2004 ACC/AHA Guidelines for the Management of Patients with STEMI: Class 1 Recommendations Pertinent to the Emergency Department

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2004 ACC/AHA Guidelines for the Management of Patients with STEMI: Class 1 Recommendations Pertinent to the Emergency Department

In August, 2004 the American College of Cardiology/American Heart Association 2004 ST-segment Elevation Myocardial Infarction (STEMI) guidelines were published. This treatise presents a comprehensive approach to the diagnosis and treatment of STEMI extending from the first pre-hospital medical contact of the patient with an ambulance, through emergency department care, to the appropriate approach to these patients on hospital discharge and beyond. The Emergency Medicine Cardiac Research and Education Group (EMCREG)-International has provided, through this concise summary of the STEMI guidelines, a practical approach for emergency physicians for this disease process.

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Cardiogenic Shock Complicating Acute Myocardial Infarction: A Silver Lining on the Horizon?

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Cardiogenic Shock Complicating Acute Myocardial Infarction: A Silver Lining on the Horizon?

We are pleased to present this cutting edge clinical update report on cardiogenic shock (CS). Acute coronary syndromes and its complications are key components of emergency medicine practice. Specifically, CS is prevalent and occurs in roughly 10% of all cases of acute myocardial infarction (AMI). Despite numerous therapeutic advances in the treatment of cardiovascular disease, CS is still the leading cause of mortality among patients with AMI. This newsletter by Drs. Jeger, Anand and Hochman summarizes the classic CS paradigm and observations from the SHOCK trial challenging that paradigm.

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Advancing the Standard of Care - Cardiovascular and Neurovascular Emergencies (2004)

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Advancing the Standard of Care - Cardiovascular and Neurovascular Emergencies (2004)

EMCREG-International is pleased to present this educational monograph summarizing our 2004 ACEP Satellite Symposium on cardiovascular and neurovascular emergency care held in San Francisco. Topics presented included: Point-of-Care Testing for ACS in the ED; STEMI Time-to-Treatment; Chest Pain Center; Heart Sound Recording; Anti-Platelet and Anti-Thrombotics in ACS; BNP Consensus Panel; Stroke, and Intracerebral Hemorrhage. It is our hope that this material will provide emergency physicians with information necessary to help care for these seriously ill 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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Cardiovascular and Neurovascular Emergencies : Implications for Clinical Practice (2003)

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Cardiovascular and Neurovascular Emergencies : Implications for Clinical Practice (2003)

Patients presenting to the Emergency Department (ED) with chest pain remain a major clinical challenge. In the United States alone there are over eight million annual visits for this problem, resulting in over four million admissions. Nontraumatic chest discomfort remains the primary catalyst for ED evaluation of possible acute coronary syndromes, including unstable angina, non-ST-segment elevation myocardial infarction and ST-segment myocardial infarction. The diagnosis and treatment of congestive heart failure is also critically important to emergency physicians and other healthcare providers. The diagnosis of cerebrovascular disease is equally difficult, with up to one million patients presenting to the emergency department with stroke each year. Therefore, it is essential that emergency physicians remain on the forefront of state of the art diagnostic and treatment options involving the newest regimens for ACS, CHF, and stroke.

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ACC/AHA 2002 Guidelines for the Management of Patients with Unstable Angina and Non-ST-Segment Elevation Myocardial Infarction: A SUMMARY FOR EMERGENCY PHYSICIANS

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ACC/AHA 2002 Guidelines for the Management of Patients with Unstable Angina and Non-ST-Segment Elevation Myocardial Infarction: A SUMMARY FOR EMERGENCY PHYSICIANS

Current literature and clinical practice places a substantial emphasis on evidence-based medicine and evidence-based practice guidelines. In the year 2000, the American College of Cardiology (ACC) and American Heart Association (AHA) published comprehensive, evidence-based guidelines on the management of patients with unstable angina (UA) and non-ST-segment elevation myocardial infarction (NSTEMI). In 2002, these guidelines were updated due to the remarkable clinical advances in the care of these patients. Many aspects of these guidelines pertain directly to emergency physicians.

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