The American journal of emergency medicine
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The aim of this study was to evaluate the additional predictive value of serum potassium (SK) to Thrombolysis In Myocardial Infarction (TIMI) risk score for malignant ventricular arrhythmias (MVA) in patients within 24 hours of acute myocardial infarction (AMI). ⋯ Serum potassium on admission to the emergency department may be used as a valuable predictor and could add predictive information to some extent to TIMI risk score for MVA attack during 24-hour post-AMI.
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Case Reports
Supraventricular tachycardia induced by chocolate: is chocolate too sweet for the heart?
Conflicting studies have been published concerning the association between chocolate and cardiovascular diseases. Fewer articles have described the potential arrhythmogenic risk related to chocolate intake. We present a case of paroxysmal supraventricular tachycardia in a woman after consumption of large quantity of chocolate. ⋯ Our case very well describes an episode of tachycardia precipitated by large amount of chocolate consumption in a patient with underlying substrate. There are occasional case reports describing association between chocolate, caffeine, and arrhythmias. A large Danish study, however, did not find any association between amount of daily caffeine consumption and risk of arrhythmia.
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A small number of patients representing a significant demand on emergency department (ED) services present regularly for a variety of reasons, including psychiatric or behavioral complaints and lack of access to other services. A care plan program was created as a database of ED high users and patients of concern, as identified by ED staff and approved by program administrators to improve care and mitigate ED strain. ⋯ An alert program that identifies challenging ED patients with psychiatric conditions and creates a care plan appears to reduce visits and lead to more appropriate use of other resources.