Cardiovascular Archives - The Emergency Medical Minute

Cardiovascular

Podcast 783: LAD Occlusion & Troponin

Contributor: Jared Scott, MD Educational Pearls: A study randomized 34 healthy patient to have their left anterior descending artery (LAD) occluded by balloon for 0, 15, 30, or 90 seconds   Subsequently,  cardiac troponins (cTns) and Copeptin were measured every 15 minutes for 3 hours, then every 30 minutes for the next 3 hours 5 conclusions…

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On the Streets #13: Pre-hospital Cardiology Concepts

On this episode of On the Streets, our host, Jordan Ourada, talks with cardiologist, Dr. Chirag Chauhan, about all things cardiac. Highlighted topics: Wrist versus femoral access in the cath lab The most important prehospital interventions for an MI Nitroglycerin: Who gets it and what are the precautions Lidocaine and amiodarone in a heart attack…

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Podcast 773: Atrial Fibrillation Medications

Contributor: Aaron Lessen, MD Educational Pearls: Atrial fibrillation is an irregular heart rhythm that sometimes requires rate control in setting of rapid ventricular response (RVR) Calcium channel blocker and beta blockers are the most frequently used medications to block the AV node and slow down the heart rate in atrial fibrillation with RVR If a…

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Podcast 771: Intubation in Cardiac Arrest

Contributor: Don Stader, MD Educational Pearls: In a secondary analysis of the PART trial, the mortality effect of timing of airway management for patients in cardiac arrest was examined Study looked at whether timing played a part in both laryngeal tube placement or endotracheal intubation during cardiac arrest Did not find any association of timing…

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Podcast 769: Pressors After Cardiac Arrest

Contributor: Aaron Lessen, MD Educational Pearls: Hypotension after cardiac arrest often requires a vasopressor to improve blood pressure Recent observational study from France examined outcomes of patients who received either epinephrine or norepinephrine for post-resuscitation shock Norepinephrine had significantly better outcomes  Death from shock was 35% in the epinephrine group vs. 9% in the norepinephrine…

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Podcast 768: Takotsubo Cardiomyopathy

Contributor: Peter Bakes, MD Educational Pearls: 3% of cases of acute coronary syndrome are due to Takotsubo Takotsubo  cardiomyopathy or “broken heart syndrome” can occur with severe physiologic or emotional stressors, as these events can result in a profound outpouring of sympathetic neurotransmitters (epinephrine/norepinephrine) Receptors for these catecholamines are very dense around the apex of…

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Podcast 762: Endocarditis

Contributor: Jared Scott, MD Educational Pearls: Variability of organisms in infecting the myocardial valves Duke Criteria for Infective Endocarditis includes three categories that can be used to definitively diagnose endocarditis Pathologic Criteria pathological evidence of infection Major Clinical Criteria positive blood cultures positive echocardiogram findings (TEE is more sensitive than a TTE) Minor Clinical Criteria…

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Podcast 759: Hyperkalemia and Myth of Kayexalate

Contributor: Nick Tsipis, MD Educational Pearls: Acute hyperkalemia is characterized as serum K of 5.4 or higher in non-hemolyzed samples Hyperkalemia is commonly associated with end stage renal disease, acute kidney injury or acute renal failure Cardiac dysrhythmias are the primary concern with hyperkalemia, common EKG changes (and approximate serum levels) can include: Peaked T…

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Podcast 744: Glucagon for Beta Blocker Toxicity

Educational Pearls: Glucagon can be used to treat hypoglycemia and esophageal foreign body, but it can also be used in beta-blocker toxicity to bypass cardiac beta-blockade The superior option for treating bradycardia due to beta-blocker toxicity is glucagon Glucagon has decreased efficacy in patients with heart failure, so increased doses up to 10 mg might…

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Podcast 742: Pulse Check During CPR

  Contributor: Aaron Lessen, MD Educational Pearls: Pulse checks are necessary during CPR to check for return of spontaneous circulation (ROSC) Previous studies have shown that assessing ROSC with palpating for pulse are not a very consistent Study compared palpating pulses at carotid/femoral artery versus a newly contrived gold standard for pulse checks The gold…

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