Archive

Medical Category: Cardiovascular

REBEL Cast Ep123: Reduced-Dose Systemic Peripheral Alteplase in Massive PE?

Background: Massive pulmonary embolism  defined as sustained hypotension (SBP <90mmHg)  has a high mortality which is why early recognition and thrombolytic therapy is typically recommended (AHA Class IIA; ESC Class IB) . However, full-dose thrombolytic therapy (Alteplase 100mg (IV) is  associated ...

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CardiovascularResuscitationThoracic and Respiratory

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

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