Cardiovascular Archives - The Emergency Medical Minute

Cardiovascular

Podcast 845: Hyperkalemic Cardiac Arrest

Contributor: Aaron Lessen, MD Educational Pearls: Hyperkalemia may cause cardiac arrest  Treatment of suspected hyperkalemic cardiac arrest begins with typical management of cardiac arrest including high-quality CPR, defibrillation if appropriate, and resuscitation medications  Administer calcium products to stabilize cardiac membrane and potassium shifting medications  If ROSC is achieved, initiate dialysis  There are several case reports…

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Podcast 843: Commotio Cordis

Contributor: Jared Scott, MD Educational Pearls: Commotio cordis is sudden ventricular fibrillation precipitated by direct impact to the chest  A national registry, US Commotio Cordis Registry, reports an average of 10-20 cases annually  95% of reported cases occur in males, indicating possible genetic component  Average age of patient in registry is 15  Most cases occur during…

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Podcast 836: Humming to get EJ

Contributor: Jared Scott, MD Educational Pearls: Two conventional ways to aid in external jugular vein (EJ) catheter placement are Trendelenburg’s position and Valsalva’s maneuver by patient  One study compared ultrasound visualization of cross sections of EJ and common femoral vein at baseline and with patients in Trendelenburg’s position, Valsalva’s maneuver, and while humming The study…

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Podcast 835: Syncope Review

Contributor: Meghan Hurley, MD Educational Pearls: Syncope is defined as a loss of consciousness with an immediate return to baseline Differential is broad Cardiogenic Structural (aortic stenosis, HOCUM, etc.) Electrical (long QT syndrome, Brugada, etc.) Neurogenic/neurovascular (brain bleed, etc.) Seizure Everything else Hypoglycemia, anemia, and bleeding into the abdominal cavity are some potential causes to…

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Podcast 826: STEMI Equivalents

Contributor: Travis Barlock, MD Educational Pearls: The presence of a STEMI has traditionally been used to determine if a patient with acute chest pain requires urgent cath lab management STEMI indicates an occluded coronary artery, and urgent intervention is needed to restore perfusion to ischemic tissue Patients with occluded coronary arteries can present with EKG…

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Podcast 821: EKGs in Syncope

Contributor: Travis Barlock, MD Educational Pearls: An EKG should be obtained quickly after a syncopal event to identify possible life-threatening causes such as ischemia and arrhythmia WOBBLER is a good mnemonic for remembering additional EKG findings to look for in syncope  Wolff-Parkinson-White (WPW) Check for delta wave on QRS Obstructed AV node Any potential heart…

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Podcast 817: MI Risk during Elections

Contributor: Aaron Lessen, MD Educational Pearls: 2020 retrospective study with dat from two California hospitals compared rates of cardiovascular admissions in a five day period two weeks before and the five days after the presidential election      Hospitalization rate for acute cardiovascular disease increased by 17% and rate of acute myocardial infarction increased by 42%    Highest…

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Podcast 813: Pulse Oximetry

Contributor: Travis Barlock, MD Educational Pearls: Most oxygen in the body is bound to hemoglobin, forming oxyhemoglobin. Less than 1% of the oxygen in the body is dissolved in plasma.  Pulse Oximeters (Pulse Ox) function by emitting wavelengths of light from one side, and capturing the amount absorbed on the opposite side. A calculation determined…

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Back From The Dead

Back from the Dead Chief Complaint: Chest Tightness HPI: 55-year-old male reporting chest tightness 8 out of 10 that began right before getting in the shower just prior to arrival to the ED, has been persistent and is now at a 5 out of 10. He took some aspirin but nothing else to treat it,…

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Podcast 806: Normal ECGs

Contributor: Jarod Scott, MD Educational Pearls: Physicians are typically advised not to trust computer interpretation of ECGs  Retrospective study was done of computer interpreted normal ECGs to evaluate the accuracy of such an interpretation 989 ECGs were interpreted as “Normal sinus rhythm, Normal ECG” by proprietary cardiology software on MUSE Cardiology Information System These EKGs…

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