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In patients with acute MI, restrictive blood transfusion thresholds (hemoglobin 8g/dL) had similar rates of all-cause death and recurrent MI at 6 months. However, the 6-month hazard of cardiac death was 52% greater (9.0% vs 6.1%; HR 1.52, 95%CI, 1.19–1.94) in the restrictive transfusion group, largely due to increased cardiac death during the first 30 days.

Source
Restrictive or Liberal Transfusion Strategy in Patients With Acute Myocardial Infarction and Anemia: 6-Month Mortality in the MINT Trial. Circulation. 2024 Sep 24;150(13):1064-1066. doi: 10.1161/CIRCULATIONAHA.124.069917. Epub 2024 Sep 2. PMID: 39221566.

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Hypertensive emergencies are associated with high morbidity and mortality and require careful and specific strategies to diminish pressure-mediated organ injury depending on the presentation. 

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This was a multi-hospital retrospective study of patients who presented to the emergency department with severe hypertension without end organ damage. The authors found that the 1 year rate of major adverse cardiovascular events (MACE) was 15.5%.

Source
Emergency Department Blood Pressure Treatment and Outcomes in Adults Presenting with Severe Hypertension. West J Emerg Med. 2024;25(5):680-689.

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This article emphasizes the difference between hypertensive emergency and asymptomatic elevated blood pressure (BP); while hypertensive emergency requires prompt treatment to lower BP, treatment of asymptomatic elevated BP in acute care settings may be harmful. 

Source
The Management of Elevated Blood Pressure in the Acute Care Setting: A Scientific Statement From the American Heart Association. Hypertension. 2024 Aug;81(8):e94-e106. doi: 10.1161/HYP.0000000000000238. Epub 2024 May 28. PMID: 38804130.

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By agitating and injecting a saline flush into an IV catheter, right ventricular (RV) dysfunction was identified when bubbles were cleared from the RV at a time of ≥ 40 seconds with high sensitivity. It was ruled out as well with good specificity, with a bubble time < 40 seconds.

Source
Right Ventricular "Bubble Time" to Identify Patients With Right Ventricular Dysfunction. Ann Emerg Med. 2024 Aug;84(2):182-194. doi: 10.1016/j.annemergmed.2024.02.005. Epub 2024 Apr 10. PMID: 38597847.

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These researchers developed and trained a deep ensemble artificial intelligence (AI) model to classify ECGs as STEMI versus non-STEMI. The AI performed well in both accuracy and in improving sensitivity.

Source
Development of Clinically Validated Artificial Intelligence Model for Detecting ST-segment Elevation Myocardial Infarction. Ann Emerg Med. 2024 Jul 25:S0196-0644(24)00327-5. doi: 10.1016/j.annemergmed.2024.06.004. Epub ahead of print. PMID: 39066765.

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Giving calcium for hyperkalemia restores normal cardiac conduction velocity but does not restore resting membrane potential, as is commonly stated.

Source
Beneficial Effect of Calcium Treatment for Hyperkalemia Is Not Due to "Membrane Stabilization". Crit Care Med. Published online July 24, 2024. PMID: 39046789.

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Using the aortic dissection detection (ADD) risk score in addition to point-of-care ultrasound (POCUS) and D-dimer, providers can increase their diagnostic accuracy and ensure that the appropriate patients are receiving advanced imaging to make the diagnosis of acute aortic syndrome (AAS).

Source
Diagnosis of acute aortic syndromes with ultrasound and d-dimer: the PROFUNDUS study. Eur J Intern Med. 2024 Jun 12:S0953-6205(24)00234-6. doi: 10.1016/j.ejim.2024.05.029. Epub ahead of print. PMID: 38871565.

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This systematic review found that approximately 4%-27% of patients presenting to the ED with presyncope experienced serious outcomes within a 30-day period.

Source
Serious outcomes among emergency department patients with presyncope: A systematic review. Acad Emerg Med. 2024 Jun 9. doi: 10.1111/acem.14943. Online ahead of print. PMID: 38853536

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This RCT of U.S. patients being evaluated for acute MI using a 0/1 hour hs-cTnI protocol, compared to standard care with a 0/3 hour hs-cTnI protocol, didn’t find a difference in the percentage of patients discharged from the ED nor in the rates of 30 day death or MI.

Source
Rapid Acute Coronary Syndrome Evaluation Over One Hour With High-Sensitivity Cardiac Troponin I: A United States-Based Stepped-Wedge, Randomized Trial. Ann Emerg Med. 2024 Jun 15:S0196-0644(24)00235-X. doi: 10.1016/j.annemergmed.2024.04.024. Epub ahead of print. PMID: 38888531.