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Total 378 results found since Jan 2013.
The Wheat Belly lifestyle BEGAN with heart health
Debbie posted this comment on the Wheat Belly Facebook page:
“I posted a few weeks back about our scare from our primary care doctor. My husband had a calcium score of 1200. We panicked! Messaged Dr. Davis and went the next day to a cardio doctor and had a stress test, ultrasound, and blood test (inflammatory markers). Got him on recommended supplements per Dr Davis.
“Latest update: Cardio doctor says, being as you started ‘Wheat Belly’ back in October, 2014, your score could have been higher and already started to improve, we don’t know. What we DO know is, because of this new way of eating,...
Source: Wheat Belly Blog - September 15, 2015 Category: Cardiology Authors: Dr. Davis Tags: Wheat Belly Lifestyle calcium score cholesterol fish oil gluten grains heart disease iodine Thyroid vitamin D Weight Loss Source Type: blogs
Research and Reviews in the Fastlane 099
This study took a sample from healthy pregnant patients (n=760) at different stages of gestation. They found, unsurprisingly, that d-dimer increases with gestational age, congruent with limited prior literature. They propose a continuous increasing d-dimer in pregnancy. With PE experts such as Dr. Kline proposing gestation adjusted d-dimer, this is a research space to watch.
Recommended by: Lauren Westafer
Systems and administration
Del Portal DA, et al. Impact of an Opioid Prescribing Guideline in the Acute Care Setting. J Emerg Med 2015. PMID: 26281819
As many EDs implement voluntary opioid prescribing guidelines, this...
Source: Life in the Fast Lane - September 9, 2015 Category: Emergency Medicine Authors: Nudrat Rashid Tags: Anaesthetics Cardiology Education Emergency Medicine Haematology Intensive Care critical care literature R&R in the FASTLANE recommendations research and reviews Source Type: blogs
Low HEART score. Acute LAD occlusion. Detected only by analysis of subtle ECG.
A completely healthy 39 year old woman with no cardiac risk factors had sudden onset of bilateral trapezius pain that radiated around to her throat. It resolved after about 5 minutes, but then recurred and was sustained for over an hour. She called 911. EMS recorded these ECGs:Time 0:In V2-V4, there is ST elevation that does not meet STEMI "criteria," of 1.5 mm at the J-point, relative to the PQ junction. But there are also unusually Large T-wavesTime = 13 minT-wave in V2 is now taller and fatter, the ST segment is more straight.T-wave in V3 is no taller, but it is fatter due to a straighter ST segmentThi...
Source: Dr. Smith's ECG Blog - September 8, 2015 Category: Cardiology Authors: Steve Smith Source Type: blogs
Functional assessment of coronary lesion – Cardiology MCQ
Functional assessment of severity of coronary lesion is best done using:
a) Optical coherence tomography
b) Coronary angiography
c) Intravascular ultrasound
d) Fractional flow reserve
Correct answer: d) Fractional flow reserve
Fractional flow reserve (FFR) of less than 0.8 as measured by a Doppler wire during maximal coronary hyperemia induced by intracoronary or intravenous adenosine is taken as the cut off level of functional significance of a coronary stenosis. FAME [1] and FAME II [2] trials have established the clinical utility of FFR, which is now accepted as standard of care. FFR is especially useful in those who ha...
Source: Cardiophile MD - July 23, 2015 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Angiography and Interventions Cardiology MCQ Coronary Interventions DM / DNB Cardiology Entrance Source Type: blogs
Emergency Transvenous Cardiac Pacing
This case was provided by one of our fine 5th year EM/IM residents, Rachael Krob MD. The description of the method for inserting a pacing wire is by one of our fine 3rd year EM residents, Mark Sandefur MD.CaseAn elderly male was found on the floor with altered mental status. When EMS arrived, he was obtunded but occasionally able to answer yes/no questions. He was found to be bradycardic in the 20's-30’s. Glucose was normal. A prehospital 12-lead was recorded; unfortunately, only half of it made it into the chart:There is a slow indeterminate rhythm with a right bundle branch block morphology. The medics repo...
Source: Dr. Smith's ECG Blog - July 21, 2015 Category: Cardiology Authors: Steve Smith Source Type: blogs
Emergency Physicians Must Make the Tough Decisions
This recent case, which occurred within the past year, was sent to me by an unnamed 2nd year EM resident. She says she is a believer in all things FOAM!As this case could have been managed better, she will remain anonymous. But rather than being critical of the management, just try to learn from it.Case presentation:A middle-aged woman with a history of vascular disease presented to a community Emergency Department after an episode of syncope. She complained of 24 hours of severe chest pain radiating to her back, and epigastric abdominal pain. Initial vital signs were BP 128/85, HR 122, RR 22 and O2 saturation ...
Source: Dr. Smith's ECG Blog - June 12, 2015 Category: Cardiology Authors: Steve Smith Source Type: blogs
LITFL Review 183
Welcome to the 183rd LITFL Review. Your regular and reliable source for the highest highlights, sneakiest sneak peeks and loudest shout-outs from the webbed world of emergency medicine and critical care. Each week the LITFL team casts the spotlight on the blogosphere’s best and brightest and deliver a bite-sized chuck of FOAM.
The Most Fair Dinkum Ripper Beauts of the Week
The Emergency Medicine Educator’s Conference (EMEC) posted the first of its conference videos. Dan Boden shares Derby’s ideas and success on teaching the whole department. Plenty of food for thought….. [SL]
The Best of #FOAMed Emer...
Source: Life in the Fast Lane - May 24, 2015 Category: Emergency Medicine Authors: Marjorie Lazoff, MD Tags: Education LITFL review Source Type: blogs
Atrial Septal Defect (ASD)
Atrial septal defect (ASD) is one of the commonest congenital heart diseases in the adult. It is a defect in the septum separting the two upper chambers of the heart. The defect in the septum between right and left atrium can be in various locations. The commonest variety which occurs almost in the centre is known as ostium secundum type. If it occurs at the lower end, it is called ostium primum variety. Ostium primum defect is often associated with a cleft of the mitral valve and leakage of the mitral valve (mitral regurgitation). There is another type of defect known as sinus venosus ASD. Sinus venosus ASD can occur ne...
Source: Cardiophile MD - April 24, 2015 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: General Cardiology Source Type: blogs
Research and Reviews in the Fastlane 080
This study calls into question the current guidelines and will hopefully lead to more evidence-based recommendations in the future.Recommended by: Zack RepanshekRead More: Antibiotics for community-acquired pneumonia: Is azithromycin out? (Pulm CCM)The Best of the RestOphthalmology, Ultrasound Vrablik ME et al. The diagnostic accuracy of bedside ocular ultrasonography for the diagnosis of retinal detachment: a systematic review and meta-analysis. Ann Emerg Med 2015; 65(2):199-203. PMID: 24680547Nice meta-analysis of bedside US for retinal detachment in Annals of EM showing 97-100% sensitivity, 83-100% specificity, based...
Source: Life in the Fast Lane - April 23, 2015 Category: Emergency Medicine Authors: Anand Swaminathan Tags: Cardiology Education Emergency Medicine Infectious Disease Intensive Care Ophthalmology Psychiatry and Mental Health Resuscitation Trauma critical care R&R in the FASTLANE recommendations research and reviews Source Type: blogs
ED Syncope Workup: After H and P, ECG is the Only Test Required for Every Patient.....
Conclusions: Many unnecessary tests are obtained to evaluate syncope. Selecting tests based on history and examination and prioritizing less expensive and higher yield tests would ensure a more informed and cost-effective approach to evaluating older patients with syncope._____________________________________________________________________________4) Reed MJ. The ROSE (Risk Stratification of syncope in the emergency department) Study. J Am Coll Cardiol, 2010; 55:713-721, doi:10.1016/j.jacc.2009.09.049 Objectives: The aim of this study was to develop and validate a clinical deci...
Source: Dr. Smith's ECG Blog - April 8, 2015 Category: Cardiology Authors: Steve Smith Source Type: blogs
Emergency Department Syncope Workup: After H and P, ECG is the Only Test Required for Every Patient.....
Conclusions: Many unnecessary tests are obtained to evaluate syncope. Selecting tests based on history and examination and prioritizing less expensive and higher yield tests would ensure a more informed and cost-effective approach to evaluating older patients with syncope._____________________________________________________________________________4) Reed MJ. The ROSE (Risk Stratification of syncope in the emergency department) Study. J Am Coll Cardiol, 2010; 55:713-721, doi:10.1016/j.jacc.2009.09.049 Objectives: The aim of this study was to develop and validate a clinical deci...
Source: Dr. Smith's ECG Blog - April 8, 2015 Category: Cardiology Authors: Steve Smith Source Type: blogs
From Scott Weingart EMCrit Interview: Who needs the Cath Lab now??
Who Needs the Cath Lab/Cards Consult?Here is the podcast of Scott's Interview with me . (some of this gets distorted in MS internet explorer)FirstActivate the Lab for unambiguous STEMI (only clear STEMIs have a 90 minute CMS mandate)Get Cardiology or Interventional Consultation for more complicated cases: difficult ECGs, subtle ST elevation, ST depression with ongoing symptoms, STEMI "Equivalents.This requires a systematic approach, with buy-in from Cardiology, that they will respond immmediately to such requests for help. What do they get out of it? Fewer false positive activations and more activatio...
Source: Dr. Smith's ECG Blog - March 29, 2015 Category: Cardiology Authors: Steve Smith Source Type: blogs
LITFL Review 168
Welcome to the 168th LITFL Review. Your regular and reliable source for the highest highlights, sneakiest sneak peeks and loudest shout-outs from the webbed world of emergency medicine and critical care. Each week the LITFL team casts the spotlight on the blogosphere’s best and brightest and deliver a bite-sized chuck of FOAM.The Most Fair Dinkum Ripper Beauts of the Week Those awesome Swedes. Not only do they host an excellent emergency ultrasound conference (SonoSweden), they livestream it free, and then save all the archives for all to see. That’s hours and hours of FREE ultrasound tutorial videos featuring Matt...
Source: Life in the Fast Lane - February 9, 2015 Category: Emergency Medicine Authors: Marjorie Lazoff, MD Tags: Education LITFL review Source Type: blogs
What is current status of self expanding coronary stents?
Originally used in early 1990s, self expanding coronary stents (Wall stent from Boston scientific ) subsequently lost interest because of delivery related issues. Many feel , it makes cardiologist judgment tentative and delivery system prevail over our hand skills. It is possible stents can longitudinally jump with high radial force making a geographical miss more likely.While it could be true with any technique till we master it, one should recall ,most endo-vascular work other than coronary still involve self expandable techniques.
Balloon expandable stent is ruling the PCI field for more than 2 decades. There ha...
Source: Dr.S.Venkatesan MD - February 5, 2015 Category: Cardiology Authors: dr s venkatesan Tags: Cardiology -Interventional -PCI Infrequently asked questions in cardiology (iFAQs) radial strengh of coronary stent self expanding stents Source Type: blogs
Maleficent Troponins
We physicians are obsessed with classifying, sorting, and differentiating in a quest for never-ending precision. We gather all manner of “facts” from our patients. Sights, smells, reactions to pushing or pulling. We divine sounds with antiquated stethoscopes or peer underneath the skin with ultrasound. We subject them to tests of blood, urine, and fluids from any place our needles can reach.
All of this is to arrive at an exact diagnosis that is often frustrated by the secondary nature of the data. Our disappointment has driven us mad, but the promise of exactness from biomarkers leaves us giddy. We have convi...
Source: Spontaneous Circulation - February 2, 2015 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
