Nov 3 Cardiology News
The ORBITA sham-control PCI study, Watchman, revascularization in cardiogenic shock, Absorb BVS, quality-of-life outcomes after PCI or bypass, and chronic total occlusion PCI are discussed in this week's podcast.
To examine time trends of management and mortality of acute coronary syndrome patients with associated diabetes mellitus.
CONCLUSIONS: Use of Impella for CS and HR-PCI is increasing substantially in Italy, despite relatively high rates of device-related complications. PMID: 31422925 [PubMed - as supplied by publisher]
An 80 year old presented with a couple days of SOB, weakness, and diaphoresis. There was no chest pain.Here was her initial ECG:What do you think?-There is a paced rhythm. -There is some concordant ST Elevation (STE) in V5 and V6. -There is ST depression in V2. -There is minimal concordant ST depression in V3 (remember there should be, if anything, appropriately discordant STElevation).The treating physician did not think that there was sufficient concordant STE in V5 and V6. He saw the ST depression in V2, but did not see it as concordant or excessively discordant because the R-wave and S-wave w...
Conclusions: Extracorporeal membrane oxygenation is a powerful mechanical circulatory support modality capable of rapidly restoring systemic perfusion yet lacking in defined approaches to management. Adopting a management approach based physiologic principles provides a basis for care.
Conclusion: Data from our single-center study indicate that urgent and vital decisions based on potassium measurements can be made by trusting the value obtained on the ABG machine irrespective of pH values. PMID: 31396417 [PubMed]
Cardiogenic shock, cardiac arrest, acute respiratory failure, or a combination of such events, are all potential complications after cardiac surgery which lead to high mortality. Use of extracorporeal temporary cardio-circulatory and respiratory support for progressive clinical deterioration can facilitate bridging the patient to recovery or to more durable support. Over the last decade, extracorporeal membrane oxygenation (ECMO) has emerged as the preferred temporary artificial support system in such circumstances.
Post by Smith and MeyersSam Ghali (https://twitter.com/EM_RESUS) just asked me (Smith):" Steve, do left main coronary artery *occlusions* (actual ones with transmural ischemia) have ST Depression or ST Elevation in aVR? "Smith and Meyers answer:First, LM occlusion is uncommon in the ED because most of these die before they can get a 12-lead recorded.But if they do present:The very common presentation of diffuse STD with reciprocal STE in aVR is NOT left main occlusion, though it might be due to subtotal LM ACS, but is much more often due to non-ACS conditions, especially demand ischemia. ...
To the Editor,
CONCLUSION: Although veno-arterial extracorporeal membrane oxygenation can improve the survival, it is associated with morbidity. Therefore, risk-benefit analysis for veno-arterial extracorporeal membrane oxygenation and prevention of complications are important to improve prognosis. PMID: 31394965 [PubMed - as supplied by publisher]