Archive

Medical Category: Cardiovascular

GRACE Guidelines: A Pragmatic Approach to Recurrent Low-Risk Chest Pain

In the United States, a patient with chest pain presents to the emergency department (ED) every 5 seconds. By the time you finish reading this post, 60 patients will have sought treatment for chest pain. In 2017, chest pain was …

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Cardiovascular

The REALITY Trial: Restrictive vs Liberal Blood Transfusion in Patients with AMI and Anemia

Background: Transfusion thresholds for anemia have large variations in clinical practice.  This is especially true in patients with acute myocardial infarction (AMI).  Part of the reason for this is the lack of high-quality data.  There was a large, randomized trial …

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Cardiovascular

I Love Me Some High-Dose NTG and NIV for SCAPE

Background: Hypertensive acute heart failure is a subgroup of acute congestive heart failure (CHF) patients.  Physiologically there is increased afterload and decreased venous capacitance both leading to fluid shifts resulting in pulmonary vascular congestion.  Sympathetic crashing acute pulmonary edema (SCAPE) …

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Cardiovascular

External Validation of the Canadian Syncope Risk Score

Background Information: The Canadian Syncope Risk Score (CSRS) is one of several clinical decision tools used in the emergency department (ED) following a syncopal episode. (Figure 1) It was derived from one of the largest datasets currently available and its …

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Cardiovascular

Thromboembolic Events After Cardioversion of Acute Atrial Fibrillation and Flutter: Should we Anticoagulate?

Background: Atrial fibrillation and atrial flutter are two of the most common dysrhythmias seen in the emergency department (ED). Rarely does a shift go by that you don’t see one or the other. For decades, there has been a debate …

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CardiovascularNeurology

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