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20 papers 25 to 100 followers Cardiology for Emergency Medicine Providers
By Merlin Curry MD, EMT-P
https://www.readbyqxmd.com/read/26547467/does-this-patient-with-chest-pain-have-acute-coronary-syndrome-the-rational-clinical-examination-systematic-review
#1
REVIEW
Alexander C Fanaroff, Jennifer A Rymer, Sarah A Goldstein, David L Simel, L Kristin Newby
IMPORTANCE: About 10% of patients with acute chest pain are ultimately diagnosed with acute coronary syndrome (ACS). Early, accurate estimation of the probability of ACS in these patients using the clinical examination could prevent many hospital admissions among low-risk patients and ensure that high-risk patients are promptly treated. OBJECTIVE: To review systematically the accuracy of the initial history, physical examination, electrocardiogram, and risk scores incorporating these elements with the first cardiac-specific troponin...
November 10, 2015: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/26395004/a-case-of-st-segment-elevated-myocardial-infarction-with-less-common-forms-of-single-coronary-artery
#2
Masashi Koga, Yota Kawamura, Daiki Ito, Harukazu Iseki, Yuji Ikari
A 60 year-old man presenting with chest pain was diagnosed with acute ST-elevated myocardial infarction. An emergency coronary angiography showed distal left circumflex artery (LCX) occlusion. The ostium of the right coronary artery (RCA) was not detectable. Following primary percutaneous coronary intervention in the occluded LCX, we confirmed that RCA region was fed from both LAD and LCX. Coronary computed tomography showed similar findings. This single coronary artery anomaly is extremely rare and cannot be categorized according to the established classification system...
October 2016: Cardiovascular Intervention and Therapeutics
https://www.readbyqxmd.com/read/26395948/usefulness-of-aortic-knob-width-on-chest-radiography-to-predict-central-hemodynamics-in-patients-with-known-or-suspected-coronary-artery-disease
#3
Tadanao Higaki, Satoshi Kurisu, Noriaki Watanabe, Hiroki Ikenaga, Takashi Shimonaga, Toshitaka Iwasaki, Ken Ishibashi, Yoshihiro Dohi, Yukihiro Fukuda, Yasuki Kihara
BACKGROUND: Aortic knob width on chest radiography is independently related to cardiovascular disease. However, little is known about the correlation between aortic knob width and central hemodynamics. METHODS: Central blood pressure was measured invasively with diagnostic catheter in 92 patients with known or suspected coronary artery disease. RESULTS: Aortic knob width was positively associated with age (r = 0.42; p < 0.001), central systolic blood pressure (r = 0...
2015: Clinical and Experimental Hypertension: CHE
https://www.readbyqxmd.com/read/26341945/infective-endocarditis
#4
REVIEW
Thomas J Cahill, Bernard D Prendergast
Infective endocarditis occurs worldwide, and is defined by infection of a native or prosthetic heart valve, the endocardial surface, or an indwelling cardiac device. The causes and epidemiology of the disease have evolved in recent decades with a doubling of the average patient age and an increased prevalence in patients with indwelling cardiac devices. The microbiology of the disease has also changed, and staphylococci, most often associated with health-care contact and invasive procedures, have overtaken streptococci as the most common cause of the disease...
February 27, 2016: Lancet
https://www.readbyqxmd.com/read/26209466/novel-vagal-maneuver-technique-for-termination-of-supraventricular-tachycardias
#5
Haluk Un, Mehmet Dogan, Omer Uz, Zafer Isilak, Mehmet Uzun
Hemodynamically unstable patients with supraventricular tachycardias (SVTs) should be treated with electrical cardioversion. If the patient is stable, acute termination of tachycardia can be achieved by vagal maneuvers or medical therapy. The Valsalva maneuver, carotid massage, and ice to the face are the most common vagal maneuvers. In our experience with patients, we observed that vagal stimulation increases with lying backward. Our suggested maneuver is based on quickly lying backward, from a seated position...
January 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/26145584/emergency-coronary-angiography-in-out-of-hospital-cardiac-arrest-patients-without-stemi
#6
Sang Kyoon Han, Soon Chang Park, Sung Hwa Lee, Seok Ran Yeom, Sung Wook Park
Current guideline recommends that immediate coronary angiography (CAG) should be considered in all postcardiac arrest patients in whom acute coronary syndrome is suspected. In the setting of out-of-hospital cardiac arrest (OHCA), obtaining clinical data such as chest discomfort and medical diseases associated with acute coronary syndrome can be difficult. Therefore, emergency physicians depend on electrocardiographic findings after return of spontaneous circulation (ROSC) when they have to decide whether emergency CAG should be performed...
January 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/24902881/identification-of-the-optimum-vagal-manoeuvre-technique-for-maximising-vagal-tone
#7
RANDOMIZED CONTROLLED TRIAL
Gavin Smith, Alicia Broek, David McD Taylor, Amee Morgans, Peter Cameron
OBJECTIVES: This study sought to determine the most effective technique for Valsalva Manoeuvre (VM) and Human Dive Reflex Manoeuvre (HDR) generation of vagal tone. METHODS: We conducted a repeated-measures trial of healthy adult volunteers from a university campus, aged 18-56 years, in sinus rhythm. Participants were randomised to VM (in supine or Trendelenberg postures) and HDR (supine or sitting postures) sequentially. Participants performed three trials of each technique, in random order, with a continuous ECG recording...
January 2015: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/24686400/pharmacologic-therapies-for-acute-cardiogenic-shock
#8
REVIEW
Jose Nativi-Nicolau, Craig H Selzman, James C Fang, Josef Stehlik
PURPOSE OF REVIEW: The natural history of cardiogenic shock has improved significantly with the utilization of revascularization and mechanical circulatory support. Despite the interest in identifying new pharmacological agents, the medical therapy to restore perfusion is limited by their side-effects and no solid evidence about improving outcomes. In this article, we review the current pharmacological agents utilized during cardiogenic shock. RECENT FINDINGS: Inotropes and vasopressors are widely used to improve hemodynamics acutely; however, reliable information regarding comparative efficacy of individual agents is lacking...
May 2014: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/24024842/case-records-of-the-massachusetts-general-hospital-case-28-2013-a-52-year-old-man-with-cardiac-arrest-after-an-acute-myocardial-infarction
#9
David F M Brown, Farouc A Jaffer, Joshua N Baker, M Edip Gurol
Presentation of Case. Dr. Lisa A. Arvold (Emergency Medicine): A 52-year-old man was brought to the emergency department at this hospital because of chest pain and ST-segment elevations on electrocardiography (ECG). The patient had been in his usual health, with hypertension, dyslipidemia, and..
September 12, 2013: New England Journal of Medicine
https://www.readbyqxmd.com/read/24004114/time-to-treatment-in-patients-with-stemi
#10
Eric R Bates, Alice K Jacobs
ST-segment elevation myocardial infarction (STEMI) usually results from acute thrombotic occlusion of a coronary artery and is a leading cause of death. Although myocardial cell injury can occur after 20 to 30 minutes of ischemia, it takes several hours for transmural myocardial necrosis to develop...
September 5, 2013: New England Journal of Medicine
https://www.readbyqxmd.com/read/23741058/2013-accf-aha-guideline-for-the-management-of-heart-failure-a-report-of-the-american-college-of-cardiology-foundation-american-heart-association-task-force-on-practice-guidelines
#11
Clyde W Yancy, Mariell Jessup, Biykem Bozkurt, Javed Butler, Donald E Casey, Mark H Drazner, Gregg C Fonarow, Stephen A Geraci, Tamara Horwich, James L Januzzi, Maryl R Johnson, Edward K Kasper, Wayne C Levy, Frederick A Masoudi, Patrick E McBride, John J V McMurray, Judith E Mitchell, Pamela N Peterson, Barbara Riegel, Flora Sam, Lynne W Stevenson, W H Wilson Tang, Emily J Tsai, Bruce L Wilkoff
No abstract text is available yet for this article.
October 15, 2013: Circulation
https://www.readbyqxmd.com/read/23741057/2013-accf-aha-guideline-for-the-management-of-heart-failure-executive-summary-a-report-of-the-american-college-of-cardiology-foundation-american-heart-association-task-force-on-practice-guidelines
#12
Clyde W Yancy, Mariell Jessup, Biykem Bozkurt, Javed Butler, Donald E Casey, Mark H Drazner, Gregg C Fonarow, Stephen A Geraci, Tamara Horwich, James L Januzzi, Maryl R Johnson, Edward K Kasper, Wayne C Levy, Frederick A Masoudi, Patrick E McBride, John J V McMurray, Judith E Mitchell, Pamela N Peterson, Barbara Riegel, Flora Sam, Lynne W Stevenson, W H Wilson Tang, Emily J Tsai, Bruce L Wilkoff
No abstract text is available yet for this article.
October 15, 2013: Circulation
https://www.readbyqxmd.com/read/23465250/a-prospective-validation-of-the-heart-score-for-chest-pain-patients-at-the-emergency-department
#13
MULTICENTER STUDY
B E Backus, A J Six, J C Kelder, M A R Bosschaert, E G Mast, A Mosterd, R F Veldkamp, A J Wardeh, R Tio, R Braam, S H J Monnink, R van Tooren, T P Mast, F van den Akker, M J M Cramer, J M Poldervaart, A W Hoes, P A Doevendans
BACKGROUND: The focus of the diagnostic process in chest pain patients at the emergency department is to identify both low and high risk patients for an acute coronary syndrome (ACS). The HEART score was designed to facilitate this process. This study is a prospective validation of the HEART score. METHODS: A total of 2440 unselected patients presented with chest pain at the cardiac emergency department of ten participating hospitals in The Netherlands. The HEART score was assessed as soon as the first lab results and ECG were obtained...
October 3, 2013: International Journal of Cardiology
https://www.readbyqxmd.com/read/23247304/2013-accf-aha-guideline-for-the-management-of-st-elevation-myocardial-infarction-a-report-of-the-american-college-of-cardiology-foundation-american-heart-association-task-force-on-practice-guidelines
#14
Patrick T O'Gara, Frederick G Kushner, Deborah D Ascheim, Donald E Casey, Mina K Chung, James A de Lemos, Steven M Ettinger, James C Fang, Francis M Fesmire, Barry A Franklin, Christopher B Granger, Harlan M Krumholz, Jane A Linderbaum, David A Morrow, L Kristin Newby, Joseph P Ornato, Narith Ou, Martha J Radford, Jacqueline E Tamis-Holland, Carl L Tommaso, Cynthia M Tracy, Y Joseph Woo, David X Zhao, Jeffrey L Anderson, Alice K Jacobs, Jonathan L Halperin, Nancy M Albert, Ralph G Brindis, Mark A Creager, David DeMets, Robert A Guyton, Judith S Hochman, Richard J Kovacs, Frederick G Kushner, E Magnus Ohman, William G Stevenson, Clyde W Yancy
No abstract text is available yet for this article.
January 29, 2013: Circulation
https://www.readbyqxmd.com/read/23247303/2013-accf-aha-guideline-for-the-management-of-st-elevation-myocardial-infarction-executive-summary-a-report-of-the-american-college-of-cardiology-foundation-american-heart-association-task-force-on-practice-guidelines
#15
Patrick T O'Gara, Frederick G Kushner, Deborah D Ascheim, Donald E Casey, Mina K Chung, James A de Lemos, Steven M Ettinger, James C Fang, Francis M Fesmire, Barry A Franklin, Christopher B Granger, Harlan M Krumholz, Jane A Linderbaum, David A Morrow, L Kristin Newby, Joseph P Ornato, Narith Ou, Martha J Radford, Jacqueline E Tamis-Holland, Jacqueline E Tommaso, Cynthia M Tracy, Y Joseph Woo, David X Zhao
No abstract text is available yet for this article.
January 29, 2013: Circulation
https://www.readbyqxmd.com/read/23158526/pathogenesis-of-acute-coronary-syndromes
#16
REVIEW
Filippo Crea, Giovanna Liuzzo
Experimental models of atherogenesis have provided a growing body of information about molecular mechanisms of plaque growth; however, transition from coronary stability to instability is less well understood due to the lack of animal models reflective of human disease. The abrupt clinical presentation of acute coronary syndromes gives a strong signal of discontinuity in the natural history of atherothrombosis. The causes of such discontinuity are complex, probably multiple, and still largely unknown. A better knowledge of the causes of coronary instability might allow identification of new therapeutic targets aimed at the preservation of plaque stability in those subjects in whom primary prevention fails to prevent plaque growth...
January 8, 2013: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/21366472/diuretic-strategies-in-patients-with-acute-decompensated-heart-failure
#17
RANDOMIZED CONTROLLED TRIAL
G Michael Felker, Kerry L Lee, David A Bull, Margaret M Redfield, Lynne W Stevenson, Steven R Goldsmith, Martin M LeWinter, Anita Deswal, Jean L Rouleau, Elizabeth O Ofili, Kevin J Anstrom, Adrian F Hernandez, Steven E McNulty, Eric J Velazquez, Abdallah G Kfoury, Horng H Chen, Michael M Givertz, Marc J Semigran, Bradley A Bart, Alice M Mascette, Eugene Braunwald, Christopher M O'Connor
BACKGROUND: Loop diuretics are an essential component of therapy for patients with acute decompensated heart failure, but there are few prospective data to guide their use. METHODS: In a prospective, double-blind, randomized trial, we assigned 308 patients with acute decompensated heart failure to receive furosemide administered intravenously by means of either a bolus every 12 hours or continuous infusion and at either a low dose (equivalent to the patient's previous oral dose) or a high dose (2...
March 3, 2011: New England Journal of Medicine
https://www.readbyqxmd.com/read/20580877/rapid-progression-of-wellens-syndrome-in-the-emergency-department
#18
Brian Donahue, Shu B Chan, Steve Bhandarkar
BACKGROUND: In 1982, Wellens and colleagues described characteristic electrocardiogram (ECG) findings in angina patients virtually pathognomonic for significant stenosis of the proximal left anterior descending coronary artery and associated with a high risk of acute anterior wall myocardial infarction. CASE REPORT: We present the case of a 74-year-old emergency department patient with classic ECG findings of Wellens syndrome and progression to acute ST elevation within 55 min...
October 2012: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/20522282/association-of-the-ottawa-aggressive-protocol-with-rapid-discharge-of-emergency-department-patients-with-recent-onset-atrial-fibrillation-or-flutter
#19
Ian G Stiell, Catherine M Clement, Jeffrey J Perry, Christian Vaillancourt, Cheryl Symington, Garth Dickinson, David Birnie, Martin S Green
OBJECTIVE: There is no consensus on the optimal management of recent-onset episodes of atrial fibrillation or flutter. The approach to these conditions is particularly relevant in the current era of emergency department (ED) overcrowding. We sought to examine the effectiveness and safety of the Ottawa Aggressive Protocol to perform rapid cardioversion and discharge patients with these arrhythmias. METHODS: This cohort study enrolled consecutive patient visits to an adult university hospital ED for recent-onset atrial fibrillation or flutter managed with the Ottawa Aggressive Protocol...
May 2010: CJEM
https://www.readbyqxmd.com/read/18665203/chest-pain-in-the-emergency-room-value-of-the-heart-score
#20
A J Six, B E Backus, J C Kelder
BACKGROUND: Chest pain is one of the most common causes of presentation to the emergency room. The diagnosis of non-ST-elevation acute coronary syndrome typically causes uncertainty. Classical considerations for risk stratification are History, ECG, Age, Risk factors and Troponin (HEART). Each can be scored with zero, one or two points, depending on the extent of the abnormality. The HEART score is the sum of these five considerations. Methods. Clinical data from 122 patients referred to the emergency room for chest pain were analysed...
June 2008: Netherlands Heart Journal
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