Archive

Medical Category: Cardiovascular

REBEL Core Cast 113.0 – ACS Therapies and Management

Take Home Points: All STEMIs should be loaded with dual antiplatelet therapy. Prasugrel (Effient) is avoided as there is an increase in bleeding complications if the patient requires a CABG. NSTEMI cases can be challenging to manage. Consult Cardiology early …

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Cardiovascular

Hydroxycobalamin vs Methylene Blue for Vasoplegic Shock from Cardiopulmonary Bypass

Background Information: Vasoplegic shock is defined as hypotension with normal or increased cardiac output and can commonly occur in post-cardiac surgery patients having received cardiopulmonary bypass. This dysregulation of vasodilation is associated with a mortality of close to 25%. After …

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CardiovascularResuscitation

REBEL Core Cast 111.0 – Cardiac Testing

Take Home Points: A CCTA is an anatomic test to determine if a patient has normal coronary arteries, non-obstructive disease, or obstructive disease. The warranty period for a CCTA is anywhere from 3-10 years depending on the characteristics of the …

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Cardiovascular

STREAM-2: Half-Dose Tenecteplase vs Primary PCI in Older Patients with STEMI?

Background: Primary PCI is the recommended reperfusion strategy in patients with STEMI and should be initiated within 2 hours after first medical contact.  In non-PCI-capable hospitals this goal is not always achievable due to delays in transfer.  In these cases, …

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Cardiovascular

Clinical Conundrum: Should a Troponin Routinely be Ordered in Patients with SVT?

Bottom Line Up Top: Troponins should not be routinely sent in patients presenting with SVT. Rarely, they may be necessary if the patient has concerning ischemic symptoms that persist after conversion to sinus rhythm. Clinical Scenario: A 44-year-old man presents …

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Cardiovascular

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