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Despite the elevated mortality rates associated with high-risk pulmonaryembolism (PE), this condition remains understudied. Data regarding the effectiveness and safety of invasive therapies such as venoarterial extracorporeal membrane oxygenation (VA-ECMO) in this patient population remains controversial.
BackgroundPercutaneous mechanical thrombectomy (PMT) is increasingly used in the treatment of intermediate and high-risk acute pulmonaryembolism (PE), and the treatment of high-risk PE with the aid of veno-arterial extracorporeal membrane oxygenation (VA-ECMO) has also been reported. The 12-month mortality rate was 36.4%.ConclusionVA-ECMO-assisted
Massive pulmonaryembolism (MPE) carries significant 30-day mortality and is characterized by acute right ventricular failure, hypotension, and hypoxia, leading to cardiovascular collapse and cardiacarrest.
BackgroundAcute pulmonaryembolism (APE) is a common and potentially fatal cardiovascular disease that can lead to sudden cardiacarrest in severe cases. For patients with concurrent main pulmonary artery embolism and bleeding, balloon pulmonary angioplasty may be an option.
The post EM Quick Hits 5 Ludwig’s Angina, Transient Monocular Vision Loss, D-dimer for PE Workup in Pregnancy, Pediatric Nasal Foreign Bodies, Trimethoprim Drug Interactions, Airway Management in CardiacArrest appeared first on Emergency Medicine Cases.
High profile cases of sudden cardiacarrest in elite athletes in recent years has reminded the cardiology community of the challenging questions posed to cardiologists in these settings. Questions like: How do we prevent cardiacarrest in athletes? Can an athlete return to play after cardiacarrest?
The morphology of V2-V4 is very specific in my experience for acute right heart strain (which has many potential etiologies, but none more common and important in EM than acute pulmonaryembolism). He had multiple cardiacarrests with ROSC regained each time. CT angiogram showed extensive saddle pulmonaryembolism.
Background Data on the management of patients with cancer presenting with sudden cardiacarrest (SCA) are scarce. Cardiac causes were less frequent among patients with cancer (mostly acute coronary syndromes, 25.5% vs 46.8%, p<0.001) and had more respiratory causes (pulmonaryembolism and hypoxaemia in 34.2%
BACKGROUND:The aim of this study was to examine the impact of early versus delayed catheter-based therapies (CBTs) on clinical outcomes in patients with acute intermediate-risk pulmonaryembolism (PE).METHODS:This Secondary outcomes included a composite of 30-day mortality, resuscitated cardiacarrest, and hemodynamic instability.
Chronic Pulmonary Disease Lung diseases like chronic obstructive pulmonary disease (COPD) can lead to pulmonary hypertension, which in turn can cause the right side of the heart to enlarge, a condition known as cor pulmonale.
The post EM Quick Hits 33 Polytrauma Tips & Tricks, Toxic Megacolon, ECG in PE, Patch Calls, CT Before LP, Nebulized Ketamine appeared first on Emergency Medicine Cases.
This false electrical capture may have made cardiacarrest recognition difficult, and the re-arrest may have gone unrecognized for an unknown amount of time. The receiving staff suspects pulmonaryembolism due to S1Q3T3 on the ECG and administers TPA. On ED arrival ROSC is achieved.
Although one may have all kinds of ischemic findings as a result of cardiacarrest (rather than cause of cardiacarrest), this degree of ST elevation and HATW is all but diagnostic of acute proximal LAD occlusion. This prompted cath lab activation. On arrival to the ED, this ECG was recorded: What do you think?
Introduction The use of venoarterial extracorporeal membrane oxygenation (VA-ECMO) in extracorporeal cardiopulmonary resuscitation (eCPR) has emerged as a treatment option for selected patients who are experiencing refractory cardiacarrest (CA).
Bedside cardiac ultrasound showed moderately decreased LV function. CT of the chest showed no pulmonaryembolism but bibasilar infiltrates. See this post: How a pause can cause cardiacarrest 2. She was intubated. The plan: 1. Place temporary pacemaker 3. Discontinue amiodarone, since it prolongs the QT 4.
and the patient was converted to veno-venous (V-V) ECMO due to persistent pulmonary insufficiency. Clinically — despite an initial 2-fold increased troponin, the normal bedside Echo was reassuring against OMI or pulmonaryembolism. He remained supported on an intraaortic balloon pump. Here they are: Learning Points: 1.
Smith interpretation: This is highly likely to be due to extreme right heart strain and is nearly diagnostic of pulmonaryembolism. What is the clear diagnosis and reason for arrest? It is of course pulmonaryembolism. The Queen diagnosed "OMI with high confidence" due to the ST Elevation in V1-V3.
This case highlights such a scenario.Case:A 75-year-old female with a history of cardiacarrest 30 years ago presented with shortness of breath and left leg swelling. She experienced massive hemoptysis, leading to respiratory and cardiacarrest, but was resuscitated. Bronchoscopy revealed clots in the left lower lobe.
Smith comment: before reading anything else, this case screamed pulmonaryembolism to me. I would do bedside ultrasound to look at the RV, look for B lines as a cause of hypoxia (which would support OMI, and argue against PE), and if any doubt persists, a rapid CT pulmonary angiogram.
It makes pulmonaryembolism (PE) very likely. The small LV implies very low LV filling pressures, which implies low pulmonary venous pressure. First, what kind of arrest was this? It was a PEA or bradyasystolic arrest , not a shockable rhythm. Possible, but huge pulmonaryembolism is more likely.
Compared with 2012‐2014, the 2015‐2019 cohort showed increased odds of ICH and shock while the odds of DVT, pulmonaryembolism, pneumonia, and UTI were significantly lower. Odds of a mild disability outcome increased from 16% to 20%, OR 0.65 (0.57, 0.74), while mortality decreased from 15% to 12%, OR 0.69 (0.61, 0.78).
However, AKI patients had higher rates of deep vein thrombosis (6.36% vs. 3.54%, p < 0.01), pulmonaryembolism (4.22% vs. 1.42%, p < 0.01), pneumonia (21.39% vs. 8.84%, p < 0.01), urinary tract infection (19.07% vs. 13.32%, p < 0.01), sepsis (20.27% vs. 4.18%, p < 0.01), acute myocardial infarction (12.14% vs. 3.21%, (..)
I suspect this is Type 2 MI due to prolonged severe hypotension from cardiacarrest. pulmonaryembolism, sepsis, etc.), Coronary thrombosis or embolism can result in MINOCA, either with or without a hypercoagulable state. In non-arrest situations — escape beats and escape rhythms tend to be at least fairly regular.
They include myocardial ischemia, acute pericarditis, pulmonaryembolism, external compression due to mass over the right ventricular outflow tract region, and metabolic disorders like hyper or hypokalemia and hypercalcemia. According to a recent systematic review and meta-analysis, spontaneous type 1 ECG had 2.4%
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