How Aortic Dissection Presents
Sudden-onset, severe ("worst-ever"), sharp chest pain was the hallmark type A and B aortic dissection. Ripping or tearing pain was present in only half of patients. Classic features of aortic regurgitation murmur and pulse deficit were frequently lacking.
Coronary CTA vs Functional Stress – Which Is Better?
There was no mortality difference based on which stress test was done, coronary CTA (CCTA) or functional stress testing. But CCTA led to more downstream testing. Either test is fine, but know that tests may have unintended consequences.
A New Better Way to Detect LVH on ECG
Adding the magnitudes of the deepest S wave anywhere in the ECG to the deepest S wave in lead V4 (SD + SV4) was the most sensitive ECG test for LVH (62%) while maintaining specificity above 90%.
Morphine Harmful in CHF
Morphine was associated with worse short-term mortality all other known variables being equal: 20% vs. 12.7%.
Ibutilide for A-fib in Real World Practice
Ibutilide worked to chemically cardiovert rapid atrial fibrillation in just over half of cases but was associated with the feared complication, ventricular tachycardia, in 2 patients (0.6%).
Oxygen Therapy in Suspected Acute Myocardial Infarction
In this RCT, patients suspected of acute myocardial infarction (AMI) with O2 saturations >/=90% were randomized to receive supplemental oxygen vs ambient air. There was no statistically significant difference between patients in death from any cause at 1 year.
Which Compression to Ventilation Ratio Should You Use?
According to this large systematic review, in adults a 30:2 compression to ventilation ratio was better than 15:2. For kids, either ratio was better than compression only CPR, except under 1 year in which ventilations did not improve outcome beyond compression-only.
Push Alert Labs – ICYMI Troponin Is Positive
Push alerts for troponin results to a physician's smartphone decreased time to disposition by 26 minutes, but it didn't affect total length of stay.
AHA Cardiogenic Shock Spoon Feed
This 50 page AHA guideline is very concisely but completely summarized right here. Save some time and get the pearls. Table 5 is fantastic, and this article is available in free full text (see Source below), so take advantage and look at this.
New AHA Syncope Guidelines – Spoon Feed
The new AHA syncope guidelines have useful information for us clinically, but slogging through this 232 page tome wasn't easy. Thomas Davis highlights what's most important. This is a huge time saver - take advantage of this.