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Cardiology

Coronary Angiography after Cardiac Arrest without ST-Segment Elevation

2019-10-07
By: Hans Rosenberg
On: October 7, 2019
In: cardiac arrest, Cardiology, Journal Club, Resuscitation

Methodology Score: 4.5/5 Usefulness Score: 3.5/5 Lemkes JS, et al. N Engl J Med. 2019 Apr 11;380(15):1397-1407. Editorial: Coronary Angiography after Cardiac Arrest – The Right Timing or the Right Patients? Question and Methods: Patients with out-of-hospital cardiac arrest (OHCA) and shockable rhythm, but without STEMI on ECG following ROSCRead More →

Early or Delayed Cardioversion in Recent-Onset Atrial Fibrillation

2019-06-24
By: Hans Rosenberg
On: June 24, 2019
In: Cardiology, Journal Club

Journal Club Summary Methodology Score: 4/5 Usefulness Score: 2/5 Pluymaekers NAHA, et al. N Engl J Med. 2019 Mar 18.  Editorial: The RACE to Treat Atrial Fibrillation in the Emergency Department.  Question and Methods: This multicenter, randomized, open-label, non-inferiority trial compared delayed vs early cardioversion for emergency department patients withRead More →

Canadian Syncope Risk Score – Duration of Cardiac Monitoring

2019-02-06
By: Venkatesh Thiruganasambandamoorthy
On: February 6, 2019
In: Cardiology, Featured, Infographics

Syncope constitutes 1% of Emergency Department (ED) visits, and approximately 10% of these patients will have serious underlying conditions causing syncope (arrhythmia, MI, serious structural heart disease, pulmonary embolism, subarachnoid or severe hemorrhage). Alarmingly, half to one-third of these serious conditions will not be identified during ED evaluation. We previously derived theRead More →

Does Point-of-Care Ultrasonography Improve Clinical Outcomes in Emergency Department Patients With Undifferentiated Hypotension? An International Randomized Controlled Trial From the SHoC-ED Investigators

2019-01-07
By: Hans Rosenberg
On: January 7, 2019
In: cardiac arrest, Cardiology, Critical Care, Journal Club, Resuscitation, Ultrasound

Journal Club Summary Methodology Score: 3/5 Usefulness Score: 2/5 Atkinson PR, et al. Ann Emerg Med. 2018 Oct;72(4):478-489 Question and Methods: This was the first multicenter, prospective, RCT examining the effect of POCUS on 30-day survival of undifferentiated hypotensive patients presenting to ED. Findings: There was no important survival benefit with theRead More →

Epinephrine

A Randomized Trial of Epinephrine in Out-of-Hospital Cardiac Arrest.

2018-10-29
By: Hans Rosenberg
On: October 29, 2018
In: cardiac arrest, Cardiology, Critical Care, Journal Club, Resuscitation

Journal Club Summary: A Randomized Trial of Epinephrine in Out-of-Hospital Cardiac Arrest Methodology Score: 4/5 Usefulness Score: 3.5/5 Perkins GD, et al N Engl J Med. 2018 Jul 18. Editorial:  Testing Epinephrine for Out-of-Hospital Cardiac Arrest. Callaway CW, et al. N Engl J Med. 2018 Jul 18. Question and Methods: Multicenter, randomized,Read More →

Congenital Cardiac Disease in the ED

2018-08-30
By: Shahbaz Syed
On: August 30, 2018
In: Cardiology, Featured, Grand Round Summaries

Let’s start off with a case: 29 year old male, HR: 140, BP: 70/40, Temperature of 39.1. Sounds like straight forward, bread-and-butter emergency medicine doesn’t it? That is, until you look at the past medical history: Single Ventricle Hypoplastic RV Left AV Valve Atresia Large Ventricular Septal Defect Patent FormalRead More →

creatine kinase

Creatine Kinase: Antiquated Relic or useful adjunct in Diagnosing Acute Coronary Syndrome?

2018-08-02
By: Daniel Beamish
On: August 2, 2018
In: Cardiology, Featured, Grand Round Summaries, Quality Improvement

Chest pain is a common presenting complaint to Emergency Departments (ED) worldwide. Massive resource investment is required to differentiate benign from sinister causes of chest pain, and for the treatment, referral, and risk stratification of chest pain patients.  A cardiac etiology of chest pain is found in roughly 15% ofRead More →

Diagnostic Accuracy of the Aortic Dissection Detection Risk Score Plus D-Dimer for Acute Aortic Syndromes: The ADvISED Prospective Multicenter Study

2018-06-18
By: Hans Rosenberg
On: June 18, 2018
In: Cardiology, Cardiothoracic Surgery, Journal Club

Methodology Score: 3/5 Usefulness Score: 3/5 Nazerian P, et al. Circulation. 2018 Jan 16;137(3):250-258.  Editorial – Biomarker-Assisted Diagnosis of Acute Aortic Dissection. Question: The ADvISED trial was an International Multicenter prospective observational study of  a novel diagnostic strategy that integrated the Aortic Dissection Detection Risk Score (ADD-RS) and D-Dimer in an ED population to rule outRead More →

afib

An Update: Rate Control in Atrial Fibrillation

2018-04-26
By: Harrison Carmichael
On: April 26, 2018
In: Cardiology, Featured, Grand Round Summaries

In this post, we will discuss updates and controversies surrounding rate control in Afib, specifically we will: Review the new 2017 CAEP Afib best practices guidelines Review Tachycardia Induced Cardiomyopathy Review Afib and Type 2 ACS Discuss the identification and management of secondary Afib 2017 CAEP AAF Best Practices GuidelineRead More →

Efficacy of High-Sensitivity Troponin T in Identifying Very-Low-Risk Patients With Possible Acute Coronary Syndrome.

2018-04-09
By: Hans Rosenberg
On: April 9, 2018
In: Cardiology, Journal Club

Journal Club Summary Methodology: 3.5/5           Usefulness: 3/5 Peacock WF, et al. JAMA Cardiol. 2017 Dec 13 EDITORIAL: The Wait for High-Sensitivity Troponin Is Over-Proceed Cautiously Korley FK. JAMA Cardiol. 2017 Dec 13 Question and Methods: This prospective, observational, multicenter study evaluated if a negative hsTnt assay at 0h and 3h post EDRead More →

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