The paradigm of STEMI vs NSTEMI is one of the most well known in Emergency Medicine.  Could a change in thinking shift this paradigm to OMI vs NOMI and result in a more complete identification of patients with significant morbidity and mortality?

The Danger of the OMI

Time is myocardium, and minimizing door-to-activation time improves outcomes in patients with acute coronary occlusion. There are a number of existing quality metrics used to help drive improvements in the time-based care of STEMI patients. Could a new quality metric help the decision making time of Emergency Physicians?

ECG to Activation

In this podcast, Dr. Vassilios Bezzerides reviews the case of a tachyarrhythmic patient, discussing management and treatment strategies.

Please visit: http://www.openpediatrics.org 

OPENPediatrics™ is an interactive digital learning platform for healthcare clinicians sponsored by Boston Children’s Hospital and in collaboration with the World Federation of Pediatric Intensive and Critical Care Societies. It is designed to promote the exchange of knowledge between healthcare providers around the world caring for critically ill children in all resource settings. The content includes internationally recognized experts teaching the full range of topics on the care of critically ill children. All content is peer-reviewed and open access-and thus at no expense to the user.

For further information on how to enroll, please email: openpediatrics@childrens.harvard.edu

"Tachyarrhythmias" by Dr. Vassilios Bezzerides, for OPENPediatrics

In this episode of the Heart podcast, Digital Media Editor, Dr James Rudd, is joined by Professor Philip MacCarthy from King's College Hospital, London. They discuss what the heart team is, how's it's evolved and what the future heart team might look like.
If you enjoy the show, please subscribe to the podcast to get episodes automatically downloaded to your phone and computer. Also, please consider leaving us a review at https://itunes.apple.com/gb/podcast/heart-podcast/id445358212?mt=2
Link to published paper:
https://heart.bmj.com/content/107/8/674

The Heart Team - time to refresh the concept?

Disclosures  
00:48 to 02:33 Muntner P, Hardy ST, Fine LJ, Jaeger BC, Wozniak G, Levitan EB, Colantonio LD. Trends in Blood Pressure Control Among US Adults With Hypertension, 1999-2000 to 2017-2018. JAMA. 2020 Sep 22;324(12):1190-1200. doi: 10.1001/jama.2020.14545. PMID: 32902588; PMCID: PMC7489367.  

02:36 to 04:50 Cohen DJ, Sweeney SM, Miller WL, et al. Improving Smoking and Blood Pressure Outcomes: The Interplay Between Operational Changes and Local Context. Ann Fam Med. 2021;19(3):240-248. doi:10.1370/afm.2668  

05:13 to 07:56  Blood Pressure Lowering Treatment Trialists' Collaboration. Pharmacological blood pressure lowering for primary and secondary prevention of cardiovascular disease across different levels of blood pressure: an individual participant-level data meta-analysis. Lancet. 2021 May 1;397(10285):1625-1636. doi: 10.1016/S0140-6736(21)00590-0. Erratum in: Lancet. 2021 May 22;397(10288):1884. PMID: 33933205; PMCID: PMC8102467.  

07:57 to 10:37 Jones DW, Whelton PK, Allen N, Clark D 3rd, Gidding SS, Muntner P, Nesbitt S, Mitchell NS, Townsend R, Falkner B; American Heart Association Council on Hypertension; Council on the Kidney in Cardiovascular Disease; Council on Arteriosclerosis, Thrombosis and Vascular Biology; Council on Cardiovascular Radiology and Intervention; Council on Lifelong Congenital Heart Disease and Heart Health in the Young; and Stroke Council. Management of Stage 1 Hypertension in Adults With a Low 10-Year Risk for Cardiovascular Disease: Filling a Guidance Gap: A Scientific Statement From the American Heart Association. Hypertension. 2021 Jun;77(6):e58-e67. doi: 10.1161/HYP.0000000000000195. Epub 2021 Apr 29. PMID: 33910363.

Cardiowatch - Second Episode

The American College of Cardiology surveyed cardiologists across the globe to have a more detailed understanding on the impact of hostility, discrimination, and harassment in the workplace. Of almost 6000 cardiologists who took part in the survey 44% reported hostile work environment. 

Dr Ankur Kalra’s guest this week is Dr Garima Sharma, Director of CardioObstetrics and Assistant Professor of Medicine at the Johns Hopkins University as well as an investigator of the “Global Prevalence and Impact of Hostility, Discrimination, and Harassment in the Cardiology Workplace”.

According to Dr Sharma, the culture of a place is defined by what is tolerated. In this introspective and solution-seeking interview Garima explains how can microaggressions be identified and how does institutional culture normalise hostility by numbing the victims and making allowances for the perpetrators. In light of the data, they talk about the burden on early career cardiologists, and examine the role of institutions, senior faculty, and bystanders. Garima summarises the potential solutions and calls for making cardiology a viable option for all. 

What is Dr Sharma’s take-home message from the ACC survey on hostile work environment? What could be the root causes of hostile behaviour? What are some of the solutions for work equity?

Questions and comments can be sent to “podcast@radcliffe-group.com” and may be answered by Ankur in the next episode. Guest @GarimaVSharmaMD, hosted by @AnkurKalraMD. Produced by @RadcliffeCARDIO.

Brought to you by Edwards: www.edwardstavr.com

EP 49: Workplace Hostility, Responsibility & Solutions with Dr Garima Sharma

A calcium score screening heart test (also called coronary calcium scan) is a test that uses computerized tomography (CT) to detect calcium deposits in the coronary arteries of your heart. A higher coronary calcium score suggests you have a higher chance of significant narrowing in the coronary arteries and a higher risk of future heart attack.  Cardiologist Dr. Milind Desai talks about the test and why your doctor may order one, who should and should not get this test, how the test results are used, other information you can find through calcium score testing, and how tests are ordered and results provided at Cleveland Clinic.

Coronary Calcium Score Test for Heart Risk

Disclosures

00:56 to 03:34
Prevalence of Left Atrial Thrombus in Anticoagulated Patients with Atrial Fibrillation
Lurie A, Wang J, Hinnegan KJ, McIntyre WF, Belley-Côté EP, Amit G, Healey JS, Connolly SJ, Wong JA. Prevalence of Left Atrial Thrombus in Anticoagulated Patients with Atrial Fibrillation. J Am Coll Cardiol. 2021 Jun 15;77(23):2875-2886. doi: 10.1016/j.jacc.2021.04.036. PMID: 34112315

03:56 to 04:58
Effect of Long-term Continuous Cardiac Monitoring Vs Usual Care on Detection of Atrial Fibrillation in Patients with Stroke Attributed to Large- or Small-Vessel Disease: The STROKE-AF Randomized Clinical Trial
Bernstein RA, Kamel H, Granger CB, Piccini JP, Sethi PP, Katz JM, Vives CA, Ziegler PD, Franco NC, Schwamm LH; STROKE-AF Investigators. Effect of Long-term Continuous Cardiac Monitoring vs Usual Care on Detection of Atrial Fibrillation in Patients With Stroke Attributed to Large- or Small-Vessel Disease: The STROKE-AF Randomized Clinical Trial. JAMA. 2021 Jun 1;325(21):2169-2177. doi: 10.1001/jama.2021.6470. PMID: 34061145; PMCID: PMC8170544.

05:01 to 06:43
Effect of Implantable Vs Prolonged External Electrocardiographic Monitoring on Atrial Fibrillation Detection in Patients with Ischemic Stroke: The PER DIEM Randomized Clinical Trial
Buck BH, Hill MD, Quinn FR, Butcher KS, Menon BK, Gulamhusein S, Siddiqui M, Coutts SB, Jeerakathil T, Smith EE, Khan K, Barber PA, Jickling G, Reyes L, Save S, Fairall P, Piquette L, Kamal N, Chew DS, Demchuk AM, Shuaib A, Exner DV. Effect of Implantable vs Prolonged External Electrocardiographic Monitoring on Atrial Fibrillation Detection in Patients With Ischemic Stroke: The PER DIEM Randomized Clinical Trial. JAMA. 2021 Jun 1;325(21):2160-2168. doi: 10.1001/jama.2021.6128. PMID: 34061146; PMCID: PMC8170545.

07:33 to 09:05
HOLIDAY Monitors: Alcohol Consumption Significantly Increases Risk of AFib Episode
Gregory M. Marcus, et. al. results presented during ACC.21
https://www.acc.org/latest-in-cardiology/articles/2021/05/12/19/40/mon-1045am-holiday-monitors-acc-2021

09:41 to 11:06
Finerenone Reduces Onset of Atrial Fibrillation in Patients with Chronic Kidney Disease and Type 2 Diabetes
Filippatos G, Bakris GL, Pitt B, Agarwal R, Rossing P, Ruilope LM, Butler J, Lam CSP, Kolkhof P, Roberts L, Tasto C, Joseph A, Anker SD; FIDELIO-DKD Investigators. Finerenone Reduces Onset of Atrial Fibrillation in Patients with Chronic Kidney Disease and Type 2 Diabetes. J Am Coll Cardiol. 2021 May 4:S0735-1097(21)04966-4. doi: 10.1016/j.jacc.2021.04.079. Epub ahead of print. PMID: 34015478.

Cardiowatch - Third Episode

The American College of Cardiology completed their 2021 scientific sessions, where many research teams presented trial results. Dr. Steve Nissen, Chief Academic Officer, Cleveland Clinic Heart, Vascular & Thoracic Institute, presents summaries of three trials of interest.

ACC 2021: A Review of Three Trials of Interest

When it comes to matters of the heart, you can trust the experts at McLaren Bay Region. With over 100,000 cardiac catheterizations performed, our experienced team is committed to doing what’s best. Our world-class structural heart program is proud to provide the latest in minimally invasive procedures such as TAVR, Mitraclip and the Watchman. To learn more, or to find upcoming community education and screening events, visit mclaren.org/hearthealth.

Trust the Heart Experts at McLaren Bay Region

A Cleveland Clinic podcast exploring heart, vascular and thoracic topics of interest to healthcare providers: medical and surgical treatments, diagnostic testing, medical conditions, and research, technology and practice issues.

A Cleveland Clinic podcast to help you learn more about heart and vascular disease and conditions affecting your chest. We explore prevention, diagnostic tests, medical and surgical treatments, new innovations and more.

‘Parallax’ (/ˈparəlaks/)-noun: the effect whereby the position or direction of an object appears to differ when viewed from different positions. Join Ankur Kalra, MD from Cleveland Clinic as he shows you a different side to cardiovascular care, management and science. Listen to Ankur’s conversations with legendary cardiologists, critical reviews of key congresses and late-breaking trials, and concise summaries of the best US Cardiology Review articles (we call them #AudioArticles!). Published every second Monday of the month, this is your fix of reliable updates on all things cardiology by someone from a non-traditional background, who is always trying to look at it from new angles! Dear cardiologists, we want to make this podcast about you, and for you! Please email us critical thoughts, comments and questions for Ankur at podcast@radcliffe-group.com and visit www.uscjournal.com for more.

www.tamingthesru.com - Free. Open-Access. Focused on Emergency Medicine, critical care and prehospital medicine, as well as practice algorithms and decreasing knowledge translation in Med Ed.

#cardiology