Cardiology

5-Minute Journal Club: High-Sensitivity Cardiac Troponin and the Risk Stratification of Patients with Renal Impairment Presenting With Suspected Acute Coronary Syndrome

Jan 12, 20225-Minute Journal, Cardiology

Author: Dr. Eric Moyer Background: It is often difficult to interpret high-sensitivity cardiac troponin values in patients with renal impairment given the reduced clearance by the kidneys. This study attempts to quantify ways to risk stratify patients with renal impairment and suspected acute coronary syndrome using high-sensitivity cardiac troponins. Design: Prospective, multicenter study Inclusion: All…

5-Minute Journal Club: Electrocardiographic differentiation of early repolarization from subtle anterior ST-segment elevation myocardial infarction

Aug 8, 20215-Minute Journal, Cardiology, EKG

Author: Dr. Hans Murcia Background: Early repolarization, also known as J-point elevation, may present with ST segment elevations similar to STEMI on ECG. Given the risks and expense of activating the Cath lab for every patient with ST elevation, it is important to recognize true STEMI from early repolarization. Study Question: How can we use…

Atrial Fibrillation…in a Rush

Feb 11, 2021Cardiology

By Dr. Alexander Jay PGY2 Basics Atrial fibrillation is defined as an irregularly irregular rhythm, in which there are many irritable atrial foci firing all at once. Although many atrial foci are firing at once, the AV node is still at peak function and only allows a set number of beats to pass through (the…

5 Minute Journal: Duration of ECG Monitoring in Emergency Department Patients with Syncope

Oct 15, 20205-Minute Journal, Cardiology

Author: Dr. Tucker Matthews Background Lots of patients in the ED present after a syncopal episode, but we don’t do a good job of choosing which patients need further monitoring and/or admission. We have risk stratification tools, but they don’t really tell us what to do with high risk or medium risk or low risk…

Non-emergent Hypertension

Feb 6, 2020Cardiology

“Doctor, this patient’s blood pressure is 184/101, do you want to do anything about it?” 1 of every 3 adults in the United States has high blood pressure.1 Because of this, hypertension is something we see constantly in the ED, from incidentally noted hypertension in patients presenting with other complaints to patients coming to the…

Aortic Dissection

Jan 21, 2020CardiologyCardiovascular

Intro We had an awesome lecture by Dr. K Gore this past week–this blog is a quick review of her lecture on aortic dissection. Background An aortic dissection (AD) is a tear into the intimal layer of the aortic wall. It is commonly described as a “tearing” chest pain that radiates to the back–which is…

Acute Valvular Emergencies

Jan 16, 2020CardiologyCardiovascular

Author: Dr. Catherine Buckley

When I think of patients with valvular disease in the setting of the emergency department, it is frequently the acute on chronic picture. For instance: the Aortic stenosis patient with significant worsening of their fluid overload symptoms because of sepsis. What I typically don’t imagine is diagnosing or treating brand new valvular emergencies. Thank goodness for didactics! We are going to briefly review acute Mitral Regurgitation and acute Aortic regurgitation based on a wonderful talk given by Dr. Yelena Dukarevich.

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Left Ventricular Assistance Device (LVAD)

Nov 1, 2019CardiologyCardiovascular

Author: Dr. Catherine Buckley

Alright. LVADs. First thing is first- use a lifeline and phone a friend. Call the patient’s VAD coordinator. Patient may have a card that they are able to give you… but if the patient is otherwise incapacitated, look for a tag on their controller.

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5 Minute Journal: BNP & Clinical Judgment in Diagnosing Heart Failure

Sep 5, 20195-Minute Journal, Cardiology5 Minute Journal Article, Cardiovascular

Author: Dr. William McDowell

Background

This blog posts looks at the article “B-Type Natriuretic Peptide and Clinical Judgment in Emergency Diagnosis of Heart Failure” (2002)

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NSTEMI, STEMI, ACS

Aug 31, 20192 CommentsCardiologyCardiovascular

Author: Catherine Buckley MD There are about 8 – 10 million ED visits with the chief complaint of chest pain per year in the US. (Owens et al.)10 billion dollars are spent on chest pain, 10% of which goes to the work up for ACS diagnosis. Yet somehow despite these millions we still miss 1-2%…