Category: Cardiology

Cardiology PGY1 PGY2 PGY3 PGY4 Pulmonary VTE

One of our favorite question in ED is: “Does this patient with chest pain have ACS?” JAMA in Nov. 2015 tried to answer this question from the eyes of cardiologist…

Cardiology PGY1 PGY2 PGY3 PGY4

I cannot say that  we did not know about this, but having an article to support this is very exciting. Jeff Kline and his colleagues analyzed 45 studies of 8,209…

Cardiology PGY1 PGY2 PGY3 PGY4

Troponin 1 set, 2 sets, 3 sets, Stress test, Echo, Observation vs Admission. LOW risk chest pain, when will be a safe practice. JAMA internal medicine in March found patients that they do not have

Cardiology PGY1 PGY2 PGY3 PGY4

Cardiology PGY1 PGY2 PGY3 PGY4

Cardiology PGY1 PGY2 PGY3 PGY4

Cardiology PGY1 PGY2 PGY3 PGY4

I highly recommend you to take a look at this article published in American Heart Journal last week(Feb, 2015). The authors identified 11 class 1A(means the best evidence) in  STEMI or UA/NSTEMI and they followed them form clinical trial publication til meaningful application into clinical practice.  It took 16 years for clinician to apply those evidence into practice.

Cardiology PGY1 PGY2 PGY3 PGY4

Another study from AJR in Jan 2015 focused on dizziness/syncope. Due to difficulty to define definition of dizziness among patients, they used 3 terms of Dizziness, Syncope, and

Cardiology PGY1 PGY2 PGY3 PGY4

Cardiology PGY1 PGY2 PGY3 PGY4

We discussed 2 studies in our class specific session on impact of EPi on out of hospital cardiac arrest. J Am Coll Cardiol published another study  this month and challenged again use of Epi in OHCA. 1,556 patients from 2000 to 2012, using EPi with different doses, and the conclusion is  pre-hospital use of epinephrine was consistently associated with a lower chance of survival.

Cardiac arrest Cardiology PGY1 PGY2 PGY3 PGY4

Morphine can affect functionality of Clopidogrel. There is an article in JACC, March 2014, that showed “Morphine delays clopidogrel absorption, decreases plasma levels of clopidogrel active metabolite, and retards and diminishes its effects,

Cardiology PGY1 PGY2 PGY3 PGY4

Cardiology PGY1 PGY2 PGY3 PGY4

Cardiology PGY1 PGY2 PGY3 PGY4

Cardiology

There is a new clinical Policy that Published in Feb, Evaluation and Management of Adult Patients in the Emergency Department With Asymptomatic Elevated Blood Pressure. There was always a big ? regarding triage and disposition of these patients. There is no great data even on this clinical policy but at least we have some references for that. They answered to following questions:

Cardiology

This is the last update in 2012, but I am happy to end this year with one of the most challenging topics in medicine. The article is from J Am Coll Cardiol in Dec. You can find the Full text link here
1. Remeber: Troponin elevation imparts a worse prognosis, irrespective of the underlying etiology.

Cardiology PGY1 PGY2 PGY3 PGY4

JACC in 2001 published an article that nicely explained the necessity of interpreting lead aVR in clinical setting. There are 3 categorizes that we should consider in this regard:1. acute…

Cardiology PGY1 PGY2 PGY3 PGY4

 

What does typical chest pain mean? Traditionally, we thought that midsternal chest pain with radiation to left arm and increased with exertion, we just had another discussion on this topic on our grand round and all the studies and even

Cardiology PGY1 PGY2 PGY3 PGY4

What is your favorite hypertension numbers to treat in ED? there are a lots of controversies regarding the exact number to start treatment in ED but recent Cochrane review on mild HTN suggest that antihypertensive agents used in the treatment of adults with hypertension stage I (systolic BP 140-159 mmHg and/or diastolic BP 90-99 mmHg)

Cardiology PGY1 PGY2 PGY3 PGY4

Annals of Emergency Medicine published an article which it provided a formula to determine if we can differentiate between STEMI vs Early Repolarization. I really do not know in an acute setting I am able to sit down and calculate this but sometimes in terms of training it could be fun to do this practice!!!

Cardiology PGY3 PGY4

I read this article long time ago but I had a discussion with one of my resident and to give her reference I would like to have it here. Basically…

Cardiology PGY1 PGY2 PGY3 PGY4

Cardiology PGY3 PGY4

Cardiology PGY1 PGY2 PGY3 PGY4

Cardiology Ultrasound

Cardiology PGY1 PGY2 PGY3 PGY4

There are lots of questions raised recently regarding activation of cath. lab  in the setting of new LBBB or presumed new LBBB. It is really challenging when you have a patient with chest pain and there is no old EKG to compare findings of LBBB.

Cardiology