recent articles

practice updates

Amiodarone vs Procainamide for Stable VT

Case Scenario: A 38-year-old male with a history of hypertension and an unknown heart defect status post repair in infancy presents to the Emergency Department with acute onset chest pain, dyspnea, and diaphoresis.  He had a similar episode at another hospital 1 month prior that resolved after "some medication."  He denies drug use. An EKG is obtained in triage, and is shown below. The patient’s blood pressure is 120/70.  He is alert and oriented, and speaking in full sentences although dyspneic with respiratory rate in lower 20s and O2 saturation 98% on RA. Clinical Question: Which pharmacologic agent is most effective for termination of monomorphic ventricular tachycardia?

practice updates

Aggressive BP Management in Patients with ICH

"The patient was hypertensive with SBP in 220s...a stat CT scan revealed a large intraparenchymal hemorrhage"
What's the goal BP in a patient with ICH? How quickly should that target be reached? What's the evidence? Ben Cooper, MD addresses these questions and more in this review of the recent literature.