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The most-popular HEART SISTERS posts from 2023 were all over the map - from 'Struggle Care' to sweating, hanging up that iconic Red Dress, or cardiacarrest on the toilet!
Among young athletes, while overall survival after a sudden cardiacarrest (SCA) is improving, the likelihood of survival varies by race, and SCA is more likely to occur during practice than games, according to a study presented at ACC.25 25 in Chicago and simultaneously published in JACC.
In a prospective, multicentre, parallel, randomised clinical trial titled ARREST, researchers aimed to evaluate the effectiveness of expedited transfer to a cardiacarrest center compared to standard care following out-of-hospital cardiacarrest. The ARREST study is the first randomized trial of its kind.
What is the prevalence and what are the characteristics of mitral valve prolapse (MVP) in a large cohort of patients with unexplained cardiacarrest (UCA)?
The impact of chest compression (CC) pause duration on survival outcomes in pediatric in-hospital cardiacarrests remains unclear, despite the American Heart Association’s recommendation to limit pauses to less than 10 seconds for children without solid evidence. Original article: Lauridsen KG et al.
The goal of the PARAMEDIC-3 trial was to compare the efficacy and safety of an initial vascular access strategy of intraosseous (IO) versus peripheral intravenous (IV) access for medication administration in out-of-hospital cardiacarrest.
The goal of the IVIO trial was to compare the efficacy and safety of an initial vascular access strategy of intraosseous (IO) versus peripheral intravenous (IV) access for medication administration in nontraumatic out-of-hospital cardiacarrest.
Here is an article I wrote: Updates on the ECG in ACS. Cardiacarrest can cause diffuse subendocardial ischemia, usually transient (it often resolves as time goes by after ROSC). STE limited to aVR is due to diffuse subendocardial ischemia, but what of STE in both aVR and V1? If you want to understand aVR, read this.]
Does hospital median cardiopulmonary resuscitation (CPR) duration in patients without return of circulation (ROC) predict survival among hospitalized children?
About 45 minutes after the second EKG, the patient was found in cardiacarrest. Later the next day, she went into cardiacarrest again. By the time I saw the repeat EKG, the patient was already in cardiacarrest. She was worked as a full code, and ROSC was achieved. She could not be resuscitated.
Two recent interventions have proven in randomized trials to improve neurologic survival in cardiacarrest: 1) the combination of the ResQPod and the ResQPump (suction device for compression-decompression CPR -- Lancet 2011 ) and 2) Dual Sequential defibrillation. The patient had ROSC and maintained it.
Because of recent incidents of sudden cardiacarrest (SCA) among high-profile athletes, including Damar Hamlin and Bronny James, there has been greater scrutiny regarding the medical evaluation process for athletes.
This year's American Heart Association Scientific Sessions (AHA 2023) in Philadelphia featured several sessions dedicated to exercise and sports cardiology, including an expert-led session on sudden cardiacarrest (SCA) on the athletic field and two major sports cardiology studies.
A small proportion of patients with STEMI treated via primary PCI experienced late ventricular tachycardia (VT) or ventricular fibrillation (VF), occurring one or more days following the procedure, but late VT or VF with cardiacarrest occurred rarely, especially among patients with uncomplicated STEMI, according to a study published in JAMA Network (..)
By advocating for evidence-based policies like CPR education, AED access and emergency action plan (EAP) implementation, cardiovascular societies like the ACC and American Heart Association are working in tandem with initiatives like the National Football League (NFL)-led Smart Heart Sports Coalition to improve outcomes in young athletes experiencing (..)
The following are key points to remember from an AHA Scientific Statement on cardiac catheterization laboratory management of the comatose adult patient with an out-of-hospital cardiacarrest (OHCA).
If cardiacarrest from hypokalemia is imminent (i.e., CASE : Prehospital CardiacArrest due to Hypokalemia I recently had a case of prehospital cardiacarrest that turned out to be due to hypokalemia. As I indicated above, in our cardiacarrest case, after pushing 40 mEq, the K only went up to 4.2
Aims Few studies have reported data on the optimal timing of left ventricular (LV) unloading during venoarterial extracorporeal membrane oxygenation (VA-ECMO) for cardiacarrest or shock. CV, cardiovascular; HT, heart transplantation; ICU, intensive care unit; LVAD, left ventricular assist device.
We present the case of a man in his 50s, admitted with cardiacarrest secondary to inferolateral STEMI. However, it is associated with rare, but life-threatening, complications such as perforation, leading to retroperitoneal haemorrhage.
I suspect this is Type 2 MI due to prolonged severe hypotension from cardiacarrest. PEARL: In my experience, cardiac rhythms observed during ( or shortly after ) cardiacarrest do not obey the usual rules for AV blocks and escape rhythms. This is a troponin I level that is almost exclusively seen in STEMI.
for the NIV group ( p =0.005), even after excluding patients with cardiacarrest at presentation. All-cause mortality at 24h did not differ amongst the three groups. The 60-day mortality rates were 40.2% for the iMV group, 26% for the OT group, and 29.3%
If cardiacarrest from hypokalemia is imminent (i.e., However, this review references the Sterns article above, which by my reading does not state this. As I indicated above, in our cardiacarrest case, after pushing 40 mEq, the K only went up to 4.2 How would you treat? mEq/L for every 100 mEq total body deficit.
Regarding AFib with WPW: The very rapid heart rate and at times extremely short R-R intervals put the patient with AFib and WPW at risk of cardiacarrest from VFib. Figure-4: Magnified view of a selected portion of ECG #1 that shows the irregularity of the rhythm ( measurements of R-R intervals in milliseconds ).
Impella patients were older (34% vs. 13% >75 years, p < 0.001) and less frequently presented after an out-of-hospital cardiacarrest (18% vs. 40%, p < 0.001). Impella and/or VA-ECMO were used in 20% of all AMICS cases ( n = 4088).
It is apparently fortunate that she had a cardiacarrest; otherwise, her ECG would have been ignored. In a recent article (J Electrocardiol this year, see reference below), peak trop onin I levels in takotsubo presenting with ST Elevation were median 1.02 She was defibrillated and resuscitated. ng/mL [IQR: 0.46, 2.35].
Aslanger added in the limitations in his article: " Theoretically, an isolated basal inferoseptal infarction or an acute inferior MI in the presence of previous infarctions that may change the orientation of lesion vector can also cause a similar picture. (Our with ADDED STE in III?
He had a previous MI with cardiacarrest 2 years prior. Down below are 3 more cases and a discussion of how to differentiate false positive isolated STE in aVL from True positive. Case A 47 year old male called 911 for severe chest pain. He was clammy and looked unwell. Is this due to coronary occlusion?
These include ( among others ) — acute febrile illness — variations in autonomic tone — hypothermia — ischemia-infarction — malignant arrhythmias — cardiacarrest — and especially Hyperkalemia. Figure-1 : Visual summary of ECG Patterns in Brugada Syndrome ( adapted from the article by Brugada et al in JACC: Vol.
And the article was rejected. LEARNING Point: Maximal ST depression in leads V2-thru-V4 ( especially when the ST-T waves are shaped as they are in ECG #1 ) in a patient with new chest pain ( or sudden cardiacarrest, as in today’s case ) — is diagnostic of acute Posterior OMI until proven otherwise!
If a patient presents with chest pain and a normal heart rate, or with shockable cardiacarrest, then ischemic appearing ST elevation is STEMI until proven otherwise. An excellent review of myocardial bridging, with full text: [link] Myocardial bridging is when the coronary artery, usually the LAD, dives into the myocardium.
4 Unfortunately, this article provides no electrocardiographic, echo, or angiographic data, so it is not certain that these high levels were in the absence of acute MI. In a series of 18 patients with COVID and ST elevation, 8 were diagnosed with STEMI, 6 of whom had an angiogram and it showed obstructive coronary disease.
The study utilized the ISCHEMIA primary outcome, a composite measure of cardiovascular death, protocol-defined myocardial infarction, or hospitalization for unstable angina, heart failure, or resuscitated cardiacarrest. Original article: Redfors B et al. years, with 57.1% occurring within 30 days after CABG.
Is there a differential association between bystander cardiopulmonary resuscitation (CPR) and survival by sex and race and ethnicity of the patient with out-of-hospital cardiacarrest (OHCA)?
Using automated external defibrillators (AEDs) and cardiopulmonary resuscitation (CPR) as soon as possible increases a person's chance of surviving a cardiacarrest. After meeting the exclusion criteria, more than 9,500 cases of out-of-hospital cardiacarrest were included in the study cohort. versus 4.6%
If cardiacarrest from hypokalemia is imminent (i.e., However, this review references the Sterns article above, which by my reading does not state this. As I indicated above, in our cardiacarrest case, after pushing 40 mEq, the K only went up to 4.2 mEq/L for every 100 mEq total body deficit. mEq/L, from 1.9
Graphical abstract depicting cardiacarrest mortality disparities in the young, temporal trends, and its correlation with the social vulnerability index. Abstract Background Cardiacarrest (CA) is a leading cause of death in the United States (US). Social determinants of health may impact CA outcomes.
He then discusses sudden cardiacarrest and death in competitive and recreational athletes. In this weeks View, Dr. Eagle looks at what adult cardiologists should know about congenital heart disease patients.
Here are three more dramatic cases that illustrate RBBB + LAFB Case 1 of cardiacarrest with unrecognized STEMI, died. Furthermore, among 35 patients with acute left main coronary artery occlusion, 9 presented with RBBB (mostly with LAH) on the admission ECG.
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