Category: Cardiology

What are indications for a permanent pacemaker?

What are indications for a permanent pacemaker?

An 81-year-old male with significant past medical history of CAD s/p single-vessel CABG, aortic stenosis s/p TAVR, atrial fibrillation on Coumadin presented to the ED after a syncopal episode. He described “blacking out” during ambulation without seizure-like activity. In the ED, he was found to be in sinus bradycardia with a heart rate in the … Continue reading What are indications for a permanent pacemaker?

How do you evaluate patients before surgery?

How do you evaluate patients before surgery?

A 70-year old female presents to the ED for evaluation of left hip pain after a mechanical fall.  X-ray shows a nondisplaced femoral neck fracture. After bedside evaluation, the Orthopedic team would like to plan for surgical correction with open reduction internal fixation (ORIF). Her past medical history is significant for CAD s/p 3-vessel CABG … Continue reading How do you evaluate patients before surgery?

When do you need an echo when evaluating syncope?

When do you need an echo when evaluating syncope?

A 45-year-old male with history of hypertension presents to the emergency department complaining of abrupt onset dizziness that occurred when he stood from a seated position, the dizziness was accompanied by nausea and lightheadedness as well as a brief period of blacking out when the patient fell backward into his chair. He has never experienced … Continue reading When do you need an echo when evaluating syncope?

Who gets an AICD in ischemic cardiomyopathy?

Who gets an AICD in ischemic cardiomyopathy?

A 56-year-old woman with a history of hypertension and COPD experiences a sharp chest pain and acute dyspnea. An emergency medical team was activated, was found to be in Ventricular Fibrillation and the VF was successfully defibrillated with an automatic external defibrillator. The patient was taken to a cardiac care unit by the emergency medical … Continue reading Who gets an AICD in ischemic cardiomyopathy?

For PAD, what is the recommended antithrombotic therapy?

For PAD, what is the recommended antithrombotic therapy?

Before diving into the latest recommendations on antithrombotic therapy management of Peripheral Arterial Disease (PAD), a quick review: Diagnosis of Lower Extremity PAD The vascular testing work up varies based on whether they are symptomatic or asymptomatic.For Asymptomatic, use a formal Ankle-Branchial Index (ABI) to confirm (more Sn/Sp than a bedside ABI for assessing location … Continue reading For PAD, what is the recommended antithrombotic therapy?