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Fatal hemopericardium after intravenous recombinant transplasminogeen activator (rt-PA) for acute ischemic stroke
Intravenous recombinant transplasminogeen activator (rt-PA) treatment is considered as standard acute phase treatment in ischemic stroke. In the initial stroke guidelines, recent myocardial infarction (MI) was listed as a contraindication for rt-PA treatment due to the increased risk of myocardial wall rupture. However, in the recent American Heart Association/American Stroke Association guideline, it is regarded only as a relative contraindication, and in the European guidelines, currently it is not listed as a contraindication.
Source: The American Journal of Emergency Medicine - May 26, 2016 Category: Emergency Medicine Authors: Hanna Hensen, Fianne Spaander, Matthijs Bax, Hille Koppen Tags: Case Reports Source Type: research

Rescue thrombolysis in the treatment of cardiac shock and acute stroke
The patients with ST-elevation myocardial infarction are primarily managed with percutaneous coronary intervention (PCI) or thrombolysis. It is well accepted that rescue PCI should be implemented in case of unsuccessful thrombolysis. However, the reverse, rescue thrombolysis, that is, administering of thrombolytic therapy in a patient in whom primary PCI fails, is not well defined. There are no available data about rescue thrombolysis so far. We represent a 43-year-old male patient with Buerger disease (thromboangiitis obliterans) who was admitted to our emergency department for cardiac shock related to inferior and right ...
Source: The American Journal of Emergency Medicine - April 19, 2013 Category: Emergency Medicine Authors: Sukru Akyuz, Mustafa Azmi Sungur, Cevdet Donmez, Aylin Sungur, Nese Cam Tags: Case Reports Source Type: research

Thrombolytic therapy-associated acute myocardial infarction in patients with acute ischemic stroke: A treatment dilemma
Acute myocardial infarction (AMI) is uncommon in the acute phase of acute ischemic stroke (AIS) and occurs in approximately 1% of the population. Here, we report a paradoxical case of AMI during tissue plasminogen activator (t-PA) infusion for AIS. We review and analyze the previously reported cases. We found that only patients with AMI which occurred after thrombolytic therapy for AIS who received an adequate combination of anticoagulation plus percutaneous coronary intervention survived their events.
Source: The American Journal of Emergency Medicine - November 21, 2016 Category: Emergency Medicine Authors: Chih-Jen Yang, Po-Chuan Chen, Chin-Sheng Lin, Chia-Lin Tsai, Shih-Hung Tsai Source Type: research

Optimal treatment modality for coexisting acute myocardial infarction and ischemic stroke
We present a rare case of coexisting thrombosis of the coronary artery and mid cerebral artery that was managed successfully with tissue plasminogen activator thrombolytic therapy.
Source: The American Journal of Emergency Medicine - December 31, 2018 Category: Emergency Medicine Authors: Fatih Gungoren, Feyzullah Besli, Zulkif Tanriverdi, Ozcan Kocaturk Source Type: research

Effect of COVID19 on prehospital pronouncements and ED visits for stroke and myocardial infarction
In this study, our goal was to determine if there was an increase in prehospital ALS pronouncements and a decrease in ED visits for potentially serious conditions such as MI and stroke during the peak of the COVID-19 pandemic in northern NJ.
Source: The American Journal of Emergency Medicine - January 14, 2021 Category: Emergency Medicine Authors: Nikhil Jain, Michael Berkenbush, David C. Feldman, Barnet Eskin, John R. Allegra Source Type: research

Simultaneous thrombosis of 2 vascular territories: is thrombolytic therapy a better option?
We have read with great interest the article by Akyuz and colleagues in the American Journal of Emergency Medicine and congratulate them for their observation. Their case exemplifies the concurrent occurrence of ST-segment elevation myocardial infarction (STEMI) and posterior circulation stroke that was eventually managed with thrombolytic therapy. Simultaneous thrombosis of 2 distant vascular territories is a rare and complicated clinical scenario. In these instances, there is usually an underlying cause linking both thrombotic events rather than being a mere coincidence. We have previously described the myocardial infarc...
Source: The American Journal of Emergency Medicine - July 1, 2013 Category: Emergency Medicine Authors: Hesham R. Omar, Devanand Mangar, Enrico M. Camporesi Tags: Correspondence Source Type: research

Troponin rise and poor outcome in patients with acute atrial fibrillation: rationale and criteria of selection of patients
The role of new onset atrial fibrillation (AF) as a marker of thromboembolic risk has been demonstrated in the setting of acute myocardial infarction . Thus, someone might inquire the role of acute AF in patients with abnormal troponin not fulfilling criteria of acute myocardial infarction and might question if the minor reported range of troponin I (cTn-I) values in the study population of Conti et al (from 0.15 to 7.0 ng/mL) may not be linked with a secondary ischemic mechanism, likely an imbalance between demand and supply . However, the independent predictive value of abnormal troponin for a composite of stroke, acute ...
Source: The American Journal of Emergency Medicine - May 22, 2013 Category: Emergency Medicine Authors: Alberto Conti, Yuri Mariannini, Erica Canuti Tags: Correspondence Source Type: research

Reperfusion strategy for simultaneous ST-segment elevation myocardial infarction and acute ischemic stroke within a time window
Source: The American Journal of Emergency Medicine - March 5, 2014 Category: Emergency Medicine Authors: Héctor González-Pacheco, Aurelio Méndez-Domínguez, Gerardo Vieyra-Herrera, Francisco Azar-Manzur, Aloja Meave-González, Hugo Rodríguez-Zanella, Carlos Martínez-Sánchez Source Type: research

Intravenous methylphenidate: an unusual way to provoke ST-elevation myocardial infarction
Acute ST-T elevation is a sign of myocardial ischemia or infarction usually due to coronary artery atherosclerosis or coronary spasm. Coronary spasm may be spontaneous or can occur as a result of a drug that causes arterial spam. Ritalin, Novartis Pharmaceut. Corporation, USA (methylphenidate hydrochloride), a dopamine reuptake inhibitor, is an oral drug used to treat attention-deficit/hyperactivity disorder and narcolepsy. Sudden deaths, stroke, and myocardial infarction have been reported in adults taking stimulant drugs at usual dose for attention-deficit/hyperactivity disorder [1].
Source: The American Journal of Emergency Medicine - August 7, 2014 Category: Emergency Medicine Authors: Emile Hay, Vitaly Shklovski, Yossef Blaer, Vladimir Shlakhover, Amos Katz Tags: Case Report Source Type: research

Achieving Regionalization through Rural Inter-hospital Transfer
Regionalization of emergency medical care aims to provide consistent and efficient high quality care leading to optimal clinical outcomes by matching patient needs with appropriate resources at a network of hospitals. Regionalized care has been shown to improve outcomes in trauma, myocardial infarction, stroke, cardiac arrest, and acute respiratory distress syndrome. In rural areas, effective regionalization often requires inter-hospital transfer. The decision to transfer is complex and includes such factors as capabilities of the presenting hospital, capacity at the receiving hospital, financial, geographic, and patient-p...
Source: The American Journal of Emergency Medicine - May 29, 2015 Category: Emergency Medicine Authors: Leah Feazel, Adam B. Schlichting, Gregory R. Bell, Dan M. Shane, Azeemuddin Ahmed, Brett Faine, Andrew Nugent, Nicholas M. Mohr Tags: Review Source Type: research

Achieving regionalization through rural interhospital transfer
Regionalization of emergency medical care aims to provide consistent and efficient high-quality care leading to optimal clinical outcomes by matching patient needs with appropriate resources at a network of hospitals. Regionalized care has been shown to improve outcomes in trauma, myocardial infarction, stroke, cardiac arrest, and acute respiratory distress syndrome. In rural areas, effective regionalization often requires interhospital transfer. The decision to transfer is complex and includes such factors as capabilities of the presenting hospital; capacity at the receiving hospital; and financial, geographic, and patien...
Source: The American Journal of Emergency Medicine - May 29, 2015 Category: Emergency Medicine Authors: Leah Feazel, Adam B. Schlichting, Gregory R. Bell, Dan M. Shane, Azeemuddin Ahmed, Brett Faine, Andrew Nugent, Nicholas M. Mohr Tags: Review Source Type: research

Brugada Electrocardiogram Pattern Induced by Cannabis; is cannabis safe?
The objective of this study was to present a case report that bring attention to relationship between cannabis consumption and Brugada electrocardiogram pattern (BEP). Here we present a case of a 19-year-old male patient with symptomatic BEP induced after cannabis consumption. With the potential for more widespread legalization of cannabis several studies are raising the issue of adverse vascular effects of cannabis, including myocardial infarction, sudden cardiac death, cardiomyopathy, stroke, transient ischemic attack, and cannabis arteritis.
Source: The American Journal of Emergency Medicine - December 30, 2015 Category: Emergency Medicine Authors: Joaquín Valle Alonso, Beatrix Theo, F. Javier Fonseca del Pozo, Miguel Angel Aguayo, Almudena Sanchez Tags: Case Report Source Type: research

2016: Emergency Medical Services Annotated Literature in Review
In the daily practice of emergency medicine, physicians constantly interact with components of emergency medical services (EMS) systems. The provision of high quality care in the prehospital setting requires emergency physicians to remain abreast of recent literature that may inform the care of patients prior to their arrival at the emergency department. This literature review will examine some recent trends in the prehospital literature, including cardiac arrest care, trauma, myocardial infarction, and stroke.
Source: The American Journal of Emergency Medicine - July 17, 2016 Category: Emergency Medicine Authors: Jose V. Nable, Benjamin J. Lawner, William J. Brady Source Type: research

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