Beta-Blockers For High Blood Pressure: Types, Side Effects, Drug Interactions
Conclusion In conclusion, beta-blockers serve as an indispensable tool in the realm of modern medical treatment, particularly in managing a broad range of cardiovascular conditions. Their unique mechanism of action, which includes decreasing heart rate and blood pressure, confers a significant cardio-protective effect. This, combined with their versatility and the extensive clinical experience with their use, has cemented beta-blockers as a first-line treatment for various conditions, from hypertension and heart failure to anxiety and migraines. Although beta-blockers present unique benefits, it’s crucial...
Source: The EMT Spot - July 24, 2023 Category: Emergency Medicine Authors: Michael Rotman, MD, FRCPC, PhD Tags: Blood Pressure Source Type: blogs

Syncope in a 20-something woman
A 20-something was outside exerting herself.  She states that  it was hot outside and that she was probably dehydrated. At one point, she felt lightheaded and then can ' t remember anything until waking up in the ambulance.  Her friends saw her lose consciousness and fall on the ground.  She regained consciousness spontaneously before responders arrived. Fire department was on scene first, who noted a cyanotic color to the patient ' s face.  EMS arrived and also noted cyanotic color which improved en route to HCMC. She denies head pain, neck pain, back pain, abdominal pain or any pain at this ...
Source: Dr. Smith's ECG Blog - July 17, 2018 Category: Cardiology Authors: Steve Smith Source Type: blogs

The cirrhosis chalk talk
Some days on ward rounds we have time for relatively short chalk talks.  Over the years I have developed many.  Learners seem to like this one in particular. We start with this question – name complications that cirrhotic patients develop for which we have secondary prevention.  Knowing this list and the associated drugs allows us to peruse the drug list to add to the PMH when it is not readily available. Here is my list: Esophageal varices – most patients with significant varices are taking a non-specific beta blocker.  More recently evidence suggests that carvedilol might be better than propranolol or nad...
Source: DB's Medical Rants - April 2, 2018 Category: Internal Medicine Authors: rcentor Tags: Medical Rants Source Type: blogs

Long QT Syndrome with Continuously Recurrent Polymorphic VT: Management
A young woman presented with intermittent shocks from her implantable defibrillator.  She was intermittently unconscious and unable to give history.   The monitor showed intermittent polymorphic ventricular tachycardia.    The physician was presented with this ECG at the same moment he was observing the repeated syncope:Time zeroIt is a bigeminal rhythm with a very bizarre PVC.  The PVC has an incredibly long QT, but the intervening native rhythms do not.  However, when I saw this (it was texted to me), it immediately reminded me of this case, so I knew by sheer recognition that it was lo...
Source: Dr. Smith's ECG Blog - July 8, 2015 Category: Cardiology Authors: Steve Smith Source Type: blogs

Does Insurance Cover Botox Injections for Migraine Headaches?
Unfortunately no insurance company covers Botox therapy for generic headaches. Many will cover Botox for chronic migraines, which have been unresponsive to standard preventative therapies. In 2011, the FDA approved Botox for treating chronic migraines which have been unresponsive to an adequate trial of preventative medications. Preventative medications do not include the use of any narcotic pain killers. Insurance companies have made it difficult for patients to obtain Botox payment authorization, by putting in place numerous qualification barriers – if they cover Botox at all. Insurance companies do require e...
Source: Sarasota Neurology - March 3, 2015 Category: Neurology Authors: Dan Kassicieh, D.O. Tags: Migraines / Headache Boto for headaches Botox covered by insurance botox for headaches Botox Headaches Insurance Source Type: blogs

ED Case of Catecholaminergic Polymorphic Ventricular Tachycardia
This article only comments on chronic management, not acute management. (Source: Dr. Smith's ECG Blog)
Source: Dr. Smith's ECG Blog - February 6, 2015 Category: Cardiology Authors: Steve Smith Source Type: blogs