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Check out the latest installment in JAMA’s Rational Clinical Exam series, which covers intra-vascular volume overload.
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Does This Patient Have Volume Overload?: The Rational Clinical Examination. JAMA. 2026 Feb 23. doi: 10.1001/jama.2026.0446. Epub ahead of print. PMID: 41729549
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This paper summarizes three professional society recommendations for management of atrial fibrillation in the ED, including rate and rhythm control and when to anticoagulate.
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Comparing Guidelines for Atrial Fibrillation: Focus on Emergency Medicine. Ann Emerg Med. 2026 Jan 27:S0196-0644(25)01291-0. doi: 10.1016/j.annemergmed.2025.10.004. Epub ahead of print. PMID: 41603838.
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Despite being well documented, females with chest pain continue to suffer from misdiagnosis and later presentation, receive fewer guideline-directed therapies and invasive procedures, and have worse short- and long-term cardiovascular outcomes compared to males.
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Evaluation and management of chest pain from cardiovascular causes in female patients. BMJ (Clinical research ed.). 2026;392:e086177. PMID: 41617253
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In children with paroxysmal supraventricular tachycardia (pSVT), a modified Valsalva maneuver significantly improved conversion rates and patient satisfaction compared with the standard Valsalva maneuver.
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Efficacy of modified versus standard Valsalva maneuvers on clinical outcomes and satisfaction of children with paroxysmal supraventricular tachycardia: randomized control trial. BMC Pediatr. 2025 Dec 17;25(1):1003. doi: 10.1186/s12887-025-06396-9. PMID: 41408522; PMCID: PMC12752250.
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A meta-analysis of over 70,000 patients found that non-vitamin-K antagonists (NOACs) were slightly more effective at preventing systemic embolic events (SEE) than warfarin in patients with atrial fibrillation (AF).
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Systemic Embolic Events in Atrial Fibrillation: An Individual Patient Data Meta-analysis of 71 683 Participants Randomized to NOAC Versus Warfarin. Circulation. 2026 Feb 24;153(8):567-575. doi: 10.1161/CIRCULATIONAHA.125.075275. Epub 2026 Jan 30. PMID: 41614257.
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A novel multi-drug treatment protocol for fentanyl/xylazine “tranq dope” withdrawal did not result in clinically significant increases in QTc. However, less than half of the patients adhered to the protocol.
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Assessing the Cardiac Safety of a Multimodal Protocol for ‘Tranq Dope’ Withdrawal: A Retrospective QTc Analysis. Am J Emerg Med. 2026 Jan;99:313-324. doi: 10.1016/j.ajem.2025.10.033. Epub 2025 Oct 17. PMID: 41151217.
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Patients presenting with anginal symptoms and a new right bundle branch block (RBBB) on ECG or RBBB-specific high-risk features should prompt emergent evaluation for reperfusion therapy.
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Right bundle-branch block (RBBB) and acute coronary syndrome (ACS) a narrative review. Am J Emerg Med. 2026 Jan;99:325-334. doi: 10.1016/j.ajem.2025.10.037. Epub 2025 Oct 17. PMID: 41429745.
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This review on cardiogenic shock summarizes modern definitions, phenotypes, and evidence-based management strategies for cardiogenic shock, highlighting both effective therapies and persistent gaps in care.
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Cardiogenic Shock. N Engl J Med. 2026 Jan 1;394(1):62-77. doi: 10.1056/NEJMra2312086. PMID: 41467651.
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Point-of-care ultrasound (POCUS) is a powerful adjunct during cardiac arrest that can identify reversible causes, improve pulse checks, optimize chest compressions, and aid prognostication—as long as it does not interrupt high-quality CPR. When utilized correctly, POCUS may meaningfully guide resuscitation without prolonging pauses.
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Emergency medicine updates: Point-of-care ultrasound in cardiac arrest. Am J Emerg Med. 2026 Jan;99:176-187. doi: 10.1016/j.ajem.2025.09.021. Epub 2025 Sep 15. PMID: 41045789.
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Practice patterns over a recent 11-year period suggest that immediate pericardiocentesis is falling out of favor due to high false negative rate, with more reliance being placed on sternotomy.
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The contemporary use of emergency pericardiocentesis in trauma: A nationwide trend analysis. Am J Emerg Med. 2025 Dec;98:213-219. doi: 10.1016/j.ajem.2025.08.062. Epub 2025 Aug 29. PMID: 40907275.