emergency medicine cardiology

Ep 112 Tachydysrhythmias with Amal Mattu and Paul Dorian

In this EM Cases main Episode 112 Tachydysrhythmias with Amal Mattu and Paul Dorion we discuss a potpurri of clinical goodies for the recognition and management of both wide and narrow complex tachydysrhythmias and answer questions such as: Which patients with stable Ventricular Tachycardia (VT) require immediate electrical cardioversion, chemical cardioversion or no cardioversion at all? Are there any algorithms that can reliably distinguish VT from SVT with aberrancy? What is the "verapamil death test"? While procainamide may be the first line medication for stable VT based on the PROCAMIO study, what are the indications for IV amiodarone for VT? How should we best manage patients with VT who have an ICD? How can the Bix Rule help distinguish Atrial Flutter from SVT? What is the preferred medication for conversion of SVT to sinus rhythm, Adenosine or Calcium Channel Blockers (CCBs)? Why is amiodarone contraindicated in patients with WPW associated with atrial fibrillation? What are the important differences in the approach and treatment of atrial fibrillation vs. atrial flutter? How can we safely curb the high bounce-back rate of patients with atrial fibrillation who present to the ED? and many more...

By Anton Helman|2022-10-16T12:53:36-04:00July 17th, 2018|Categories: Cardiology, EM Cases, Emergency Medicine, Episodes, Medical Specialty, Resuscitation|Tags: Amal Mattu, amiodarone, atrial fibirillation, atrial flutter, diltiazem, electrical cardioversion, ICD, Paul Dorion, procainamide, SVT, ventricular tachycardia, WPW|9 Comments

$esmolol for refractory ventricular vibrillation$

BCE 73 Esmolol in Refractory Ventricular Fibrillation

In anticipation of EM Cases Episode 112 on Tachydysrhthmias with Amal Mattu and Paul Dorion, Melanie Baimel tells her Best Case Ever of a previously healthy young man who presents in refractory ventricular fibrillation after receiving multiple single shocks, ongoing chest compressions, several rounds of epinephrine, amiodarone and dual sequence defibrillation without ROSC...

By Anton Helman|2023-05-14T17:54:52-04:00July 3rd, 2018|Categories: Best Case Ever, Cardiology, EM Cases, Emergency Medicine, Medical Specialty, Resuscitation|Tags: Melanie Baimel, ventricular fibrillation, ventricular storm, VF|3 Comments

JJ 12 BNP for Diagnosis of Acute CHF

BNP is currently in use in many EDs across North America and Europe. In this Journal Jam podcast we discuss the clinical utility of BNP and pro-NT-BNP in the work-up of the dyspneic ED patient. We ask the questions: does BNP add much beyond physician gestalt? Which patients might BNP be useful for? Should we abandon BNP as a dichotomous rule-in/rule-out variable and instead use it as a continuous variable? Does using BNP effect patient oriented outcomes? Is lung POCUS a better test? Are prediction models that include BNP useful? and many more....

By Anton Helman|2019-01-01T18:12:01-05:00March 13th, 2018|Categories: Cardiology, EM Cases, Emergency Medicine, Journal Jam, Medical Specialty|Tags: acute heart failure, BNP, Brian Steinhart, CHF, Chris Carpenter, spectrum bias|3 Comments

BCE 66 CHD with Bronchiolitis: A Delicate Balance

When patients with known congenital heart disease present to the ED with common illnesses we need to consider how their physiology might alter our approach to those common illnesses. Max Ben-Yakov guides us through his Best Case Ever of a CHD patient who presents with bronchiolitis and gives us some tips on how best to approach these fragile patients in a crisis situation...

By Anton Helman|2018-06-08T12:09:04-04:00February 13th, 2018|Categories: Best Case Ever, Cardiology, EM Cases, Emergency Medicine, Medical Specialty, Pediatrics, Resuscitation|Tags: bronchiolitis, CHD, cogenital heart disease, cyanosis, cyanotic infant, Tet spell|1 Comment

Best Case Ever 59 Management of Acute Renal Failure with Volume Overload

Sometimes our renal failure patients present short of breath with volume overload and we don't have immediate access to dialysis. What then? Dr. Mike Betzner, EM doc and medical director of STARS air ambulance service and collaborator on EM Cases CritCases blog tells his Best Case Ever and his approach to this challenging clinical situation. He offers two commonly used solutions: nitroglycerin and BiPAP as well as two not so common solutions: phlebotomy and rotating BP cuffs blown to above SBP...

By Anton Helman|2017-07-17T14:08:29-04:00June 27th, 2017|Categories: Best Case Ever, Cardiology, EM Cases, Emergency Medicine, Medical Specialty|Tags: ARF, BIPAP, Mike Betzner, nitroglycerin, pulmonary edema|4 Comments

Episode 96 Beyond ACLS Cardiac Arrest – Live from EMU Conference 2017

This is the first ever video podcast on EM Cases with Jordan Chenkin from EMU Conference 2017 discussing how to optimize three aspects of cardiac arrest care: persistent ventricular fibrillation, optimizing pulse checks and PEA arrest, with code team videos contrasting the ACLS approach to an optimized approach...

By Anton Helman|2021-04-04T11:54:58-04:00May 23rd, 2017|Categories: Cardiology, Conference, EM Cases, Emergency Medicine, Episodes, NYGH EM Update, Resuscitation, Ultrasound|Tags: cardiac arrest, dual defibrillation, esmolol, Jordan Chenkin, PEA arrest, POCUS, ventricular fibrillation|3 Comments

Episode 93 – PALS Guidelines

I remember when I started practicing emergency medicine a decade and a half ago it seemed that any kid who came to our ED in cardiac arrest died. I know, depressing thought. But, over the past 15 years, survival to discharge from pediatric cardiac arrest has markedly improved, at least for in-hospital arrests. This is probably mostly due to an emphasis on high-quality CPR and advances in post-resuscitation care; nonetheless the more comfortable, knowledgeable and prepared we are for the always scary critically ill pediatric patient, the more likely we will be able to resuscitate them successfully - which is always a huge save.

By Anton Helman|2022-12-06T07:28:41-05:00March 14th, 2017|Categories: Cardiology, EM Cases, Emergency Medicine, Episodes, Medical Specialty, Pediatrics, Resuscitation|Tags: amiodarone, atropine, cardiac arrest, chest compressions, CPR, ECMO, fluid management, lidocaine, septic shock, TTM|3 Comments

Episode 92 – Aortic Dissection Live from The EM Cases Course

While missing aortic dissection was considered "the standard" in the late 20th century, our understanding of the clinical diagnoses has improved considerably since the landmark International Registry of Aortic Dissection (IRAD) study in 2000. Nonetheless, aortic dissection remains difficult to diagnosis with 1 in 6 being missed at the initial ED visit. With the help of Dr. David Carr we’ll discuss how to pick up atypical presentations of aortic dissection without over-imaging as well as manage them like pros by reviewing: 1. The 5 Pain Pearls, 2. The concepts of CP +1 and 1+ CP, 3. Physical exam pearls, 4. CXR pearls and blood test pitfalls, and 5. The importance of the correct order and aggressive use of IV medications. So with these objectives in mind…

By Anton Helman|2024-05-21T01:36:54-04:00February 21st, 2017|Categories: Cardiology, Conference, EM Cases, Emergency Medicine, Episodes, Medical Specialty|Tags: David Carr, EM Cases Course, esmolol, labetolol, troponin|0 Comments

Journal Jam 9 – D-dimer to Rule Out Aortic Dissection

The EM Cases Team is very excited to bring you not only a new format for the Journal Jam podcast but a new member of the team, Dr. Rory Spiegel, aka @EM_Nerd an Emergency Medicine physician from The University Maryland Medical Center in Baltimore, the founder of the EM Nerd blog and the co-host of the Annals of EM podcast. The new format sees Justin Morgenstern, Teresa Chan, Rory Spiegel and Anton Helman doing deep dives into the world's literature on specific practical questions while highlighting some important evidence-based medicine concepts. The question we ask in this Journal Jam podcast: Is there a role for D-dimer testing in the workup of aortic dissection in the ED?

By Anton Helman|2018-12-21T19:15:51-05:00February 7th, 2017|Categories: Cardiology, EM Cases, Emergency Medicine, Hematology, Journal Jam, Medical Specialty|Tags: ADD score, aortic dissection, D-dimer, EBM, Justin Morgenstern, Rory Spiegel, spectrum bias, Teresa Chan|1 Comment

Best Case Ever 52 – Pediatric Hypothermia Cardiac Arrest

In anticipation of EM Cases Episode 90 on the Pediatric Advanced Life Support (PALS) guidelines with the lead author Dr. Allan DeCaen and Dr. Anthony Crocco, Dr. DeCaen tells his Best Case Ever showing us the value of orchestrated team work and a great example of the saying, "they're not dead until they're warm and dead"...

By Anton Helman|2016-12-06T16:45:45-05:00December 6th, 2016|Categories: Best Case Ever, Cardiology, EM Cases, Emergency Medicine, Medical Specialty, Pediatrics, Resuscitation|Tags: Allan DeCaen, CPR, ECMO, hypothermia, pediatric arrest|0 Comments