Association of Admission Blood Glucose Level with Major Adverse Cardiac Events in Acute Coronary Syndrome; a Cohort Study.

This study aims to assess the influence of ABGL on development of 30-day major adverse cardiac events (MACEs) in patients with suspected ACS. Methods: This is a prospective cohort study based on analysis of data collected from patients suspected to acute coronary syndrome admitted to emergency department. ABGL of patients was measured and its association with development of MACEs (MI, CVA, mortality) within 30 days of follow-up was studied. Results: 814 participants with the mean age of 61.8 ± 13.4 years were studied (58.1% male). MACE endpoints were developed in 166 (39.0%) hyperglycemic, 30 (46.9%) hypoglycemic, and 53 (16.4%) normoglycemic patients (p
Source: Accident and Emergency Nursing - Category: Emergency Medicine Authors: Tags: Arch Acad Emerg Med Source Type: research

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A previously healthy, well-appearing 42-year-old female living in a modern, high-rise apartment in downtown Los Angeles calls 9-1-1 at 5:30 am complaining of worsening of a burning, epigastric pain she had been experiencing for the last three days. She reports associated nausea and non-bloody, non-bilious vomiting, and that she couldn’t manage to get comfortable in bed until she finally decided to call for help at daybreak. During her 9-1-1 call, she reports “pain, like heartburn, that just woke me up again and I had to throw up, … and then I was sweating so much.” Using the Los Angeles Tiered Disp...
Source: JEMS Special Topics - Category: Emergency Medicine Authors: Tags: Exclusive Articles Cardiac & Resuscitation Source Type: news
Written by Pendell MeyersA 76 year old man with history of CHF, moderate aortic stenosis, insulin-dependent diabetes, hypertension, stroke, CAD s/p stents, CKD, PVD, OSA presented to the ED with shortness of breath and chest pain off and on for 2 weeks. This afternoon his symptoms intensified so he called EMS.In the ED he appeared acutely ill, with HR 100-115, RR 20-25, BP 93/52, hypoxic to 88-92% on 5L nasal cannula, afebrile.Here is his presentation ECG, followed by his baseline ECG on file:Presentation ECG.Baseline ECG.The presentation ECG shows ventricular paced rhythm at rate of approximately 120 bpm. The J-point in V...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs
This case is posted by Salim Rezaie (@srrezaie)Chest Pain, “Negative” Stress Tests, POCUS,&ECG EquationsIt has some peer review by me at the end, so we'reco-posting!!Chest Pain, " Negative " Stress Tests, POCUS,&ECG Equationsby Salim RezaieI was working a busy shift in the ED, like many of us do, and the next patient I was going to see was a 57 year old male with no real medical problems complaining of chest pain.  I remember thinking as I walked into the room this guy looks ashen and diaphoretic ….he doesn’t look well.  He is a paramedic telling me how he has been havin...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs
A late middle-aged male with h/o 3 vessel bypass (CABG), type 2 diabetes, peripheral vascular disease, DVT, Chronic Kideny Disease, and chronic combined systolic and diastolic congestive heart failure presented with chest pain which started approximately 2 hours prior to arrival.Here was the initial ED ECG:Sinus RhythmThere is an rSR'in V1, with wide S-waves in lateral leads (right bundle branch block, RBBB).Normally, RBBB has a bit of ST depression in V1-V3 that is discordant (in the opposite direction of) the R'-wave.So that bit of ST Depression in V1 is normal.What about V2 and V3?Notice there is no R'-wave in V2 and V3...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs
Time limit: 0 Quiz-summary 0 of 20 questions completed Questions: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 Information This test series requires login for attempting. You can login easily with your Facebook account (Use the CONNECT WITH icon on the upper part of right sidebar displaying t...
Source: Cardiophile MD - Category: Cardiology Authors: Tags: General Cardiology Source Type: blogs
Conclusions: Our study suggested that incident CHD was positively associated with plasma levels of titanium and arsenic, and inversely associated with selenium. Additional research is needed to confirm these findings in other populations. https://doi.org/10.1289/EHP1521 Received: 22 December 2016 Revised: 17 September 2017 Accepted: 19 September 2017 Published: 19 October 2017 Address correspondence to T. Wu, or A. Pan, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hongkong Rd., Wuhan 430030, Hubei, China. Telephone: +86-27-83692347. Email: wut@mails.tjmu.edu.cn or p...
Source: EHP Research - Category: Environmental Health Authors: Tags: Research Source Type: research
Conclusion: Progression of AVC system disease in patients with STEMI treated with primary PCI is uncommon, occurs primarily in the setting of anterior myocardial infarction, and portends a high risk for death and major adverse cardiac events.
Source: Coronary Artery Disease - Category: Cardiology Tags: Original Research Source Type: research
A 50-something with diabetes presented with 3 hours of sharp chest pain radiating to the left hand, with dyspnea and diaphoresis; it was worse with exertion and with lying flat.He had this second ECG, which was texted to me and I looked at it on my iPhone. At the time of this ECG, the patient had received NTG and the pain was decreasing.ECG-1:There is 1 mm of ST elevation at the J-point in both V2 and V3 (within normal limits).Computer interpretation is normalCardiologist overread is normalWhat do you think?More description: There is also poor R wave progression, with small R waves in V4. The T waves are sli...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs
ANISH KOKA MD In an age where big data is king and doctors are urged to treat populations, the journey of one man still has much to tell us. This is a tale of a man named Joe. Joseph Carrigan was a bear of a man – though his wife would say he was more teddy than bear.  He loved guitar playing,  and camp horror movies.  Those who knew him well said he had a kind heart, a quick wit and loved cats. I knew none of these things when I met Joe in the Emergency Department on a Sunday afternoon.  I had been called because of an abnormal electrocardiogram – the ER team was worried he could be having ...
Source: The Health Care Blog - Category: Consumer Health News Authors: Tags: Uncategorized Source Type: blogs
ANISH KOKA MD In an age where big data is king and doctors are urged to treat populations, the journey of one man still has much to tell us. This is a tale of a man named Joe. Joseph Carrigan was a bear of a man – though his wife would say he was more teddy than bear.  He loved guitar playing,  and camp horror movies.  Those who knew him well said he had a kind heart, a quick wit and loved cats. I knew none of these things when I met Joe in the Emergency Department on a Sunday afternoon.  I had been called because of an abnormal electrocardiogram – the ER team was worried he could be having ...
Source: The Health Care Blog - Category: Consumer Health News Authors: Tags: Uncategorized Cardiac surgery High-risk Quality Reporting Source Type: blogs
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