The notification phone rings: “Cardiac arrest, intubated, ETA 3 minutes.” Take a breath. You look around and notice you have a loaded team! EMS rolls in and moves that patient to the stretcher. Your awesome nurses get IV access on the first try while you promptly assemble the LUCAS device Read more…
Preface: I write this piece humbly from my own perspective, acknowledging that this is not the “answer” as to how to become an effective learner, but just what I have found to be effective for me. There are many different learning styles, and my style may not fit all or Read more…
As some of you may have heard, COVID-19 is a thing. We’ve covered it in-depth, here. Fortunately, there’s a cure. President Trump touted it himself and therefore it must be true. So good – so, so good that this will all be over by Easter. Could this be true? Let’s Read more…
To My Family, These past several weeks have been a whirlwind, to say the least. Developing and changing information coming every 10 minutes from all angles. The feeling as if the world you’re taking care of does not appreciate you, while you witness critical shortages of protective equipment and college Read more…
In a previous post, I presented a case of Takotsubo non-ischemic cardiomyopathy that met “STEMI” criteria and was diagnosed by angiography. Let’s take a moment to discuss some other non-ischemic cause of ST elevation, otherwise known as “STEMI mimics.” 1) Benign Early Repolarization and Left Ventricular Hypertrophy ST-elevation does Read more…
Editorial preface: I will be occasionally using the term occlusion myocardial infarction (OMI) to signify acute coronary occlusions which should be emergently reperfused (thrombolysis or percutaneous coronary intervention). Unfortunately, as OMI inherently does not have ‘false negatives’, I will still begrudgingly include the phrases ACS and STEMI as many are Read more…
A 50-year-old woman with no significant past medical history is brought to the ED via EMS as a “STEMI notification”. As per family, the patient was at the post office when she developed sudden onset chest pain and then syncopized. The patient had not seen a doctor recently and does Read more…
In last week’s post, we reviewed Pluymaekers et al (1), a randomized control trial from the Netherlands on early or delayed cardioversion for recent-onset atrial fibrillation (AF). In this post, we will analyze our practice in the U.S. and discuss some of the arguments for and against cardioversion in the Read more…
A recent NEJM article, “Early or Delayed Cardioversion in Recent-Onset Atrial Fibrillation” by Pluymaekers et al has reinvigorated debate in the blogosphere, academia conference halls, and podcast-dom over management of recent-onset atrial fibrillation (AF) (1,2,3). Prior studies have demonstrated that cardioversion for recent-onset atrial fibrillation (typically defined by a duration Read more…