Podcast #286: Coronary Vascular Conditions that aren't STEMI

Podcast #286: Coronary Vascular Conditions that aren't STEMI

Author: Don Stader, M.D.

Educational Pearls

  • While we usually associate the coronary vasculature with STEMIs, there are other pathologies that can affect the heart's blood supply.
  • Kounis syndrome: an allergic vasospasm of the coronary arteries. This can happen post anaphylaxis or be caused by a stent allergy. It is best treated with aggressive management of the allergic reaction.
  • Kawasaki disease: An autoimmune condition that presents in kids as conjunctivitis, lymphadenopathy, hand/foot swelling, rash, and fever. It can also cause coronary aneurysms, which can rupture and be rapidly fatal.
  • Prinzmetal angina: Caused by coronary vasospasm. Presents with transient chest pain at rest. Treat with CCBs.
  • Cocaine: Causes coronary vasospasm. Cocaine-induced vasospasm is best treated with BZDs.
  • Coronary artery dissection: increased risk in pregnant women and those with connective tissue disorders.

References: Memon S, Chhabra L, Masrur S, Parker MW. Allergic acute coronary syndrome (Kounis syndrome). Proceedings (Baylor University Medical Center). 2015;28(3):358-362.

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Podcast #279: Sedation After Intubation

Podcast #279: Sedation After Intubation

Author: Aaron Lessen, M.D. Educational Pearls Post-intubation care should always include pain control and adequate sedation. Commonly used sedation agents include propofol, ketamine and versed. Howev...

8 Joulu 20171min

Podcast #278: Subdural Hematomas

Podcast #278: Subdural Hematomas

Educational Pearls Subdural hematomas can happen in the elderly because of brain atrophy, and can manifest with neurological deficit. Subdural hematomas are caused by rupture of the bridging veins of...

6 Joulu 20172min

Podcast #277: Mucor

Podcast #277: Mucor

Author: Don Stader, M.D. Educational Pearls Mucor/Rhizopus fungal infections usually present in diabetic or immunocompromised patients as a black, necrotic lesion on the face. The fungus invades the ...

4 Joulu 20172min

Podcast #276: Angioedema

Podcast #276: Angioedema

Author: John Winkler, M.D. Educational Pearls Angioedema is immediately life-threatening due to airway obstruction. Mechanisms include allergic reaction (histamine-related) or bradykinin-related (ACE...

1 Joulu 20173min

Podcast #275: Battery Ingestions

Podcast #275: Battery Ingestions

Author: Nick Hatch, M.D. Educational Pearls Unlike coin ingestions, button batteries can cause necrosis of the GI tract. If lodged in the esophagus, removal within 2 hours is important, because they ...

29 Marras 20174min

Podcast #274: Pediatric Sedation

Podcast #274: Pediatric Sedation

Author: Aaron Lessen, M.D. Educational Pearls A recent prospective observational study was performed to examine the safety of different sedation medications in the pediatric ED. This study included 6...

27 Marras 20172min

Podcast #273:  Bag Valve Masks

Podcast #273: Bag Valve Masks

Author: Sam Killian, M.D. Educational Pearls Difficulty with bag valve mask (BVM) ventilation can be addressed using the MOANS mnemonic. Mask seal, Obesity/obstruction, Age, No teeth, Sleep apnea. O...

17 Marras 20173min

Podcast #272: More on Temperature in Sepsis

Podcast #272: More on Temperature in Sepsis

Author: David Rosenberg, M.D. Educational Pearls A study of 20,000 subjects found that reducing fever in sepsis did not improve outcomes such as morbidity, mortality, or length of stay. However, corr...

16 Marras 20172min

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