The American journal of emergency medicine
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We report a rare case presenting with up to 50 episodes of syncopes per day in a 54-year-old man with the ultimate diagnosis of idiopathic glossopharyngeal neuralgia. All episodes were started with a severe pain sensation in the right side of the throat followed by asystole and then very slow ventricular escape beats. The patient was successfully treated with the combination of carbamazepine, gabapentin, and dual-chamber pacemaker implantation.
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Most complications from traumatic isolated adrenal hemorrhage are thought to be minor and do not require specific treatment. However, there are often additional intraabdominal organ injuries, such as liver and ipsilateral kidney, associated with adrenal injury. It is, therefore, important to identify these injuries as early as possible, preferably on initial assessment. We describe a case of a 43-year-old man who presented to the emergency department after sustaining blunt force trauma to the flank during a soccer match and was subsequently diagnosed with acute adrenal injury by use of bedside ultrasonography.
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Electrical storm is a challenging diagnosis for the clinician and requires detailed evaluation of the patient. Amiodarone is frequently used for the cessation of ventricular tachycardia attacks. ⋯ Thyrotoxicosis may alter arrhythmia and lead to frequent ventricular tachycardia attacks. Herein, we report a case of electrical storm caused by amiodarone-induced thyrotoxicosis.
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Several risk scores are available for prognostic purpose in patients presenting with chest pain. ⋯ The FPR effectively succeeds in ruling out coronary events in patients categorized with overall low risk score. Exercise ECG, nonetheless being an independent predictor of coronary events could be considered questionable in this subset of patients.
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The objective was to evaluate whether passive leg raising during cardiopulmonary resuscitation in a porcine model of prolonged ventricular fibrillation improves hemodynamics, return of spontaneous circulation, 24-hour survival, and neurological outcome. ⋯ Passive leg raising during cardiopulmonary resuscitation significantly increased coronary perfusion pressure in the minute prior to the first shock. Return of spontaneous circulation and 24-hour survival rate were comparable between groups. However, the animals in the passive leg raising group exhibited significantly higher neurological scores.