Tuesday, September 24, 2013

Symptomatic Bradycardia in Cardiovascular Emergencies

          Bradycardia in Cardiovascular Emergencies is when heart rate < 60 beats per minute and inadequate for clinical condition. So what would you do as a Doctor or paramedic to treat this condition? There are step which must done: SSSSSlow

Sunday, September 22, 2013

Cardiac Tamponade

Cardiac tamponade occurs with an increase in intrapericardial pressure due to a pericardial effusion, which is characterized by
               1. Elevation of intrapericardial pressure
               2. Limitation of Right Ventricle Diastolic Filling
               3. Reduction of Stroke Volume and Cardiac Output.
The presence of a pericardial effusion does not necessarily mean tamponade physiology is present.

Friday, September 20, 2013

Cardiogenic Shock

Patients with the highest immediate mortality (>50%) are those with cardiogenic shock: a low-output state with signs and symptoms of organ underperfusion.

Thursday, September 19, 2013

Hypertensive Emergency

Hypertensive crises should be differentiated into Hypertensive emergency or urgency, based on evidence of end-organ damage. Severe hypertensiion specifically affects the renal (elevated serum creatinin, hematuria (angina, heart failure, aortic dissection), and neurologic (headache, mental status changes), cardiovascular

Tuesday, September 17, 2013

How to Make Diagnosis of Heart Failure

History or Anamnesis
              There are three primary objectives of the history when interviewing a patient with Heart Failure:
           1. Identify etiology of Heart Failure
           2. Asses progression and severity of illness
           3. Assess volume status

Saturday, September 14, 2013

Etiology of Heart Failure

           There are many causes of myocardial injury that can result in clinically apparent Heart Failure. However, in considering the etiology of cardiac dysfunction it is useful to subdivide patients into those with abnormal systolic function and those with preserved systolic function. Among patients with abnormal systolic function, defined as ejection fraction < 40%, approximately two thirds will have an ischemic cardiomyopathy (ICM), usually resulting from prior myocardial infarction (MI).

Heart Failure

             Heart failure is one of the fastest-growing, cardiovascular diagnose in the United States, where therea re over 1 million hospitalizations for heart failure annually, at a cost exceeding $33 billion. Despite significant advancements in the management of Heart Failure, the mortality remains high; once a patient is hospitalized for Heart failure, the 1 - and 5 - years death are 30% and 50% respectively, In order to improve HF outcomes and reduce hospitalizations, physicians must be able to identify these patients early in their disease and initiate appropiate lifesaving and symptom-reducing therapies.

Friday, September 13, 2013

Diagnosis and Treatment for Chest Pain

Diagnosis Testing
         The ECG is critical to the evaluation of chest pain. In fact, for the acutely ill patient, it is prudent to quickly review the ECG prior to completing the history and physical. ECG findings that should not be missed are outlined in Table A. Prior ECGs for comparison are invaluable. If ischemia is a concern. serial ECGs are useful to look for evolution of the infarct pattern. Suspicion for right ventricular infarct should be investigated with right-sided precordial leads, and suspicion for a posterior infarct should prompt evaluation with posterior chest leads.

Wednesday, September 11, 2013

Physical Examination for Chest Pain

                A history-directed physical exam is not a full physical exam. Base on information obtained in the history, the directed exam should confirm a suspected diagnosis or narrow a differential diagnosis list. Much like the focused history, a directed exam should rapidly and accurately characterize the cest pain and screen for life-threatening findings. Most of the few minutes spent examining the patient should be focused on the cardiovascular and pulmonary exams. Clinical pearls for a chest pain-directed exam listed  below

Tuesday, September 10, 2013

Evaluation of Chest Pain

            Chest pain is the chief complaint for 5% to 10% of all emergency department visits in the United States and  represents a wide spectrum of disease, from benign to life-threatening conditions. Consequently the initial evaluation must rapidly focus on ruling out the five most common life-threatening conditions that present with chest pain:

This Blog Contents are protected by