Episode 28: Aortic Dissection, Acute Limb Ischemia and Compartment Syndrome

Dr. Anil Chopra & Dr. David Carr discuss the breadth of presentations and key diagnostic clues of Aortic Dissection. They review the value of ECG, CXR and biomarkers as well as compare and contrast the use of Transesophageal Echo and CTA in this sometime elusive diagnosis. Being the authors of the Tintanalli chapter on Occlusive Arterial Disease, they give as lots of clinical pearls and pitfalls when it comes to Acute Limb Ischemia. We end with a discussion on the trials and tribulations of Compartment Syndrome.

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 /]

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....

Episode 4: Acute Congestive Heart Failure

Dr. Eric Letovsky and Dr. Brian Steinhart describe a practical way to approach patients with undifferentiated SOB and acute congestive heart failure, the utility of various symptoms and signs in the diagnosis of CHF, as well as the controversies surrounding the best use of BNP and Troponin in the ED. A discussion of the use of ultrasound for patients with SOB as well as the indications for formal Echo are reviewed. In the second part of the episode they discuss the management of acute congestive heart failure based on a practical EM model, as well as the difficulties surrounding disposition of patients with CHF.