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‘Cardiology’ Category

  1. Mortality of Patients With Atrial Fibrillation and an Alternative Primary Diagnosis

    March 4, 2013 by Pourmand

    Acad Emerg Med, Feb 2013 published a Canadian retrospective cohort study reviewed patients with ECG, presented to ED with atrial fibrillation. The Outcome measure was mortality in short and long term (30 , 90 , 365 days) among patients with atrial fibrillation who had different primary ED diagnosis for their visits. (more…)


  2. ACEP Clinical Policy: Asymptomatic HTN in ED

    February 19, 2013 by Pourmand

    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:
    (more…)


  3. Challenges regarding Troponin

    January 3, 2013 by Pourmand

    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. (more…)


  4. aVR: The most Ignored Lead

    October 23, 2012 by Pourmand

    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 coronary syndromes, 2. acute PE, 3. arrhythmia. I strongly recommend you to take a look to the following link

    JACC article


  5. Typical Vs Atypical Chest pain

    October 19, 2012 by Pourmand

     

    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 (more…)


  6. Hypertension treatment

    August 19, 2012 by Pourmand

    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) (more…)


  7. EKG differentiation of early Repol vs STEMI

    June 4, 2012 by Pourmand

    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!!! (more…)


  8. SYNCOPE vs Near SYNCOPE

    May 20, 2012 by Pourmand

    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 this study showed that Syncope and Near syncope has same critical interventions or adverse outcomes. This term should be taking care as we care about syncope.

    Link To article


  9. New Concepts in the Assessment of Syncope

    May 16, 2012 by Pourmand

    There is a State-of-the-Art Paper in the latest edition of Journal of the American College of Cardiology, May 2012.The title of article is New Concepts in the Assessment of Syncope. The authors perspective was based on the presence of a syncope specialist (“the right physician”), adequate equipment including online prompting tools and logistics (“the right place”), and optimal organization (“the right time”), as exemplified in a syncope facility, have been shown to improve at least short-term outcomes.

    Link to article


  10. What is the role of Morphine in Flash Pulmonary Edema?

    May 11, 2012 by Pourmand

    We always taught that Morphine can decrease preload and can help with anxiety and  pain in acute flash pulmonary edema. But evidence does not support this Claim.  (more…)


  11. Focused Cardiac Ultrasound in the Emergent Setting

    February 5, 2012 by Pourmand

    American Society of Echocardiography (ASE) and the American College of Emergency Physicians (ACEP) described the important role of focused cardiac ultrasound (FOCUS) in patient (more…)


  12. Cardiac arrest and prognosis

    December 22, 2011 by Pourmand

     

    This is one of the challenging topics in EM. when should you stop CPR? what parameters do you have to continue versus terminate CPR? (more…)


  13. New LBBB and STEMI

    November 28, 2011 by Pourmand

    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. (more…)