Cardiology

Chest Pain (CP) is a very common complaint seen in emergency departments around the world. In the US specifically anywhere from 8 – 10 million patients present to the ED complaining of CP. Many use liberal testing strategies to prevent missing acute coronary syndrome (ACS) or other major adverse cardiac events (MACE), but this is not without increase in healthcare cost and false positive testing leading to more downstream testing.

The management of unstable ventricular tachycardia and pulseless tachycardia is simple – electric cardioversion. However, there are several management options for stable tachycardia. This article reviews these options as well as the most recent updates.

Managing the patient in cardiac arrest is both frightening and exhilarating. The majority of arrests in older patients is due to CAD. The young cardiac arrest patient presents a difficult situation for the emergency provider. In general, younger patients are healthier than their geriatric counterparts. There are differences in physiology which may contribute to different prognosis and care. This post reviews the literature behind cardiac arrest in the younger patient.

Treatment of STEMI is straightforward, but the treatment of NSTEMI is not as clear-cut! This post will review the risk stratification and treatment of patients with NSTEMI.

BNP (Brain Natriuretic Peptide) is a commonly used biomarker for detecting heart failure in the emergency department. It’s levels can be affected by various extraneous factors such as obesity and renal failure. This article reviews the potential uses of BNP, including its pros and cons, in the emergency department.

Aortic dissection may occur in any location along the aorta and therefore the range of presentations is broad. Many AD patients do not fit the textbook presentation.

This review article focuses on 5 under recognized high-risk ECG patterns in the ACS patient that result in poor outcomes including malignant dysrhythmias, higher rates of cardiogenic shock, and death.

Complementing the recent atrial fibrillation post this week, dive into more pearls of atrial fibrillation management in the ED by our own Dr. Jennifer Robertson

A post filled with management pearls for atrial fibrillation. What are potential etiologies? What medications should you use, when should you use them, and what are potential problems with these medications? What about anticoagulation?

Third degree, or complete, heart block indicates complete dissociation between the atria and the ventricles. It is a cardiac emergency that has numerous causes including primary cardiac, electrolyte and medication toxicity. It needs to be managed with emergent pacing, either trancutaneous or transvenous. This article describes complete heart block and its management.