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SGEM#370: Listen to your Heart (Score)…MACE Incidence in Non-Low Risk Patients with known Coronary Artery Disease

The Skeptics' Guide to EM

Date: June 30th, 2022 Reference: McGinnis et al. AEM June 2022. Date: June 30th, 2022 Reference: McGinnis et al. AEM June 2022. Reference: McGinnis et al. AEM June 2022. Major adverse cardiac event rates in moderate-risk patients: Does prior coronary disease matter?

Coronary 100
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emDOCs Videocast: EBM Update – Steroids in Severe CAP and CT in Post ROSC OHCA

EMDocs

EBM Update: Steroids in Severe CAP and CT in Post ROSC OHCA #1: Dequin PF, Meziani F, Quenot JP, et al; CRICS-TriGGERSep Network. 2022 Aug;48(8):1009-1023. Author Takeaway: No difference in mortality at 60 days with methylprednisolone vs. placebo in severe CAP #3: Wu JY, Tsai YW, Hsu WH, et al. N Engl J Med. Intensive Care Med.

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emDOCs Podcast – Episode 94: GLP-1 Agonist Complications

EMDocs

American Gastroenterological Association issued a practice guideline in November 2022 recommending that semaglutide 2.4 Retrospective study published in 2022 of 81,752 adverse events associated with GLP-1 agonist therapy found an increased risk of pancreatitis, particularly with liraglutide (ROR 32.67; 95% CI 29.44-36.25).

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Is OMI an ECG Diagnosis?

Dr. Smith's ECG Blog

Similarly, if a patient with known CAD presents with refractory ischemic chest pain, the ECG barely matters: the pre-test likelihood of acute coronary occlusion is so high that they need an emergent angiogram. Amsterdam et al. Alencar et al. Lupu et al. Clin Cardiol 2022 4. Herman, Meyers, Smith et al.

STEMI 121
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A man in his 70s with weakness and syncope

Dr. Smith's ECG Blog

The patient proceeded to cath where all coronaries were described as normal with no evidence of any CAD, spasm, or any other abnormality. In the largest study looking at this topic by Mizusawa et al., Recently the rate of true arrhythmic events related to fevers in the classic Brugada Type 1 syndrome was explored by Michowitz et al.

E-9-1-1 92
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See this "NSTEMI" go unrecognized for what it really is, how it progresses, and what happens

Dr. Smith's ECG Blog

A man in his 70s with past medical history of hypertension, dyslipidemia, CAD s/p left circumflex stent 2 years prior presented to the ED with worsening intermittent exertional chest pain relieved by rest. Hayakawa A, Tsukahara K, Miyagawa S, et al. Published 2022 Feb 20. 2022;Available from: [link] 7. Am J Emerg Med.

ACS 82
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A young lady with wide complex tachycardia. My first time actually making this diagnosis de novo in real life in the ED!

Dr. Smith's ECG Blog

Late Gadolinium enhancement: Multifocal scarring of the septum (including RV septum), basal anterior wall and transmural mid inferior region scarring - a non-CAD hyperenhacement pattern. For review of a case of RVOT VT — Please see My Comment at the bottom of the page in the February 14, 2022 post in Dr. Smith's ECG Blog.

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