collection
https://read.qxmd.com/read/34126755/mechanical-complications-of-acute-myocardial-infarction-a-scientific-statement-from-the-american-heart-association
#1
REVIEW
Abdulla A Damluji, Sean van Diepen, Jason N Katz, Venu Menon, Jacqueline E Tamis-Holland, Marie Bakitas, Mauricio G Cohen, Leora B Balsam, Joanna Chikwe
Over the past few decades, advances in pharmacological, catheter-based, and surgical reperfusion have improved outcomes for patients with acute myocardial infarctions. However, patients with large infarcts or those who do not receive timely revascularization remain at risk for mechanical complications of acute myocardial infarction. The most commonly encountered mechanical complications are acute mitral regurgitation secondary to papillary muscle rupture, ventricular septal defect, pseudoaneurysm, and free wall rupture; each complication is associated with a significant risk of morbidity, mortality, and hospital resource utilization...
July 13, 2021: Circulation
https://read.qxmd.com/read/18180024/new-algorithm-using-only-lead-avr-for-differential-diagnosis-of-wide-qrs-complex-tachycardia
#2
COMPARATIVE STUDY
András Vereckei, Gábor Duray, Gábor Szénási, Gregory T Altemose, John M Miller
BACKGROUND: We recently reported an ECG algorithm for differential diagnosis of regular wide QRS complex tachycardias that was superior to the Brugada algorithm. OBJECTIVE: The purpose of this study was to further simplify the algorithm by omitting the complicated morphologic criteria and restricting the analysis to lead aVR. METHODS: In this study, 483 wide QRS complex tachycardias [351 ventricular tachycardias (VTs), 112 supraventricular tachycardias (SVTs), 20 preexcited tachycardias] from 313 patients with proven diagnoses were prospectively analyzed by two of the authors blinded to the diagnosis...
January 2008: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://read.qxmd.com/read/33240511/differential-diagnosis-of-wide-qrs-tachycardias
#3
REVIEW
Demosthenes G Katritsis, Josep Brugada
In this article, the authors discuss the differential diagnostic methods used in clinical practice to identify types of wide QRS tachycardias (QRS duration >120 ms). A correct diagnosis is critical to management, as misdiagnosis and the administration of drugs usually utilised for supraventricular tachycardia can be harmful for patients with ventricular tachycardia.
November 2020: Arrhythmia & Electrophysiology Review
https://read.qxmd.com/read/31345421/outcome-of-applying-the-esc-0-1-hour-algorithm-in-patients-with-suspected-myocardial-infarction
#4
JOURNAL ARTICLE
Raphael Twerenbold, Juan Pablo Costabel, Thomas Nestelberger, Roberto Campos, Desiree Wussler, Rosina Arbucci, Marcia Cortes, Jasper Boeddinghaus, Benjamin Baumgartner, Christian H Nickel, Roland Bingisser, Patrick Badertscher, Christian Puelacher, Jeanne du Fay de Lavallaz, Karin Wildi, Maria Rubini Giménez, Joan Walter, Mario Meier, Benjamin Hafner, Pedro Lopez Ayala, Jens Lohrmann, Valentina Troester, Luca Koechlin, Tobias Zimmermann, Danielle M Gualandro, Tobias Reichlin, Florencia Lambardi, Silvana Resi, Alberto Alves de Lima, Marcelo Trivi, Christian Mueller
BACKGROUND: The European Society of Cardiology (ESC) recommends the 0/1-h algorithm for rapid triage of patients with suspected non-ST-segment elevation myocardial infarction (MI). However, its impact on patient management and safety when routinely applied is unknown. OBJECTIVES: This study sought to determine these important real-world outcome data. METHODS: In a prospective international study enrolling patients presenting with acute chest discomfort to the emergency department (ED), the authors assessed the real-world performance of the ESC 0/1-h algorithm using high-sensitivity cardiac troponin T embedded in routine clinical care and its associated 30-day rates of major adverse cardiac events (MACE) (the composite of cardiovascular death and MI)...
July 30, 2019: Journal of the American College of Cardiology
https://read.qxmd.com/read/31338902/can-emergency-physician-gestalt-rule-in-or-rule-out-acute-coronary-syndrome-validation-in-a-multicenter-prospective-diagnostic-cohort-study
#5
MULTICENTER STUDY
Govind Oliver, Charlie Reynard, Niall Morris, Richard Body
BACKGROUND: Chest pain is a common problem presenting to the emergency department (ED). Many decision aids and accelerated diagnostic protocols have been developed to help clinicians differentiate those needing admission from those who can be safely discharged. Some early evidence has suggested that clinician judgment or gestalt alone could be sufficient. OBJECTIVES: Our aim was to externally validate whether emergency physician's gestalt could "rule in" or "rule out" acute coronary syndromes (ACS)...
January 2020: Academic Emergency Medicine
https://read.qxmd.com/read/31374211/managing-massive-hemoptysis
#6
REVIEW
Kevin Davidson, Samira Shojaee
Massive hemoptysis is a medical emergency with high mortality presenting several difficult diagnostic and therapeutic challenges. The origin of bleeding and underlying etiology often is not immediately apparent, and techniques for management of this dangerous condition necessitate an expedient response. Unlike hemorrhage in other circumstances, a small amount of blood can rapidly flood the airways, thereby impairing oxygenation and ventilation, leading to asphyxia and consequent cardiovascular collapse. Of paramount importance is early control of the patient's airway and immediate isolation of hemorrhage in an attempt to localize and control bleeding...
January 2020: Chest
https://read.qxmd.com/read/31060863/dysrhythmias-and-heart-failure-complicating-acute-myocardial-infarction-an-emergency-medicine-review
#7
REVIEW
William T Davis, Tim Montrief, Alex Koyfman, Brit Long
INTRODUCTION: Patients with acute myocardial infarction (AMI) may suffer several complications after the acute event, including dysrhythmias and heart failure (HF). These complications place patients at risk for morbidity and mortality. OBJECTIVE: This narrative review evaluates literature and guideline recommendations relevant to the acute emergency department (ED) management of AMI complicated by dysrhythmia or HF, with a focus on evidence-based considerations for ED interventions...
August 2019: American Journal of Emergency Medicine
https://read.qxmd.com/read/31166204/inotropes-and-vasopressors-use-in-cardiogenic-shock-when-which-and-how-much
#8
REVIEW
Bruno Levy, Julie Buzon, Antoine Kimmoun
PURPOSE OF REVIEW: Data and interventional trials regarding vasopressor and inotrope use during cardiogenic shock are scarce. Their use is limited by their side-effects and the lack of solid evidence regarding their effectiveness in improving outcomes. In this article, we review the current use of vasopressor and inotrope agents during cardiogenic shock. RECENT FINDINGS: Two recent Cochrane analyses concluded that there was not sufficient evidence to prove that any one vasopressor or inotrope was superior to another in terms of mortality...
August 2019: Current Opinion in Critical Care
https://read.qxmd.com/read/31027937/initial-evaluation-and-management-of-wide-complex-tachycardia-a-simplified-and-practical-approach
#9
REVIEW
Laszlo Littmann, Elizabeth G Olson, Michael A Gibbs
The evaluation and treatment of wide QRS-complex tachycardia remains a challenge, and mismanagement is quite common. Diagnostic aids such as wide-complex tachycardia algorithms perform poorly in the real-life setting. The purpose of this review is to offer a simple clinical-electrocardiographic approach for the initial evaluation and management of the adult patient with stable wide-complex tachycardia that does not require recollection of complex guidelines or algorithms.
July 2019: American Journal of Emergency Medicine
https://read.qxmd.com/read/29627355/atrial-fibrillation-in-the-icu
#10
REVIEW
Nicholas A Bosch, Jonathan Cimini, Allan J Walkey
Atrial fibrillation (AF) is the most common arrhythmia encountered in the ICU. Preexisting AF is highly prevalent among older patients with chronic conditions who are at risk for critical illness, whereas new-onset AF can be triggered by accelerated atrial remodeling and arrhythmogenic triggers encountered during critical illness. The acute loss of atrial systole and onset of rapid ventricular rates that characterize new-onset AF often lead to decreased cardiac output and hemodynamic compromise. Thus, new-onset AF is both a marker of disease severity as well as a likely contributor to poor outcomes, similar to other manifestations of organ dysfunction during critical illness...
December 2018: Chest
https://read.qxmd.com/read/29287074/coronary-angiography-is-related-to-improved-clinical-outcome-of-out-of-hospital-cardiac-arrest-with-initial-non-shockable-rhythm
#11
MULTICENTER STUDY
Eunsil Ko, Ji Kyoung Shin, Won Chul Cha, Joo Hyun Park, Tae Rim Lee, Hee Yoon, Guntak Lee, Sung Yeon Hwang, Tae Gun Shin, Min Seob Sim, Ik Joon Jo, Joong Eui Rhee, Keun Jeong Song, Yeon Kwon Jeong, Sang Do Shin, Jin-Ho Choi
OBJECTIVE: Coronary angiography (CAG) for survivors of out-of-hospital cardiac arrest (OHCA) enables early identification of coronary artery disease and revascularization, which might improve clinical outcome. However, little is known for the role of CAG in patients with initial non-shockable cardiac rhythm. METHODS: We investigated clinical outcomes of successfully resuscitated 670 adult OHCA patients who were transferred to 27 hospitals in Cardiac Arrest Pursuit Trial with Unique Registration and Epidemiologic Surveillance (CAPTURES), a Korean nationwide multicenter registry...
2017: PloS One
https://read.qxmd.com/read/23927955/early-cardiac-catheterization-is-associated-with-improved-survival-in-comatose-survivors-of-cardiac-arrest-without-stemi
#12
JOURNAL ARTICLE
Ryan D Hollenbeck, John A McPherson, Michael R Mooney, Barbara T Unger, Nainesh C Patel, Paul W McMullan, Chiu-Hsieh Hsu, David B Seder, Karl B Kern
AIM: To determine if early cardiac catheterization (CC) is associated with improved survival in comatose patients who are resuscitated after cardiac arrest when electrocardiographic evidence of ST-elevation myocardial infarction (STEMI) is absent. METHODS: We conducted a retrospective observational study of a prospective cohort of 754 consecutive comatose patients treated with therapeutic hypothermia (TH) following cardiac arrest. RESULTS: A total of 269 (35...
January 2014: Resuscitation
https://read.qxmd.com/read/30496838/european-resuscitation-council-guidelines-for-resuscitation-2018-update-antiarrhythmic-drugs-for-cardiac-arrest
#13
JOURNAL ARTICLE
Jasmeet Soar, Gavin D Perkins, Ian Maconochie, Bernd W Böttiger, Charles D Deakin, Claudio Sandroni, Theresa M Olasveengen, Jonathan Wyllie, Robert Greif, Andrew Lockey, Federico Semeraro, Patrick Van de Voorde, Carsten Lott, Leo Bossaert, Koenraad G Monsieurs, Jerry P Nolan
This European Resuscitation Council (ERC) Guidelines for Resuscitation 2018 update is focused on the role of antiarrhythmic drugs during advanced life support for cardiac arrest with shock refractory ventricular fibrillation/pulseless ventricular tachycardia in adults, children and infants. This update follows the publication of the International Liaison Committee on Resuscitation (ILCOR) 2018 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations (CoSTR)...
January 2019: Resuscitation
https://read.qxmd.com/read/30466486/the-paramount-parameter-arterial-oxygen-tension-versus-arterial-oxygen-saturation-as-target-in-trials-on-oxygenation-in-intensive-care
#14
EDITORIAL
Olav Lilleholt Schjørring, Bodil Steen Rasmussen
No abstract text is available yet for this article.
November 22, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://read.qxmd.com/read/30528423/acute-lobar-atelectasis
#15
REVIEW
John J Marini
Lobar atelectasis (or collapse) is an exceedingly common, rather predictable, and potentially pathogenic companion to many forms of acute illness, postoperative care, and chronic debility. Readily diagnosed by using routine chest imaging and bedside ultrasound, the consequences from lobar collapse may be minor or serious, depending on extent, mechanism, patient vulnerability, abruptness of onset, effectiveness of hypoxic vasoconstriction, and compensatory reserves. Measures taken to reduce secretion burden, assure adequate secretion clearance, maintain upright positioning, reverse lung compression, and sustain lung expansion accord with a logical physiologic rationale...
May 2019: Chest
https://read.qxmd.com/read/30537337/prehospital-double-sequential-defibrillation-a-matched-case-control-study
#16
JOURNAL ARTICLE
Julian G Mapp, Alan J Hans, Anthony M Darrington, Elliot M Ross, Calvin C Ho, David A Miramontes, Stephen A Harper, David A Wampler
OBJECTIVES: The goal of our study was to determine whether prehospital double sequential defibrillation (DSD) is associated with improved survival to hospital admission in the setting of refractory ventricular fibrillation/pulseless ventricular tachycardia (VF/pVT). METHODS: This project is a matched case-control study derived from prospectively collected quality assurance/quality improvement data obtained from the San Antonio Fire Department out-of-hospital cardiac arrest (OHCA) database between January 2013 and December 2015...
September 2019: Academic Emergency Medicine
https://read.qxmd.com/read/29427301/prospective-validation-and-refinement-of-a-decision-rule-to-obtain-chest-x-ray-in-patients-with-nontraumatic-chest-pain-in-the-emergency-department
#17
MULTICENTER STUDY
Case Newsom, Rebecca Jeanmonod, Wendy Woolley, Nirali Shah, Shellie Asher, Eric Bruno, Michael Silberman, Mark Reiter, Donald Jeanmonod
OBJECTIVES: The objective was to prospectively validate and refine previously published criteria to determine the potential utility of chest x-ray (CXR) in the evaluation and management of patients presenting to the emergency department (ED) with nontraumatic chest pain (CP). METHODS: A prospective observational study was performed of patients presenting to three EDs in the United States with a chief complaint of nontraumatic CP. Previously defined high-risk history and examination elements were combined into a refined decision rule and these elements were recorded for each patient by the ED physician...
June 2018: Academic Emergency Medicine
https://read.qxmd.com/read/30375097/prognostic-accuracy-of-the-heart-score-for-prediction-of-major-adverse-cardiac-events-in-patients-presenting-with-chest-pain-a-systematic-review-and-meta-analysis
#18
JOURNAL ARTICLE
Shannon M Fernando, Alexandre Tran, Wei Cheng, Bram Rochwerg, Monica Taljaard, Venkatesh Thiruganasambandamoorthy, Kwadwo Kyeremanteng, Jeffrey J Perry
OBJECTIVE: The HEART score has been proposed for emergency department (ED) prediction of major adverse cardiac events (MACE). We sought to summarize all studies assessing the prognostic accuracy of the HEART score for prediction of MACE in adult ED patients presenting with chest pain. METHODS: We searched MEDLINE, PubMed, EMBASE, Scopus, Web of Science, and the Cochrane Database of Systematic Reviews from inception through May 2018 and included studies using the HEART score for the prediction of short-term MACE in adult patients presenting to the ED with chest pain...
February 2019: Academic Emergency Medicine
https://read.qxmd.com/read/30342745/clinical-policy-critical-issues-in-the-evaluation-and-management%C3%A2-of-emergency-department-patients-with-suspected%C3%A2-non-st-elevation-acute-coronary-syndromes
#19
REVIEW
Christian A Tomaszewski, David Nestler, Kaushal H Shah, Amita Sudhir, Michael D Brown
This clinical policy from the American College of Emergency Physicians addresses key issues in the evaluation and management of patients with suspected non-ST-elevation acute coronary syndromes. A writing subcommittee conducted a systematic review of the literature to derive evidence-based recommendations to answer the following clinical questions: (1) In adult patients without evidence of ST-elevation acute coronary syndrome, can initial risk stratification be used to predict a low rate of 30-day major adverse cardiac events? (2) In adult patients with suspected acute non-ST-elevation acute coronary syndrome, can troponin testing within 3 hours of emergency department presentation be used to predict a low rate of 30-day major adverse cardiac events? (3) In adult patients with suspected non-ST-elevation acute coronary syndrome in whom acute myocardial infarction has been excluded, does further diagnostic testing (eg, provocative, stress test, computed tomography angiography) for acute coronary syndrome prior to discharge reduce 30-day major adverse cardiac events? (4) Should adult patients with acute non-ST-elevation myocardial infarction receive immediate antiplatelet therapy in addition to aspirin to reduce 30-day major adverse cardiac events? Evidence was graded and recommendations were made based on the strength of the available data...
November 2018: Annals of Emergency Medicine
https://read.qxmd.com/read/30075944/on-pump-beating-heart-versus-conventional-coronary-artery-bypass-grafting-early-after-myocardial-infarction-a-propensity-score-matched-analysis-from-the-anzscts-database
#20
JOURNAL ARTICLE
Michael Z L Zhu, Molla M Huq, Baki M Billah, Lavinia Tran, Christopher M Reid, Kapilan Varatharajah, Franklin L Rosenfeldt
BACKGROUND: Coronary artery bypass grafting (CABG) performed early after acute myocardial infarction (AMI) carries a high risk of mortality. By avoiding cardioplegic arrest and aortic cross-clamping, on-pump beating heart CABG (ONBEAT) may benefit patients requiring urgent or emergency revascularisation in the setting of AMI. We evaluated the early and long-term outcomes of ONBEAT versus conventional CABG (ONSTOP) utilising the ANZSCTS National Cardiac Surgery Database. METHODS: Between 2001 and 2015, 5851 patients underwent non-elective on-pump CABG within 7 days of AMI...
July 12, 2018: Heart, Lung & Circulation
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