Category Archives: Cardiology

Validation of San Francisco Syncope Rule

Summarized By Raviraj Patel, MD Source: Quinn J, McDermott D, Stiell I “Prospective Validation of the San Francisco Syncope rule to Predict Patients With Serious Outcomes.” Annals of Emergency Medicine, Vol 47, No. 5: May 2006 Intro Syncope accounts for … Continue reading

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TCA Overdose

By Christie Lech, MD Please refer to EMRAP Classically, you see a wide QRS complex and a tall R wave in aVr (elevation in the terminal 40 msec of aVr) Treatment of your sick, dying TCA overdose patient – lots … Continue reading

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ACS Updates

By Amy Sanghvi, MD Please refer to EMRAP Updated UA on NSTEMI guidelines. Focused update from Guidelines from 2007. Done to focus on new issues relative to antiplatelet medications: Ticagralor and Prasugrel (Effient). Many using Prasugrel instead of clopidogrel. P2Y12 … Continue reading

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Posterior MI: The Dark Side of the Moon

Goreselen et al. Neth Heart J. 2007 January; 15(1): 16–21. By Vincent Roddy, MD Background: True posterior MI is difficult to recognize bc the leads of the standard EKG are not a direct representation of the area involved.   Only with indirect changes … Continue reading

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Post Cardiac Arrest Syndrome: a review of therapeutic strategies

Stub D, Bernard S, Duffy SJ, Kaye DM. Circulation. 2011 Apr 5; 123(13):1428-35   By Felipe Teran, MD   Article capsule The significant morbidity and mortality associated with patients who survive to an Out-of-Hospital Cardiac Arrest (OHCA) has driven the … Continue reading

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LBBB and Sgarbossa Criteria

By Christie Lech, MD Please refer to EMRAP Current recommendations for acute reperfusion treatment: Patient presenting with chest pain or other concerning symptoms Patient with a STEMI on EKG, a STEMI equivalent i.e. posterior MI, new or presumed new LBBB, … Continue reading

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Coronary CT’s for low-risk chest pain patients in the ED

By Will Fleischman, MD Refer to SMARTEM General comments Coronary CT and coronary angiography are anatomical tests and say nothing of the clinical significance of whatever it finds. And angiography has been made the gold standard without ever having been … Continue reading

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ACS in Women

By Christie Lech, MD Please refer to EMRAP Episode ACS in Women Younger women are at higher risk for surprising presentations of MI (compared to older, post-menopausal women) Younger (not older) women present differently than men Variables examined in the … Continue reading

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C3: CHF A Rapid Review

By Christie Lech, MD Please Review August EMRAP – C3: CHF Heart failure – inability of the heart to maintain sufficient perfusion to maintain adequate organ function Congestive heart failure – heart failure that results in abnormal fluid accumulation Increase … Continue reading

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Early Repol vs STEMI

By Kei Ko, MD EKG differentiation of early repolarization from subtle anterior STEMI By Smith, S et al. Annals of EM, vol. 60:1, pages 45-56, July 2-12 Objective Differentiating anterior STEMI from early repolarization. Authors hypothesized that ST-segment elevation, T-wave … Continue reading

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