Articles Tagged With: stemi
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What Are Hyperacute T-Waves and What Do They Mean?
A retrospective study of emergency department patients suspected of having an acute coronary syndrome has shown that a computer system for determining a new quantitative high-amplitude electrocardiogram (ECG) T-wave score has a high specificity and reasonable sensitivity for identifying patients with acute coronary occlusion that performs as well as ECG ST-elevation myocardial infarction criteria.
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Acute STEMI or Something Else?
Interpret the electrocardiogram (ECG) in the figure without the benefit of any clinical information. Is this ECG indicative of an acute anterior ST-elevation myocardial infarction?
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Direct Oral Anticoagulants vs. Warfarin for Left Ventricular Thrombus
A small pilot randomized controlled trial, plus a meta-analysis including four other randomized controlled trials, of direct oral anticoagulants compared to warfarin for the treatment of left ventricular thrombus after ST-elevation myocardial infarction has shown that there were no significant differences in the two regimens regarding thrombus resolution and major bleeding events at three-month follow-up.
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DanGer Shock Trial Post-Hoc Analysis: Microaxial Pump Risks May Outweigh Benefits
In this post-hoc analysis of the DanGer Shock trial, patients in the highest quartile of age appeared to have higher mortality compared with younger patients, suggesting less benefit from routine application of the microaxial flow pump in older patients with acute myocardial infarction-related cardiogenic shock.
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Flank Pain and ‘Heartburn?’
The electrocardiogram (ECG) in the figure was obtained from a man in his 60s who presented to the emergency department for a suspected kidney stone. The patient also noted some intermittent heartburn in recent weeks. How would you interpret his ECG? Should you activate the cath lab?
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Impella Scores a Big Win in Infarct-Related Cardiogenic Shock, but with Big Caveats
In this randomized controlled trial of patients presenting with ST-elevation myocardial infarction and cardiogenic shock, use of the Impella microaxial flow pump resulted in improved survival but also higher adverse safety events compared with standard care.
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Computer-Interpreted ECGs Sometimes Miss Acute Coronary Occlusion
Emergency physicians can shield against risk by viewing ECGs of chest pain patients immediately to identify subtle signs of acute coronary occlusion.
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Detecting Left Ventricular Thrombi
A study of early post-ST-elevation myocardial infarction patients who underwent echocardiographic testing and cardiac MRI showed echo misses about two-thirds of cardiac MRI-discovered left ventricular thrombi. However, an echo apical wall motion score can identify most patients in whom echo may miss thrombi for the selective use of cardiac MRI.
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Physician Phone Consultation Leads to Potential Liability
This case is an example of how a physician-patient relationship can be formed, even when no direct contact occurs between the physician and patient, or even when the physician is informally consulted by phone.
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Heart Attack Treatment Timing Improves, But Inequities Remain
Women remain less likely than men to receive timely angiography after myocardial infarction.