Archive

Medical Category: Cardiovascular

Chest Pain, "Negative" Stress Tests, POCUS, & ECG Equations

I was working a busy shift in the ED, like many of us do, and the next patient I was going to see was a 57 year old male with no real medical problems complaining of chest pain.  I remember …

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Cardiovascular

The BEST AF Trial: What is the Optimal Energy Selection for Cardioversion in Patients with Afib?

Background:There are two trains of thought in using transthoracic direct current cardioversion (DCCV) when it comes to converting atrial fibrillation.  The first is an escalating energy approach which allows cardioversion to occur at the lowest energy for each individual patient …

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Cardiovascular

(Dis)utility of Orthostatics in Volume Depletion

Definition: Orthostatic hypotension (OH) is a form of low blood pressure that occurs with positional change (i.e. sitting up from lying down, standing up from sitting). It is commonly used for the diagnosis of volume depletion Orthostatic Vital Signs A …

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Cardiovascular

More Trials Showing Harm of Opioids in ACS…or do They?

Background: Typical medical treatment of ACS patients include dual antiplatelet therapy (DAPT) and revascularization with primary percutaneous coronary intervention (PPCI).  Nitroglycerin is first line therapy in the treatment of pain in ACS with morphine as a common adjunct. Morphine helps …

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Cardiovascular

Door to Furosemide (D2F) in Acute CHF…Really?

Background: Acute congestive heart failure (AHF) is a common complaint seen in the ED and associated with a high morbidity, mortality, cost, and resources.  Many patients with AHF, ultimately end up being admitted and interventions in the ED can make …

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Cardiovascular

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