Daily Caffeine Consumption is Associated with Decreased Incidence of Symptoms and Hemodynamic Changes During Pharmacologic Stress with Regadenoson.

Conclusion: Caffeine consumers receiving regadenoson stress MPI was very common, and use of regadenoson for MPI in caffeine consumers is safe and associated with lower incidence of certain symptoms compared to non-caffeine consumers. Specifically, caffeine intake was associated with less aminophylline use and chest pain. PMID: 31604901 [PubMed - as supplied by publisher]
Source: Journal of Nuclear Medicine Technology - Category: Nuclear Medicine Tags: J Nucl Med Technol Source Type: research

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Written by Meyers, edits by SmithA 50-ish year old man was working construction when he suddenly collapsed. Coworkers started CPR within 1 minute of collapse. EMS arrived within 10 minutes and continued CPR and ACLS, noting alternating asystole and sinus bradycardia during rhythm checks. He received various ACLS medications and arrived at the ED with a perfusing rhythm.Initial vitals included heart rate around 100 bpm and BP 174/96. Here is his initial ECG, very soon after ROSC:What do you think?Sinus tachycardia.  There is incomplete RBBB (QRS duration less than 120 ms).  There is diffuse STD, maximal in V4-V5 a...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs
Conclusions: Chronic caffeine intake prior to regadenoson stress MPI was very common, and abruptly stopping caffeine for MPI is safe and associated more with changes in symptoms rather than physiologic parameters. Indeed, chronic caffeine intake was associated with less aminophylline use and chest pain.
Source: Journal of Nuclear Medicine - Category: Nuclear Medicine Authors: Tags: Cardiovascular Clinical Science Posters Source Type: research
Conclusion For the patient in this case, the decision to forego the convenience of a machine in favor of the skills of a knowledgeable paramedic was lifesaving. Much like the comparison often drawn between the old-fashioned barbell and more sophisticated exercise machines, newer, more complex, and more expensive might make a process more comfortable, but doesn’t always equate to superior results. As we surrender more and more of our hands-on skills to the ease of automated technology, we risk more than the loss of the aptitudes that form the foundation of sound patient assessment—we place our patients in jeopar...
Source: JEMS Special Topics - Category: Emergency Medicine Authors: Tags: Exclusive Articles Cardiac & Resuscitation Source Type: news
Abstract Background Myocardial perfusion reserve index (MPRI) and extracellular volume fraction (ECV) on cardiac magnetic resonance (CMR) are known to quantify coronary microvascular dysfunction and myocardial fibrosis, respectively. Purpose To demonstrate that cardiovascular risk factors such as hypertension, diabetes, hyperlipidemia, and smoking are correlated with MPRI and ECV on CMR in asymptomatic individuals. Material and Methods Between October 2013 and July 2014, 196 individuals underwent CMR. After excluding those with chest pain, arrhythmia, and obstructive coronary artery disease, participants were divi...
Source: Acta Radiologica - Category: Radiology Authors: Tags: Acta Radiol Source Type: research
CONCLUSION: Our findings support previously published data indicating the optimal safety profile of regadenoson MPI, even in the group of patients suffering from chronic obstructive pulmonary disease. PMID: 29177261 [PubMed - as supplied by publisher]
Source: Hellenic Journal of Nuclear Medicine - Category: Nuclear Medicine Tags: Hell J Nucl Med Source Type: research
CONCLUSION: Chest pain evaluation is challenging for ED physicians, hospitalists, and cardiologists. Although the nuclear myocardial perfusion scan has excellent sensitivity and specificity in ischemic detection, the clinical examination remains the primary determinant of further management. PMID: 28638298 [PubMed - in process]
Source: Ochsner Journal - Category: General Medicine Tags: Ochsner J Source Type: research
CONCLUSION:The variables that interplay in cases of severe aortic stenosis are what cause these patients to be so difficult to manage, and specific therapies targeted to fix one issue often worsen the effects of another issue. If someone is in respiratory distress, their airway and breathing needs to be secured, either through non-invasive or invasive means. Next, the patient ’s blood pressure needs to be stabilized. Oftentimes the most appropriate agent will be a positive inotrope, with consideration of a vasoactive agent in persistent hypotension. Once a patient is stabilized, determining the extent of damage to th...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs
This study reported 32 arrhythmic episodes in 24 patients. There was spontaneous recovery with abstinence from alcohol. Reference 1. Ettinger PO, Wu CF, De La Cruz C Jr, Weisse AB, Ahmed SS, Regan TJ. Arrhythmias and the “Holiday Heart”: alcohol-associated cardiac rhythm disorders. Am Heart J. 1978 May;95(5):555-62.Question 14Diagnosis based on the echocardiogram: AEbstein’s anomaly of tricuspid valveBNone of the aboveCEndomyocardial fibrosisDIdiopathic dilatation of right atriumQuestion 14 Explanation:  Endomyocardial Fibrosis (EMF) is a type of restrictive cardiomyopathy. It is characteris...
Source: Cardiophile MD - Category: Cardiology Authors: Tags: Cardiology MCQ DM / DNB Cardiology Entrance Featured Source Type: blogs
We present the case of a 73‐year‐old woman who suffered severe coronary perforation after stent implantation and post‐dilatation. To allow prolonged balloon inflation without ischemia, we perfused the distal area with the patient's own arterial blood injected via micro‐catheter. With this method, we could prolong balloon inflation for 20 min, successfully achieving hemostasis. This novel technique, which we named the “distal perfusion technique,” is useful to minimize ischemia during prolonged balloon inflation. © 2015 Wiley Periodicals, Inc.
Source: Catheterization and Cardiovascular Interventions - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Coronary Artery Disease Source Type: research
A 31-year-old man presented to the ED with syncope. He was previously healthy, takes no medications, and had run a marathon the day before. He was riding the light rail home from a baseball game when he developed vague 4/10 epigastric abdominal pain associated with nausea and diaphoresis. He remembers feeling lightheaded and flushed before momentarily passing out. His wife said he became quite pale immediately beforehand. He did not have any headache, chest pain, or shortness of breath before or after the syncopal episode. He has a significant family history of premature coronary artery disease. He had normal vital s...
Source: Spontaneous Circulation - Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
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