Heart Failure: Biomarkers of Diagnosis and Prognosis

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Heart Failure: Biomarkers of Diagnosis and Prognosis

Heart Failure remains a common presentation in the emergency department. For the emergency physician clarifying the course of the universal complaint, shortness of breath, requires excellent clinical acumen combined with a clear understanding of the laboratory tests available to distinguish Heart Failure from other causes of dyspnea. Dr. Frank Peacock of the Cleveland Clinic authors an excellent discussion of the scientific basis for the use of the natriuretic peptide biomarkers in heart failure including future markers currently being investigated.

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Hypertensive Emergencies: Acute Care Evaluation and Managements

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Hypertensive Emergencies: Acute Care Evaluation and Managements

Hypertension remains one of the most common disease processes in patients presenting to the Emergency Department (ED). While sometimes symptomatic and associated with end organ damage such as hypertensive encephalopathy, hemorrhagic stroke, acute coronary syndrome, heart failure, and renal insufficiency, many patients present without symptoms. Emergency physicians and hospitalists should understand the appropriate classification of patients with hypertension, the pathophysiology of this disease process, and appropriate treatment strategies. In this EMCREG-International Newsletter, Charles V. Pollack, Jr. MD and Christopher J. Rees, MD of Pennsylvania Hospital and the University of Pennsylvania discuss hypertension and parenteral medications used for treatment of these patients in the ED.

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Use of NT-ProBNP in the Emergency Department Evaluation of Shortness of Breath: Implications for Clinical Practice

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Use of NT-ProBNP in the Emergency Department Evaluation of Shortness of Breath: Implications for Clinical Practice

In this EMCREG-International newsletter, Sean P. Collins, MD, Assistant Professor of Emergency Medicine at University of Cincinnati, OH discusses incidence of heart failure has been rising over the last decade as more patients survive significant myocardial infarction, as well as other diseases which compromise the heart. All clinicians who care for these patients must be aware of the many diagnostic and therapeutic approaches to these often critically-ill patients. NT-proBNP provides an important diagnostic and prognostic test for these heart failure patients.

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Third and Fourth Heart Sounds – Lost Art to Modern Advance

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Third and Fourth Heart Sounds – Lost Art to Modern Advance

Even the most proficient of emergency care providers have difficulty discerning the low frequency rumblings of an S3 or S4 from the background noise of monitors in a hectic emergency setting. Nearly half a century has passed since phonocardiography originally was developed to assist in cardiac auscultation. Modern technology is now making it possible to once again use the analysis and reporting of S3 and S4 heart sounds to facilitate the diagnosis of heart failure and acute coronary syndrome (ACS).

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