emergency medicine cardiology

Episode 41: Hypertensive Emergencies

In this episode on Hypertensive Emergencies, Dr. Joel Yaphe, EM residency program director at the University of Toronto & Dr. Clare Atzema, one of Canada's leading cardiovascular EM researchers will discuss the controversies of how to manage patients who present to the ED with high blood pressure and evidence of end organ damage related to the high blood pressure. Hypertensive emergencies are a grab bag of diagnoses that all need to be treated differently. Hypertensive Encephalopathy, Aortic Dissection, Acute Pulmonary Edema, Pre-eclampsia & Eclampsia, Acute Renal Failure, Subarachnoid Hemorrhage and Intracranial Hemorrhage all need individualized blood pressure management.

By Anton Helman|2024-08-10T19:20:03-04:00March 24th, 2014|Categories: Cardiology, EM Cases, Emergency Medicine, Episodes, Resuscitation|Tags: acute renal failure, aortic dissection, Clare Atzema, congestive heart failure, eclampsia, hypertensive encephalopathy, intractranial hemorrhage, Joel Yaphe, labetolol, nicardipine, nitroprusside, subarachnoid hemorrhage|18 Comments

Episode 40: Asymptomatic Hypertension

University of Toronto EM Residency program director, Joel Yaphe and cardiovascular EM researcher, Clare Atzema discuss the guidelines, controversies, pearls & pitfalls of Asymptomatic Hypertension in the ED. The literature is thin in this area, and there are many controversies: Does an elevated BP measured in the ED represent true essential hypertension? Do these patients need to be worked up? Are they at risk of serious morbidity and mortality? Should we treat these patients in the ED with antihypertensives? Should we send them home on antihypertensives? and many more......

By Anton Helman|2024-08-10T19:18:54-04:00February 20th, 2014|Categories: Cardiology, EM Cases, Emergency Medicine, Episodes|Tags: ACE Inhibitor, acep guidelines, antihypertensive, b-blocker, calcium channel blocker, Clare Atzema, feature, hydralazine, hydrocholorthiazide, hypertensive emergency, Joel Yaphe|2 Comments

Episode 36: Transfusions, Anticoagulants and Bleeding

In the first part of this epic 2 part must-hear episode, Transfusions, Anticoagulants & Bleeding, we have the triumphant return of Dr. Walter Himmel (also known as 'The walking encyclopedia of EM') along with Dr. Katerina Pavenski (Head of Transfusion Medicine at St. Michael's Hospital) & Dr. Jeannie Callum (Head of Transfusion Medicine at Sunnybrook Hospital) who will update you on the latest in transfusion indications & risks, managing INRs and how Wararin compares to Dabigatran, Rivaroxiban & Apixaban. They give you the authoritative low down on: Indications for red cell transfusions in different clinical scenarios (GI bleed, cardiac disease, vaginal bleeding etc) and how to give them, Risks of red cell transfusions including Host vs Graft Disease, TRALI & TACO and how to manage them, IV Iron as an alternative to red cell transfusions, Managing INRs: indications for Vit K, Prothrombin Complex Concentrates (Octaplex & Beriplex), adjusting Warfarin Dose, liver patients, and much much more.........

By Anton Helman|2024-08-10T19:22:28-04:00September 20th, 2013|Categories: Cardiology, EM Cases, Emergency Medicine, Episodes, Hematology, Resuscitation|Tags: Apixiban, dabigitran, IV Iron, PCCs, Red Cell Transfusion, rivaroxiban, TACO, TRALI, Walter HImmel, Warfain|2 Comments

Episode 34: Geriatric Emergency Medicine

In this episode Dr. Don Melady, Canada's leading educator in Geriatric Emergency Medicine (Geri-EM) & Dr. Jaques Lee, one of Canada's leading researchers in Geri-EM, discuss the common yet challenging Geriatric Emergencies: a practical approach to geriatric Delirium, best practice for managing agitation and pain in the older patient, management of recurrent falls, pearls in the assessment of the 'Weak & Dizzy' geriatric patient, atypical presentations of common life threatening emergencies including ACS and surgical abdomen, key drug interactions in the geriatric patient and more..

By Anton Helman|2021-03-31T12:58:46-04:00July 8th, 2013|Categories: Cardiology, EM Cases, Emergency Medicine, Episodes, Gastroenterology, Neurology, Trauma|Tags: delirium, Don Melady, drug interactions, falls, Geri-EM, Jaques Lee, Warfarin, weak and dizzy|1 Comment

Episode 32: Whistler Update in Emergency Medicine Conference 2013

Whistler's Update in Emergency Medicine Conference 2013 in Whistler, British Columbia is U of Toronto's case-based interactive small group EM conference. There were so may great talks with amazing clinical pearls that I decided to wade through the 18 hours of audio recordings and packaged some of the key highlights for you here......EM Literature Review 2012 by Dr. Joel Yaphe, Neonatal Resuscitation Pearls by Dr. Nicole Kester-Greene, Fever of Unknown Origin by Dr. Shirley Lee, Improving Cosmesis in Wound Management by Dr. Maria Ivankovic, Hepato-biliary Disease by Dr. Sara Gray, & Pediatric Cardiac & Respiratory Cases by Dr. Donna Goldenberg.

By Anton Helman|2022-09-05T18:03:34-04:00April 10th, 2013|Categories: Cardiology, Conference, Emergency Medicine, Episodes, Gastroenterology, Pediatrics, Respirology, Whistler Update in EM|Tags: anticoagulants, azithromycin, cholangitis, cholycystitis, FUO, gonorrhea, hepatic encephalopathy, intubation, Joel Yaphe, laceration, Maria Ivankovic, pain managment, peritonsillar abscess, pneumothorax, Sara Grey, Shirley Lee, sinusitis, tissue adhesive, wound managment|0 Comments

Episode 30: Central Lines, Surgical Airways and Pericardiocentesis

In this episode dedicated to emergency procedures pearls and pitfalls, tips and tricks, Dr. Jordan Chenkin & Dr. Jamie Blicker take us step by step through how best to perform surgical airways and pericardiocentesis, as well as place central lines and intraosseous lines. They explain the various methods for surgical airways including the bougie-assisted surgical airway. They review the indications, contraindications, and complications for all of these life saving procedures, and give us some amazing tips and tricks on what to do when things aren't going as expected.

By Anton Helman|2021-03-31T13:03:23-04:00February 11th, 2013|Categories: Cardiology, EM Cases, Emergency Medicine, Episodes, Resuscitation|Tags: bougie, central line, Cricothyrotomy, intraosseus line, Jamie Blicker, Jordan Chenkin, pericardiocentesis, surgical airway|0 Comments

Best Case Ever 13: Aortic Dissection

Dr. David Carr, the past author of Tintinalli's chapter on occlusive arterial disease, tells us his Best Case Ever related to Aortic Dissection. In the related Episode 28: Aortic Dissection, Acute Limb Ischemia & Compartment Syndrome, we discuss the breadth of presentations and key diagnostic clues of Aortic Dissection. We review the value of ECG, CXR, biomarkers and the use of Transesophageal Echo and CTA in this sometime elusive diagnosis. We debate lots of clinical pearls and pitfalls when it comes to acute limb ischemia, and end with a discussion on the trials and tribulations of Compartment Syndrome. [wpfilebase tag=file id=398 tpl=emc-play /] [wpfilebase tag=file id=399 tpl=emc-mp3 /]

By Anton Helman|2020-05-31T23:19:18-04:00November 11th, 2012|Categories: Best Case Ever, Cardiology, EM Cases, Emergency Medicine, Neurology|Tags: aortic dissection, D-dimer, David Carr, echocardiogram, troponin|0 Comments

Episode 25: Pediatric Syncope and Adult Syncope

In this episode on Pediatric Syncope & Adult Syncope, Dr. Eric Letovksy & Dr. Anna Jarvis run through the key clinical pearls of the history, the physical, interpretation of the ECG and the value of clinical decision rules such as the ROSE rule and the San Francisco Syncope Rule in working up these patients. We discuss how to differentiate syncope from seizure, cardiac causes of syncope such as Arrhthmogenic Right Ventricular Cardiomyopthy & Prolonged QT Syndrome, and the indications for Holter monitoring, Echocardiograms and stress testing in patients with Syncope. Dr. Letvosky & Dr. Jarvis answer such questions as: How can we diagnose Hypertrophic Cardiomyopathy in the ED? What is the value of Troponin and BNP in the work-up of syncope? In what ways are patients with Down Syndrome at high risk for serious causes of syncope? In what ways are patients with alcohol dependence at risk for serious causes of syncope? Why is 'Benign' early repolarization not a benign condition in patients with syncope? Which children with syncope should be admitted? and many more....

By Anton Helman|2022-05-03T20:35:42-04:00July 16th, 2012|Categories: Cardiology, EM Cases, Emergency Medicine, Episodes, Pediatrics|Tags: Anna Jarvis, benign early repolarization, BNP, clinical decsion rules, echocardiogram, Eric Letovsky, holter, hypertrophic cardiomyopathy, prolonged QT, troponin|0 Comments

Best Case Ever 10: Pediatric Syncope

Pediatric Syncope usually has a benign cause, but may be a warning for sudden death. As a bonus to Episode 25 on ‘Pediatric & Adult Syncope’ with Dr. Eric Letovsky and Dr. Anna Jarvis, 'Canada's mother of Pediatric Emergency Medicine', we have Dr. Jarvis’s Best Case Ever. In the related episode we will cover how to differentiate syncope from seizure, key historical and physical exam clues to determine a cause of syncope, ECG pearls of syncope causing cardiac conditions, from Congenital Prolonged QT Syndrome to Arrhythmogenic Right Ventricular Cardiomyopathy, the value of syncope decision rules such as the ROSE rule and the San Francisco Syncope Rule, the value of ancillary testing, including Holter monitoring, Echocardiograms and Stress Testing and much more...... [wpfilebase tag=file id=386 tpl=emc-play /] [wpfilebase tag=file id=387 tpl=emc-mp3 /]

By Anton Helman|2016-10-20T13:22:02-04:00July 9th, 2012|Categories: Best Case Ever, Cardiology, EM Cases, Emergency Medicine, Pediatrics|Tags: Anna Jarvis, pediatric syncope, prolonged QT, sudden death|0 Comments

Episode 22a: Whistler Update in Emergency Medicine Conference 2012

In this bonus episode, our second installment of the highlights from Whistler Update in Emergency Medicine Conference 2012, we have Dr. Eric Letovsky talking about complications of MI and the importance of listening for cardiac murmurs. Next, I moderate an expert panel on the current trends on imaging patients who present with renal colic and query appendicitis with Dr. Connie Leblanc, Dr. Joel Yaphe, Dr. David MacKinnon & Dr. Eric Letovsky. We then hear from Dr. Adam Cheng, Dr. Dennis Scolnick & Dr. Anna Jarvis in a pediatric expert panel about the newest on minor head injury, otitis media, mastoiditis and bronchiolitis. Dr. David Carr reviews one of the most important articles in 2011 regarding subarachnoid hemorrhage, and Dr. David MacKinnon gives us tonnes of clinical pearls when it comes to everyone's favourite subject, anorectal disorders.

By Anton Helman|2021-03-31T13:12:31-04:00April 3rd, 2012|Categories: Cardiology, Conference, Ears Nose & Throat, Emergency Medicine, Episodes, Gastroenterology, Genitourinary, Pediatrics, Trauma, Whistler Update in EM|Tags: acute otitis media, Anna Jarvis, Appendicitis, clinical decsion rules, Dave MacKinnon, Dennis Scolnik, Eric Letovsky, minor head injury, myocardial infarction, subarachnoid hemorrhage, testicular torsion, urinary tract infection|0 Comments