Ventricular Tachycardias in Structurally Normal Hearts - A Case Report and Review of the Literature
Article Type: Case Report | First Published: June 21, 2018
The acute management of broad complex tachycardias in the Emergency Department (ED) can often pose a significant challenge, not just for the more inexperienced of doctors. This is often due to the potentially lethal nature of this arrhythmia, the perceived complexity of ECG interpretation or handling of antiarrhythmic drugs. Whilst most doctors are aware that broad complex tachycardias are in the vast majority of cases related to structural abnormalities e.g. previous myocardial infarction, it i...
Acute Inferior Wall ST Segment Elevation Myocardial Infarction diagnosed During Bi-Ventricular Pacing
Jaspreet Singh, Shankar K Thampi, Amit Alam, Rajiv Jauhar, Apoor Patel, and Avneet Singh
Article Type: Case Report | First Published: June 15, 2018
Specific criteria have been developed for the diagnosis of acute myocardial infarction in patients with right ventricular pacing, but not for patients with bi-ventricular pacing. We present a case of a patient with a biventricular implantable cardioverter defibrillator (BiVICD), who presented with symptoms consistent with acute coronary syndrome (ACS), new ST elevations of the inferior leads, and was found to have acute occlusion of right coronary artery (RCA)....
Noise Pollution in the Pediatric Intensive Care Unit and its Effect on Sedation
Bree Kramer and Christopher Heard
Article Type: Research Article | First Published: June 14, 2018
Noise exposure is an important factor in the management of intensive care patients. There are many different causes of noise in the ICU such as equipment, monitors, staff, family plus other additional sources. Patients in the ICU are exposed to these noise sources for 24 hours a day with no respite. The noise levels can vary significantly during the day as well as significantly between patient bed-spaces. There are detrimental effects from excessive noise exposure; some of this is related to the...
Bilateral Diaphragmatic Paresis after Cardiac Surgery: The Key is the Clinical Point-of-Care Ultrasound
Jose Luis Vazquez Martinez, Aida Lopez de Pedro, Ana Coca Perez, Raul Montero Yeboles and Cesar Perez-Caballero Macarron
Article Type: Case Report | First Published: January 31, 2018
Bilateral diaphragmatic paresis following cardiac surgery is rare. We present a case in which several extubation attempts failed in an infant after cardiac surgery. Point-of-care ultrasonography (POCUS) showed a slight but symmetric decrease of diaphragmatic motion, confirmed by fluoroscopy. Phrenic electromyography (EMG) was informed inconsistently as normal. After eight weeks of non-invasive ventilation the patient was weaned to room air, revealing the POCUS a recovery on the left side but per...