Index Note: Page numbers of article titles are in boldface type. A Acute coronary syndrome(s), anticoagulant therapy in, 706, 707 antiplatelet therapy in, 702 ß-blockers in, 703 cardiac biomarkers in, 690, 692 693 cardiac ischemia in, 689 clinical history screening in, 691 692 clinical presentation and diagnostic approaches in emergency department, 689 697 continuum of, 690 691 definitions of, 699 701 electrocardiogram in, 692 emergency department treatment of, 699 710 extent of testing in, 693 695 follow-up percutaneous coronary intervention in, 705 706 initial treatment of, 701 703 morphine in, 703 nitroglycerin in, 703 non-st-elevation myocardial infarction within, 690 691, 702 non-st-segment, percutaneous coronary intervention in, 706 708 treatment of, 706 708 patient screening for, 691 693, 694 potential, physical examination in, 692 primary, 699 700 secondary, 700 ST-elevation myocardial infarction within, 690 691, 700 701 criteria for, 700 supplemental oxygen in, 702 Airway management, in cardiac arrest recuscitation, 715 American Heart Association Guidelines 2010, 711 712 evidence in support of, 712 715 Angiography, coronary CT, in low-risk chest pain, 725 Antiarrhythmics, in atrial fibrillation, 751 752 Anticoagulant therapy, in acute coronary syndromes, 706, 707 Anticoagulation, in atrial fibrillation, 753 754 Antiplatelet therapy, in acute coronary syndrome, 702 Aortic aneurysm, abdominal, causes and risk factors for, 794 clinical presentation of, 795 diagnostic modalities in, 795 treatment of, 795 796 thoracic, 797 Emerg Med Clin N Am 29 (2011) 829 835 doi:10.1016/s0733-8627(11)00104-0 0733-8627/11/$ see front matter ª 2011 Elsevier Inc. All rights reserved. emed.theclinics.com
830 Index Aortic dissection, causes and risk factors for, 789 790 chest radiography in, 790, 791 classification of, 790, 791 clinical presentation of, 790 computed tomography imaging in, 791 792 magnetic resonance imaging in, 792 risk assessment in, 793 transesophageal echocardiography in, 792 transthoracic echocardiography in, 792, 793 treatment of, 793 794 Aortic emergencies, 789 800 Aortic stenosis, 817 818 disordred heart valve and, 802, 803, 804 Arial fibrillation, anticoagulation in, 753 754 heparin and low-molecular-weight heparin in, 754 vitamin K antagonist and aspirin in, 754 Arrhythmias, congenital cardiac, 823 824 primary and secondary, causes of, 730 potential causes of, 730 reversible causes of, 730, 731 Atrial fibrillation, 747 758 antiarrhythmics in, 751 752 as risk factor for stroke, 747, 753 atrial flutter in, 755 causes of, 747 748 diagnosis of, 748 direct current electrical cardioversion in, 750 751 direct thrombin inhibitors in, 754 755 disposition in, 755 in acute heart failure syndromes, 684 685 management of, 748 749 pharmacocardioversion in, 752 rate control for, 749 750 rhythm control to terminate, 750 753 Atrial flutter, in atrial fibrillation, 755 B ß-Blockers, in acute coronary syndrome, 703 in aortic dissection, 793 Bradycardia(s), and heart block, characteristics of, 732 conceptual approach to, 732 Bradydysrhythmia(s), approach to patient with, 731 733 evaluation in, 731 733 stable, treatment of, 733 unstable, treatment of, 733 C Calcium channel blockers, in aortic dissection, 794 Cardiac arrest, bedside ultrasound in, 777 778
Index 831 emergency echocardiography in. See Echocardiography, emergency, in cardiac arrest. recuscitation in, airway management in, 715 oxygenation in, 715 ventilation in, 715 resuscitation in, chest compression, 712 714 early defibrillation in, 714 early phase of, 716 late phase of, 717 middle phase of, 716 717 phase approach, involving ventricular fibrillation and pulseless ventricular techycardia, 711 719 phases of, 715 717 rescue breathing, 712 713 Cardiac biomarkers, in acute coronary syndrome, 690, 692 693 Cardiocerebral resuscitation, phases of, 715 717 Cardiomyopathies, emergency echocardiography in, 766 Chest compression, in cardiac arrest resuscitation, 712 714 Chest pain, low-risk, approach to ED patient with, 721 727 cardiac biomarkers in, 723, 724 clinical history in, 722 723 coronary CT angiography in, 725 electrocardiogram in, 723 exercise treadmill testing in, 724 provocative testing in, 724 725 radionuclide myocardial perfusion imaging in, 725 stress echocardiography in, 725 visits to emergency department for, 721 Circulatory system, anatomy and pathophysiology of, 812 813 Coarctation of aorta, 817 Complete heart block, 824 Congenital heart disease, adults with, treatment of, special considerations in, 824 825 congestive heart failure in, 815 cyanosis in, 814 815 risk factors for, 814 suspected diagnosis and stabilization of, 814 815 Coronary artery disease, assessment of, 722 Coronary syndrome, acute. See Acute coronary syndrome(s). Cyanosis, ductal-dependent obstructive lesions in, stabilization of, 815 816 in congenital heart disease, 814 815 D Defibrillation, early, in cardiac arrest recuscitation, 714 Direct current electrical cardioversion, in atrial fibrillation, 750 751 Direct thrombin inhibitors, in atrial fibrillation, 754 755 Dyastolic dysfunction, emergency echocardiography in, 766 767 E Ebstein anomaly, 819 820 Echocardiography, applied Doppler technology, 761 B-mode, 761 emergency, 759 787
832 Index Echocardiography (continued ) as goal-directed, 760 cardiac windows for, 763 case 1, 759, 762 766 case 2, 767 772 case 3, 773 777 case 4, 777 779 E-point septal separation, 761, 764 fractional shortening, 762, 764 765 in cardiac arrest, 777 779 advantages of, 778 pediatric considerations and, 778 survival and, 778 in cardiomyopathies, 766 in diastolic dysfunction, 766 767 in hyperdynamic heart, 767 in special circumstances, 766 767 modalities used in, 760 761 overall cardiac function and, 766 pericardial effusion detection and, 768 772 pulmonary embolus and, 776 quantitative methods of, 764 right ventricle and, anatomy of, 773 776 size and function of, 773 777 scope of, 759 760 semiquantitative methods of, 764 technical limitations of, 762 undifferentiated shock and hypotension and, 776 777 visual estimates of cardiac function with, 765 766 volume assessment and, 779 781 clinical utility of, 781 windows used in, 762 M-mode, 761, 762 Emergency department patient, with low-risk chest pain, approach to, 721 727 Endocardial excursion, 765 Exercise treadmill testing, in low-risk chest pain, 724 F Fibrolytic agents, efficacy and risk of, 704 Fibrolytic therapy, contraindications to, 704, 705 in ST-segment elevation myocardial infarction, 703, 704 G GPIIb/IIIa inhibitors, in acute coronary syndromes, 706 H Heart, hyperdynamic, emergency echocardiography in, 767 left-sided obstructive lesions of, 817 818 right-sided obstructive lesions of, 818 824
Index 833 Heart block, complete, 824 Heart defects, congenital, incidence of, 812 time of presentation of, 812 Heart disease, congenital. See Congenital heart disease. valvular, diagnosis and management of, in emergency medicine, 801 810 Heart failure, congestive, lesions presenting as, 820 823 stabilization of, 817 incidence of, 675 Heart failure syndromes, acute, angiotensin-converting enzyme inhibitors in, 680 681 atrial fibrillation in, 684 685 categorizing of patients with, 679 clinical profile of patients with, 676 677 definition of, 677 diagnosis of, 676 high risk features for, 685 hypertensive pathway, 679 hypotensive pathway, 679 hypotensive profile in, 684 initial approach to ED management of, 677 initial management of, 675 688 IV loop diuretics in, 678 680 morphine in, 684 nesiritide in, 681 684 normotensive pathway, 680 precipitants of, diagnosis and treatment of, 682 683, 684 special considerations in, 684 685 symptoms of, 676 therapeutic considerations in, 677 684 vasodilators in, 680, 681 Heart murmur, asymptomatic, approach of emergency physician in, 805 important, 805 806 prosthetic valve in, antibiotic therapy in, 806 807 determination of kind of, 806 Heart valve, artificial, anticoagulation in, 808 809 long-standing, late complications associated with, 807 808 recently implanted, early complications of, 807 disordered, aortic stenosis and, 802, 803, 804 clinical presentation and work-up in, 803 804 epidemiology and pathophysiology of, 802 infective endocarditis in, 802 804, 805 left-sided regurgitation in, 802, 803, 804 805 prosthetic valves and, 802 treatment and management of, 804 805 Heparin, and low-molecular-weight heparin, in atrial fibrillation, 754 Hypoplastic left heart syndrome, 817 I Infective endocarditis, in disordered heart valve, 802 804, 805 Inferior vena cava, sonographic evaluation of, limitations of, 781 782
834 Index L Long QT syndrome, 823 824 M Mitral valve motion, 765 Morphine, in acute coronary syndrome, 703 Myocardial infarction, non-st-elevation, 690 691, 702 ST-elevation. See ST-segment elevation myocardial infarction. Myocardial necrosis, causes of, 701 Myocardial wall thickening, 765 N Nitroglycerin, in acute coronary syndrome, 703 Nitroprusside, in aortic dissection, 794 Non-ST-segment elevation acute coronary syndromes, percutaneous coronary intervention in, 706 708 treatment of, 706 708 O Oxygen, supplemental, in acute coronary syndrome, 702 Oxygenation, in cardiac arrest recuscitation, 715 P Patent ductus arteriosus, 822 823 Percutaneous coronary intervention, follow-up, in acute coronary syndromes, 705 706 in ST-segment elevation myocardial infarction, 703 705 Pericardial effusion, and pleural effusion, differentiation of, 772 773 detection of, emergency echocardiography and, 768 772 etiology of, 768 770 evaluation of, pitfalls of, 772 773 size of, 768, 769, 770 tamponade physiology and, 770 772 Pericardiocentesis, 772 Pleural effusion, and pericardial effusion, differentiation of, 772 773 Pulmonary embolus, emergency echocardiography and, 776 Pulmonary venous return, total anomalous, 821 R Radionuclide myocardial perfusion imaging, in low-risk chest pain, 725 Regurgitation, left-sided, in disordered heart valve, 802, 803, 804 805 Rescue breathing, in cardiac arrest resuscitation, 712 713 Rhythm disturbance(s), 729 746 differential diagnosis of, 729 general approach to patient with, 729 731 stable versus unstable presentations of, 730, 731 S Shock, ductal-dependent obstructive lesions in, stabilization of, 815 816 in neonate of, differential diagnosis of, 814
Index 835 Shock and hypotension, undifferentiated, emergency echocardiography in, 776 777 ST-segment elevation, non-acute coronary syndrome causes of, 701, 702 ST-segment elevation myocardial infarction, facilitated percutaneous coronary intervention in, 703 705 fibrolytic therapy in, 703, 704 and percutaneous coronary intervention in, choice of, 704 treatment of, 703 706 Stress echocardiography, in low-risk chest pain, 725 Supraventricular tachycardia, 823 T Tachycardia(s), approach to patient with, 737 AV nodal reentrant, 734 735 conceptual approach to, 735 supraventricular, 730 Tachydysrhythmia, approach to patient with, 733 741 evaluation of, 733 736 narrow complex, 734 736 stable narrow complex, treatment of, 737 739 stable wide complex, treatment of, 740 741 unstable narrow complex, treatment of, 736 739 unstable wide complex, treatment of, 739 740 wide complex, 736 Tetralogy of Fallot, 818 819 Thienopyridines, in acute coronary syndromes, 706 Transposition of great vessels, 818 Truncus arteriosus, 820 821 U Ultrasound, bedside, in cardiac arrest, 777 778 V Valvular heart disease, diagnosis and management of, in emergency medicine, 801 810 Ventilation, in cardiac arrest recuscitation, 715 Ventricle, right, anatomy of, emergency echocardiography and, 773 776 dilation of, echocardiographic signs of, 774, 775 size and function of, emergency echocardiography and, 773 777 strain of, and paradoxic septal motion, 774, 775 Ventricular fibrillation, and pulseless ventricular tachycardia, in phase approach to cardiac arrest resuscitation, 711 719 Ventricular septal defect, 821 822 Ventricular tachycardia, pulseless, and ventricular fibrillation, in phase approach to cardiac arrest resuscitation, 711 719 Vitamin K antagonist, and aspirin, in atrial fibrillation, 754