Posts filed under Cardiology

Cardiac Cath Following Cardiac Arrest in Patients Without STEMI

Journal Club Podcast #7: October 2013

This month, the outspoken Chandra Aubin and hold hands and talk about which patients should undergo urgent cardiac cath following cardiac arrest...

Bottom Line: 

In patients with ST-elevation myocardial infarction (STEMI) on ECG following ROSC, the International Liaison Committee on Resuscitation (ILCOR) clearly recommends that reperfusion therapy be attempted.  In patients without STEMI, ILCOR is less clear, though, and recommends only that one “consider immediate coronary angiography in all post-cardiac arrest patients in whom ACS is suspected.”

Posted on November 11, 2013 and filed under Cardiology, Resuscitation, Critical Care.

Clinical Decision Rules in Low-Risk Chest Pain

Journal Club Podcast  #5

Chief resident Tim Koboldt sits down with me to talk about low-risk chest pain, knowledge translation, and breaking down barriers...  

Bottom Line: 

Chest pain remains a common chief complaint among patients presenting to the Emergency Department, accounting for more than 10 million visits annually in the US. According to data from the Physician Insurers Association of America, more than a quarter of all money paid in closed malpractice claims from 1985 to 2003 involved patients with a chief complaint of “chest pain.” Given the high risk of malpractice, and increased morbidity...

Posted on August 29, 2013 and filed under Cardiology.

Asymptomatic Hypertension in the Emergency Department

Journal Club Podcast #2

My good friend Greg Polites and I sit down and discuss the evaluation and management of patients with asymptomatic severely elevated hypertension in the emergency department...

Bottom Line: 

Elevated blood pressure remains a common finding in patients presenting to the emergency department (Karras 2005). While the detrimental effects of long-standing untreated hypertension have been well-documented with respect to the risk of stroke, myocardial infarction, and chronic kidney disease, the risks of untreated hypertension in the short-term... 

Posted on June 12, 2013 and filed under Cardiology.

Immediate Oral Beta-Blockers in STEMI

May 2013 - Article of the Month Podcast #1

Benefit of Immediate Beta-Blocker Therapy on Mortality in Patients With ST-Segment Elevation Myocardial Infarction. Crit Care Med 2013 March 29.   

Context: 

Prior to 2005, standard practice in treatment of ST-elevation myocardial infarction in many emergency departments (EDs) included giving IV beta-blockers (typically metoprolol 5 mg IV q 5 minutes up to 3 doses, unless contraindicated by hypotension or bradycardia). Patients were then admitted and given oral beta-blockers....

Posted on June 1, 2013 and filed under Cardiology.