Publications by authors named "Ashwini Sadhale"

3 Publications

  • Page 1 of 1

New Precordial T wave Inversions in Hospitalized Patients.

Am J Med 2021 Nov 20. Epub 2021 Nov 20.

Division of Cardiovascular Medicine, University of California San Francisco, Fresno, California.

Background: The incidence of precordial T changes has been described in athletes and in specific populations, while the etiology in a large patient population admitted to the hospital has not previously been reported.

Methods: All ECGs read by the same physician with new (compared to prior ECGs) or presumed new (no prior ECGs) precordial T wave inversions of >1 mm (0.1 mV) in multiple precordial leads were retrospectively reviewed and various ECG, patient-related and imaging parameters assessed. 226 patients and their ECGs were initially selected for analysis. Of these, 35 were eliminated leaving 191 for the final analysis.

Results: Patients and their ECGs were divided into 5 groups based on diagnosis and incidence including Wellens' syndrome, takotsubo, type 2 myocardial infarction, other (including multiple diagnoses) and unknown. While subtle differences including number of T inversion leads, depth of T waves, QTc intervals and other variables were present between some groups, diagnosis in individual cases required appropriate clinical, laboratory and/or imaging studies. For example, although Wellens' syndrome was identified in <20% of cases, a presenting history of chest discomfort with precordial T changes either on the admission or next day ECG was highly sensitive and specific for this diagnosis. In some cases, Type 2 myocardial infarction can also have a Wellens' like ECG phenotype without significant left anterior descending disease.

Conclusions: Precordial T wave changes in hospitalized patients have various etiologies and, in individual cases, the changes on the ECG alone cannot easily distinguish the presumptive diagnosis and additional data are required.
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November 2021

Supracristal Ventricular Septal Defect Complicated by Formation of an Aorto-Right Ventricular Outflow Tract Fistula: A Rare Cause of Biventricular Enlargement.

Methodist Debakey Cardiovasc J 2021 1;17(2):157-160. Epub 2021 Jul 1.

University of California, San Francisco-Fresno, Fresno, California.

Aorto-right ventricular outflow tract fistulas typically occur secondary to trauma, infective endocarditis, and sinus of Valsalva aneurysm rupture. We describe an unusual case of a spontaneous aorto-right ventricular outflow tract fistula in the absence of such findings, instead forming secondary to a complicating supracristal ventricular septal defect and leading to dilated cardiomyopathy.
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October 2021

Metastatic renal cell carcinoma presenting with melena.

Clin Case Rep 2018 May 24;6(5):961-962. Epub 2018 Mar 24.

Department of Pathology Mayo Clinic Scottsdale Arizona.

Renal cell carcinoma is a highly malignant neoplasm. Metastasis to the pancreas and gastrointestinal tract is rare. In this case report, we show images of metastatic renal cell carcinoma to the upper gastrointestinal tract in a patient who presented with melena.
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May 2018