ESO

OCTOBER 1, 2024

We hope to have a basic NERIS-compliant beta early in 2025, with additional updates (CAD imports, ESO EHR integration, ESO Insights reporting, etc.) It will be a simplified version and may not yet be ideal for agencies with ESO suite integrations like CAD and EHR imports. The timeline may vary. What will ESO charge for NERIS?

CAD 59

CAD Public Safety First Responder OR 59

Dr. Smith's ECG Blog

MAY 20, 2024

A 63 year old man with a history of hypertension, hyperlipidemia, prediabetes, and a family history of CAD developed chest pain, shortness of breath, and diaphoresis after consuming a large meal at noon. Of course, writing “hypertensive emergency, underlying CAD with demand ischemia, or NSTEMI all remain on the differential” makes no sense.

CAD 123

CAD STEMI Coronary ACS 123

Core EM

DECEMBER 1, 2023

Metoprolol Considerations: Dosing (5 mg every 10-15 minutes, max 15 mg), benefits in CAD and HF, limitations in asthma/COPD patients. ECG Interpretation: Irregularly Irregular Rhythm: Absence of discernible P waves. Ventricular Rate: Typically over 100 bpm. Alternatives like procainamide or amiodarone are often more appropriate.

CAD 130

CAD OR 130

International Journal of Paramedicine

JULY 8, 2024

This included date, POE, patient demographics, chief complaint, computer-aided dispatch (CAD), provider impression (diagnosis), and time out of service. Results : Over the study period, 8,407 encounters occurred at one of the three El Paso-Juárez POE, averaging 1,680 per year or 140 calls per month.

Prehospital Care Provider 52

Prehospital Care Provider Emergency Medical Services CAD EMS 52

Dr. Smith's ECG Blog

FEBRUARY 12, 2024

(THE PM CARDIO OMI AI APP) If you want this bot to help you make the early diagnosis of OMI and save your patient and his/her myocardium, you can sign up to get an early beta version of the bot here.

CAD 84

CAD ED OR Coronary 84

Dr. Smith's ECG Blog

DECEMBER 5, 2023

He did have a family history notable for early CAD. hematological disorder like sickle cell or antiphospholipid syndome, family history of CAD or hypercholesterolemia, prior history of vasculopathies such as Kawasaki Disease, MIS-C, prior cardiac surgery, etc.) He denied drug or alcohol use.

Coronary 112

Coronary CAD ACS ALS 112

NVFC

JULY 16, 2024

Once the new system is in place, it will also be able to integrate information from the computer-aided dispatch system (CADS). By Tom Jenkins Reprinted from the 2024 issue of Firefighter Strong In the fire academy, I doubt any candidate firefighter is excited or intrigued about incident reporting.

Firefighter 105

Firefighter Emergency Response CAD OR 105

Dr. Smith's ECG Blog

MARCH 19, 2024

The patient presented to an outside hospital An 80yo female per triage “patient presents with chest pain, also hurts to breathe” PMH: CAD, s/p stent placement, CHF, atrial fibrillation, pacemaker (placed 1 month earlier), LBBB. HPI: Abrupt onset of substernal chest pain associated with nausea/vomiting 30 min PTA. This was stented with a 2.25

CAD 89

CAD STEMI ACS ALS 89

Dr. Smith's ECG Blog

APRIL 9, 2024

By Magnus Nossen This ECG is from a young man with no risk factors for CAD, he presented with chest pain. Before the lab values returned this patient had a n emergent coronary CT angiogram done that ruled out CAD. How would you assess this ECG? How confident are you in your assessment? What is your next step? How did the Queen do?

Coronary 91

Coronary CAD ACS OR 91

The Skeptics' Guide to EM

JULY 2, 2022

In prior decades nearly all patients presenting to EDs with chest pain were admitted to hospital. If we thought about ACS, we brought them in. This would be for objective cardiac testing including stress test, CT-angiography, and/or invasive angiography. Major adverse cardiac event rates in moderate-risk patients: Does prior coronary disease matter?

Coronary 100

Coronary Heart Attack ACS CAD 100

EMS 12-Lead

AUGUST 14, 2022

Otherwise, no admission of CAD, HLD, or family history of sudden cardiac death. There was no obvious pallor, diaphoresis, or dyspnea, and he denied any prior episodes of vomiting. He described the pain as “nagging,” and equally not exacerbated by any kind of movement. it has been subsequently deemed a STEMI-equivalent.

MICU 130

MICU STEMI CAD Coronary 130

Dr. Smith's ECG Blog

DECEMBER 16, 2018

She had a normal EF, and no significant CAD, and was taking flecainide to suppress the AF. Wide-complex tachycardia: VT or aberrant, or "other?" This case is contributed by Brooks Walsh , an EM physician and ECG expert from Connecticut. The case An older woman presented to the ED with dyspnea, diaphoresis, and chest pressure.

OR 52

OR ED CAD Overdose 52

Dr. Smith's ECG Blog

APRIL 14, 2023

Sent by Anonymous, written by Pendell Meyers A man in his 60s with history of CAD and 2 prior stents presented to the ED complaining of acute heavy substernal chest pain that began while eating breakfast about an hour ago, and had been persistent since then, despite EMS administering aspirin and nitroglycerin. Pre-intervention.

CAD 52

CAD ACS STEMI Coronary 52

EMS 12-Lead

JULY 24, 2023

These concerns were readily conveyed to my supervising cardiologist with particular emphasis on high pretest probability for baseline advanced CAD (3-vessel disease, specifically) with a critically stenosed proximal LAD. This results in Type I MI. This results in Type II MI. What’s interesting is that the ECG can only detect ischemia.

Coronary 130

Coronary ACS CAD ED 130

EMDocs

NOVEMBER 29, 2023

Double-blind, placebo-controlled multicenter RCT Included 795 patients > 18 years admitted to the ICU with severe PNA Intervention: Hydrocortisone as a continuous infusion of 200 mg/day IV with a planned taper for 8 or 14 days compared to placebo Primary Outcome: All-cause mortality at 28 days Hydrocortisone 6.2% 1.40) Trial likely underpowered.

ICU 80

ICU CAD ALS OR 80

EMS 12-Lead

APRIL 8, 2022

Furthermore, there was no family history of early CAD, MI, or sudden cardiac death. A 56 y/o Male called 911 from his hotel room in the early morning hours after abruptly awakening from sleep with crushing chest discomfort and difficulty breathing. He reported to EMS a medical history of GERD only. He left AMA and is lost to follow-up.

STEMI 130

STEMI ALS Coronary CAD 130

EMS 12-Lead

JUNE 20, 2022

Moreover, he had no pertinent medical history to report in terms of CAD, HTN, HLD, or DM, for example. CASE 1 A 45 y/o Male called 911 for new onset central chest discomfort, non-radiating, 5/10 pain scale, and without any vomiting, diaphoresis, or pallor. A 12 Lead ECG was recorded. There is no dramatic change, or evolution.

ACS 130

ACS Coronary STEMI CAD 130

Dr. Smith's ECG Blog

JANUARY 20, 2024

Scattered other nonobstructive CAD. Angiogram around 9am: Culprit lesion mid LAD 100% stenosis TIMI 0 TIMI 3 after PCI Severe apical dyskinesis, severe anteroapical akinesis. Here you will sign up for the Queen of Hearts on the Telegram app: [link] Or, you can get the PM Cardio app with Queen of Hearts function through this QR code.

STEMI 115

STEMI CAD ED ALS 115

Dr. Smith's ECG Blog

JUNE 23, 2024

Stated differently, the differential diagnosis for the presenting syndrome was either ventricular fibrillation due to acute coronary syndrome, or idiopathic ventricular fibrillation and bystander stable CAD.

Coronary 108

Coronary CAD CPR Critical Care 108

Dr. Smith's ECG Blog

OCTOBER 24, 2019

However, a smooth tapering of the mid-RCA was seen, highlighted in red below: How do we explain the MI if no sign of CAD was found? This MI wasn’t caused by a ruptured plaque of CAD - it was a coronary artery dissection of the RCA. Angiography Angiography was performed after aspirin and heparin were started.

Coronary 52

Coronary CAD ACS STEMI 52

Dr. Smith's ECG Blog

APRIL 18, 2024

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. 1] European guidelines add "regardless of biomarkers".

STEMI 118

STEMI Coronary ALS CAD 118

Dr. Smith's ECG Blog

JULY 22, 2023

The patient proceeded to cath where all coronaries were described as normal with no evidence of any CAD, spasm, or any other abnormality. Written by Pendell Meyers A man in his 70s with no cardiac history presented with acute weakness, syncope, and fever. He denied chest pain or shortness of breath. PM Cardio digitized version.

E-9-1-1 70

E-9-1-1 CAD OR STEMI 70

Emergency Medicine Ireland

DECEMBER 7, 2020

As the pregnant population continues to age and with RF and smoking and DM still common we can expect to see pregnant woman with CAD. Critical illness in pregnancy is remarkably rare given the somewhat bonkers system for reproduction that we seem to have evolved over the past million or years. Improved care of complex.

Critical Care 40

Critical Care CAD Plasma ACS 40

EM Literature of Note

OCTOBER 18, 2021

CTCA certainly has a role in the evaluation of patients with chest pain and possible CAD, but certainly not as a routine investigation in the ED. Patients were eligible by symptoms of an acute coronary syndrome, supported by ECG changes, an elevated troponin, or a history of ischemic heart disease.

Coronary 40

Coronary CAD ED OR 40

EMDocs

FEBRUARY 7, 2024

Increased risk in those with preexisting CKD, other risk factors for renal disease (HTN or CAD), and those on ACEIs/ARBs. The effects of GLP-1 agonists are associated with the dose. Higher doses of GLP-1 agonists are associated with weight loss. Take for example semaglutide. Ozempic is utilized for DM2 in doses of 0.5, mg SQ every week.

Allergic Reaction 74

Allergic Reaction ALS CAD OR 74

Dr. Smith's ECG Blog

MAY 19, 2020

Diagnosis of MINOCA should be made according to the Fourth Universal Definition of MI, in the absence of obstructive coronary artery disease (CAD) (no lesion ≥50%). The authors recommend using optical coherence tomography or intravascular ultrasound imaging in patients with evidence of nonobstructive CAD by angiogram. The K was normal.

Defibrillator 52

Defibrillator CPR Coronary CAD 52

Dr. Smith's ECG Blog

JUNE 19, 2024

The ED provider ordered a coronary CT scan to assess the patient for CAD. Three months prior to this presentation, he received a pacemaker for severe bradycardia and syncope due to sinus node dysfunction. At around 1430, as the patient was being prepared to leave for the scan, he developed severe chest pain, dizziness, and became diaphoretic.

STEMI 60

STEMI Coronary CAD ED 60

Dr. Smith's ECG Blog

NOVEMBER 22, 2023

Patient stated that he has had glucose over 400 even though he has not missed any doses of insulin. Aslanger's is a combination of inferior OMI with widespread ST depression and is due to BOTH occlusion of one artery (usually the circumflex, but sometimes the RCA) AND simultantous 3 vessel disease.

ED 103

ED Coronary CAD STEMI 103

High Performance EMS

JANUARY 26, 2021

Your existing historical CAD records contain the necessary information to build such dynamic views in real-time. The next step is to adequately distribute those available resources spatially to address the variation over the geographic area by time which requires an even deeper understanding of the call patterns.

Emergency Response 100

Emergency Response Emergency Medical Services CAD Ambulance 100

Dr. Smith's ECG Blog

MARCH 19, 2023

Concerning history, known CAD" Recorded 2 hours after pain onset: What do you think? To realize — Assessment of ECG #1 is complicated by knowing: i ) That today’s patient has a history of documented CAD ; and , ii ) The lack o f a prior tracing for comparison at the time the initial ECG was interpreted.

STEMI 52

STEMI Coronary CAD OR 52

ACEP Now

APRIL 4, 2024

This patient had known coronary artery disease (CAD), and previously required drug eluting stents to the obtuse marginal and diagonal arteries. A 59-year-old male with a past medical history of a repaired ventricular septal defect (VSD), dextrocardia, hypertension, hyperlipidemia, and current smoker presented to the emergency department (ED).

Coronary 40

Coronary STEMI CAD Emergency Department 40

Dr. Smith's ECG Blog

OCTOBER 10, 2022

As in all ischemia interpretations with OMI findings, the findings can be due to type 1 AMI (example: acute coronary plaque rupture and thrombosis) or type 2 AMI (with or without fixed CAD, with severe regional supply/demand mismatch essentially equaling zero blood flow). There is also STD in V2-V4 (but maximal in V5-V6).

ACS 52

ACS CPR CAD Heart Attack 52

Dr. Smith's ECG Blog

JANUARY 30, 2019

A formal echocardiogram was completed the next day and again showed a normal ejection fraction without any focal wall motion abnormalities to suggest CAD. Schick is a PGY3 at the Brown Emergency Medicine Residency in Rhode Island. I remember Allie well from her days in the Research volunteer program at Hennepin. F (rectal). There was a 0.9%

E-9-1-1 52

E-9-1-1 CAD STEMI OR 52

Dr. Smith's ECG Blog

MAY 10, 2023

CAD-RADS category 1. --No At this point, with the information above, the patient's overall clinical picture could be consistent with either reperfused OMI, or Non-OMI, since both may have absent pain and inverted T waves. A repeat troponin returned at 0.45 ng/mL, consistent with reperfused OMI, or Non-OMI. A CT Coronary angiogram was ordered.

Coronary 52

Coronary STEMI CAD OR 52

OntarioMedic

FEBRUARY 8, 2018

Heart failure is a clinical syndrome characterized by systemic perfusion inadequate to meet the body’s metabolic demands as a result of impaired cardiac pump function. This may be further subdivided into systolic or diastolic heart failure. In many patients, both processes are present simultaneously.

Coronary 52

Coronary CAD OR 52

Dr. Smith's ECG Blog

JANUARY 9, 2023

No family history of sudden cardiac death, cardiomyopathy, premature CAD, or other cardiac issues. No similar symptoms in the past. No prior exertional complaints of chest pain, dizziness, lightheadedness, or undue shortness of breath. He denied headache or neck pain associated with exertion. No further troponins were measured. Pericarditis?

Coronary 52

Coronary STEMI Heart Attack OR 52

Dr. Smith's ECG Blog

NOVEMBER 30, 2022

J Electrocardiol [Internet] 2022;Available from: [link] Cardiology opinion: Takotsubo Cardiomyopathy (EF 30-35%) V Fib Cardiac arrest Prolonged QTC NSTEMI (Smith comment: is it NSTEMI or is it Takotsubo? -- these are entirely different) Moderate single-vessel CAD. V1 has 0.5 mm of elevation. ng/mL [IQR: 0.46, 2.35]. Learning Points: 1.

Emergency Department 52

Emergency Department E-9-1-1 Coronary STEMI 52