Medical Category: Cardiovascular

The ACTION Trial: DOACs in Hospitalized Patients with COVID-19

Background: Patients hospitalized with COVID-19 are at increased risk for both arterial and venous thromboembolic disease. Multiple recent trials have investigated the efficacy of therapeutic or standard prophylactic anticoagulation in preventing thrombotic complications among patients with COVID-19 in a variety …

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CardiovascularInfectious DiseaseThoracic and Respiratory

The MICHELLE Trial: Anticoagulation Post-Discharge in Patients Hospitalized Secondary to COVID-19

Background: Patients diagnosed with COVID-19 have an increased risk of thromboembolic events, including pulmonary embolism and deep vein thrombosis (DVT). In addition, COVID-19 patients with increased coagulation parameters such as D-dimer, fibrin degradation products, prothrombin time, and activated partial thromboplastin …

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CardiovascularHematology and OncologyInfectious DiseaseThoracic and Respiratory

The Pragmatic Combination of YEARS Score and Age-Adjusted D-Dimer

Background: The optimal approach to risk stratifying patients for pulmonary embolism (PE) remains elusive. Multiple decision instruments are available with varying degrees of complexity and acceptance among emergency medicine clinicians (Wells, Geneva, PERC, YEARS, age-adjusted D-dimer). The 2018 ACEP clinical …

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CardiovascularHematology and OncologyThoracic and Respiratory

The Modified Valsalva Maneuver: Head Down, Legs Up

Background: Supraventricular tachycardia (SVT) is not an uncommon presentation to the emergency department. A common first-line therapy for hemodynamically stable SVT is the standard Valsalva maneuver (sVm) but it has a low success rate (5-20%). After failed conversion to normal …

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Posterior Occlusion Myocardial Infarctions and STDmaxV1-4

Background: Not all occlusion myocardial infarctions (OMIs) present with classic ST-segment elevation (We have covered this on REBEL EM Before HERE, HERE, and HERE). OMIs of the “posterior” and “lateral” walls are the most commonly missed, with >50% of left …

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