However, cardiac arrhythmias are unpredictable and may be the cause of sudden cardiac death in some cases. Although treatment is mainly symptomatic, drugs like rapamycin have shown promise in the regression of astrocytomas and angiofibromas. Here, we are reporting two cases of tuberous sclerosis of which one succumbed to arrhythmias and the other to possible sudden cardiac death.

Patients with left-sided pneumothorax presenting with electrocardiogram (ECG) changes resembling acute coronary syndrome (ACS) have been reported in the literature. Takotsubo cardiomyopathy (TCM) occurs predominantly in post-menopausal women with underlying intense emotional or physical stress. However, as this case report shows, it can complicate any acute illness leading to intense stress. We report a rare combination of ECG changes mimicking ACS in a man with a large right-sided pneumothorax and TCM.