Backgroundand Objectives: Delay of reperfusion therapy is related to high mortality in cases of ST-segment elevation myocardial infarction (STEMI). Guidelines emphasize that the first-medical-contact-to-balloon (FMCTB) time should be within 90 min. A mobile cloud-based 12-lead electrocardiogram (MC-ECG) transmission system might be useful in such cases, especially in rural areas. Materials and Methods: From April 2019 to June 2021, both an MC-ECG transmission system and the conventional method in which a physician checks the ECG in a hospital (Conventional) were used for transport by emergency medical services in Shin-Yukuhashi Hospital, Fukuoka, Japan. During this period, 8684 consecutive patients were transported to this hospital. Among them, we investigated 48 STEMI patients. The MC-ECG group (n = 23) and the Conventional group (n = 25) were enrolled. Results: There was no significant difference in FMCTB time between the MC-ECG and Conventional groups (MC-ECG: 72.0 (60.5–107) min vs. Conventional: 80.0 (63.0–92.0) min, p = 0.77). The length of hospital stay in the MC-ECG group was significantly shorter than that in the Conventional group (12.0 (10.0–15.0) days vs. 16.0 (12.0–19.0) days, p = 0.039). The logistic regression model showed that patients’ non-use of MC-ECG was associated with a risk of more than 15-day length of hospital stay with an adjusted odd ratio of 0.08 (95% CI: 0.013–0.55, p = 0.0098). Conclusions: Using the MC-ECG, the length of hospital stay in patients with STEMI was significantly reduced.

Eosinophilic granulomatosis with polyangiitis (EGPA), or Churg Strauss syndrome, is a multisystem disorder that is characterized by allergic rhinitis, asthma, and prominent blood eosinophilia [1][2][3][4][5]. The prevalence of EGPA in Japan has been reported to be 17.8/1,000,000. The commonly involved organs are the peripheral nervous system and lungs, followed by the skin. However, EGPA can affect any organ system, including the cardiovascular, gastrointestinal, renal, and central nervous systems. In general, most patients with EGPA achieve remission with glucocorticoid therapy alone in the absence of factors associated with a poor prognosis, including cardiac, renal, and/or central nervous system involvement [6]. Cardiac involvement is more serious in patients with EGPA, and this case report highlights the importance of early diagnosis and treatment. We describe here a rare case of EGPA complicated with progressive pericardial effusion and discuss the importance of the early diagnosis and treatment of EGPA. Case reportA 44-year-old woman presented at a nearby clinic with inspiratory chest pain one week before hospitalization. She had a 15-year history of bronchial asthma (with allergic rhinitis) which was well-controlled by inhaled corticosteroid. She was treated for sinusitis which was diagnosed based on fever, purulent nasal drainage, and facial pain 7 months before hospitalization, and was also treated with steroid ointment for unidentified limb eruption

A 71-year-old woman with cardiac sarcoidosis underwent an implantable cardioverter-defibrillator implantation in the left precordium to prevent fatal arrhythmias. Two weeks later, she presented with dyspnea. Chest X-ray revealed right pneumothorax due to the active atrial lead perforation. Subsequently, air was detected surrounding the heart. Although it was difficult to differentiate pneumopericardium from pneumomediastinum, postural conversion computed tomography (CT) in the supine and prone positions documented air migration in the pericardial cavity and diagnosed pneumopericardium. This rare case of pneumopericardium combined with pneumothorax contralateral to the venous access site highlights the utility of postural conversion CT for diagnosis of pneumopericardium.