The American journal of emergency medicine
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Review Case Reports
ST-segment elevation after direct current shock mimicking acute myocardial infarction: a case report and review of the literature.
External direct current (DC) shocks are and have long been commonly used for electrical cardioversion/defibrillation of atrial or ventricular arrhythmias. ST-segment elevation after cardio version with DC is an easily ignored phenomenon, occurring acutely and resolving during the first few minutes postshock. Here, we describe electrocardiographic findings of widespread ST-segment elevation lasting at least 1 hour after DC cardioversion for ventricular defibrillation due to Brugada syndrome and mimicking acute myocardial infarction (AMI). This case of ST-segment elevation without a dynamic and evolving AMI underscores the need to consider other causes of ST-segment elevation.
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Automated external defibrillation (AED) and public access defibrillation (PAD) have become cornerstones in the chain of survival in modern cardiopulmonary resuscitation. Most studies of AED and PAD have been performed in urban areas, and evidence is scarce for sparsely populated rural areas. The aim of this review was to review the literature and discuss treatment strategies for out-of-hospital cardiac arrest in rural areas. ⋯ In rural areas, introducing AED programs and a 2-tier emergency medical system may increase survival of out-of-hospital cardiac arrest patients. More studies on AED and PAD in rural areas are required.
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Patients with occult, undiagnosed cardiac myxomas (CM) often present with acute complications that mimic other, more common, conditions. We describe two recently encountered patients who classically demonstrate this phenomenon and report the results of an integrative review of CM cases to define the characteristics of such patients. ⋯ CM is a rare but potentially life-threatening condition. Symptoms and signs relating to CM mimic other, more common conditions, resulting in diagnostic delay. Echocardiography can quickly and accurately diagnose CM and timely surgical intervention is curative. Clinician awareness of this condition, in a suggestive clinical context, will increase the likelihood of optimal patient outcome.
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Review Case Reports
Cervical necrotizing fasciitis of nonodontogenic origin: Case report and review of literature.
Cervical necrotizing fasciitis (CNF) is a potentially fatal infection characterized by generalized necrosis of the cervical fascia that progresses rapidly. The incidence of this entity corresponds to 2.6% of all infections of the head and neck. The most frequent primary origin is dental infection, although other causes exist that should be evaluated. ⋯ Early detection and adequate emergency treatment are critical in the management of these patients and may reduce morbimortality and improve survival. The emergency services should be prepared to manage such cases efficiently, through a multidisciplinary treatment by coordinating emergency surgery with critical support and clinical stabilization of patients. We present a case of CNF of non odontogenic origin managed in our hospital.