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Emergency department Echo

Manav Aggarwal, Mrigakshi Gupta, Vikrant Vijan, Anjith Vupputuri, Sanjeev Chintamani, Bishnukiran Rajendran, Rajesh Thachathodiyal, Rajiv Chandrasekaran
INTRODUCTION: Diagnosing heart failure is often a challenge for the healthcare providers due to it's non-specific and usually subtle physical presentations. The outcomes for treatment are strongly related to the stage of the disease. Considering the importance of early and accurate diagnosis, it is important to have an easy, inexpensive, non-invasive, reliable and reproducible method for diagnosis of heart failure. Recent advancement in radiology and cardiology are supporting the emerging technique of lung ultrasound through B-line evaluation for identifying extravascular lung water...
November 2016: Journal of Clinical and Diagnostic Research: JCDR
Louise Dunphy, Elizabeth Keating, T Parke
A man aged 33 years, born in Nepal, but resident in the UK for 7 years presented to the emergency department with a 4-day history of general malaise, fever (temperature 38.6°C) and a non-productive cough. His medical history was unremarkable and no high-risk behaviour was identified. Clinical examination confirmed decreased air entry bilaterally with bibasal crackles. He was tachycardic, with a heart rate of 120 bpm. Further investigation with a 12-lead ECG confirmed supraventricular tachycardia (SVT) which was terminated with vagal manoeuvres...
November 2, 2016: BMJ Case Reports
Avinoam Shiran, David S Blondheim, Sara Shimoni, Mohamed Jabarren, David Rosenmann, Alex Sagie, David Leibowitz, Marina Leitman, Micha Feinberg, Ronen Beeri, Salim Adawi, Avraham Shotan, Sorel Goland, Lev Bloch, Sergio L Kobal, Noah Liel-Cohen
AIMS: Left ventricular (LV) two-dimensional longitudinal strain (2DLS) analysis by echocardiography has been suggested as a useful tool for the detection of acute coronary syndromes (ACS). Our aim was to determine whether 2DLS analysis could assist in triage of patients with chest pain (CP) in the emergency department (ED). METHODS AND RESULTS: We prospectively enrolled patients presenting to the ED with CP and suspected ACS but without a diagnostic ECG or elevated troponin...
August 26, 2016: European Heart Journal Cardiovascular Imaging
Can Ozen, Emre Salcin, Haldun Akoglu, Ozge Onur, Arzu Denizbasi
OBJECTIVES: Our primary goal is to investigate the hypothesis that in patients with a detectable ventricular wall motion (VWM) in cardiac ultrasonography (US) during cardiopulmonary resuscitation (CPR), survival rate is significantly more than in patients without VWM in US. MATERIAL AND METHODS: In our prospective, single center study, 129 adult cardiac arrest (CA) patients were enrolled. Cardiac US according to Focus Assessed Transthoracic Echo (FATE) protocol was performed before CPR...
March 2016: Turkish Journal of Emergency Medicine
Echo Fallon, Sierra Fung, Georgina Rubal-Peace, Asad E Patanwala
To identify predictors of patient satisfaction with pain control measured after emergency department (ED) discharge. This was a prospective, cross-sectional study conducted in an academic, urban ED in the United States. Adult patients with a pain-related complaint were interviewed via telephone within 72 hr of discharge from the ED. A standardized questionnaire was used to obtain demographic and clinical information. The primary outcome of interest was patient satisfaction with pain management in the ED measured using the following question: "How often was your pain well controlled in the ED?" (0-10 scale; 0 = never, 10 = always)...
April 2016: Advanced Emergency Nursing Journal
Manouchehr Hekmat, Hamid Ghaderi, Hassan Tatari, Abbas Arjmand Shabestari, Seyedeh Adeleh Mirjafari
Pericardial cysts are rare lesions. These benign anomalies are located in the middle mediastinum. In this article, we present a 24-year-old man who was referred to the emergency department with dyspnea and persistent cough. In physical exam, no abnormality was found. His past medical history was normal. His trans-thoracic echocardiogram showed an echo-lucent space next to the right atrium at the right cardiophrenic angle. No pericardial effusion was found. The patient underwent surgery. After midsternotomy, a huge cyst measuring approximately 13 × 8 × 5 cm in diameters was found on the right side and outside the pericardium that was totally excised...
January 2016: Iranian Journal of Radiology: a Quarterly Journal Published By the Iranian Radiological Society
Shiv Chopra, Nadine Hachach-Haram, Daniel L H Baird, Katherine Elliott, Harry Lykostratis, Sophie Renton, Joseph Shalhoub
BACKGROUND: Efficient handover of patient information is fundamental for patient care and service efficiency. An audit exploring surgeons' views on written handover within a Trust's surgical specialties concluded that clear deficiencies existed. Such concerns have been echoed in the General Medical Council's guidance on safe surgical handover. AIMS: To design and implement bespoke software for surgical handover using the audit results of surgeons' perceptions of existing processes...
April 2016: Postgraduate Medical Journal
Teresa Victoria, Ann M Johnson, J Christopher Edgar, Deborah M Zarnow, Arastoo Vossough, Diego Jaramillo
OBJECTIVE: Fetal MRI at 3 T is emerging as a promising modality for evaluating fetal anatomy. The objective of this study was to compare the quality of images obtained with commonly used fetal imaging sequences at 1.5 T and 3 T. We hypothesized that the visualization and anatomic detail of fetal structures would be better at 3 T than at 1.5 T. MATERIALS AND METHODS: A retrospective search of the radiology department database at our institution identified 58 fetal MRI examinations performed at 3 T to evaluate body abnormalities during the period from July 2012 to February 2014...
January 2016: AJR. American Journal of Roentgenology
Emanuele Antonielli, Alfredo Pizzuti, Sarah Dogliani, Michele Stasi, Antonia Bassignana, Baldassarre Doronzo
OBJECTIVE: The aim of the present study was to evaluate the presence and degree of spontaneous echo contrast (SEC) in the left atrium and of left atrial appendage (LAA) contractility before and after cardioversion (CV) in patients with recent-onset atrial fibrillation (AF). METHODS: Our study included 56 patients divided into two groups: group 1, comprising 32 clinically stable patients who were admitted to the Emergency Department with less than or equal to 48 h duration AF, and who underwent transoesophageal echocardiography (TEE)-guided CV; and the control group (group 2), comprising 24 patients admitted to the Cardiological Department for elective TEE-guided CV of greater than 48 h AF...
October 8, 2015: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
Anthony J Weekes, Stephen M Keller, Bradley Efune, Sama Ghali, Michael Runyon
OBJECTIVE: To prospectively compare ultrasound (US) versus CXR for confirmation of central vascular catheter (CVC) placement. Secondary objective was to determine the incidence of pneumothorax (PTX) and compare US with CXR completion times. METHODS: Investigators performed the US saline flush echo test, and evaluated each anterior hemithorax for pleural sliding with US after subclavian or internal jugular CVC placement. MEASUREMENTS AND MAIN RESULTS: 151 total (135 in the emergency department, 16 in the intensive care unit) patients after CVC placement, mean age 62...
March 2016: Emergency Medicine Journal: EMJ
Melissa A Platt, Shirali Shah, Matthew Allinder
BACKGROUND: Infective endocarditis (IE) is a difficult emergency department (ED) diagnosis to make. Symptoms are nonspecific and diverse and the classic triad of fever, anemia, and murmur is rare. Severe IE causes considerable morbidity and mortality and should be diagnosed early. However, echocardiogram is essential but not readily available in the ED and can cause diagnostic delay. CASE REPORT: This case describes severe IE and its unique presentation, diagnostic challenges, and the use of bedside cardiac ultrasonography...
January 2016: Journal of Emergency Medicine
Islamiyat Babs Animashaun, Oluwaseun A Akinseye, Leah I Akinseye, Olakunle O Akinboboye
BACKGROUND: Right atrial myxoma accounts for 15-20% of cardiac myxomas and syncope is a very rare manifestation. We present the case of an 89-year-old man with right atrial myxoma and syncope, and discuss the role of cardiac magnetic resonance imaging (MRI) in the diagnosis of myxomas. CASE REPORT: An 89-year-old man with a history of hypertension, hyperlipidemia, chronic kidney disease stage 4, mild dementia, and benign prostatic hyperplasia presented to the emergency department with an episode of syncope...
2015: American Journal of Case Reports
Daniel Angeli, Stephen J Angeli
We report a case of progressive respiratory failure secondary to primary cardiac sarcoma masquerading as primary lung disease. An 18-year-old female presented to our hospital emergency department with progressive cough, dyspnea, and hemoptysis. She was treated for primary lung infection without improvement and had respiratory failure with endotracheal intubation by the third hospital day. An "intermediate" plasma brain natriuretic protein (BNP) of 216 pg/mL did not raise concerns about a heart failure diagnosis and may have delayed the correct diagnosis...
2015: Case Reports in Cardiology
Reshma M Khan, Rajaie Namas, Sachin Parikh, Bernard Rubin
We present a case of a 21-year-old African-American female with no significant medical history, who presented to the emergency department with a one-week history of blurry and double vision. Ophthalmology evaluation revealed bilateral retinal artery occlusion. Further workup with imaging of the brain was consistent with an ischemic stroke. Hereditary hypercoagulable workup was unremarkable and initial testing for antiphospholipid syndrome was positive. She underwent transesophageal echocardiogram (TEE), which showed severe mitral regurgitation and thickening of mitral valve leaflets consistent with Libman-Sacks endocarditis...
2015: Case Reports in Rheumatology
Patrick Q Brady, Matt R Nobles
Despite the growing body of scholarship on stalking victimization, the criminal justice system's response has been substantially understudied. Although scholars consider stalking to be a significant issue, its prevalence is not echoed in official data representing stalking arrests and convictions. The disparity between prevalence estimates and official data reinforces a "dark figure" of stalking that warrants further examination. To develop a better understanding of underreporting and/or underrecording, this exploratory study used official data from the Houston Police Department to examine police response to stalking...
July 30, 2015: Journal of Interpersonal Violence
Tyler L Bloomer, Eric J Thomassee, Pete P Fong
BACKGROUND: The ideal treatment strategy for acute pulmonary embolism (PE) remains a subject of debate. Treatment strategies vary based on numerous factors including the clinical scenario, hemodynamic variables, PE location, and personnel who are trained in advanced PE management therapies. METHODS: Similar to an acute myocardial infarction network, we created a regional referral system called the Acute PE Network to facilitate the transport of patients with PE from referring facilities and improve access to advanced therapies...
September 2015: Critical Pathways in Cardiology
Matthew Stewart, Joseph Bledsoe, Troy Madsen, Zachary Sturges, Trever McGuire, Thomas Rayner, David Hamilton, Erik Barton
UNLABELLED: Pulmonary embolism (PE) is a common disease in emergency medicine and treatment approaches vary greatly. Emergency department observation units (EDOUs) have provided the opportunity to complete a PE workup, initiate treatment, and arrange appropriate follow-up for low-risk patients. OBJECTIVE: We sought to evaluate the utilization and safety of a treatment protocol for low-risk PE in an EDOU. METHODS: A prospective evaluation was performed in our EDOU for the treatment of low-risk PE between December 1, 2010 and May 31, 2012...
September 2015: Critical Pathways in Cardiology
Maysam Ali Abdulwahid, Andrew Booth, Maxine Kuczawski, Suzanne M Mason
STUDY QUESTION: To determine if placing a senior doctor at triage versus standard single nurse in a hospital emergency department (ED) improves ED performance by reviewing evidence from comparative design studies using several quality indicators. DESIGN: Systematic review. DATA SOURCES: Cochrane Library, MEDLINE, EMBASE, CINAHL, Cochrane Effective Practice and Organisation of Care (EPOC), Web of Science, Clinical Trials Registry website. In addition, references from included studies and citation searches were used to identify relevant studies...
July 2016: Emergency Medicine Journal: EMJ
Andres Vargas-Estrada, Dianna Edwards, Mohammad Bashir, James Rossen, Firas Zahr
Saphenous vein grafts (SVG) pseudoaneurysms, especially giant ones, are rare and occur as a late complication of coronary artery bypass grafting. This condition affects both genders and typically occurs within the sixth decade of life. The clinical presentation ranges from an asymptomatic incidental finding on imaging studies to new onset angina, dyspnea, myocardial infarction or symptoms related to compression of neighboring structures. An 82-year-old woman presented with acute onset back pain, dyspnea and was noted to have significantly engorged neck veins...
June 26, 2015: World Journal of Cardiology
Takuya Kurazumi, Takeshi Suzuki, Satoshi Ideno, Takahiro Sakuma, Mari Nagafuchi, Tomoyuki Sato, Junya Oshida
Left ventricular non-compaction (LVNC) is a rare congenital cardiomyopathy characterized by heart failure, arrhythmia, and embolic events. A 65-year-old man, previously diagnosed as LVNC, was admitted to the emergency department with severe abdominal pain. He was diagnosed as appendicitis and treated conservatively with antibiotics. The echocardiogram examination showed left ventricular ejection fraction of less than 25%, and his B-type natriuretic peptide assay was > 5,000 pg x ml(-1) on admission. Ten days after admission, he underwent emergency surgery for suspected perforation of vermiform appendix...
February 2015: Masui. the Japanese Journal of Anesthesiology
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