Podcasts about Syncope

Commentary by Dr. Jian'an Wang.

Ecoutez L'oeil d'Alex Vizorek du 24 avril 2026.Hébergé par Audiomeans. Visitez audiomeans.fr/politique-de-confidentialite pour plus d'informations.

Broadcast from KSQD, Santa Cruz on 4-16-2026: Dr. Dawn opens with a follow-up from an email from Maryland about a friend in Switzerland, who has ongoing neurological and gastrointestinal symptoms. She reviews the earlier effort to connect him with functional-medicine resources in Switzerland, then focuses on a new observation that the patient may have had multiple parasitic infections during travel in Europe. Dawn agrees that this may have left a major gap in the workup and says that, in puzzling neurologic cases, a sleep-deprived EEG can sometimes reveal a “fingerprint” of brain-based dysfunction even if the patient is not actively having symptoms during the test. Dr. Dawn says that for people over 60 who have never had a heart attack or stroke, daily baby aspirin is no longer considered a good routine preventive measure because the bleeding risks, especially gastrointestinal bleeding, can outweigh the cardiovascular benefit. She makes the distinction that aspirin may still make sense for secondary prevention in people who already have established cardiovascular disease. She next reviews several medications that she thinks many older adults should reconsider. She explains that phenylephrine, which replaced easier access to pseudoephedrine in many cold remedies, has been found to work no better than placebo . She also says Colace is not very effective, and she strongly advises older adults to avoid Benadryl because it accumulates with age, increases fall risk, and may be associated with cognitive decline. She adds that beta blockers are no longer preferred first-line treatment for uncomplicated hypertension in many older patients, and that medications targeting the angiotensin pathway are generally favored instead. Dr. Dawn introduces Mira Achilles in the studio, describing her as her excellent administrative assistant. Mira explains that she gathered health questions from peers from her college world. Mira asks what best supports focus for someone with ADHD working at a desk job. Dr. Dawn says the two evidence-based pillars are cognitive behavioral therapy and exercise. She walks through practical strategies including using calendars, reminders, index cards, and to-do lists; sorting tasks by urgency and importance; breaking large projects into smaller steps; creating small reward loops by checking off progress; and deliberately reducing distractions in the work environment.. She emphasizes that movement and exercise improve attention and executive function, and that ADHD management often improves when sleep timing is stabilized. Another of Mira's peers asks whether women should avoid very cold showers or ice baths during the luteal phase or around menstruation. Dr. Dawn says the answer is not absolute, but she cautions that cold exposure can hit women differently depending on hormonal state. She notes that the luteal phase may make vasoconstriction and cold sensitivity more pronounced, and she raises concerns about the physiologic stress of cold immersion, including possible adverse effects on circulation and rewarming. Her overall tone is cautious rather than enthusiastic, especially for people who are already prone to feeling chilled or reactive. Another contributor asks why some people faint when seeing needles, blood, or medical procedures. Dr. Dawn explains the vasovagal response: a reflex in which blood pressure and heart rate suddenly drop, reducing blood flow to the brain. She offers simple countermeasures such as crossing the legs, tightening muscles, squatting, or using hand-grip tension to help push blood back toward the brain and prevent passing out. Dr. Dawn closes by asking whether cortisol is a “good” or a “bad” hormone. Dr. She answers that cortisol is essential: it helps regulate daily rhythms, energy balance, and the broader hormonal system, so it is not something to think of as inherently harmful. At the same time, she says problems arise when cortisol is chronically dysregulated or excessive, so the goal is to maintain a healthy rhythm and avoid overwhelming the adrenal system. Please go to KSQD.org and donate to support Ask Dr. Dawn on KSQD.

Hosts: Don Stader, Nate Novotny, Travis Barlock, and Jeffrey Olson In this episode, we reminice about the first 1000 medical minutes presented by EMM and what the next 1000 might hold. Below are all of the episodes referenced in this episode. Please go back and give them all a listen. Segment 1- Recap and Facts 1st medical minute o   April 29, 2016. Almost exactly 10 years ago. o   Diverticulitis and Antibiotics by Dr. Chris Holmes 1000th Medical Minute o   March 30, 2026 o   Treatment of burns by Aaron Lessen o   Edited by Ashley Lyons and published by Jorge Chalit Favorite sub-topics have included: o   Cardiovascular topics- 150 episodes o   Pharmacology- 97 episodes o   Toxicology- 85 episodes o   Neurology- 75 episodes The "Hunting for…" cinematic universe. -Michael Hunt o   399: Hunting for Pancreatitis o   424: Hunting for Measles o   432: Hunting for UTIs o   445: Hunting for the Endotracheal Tube o   455: Hunting for PeeCP o   460: Hunting for PE in Syncope o   487: Hunting for Epiglottitis Obsession with 1966- Chris Holmes o   120: The State of Sepsis in 1966 o   125: Old School CPR - 1966 o   138: Bromide Toxicity - 1966 o   147: GI Bleed - 1966 o   675: CHF like it's 1966 Favorite drug: naloxone/narcan (9) o   7: Heroin Overdose and OTC Narcan o   464: Narcan't? o   516: Narcan and Pulmonary Edema o   931: Naloxone in Cardiac Arrest Favorite disease state: Sepsis (13) o   22: Sepsis Sofa o   219: History of Sepsis o   244: Fever in Sepsis o   263: Early Antibiotics in Sepsis o   272: More on Temperature in Sepsis o   287: Sepsis Bundles o   544: C is for Sepsis Unhinged title combinations o   84: Hypothermia and Lightning Strike: Code Blue o   203: Wine, Milk and… Vaccines!? o   216: Roller Coasters and Kidney Stones o   299: Black Death, Lice, Math, and Pottery o   427: Cookie Dough is Delicious o   670: Operation Tat-Type o   695: Einstein and Cellophane o   777: Grass, weed and ancient Rome o   781: Foxglove, dropsy, and Salvador Dali o   959: The KLM Flight Disaster and Lessons in Healthcare Communication Most frequent contributors -          Aaron Lessen- 192 -          Don Stader- 84 -          Jarod Scott- 83 -          Peter Bakes- 53 -          Samuel Killian- 45 -          Dylan Luyten- 41 -          Erik Verzemnieks- Dozens -          Michael Hunt- 34 -          Travis Barlock- 30 -          Ricky Dhaliwal- 25 Top female voices o   Rachael Duncan, PharmD o   Rachel Beham, PharmD o   Meghan Hurley o   Gretchen Hinson o   Suzanne Chilton o   Katie Sprinkle Most listened to -          8. Podcast 835: Syncope Review -          7. Podcast 766: Truth about Tramadol -          6. Podcast 839: Causes of Pancreatitis -          5. Podcast 760: Why Fentanyl is the Worst -          4. Podcast 844: Dental Infections -          3. Podcast 846: Early Repolarization vs. Anterior STEMI -          2. Podcast 845: Hyperkalemic Cardiac Arrest -          1. Podcast 847: ECMO CPR Mini-game: who has actually seen our most rare diagnoses? o   18: Lemierre's Syndrome – Septic thrombophlebitis of the internal jugular vein after oropharyngeal infection leading to septic emboli. o   139: Locked-in Syndrome – Ventral pontine lesion causing quadriplegia and inability to speak with preserved consciousness and eye movements. o   144: Moyamoya Disease – Progressive stenosis of intracranial carotids with development of fragile collateral vessels causing strokes. o   221: Cotard Delusion (Walking Corpse Syndrome) – Psychiatric disorder where patients believe they are dead or do not exist. o   240: Pott's Puffy Tumor – Frontal bone osteomyelitis with subperiosteal abscess from sinusitis causing forehead swelling. o   277: Mucormycosis (Rhizopus) – Angioinvasive fungal infection in immunocompromised patients causing rapid tissue necrosis. o   293: Transient Global Amnesia – Sudden, transient loss of ability to form new memories that resolves within 24 hours. o   329: Hypokalemic Periodic Paralysis – Episodic muscle weakness due to intracellular potassium shifts. o   374: Iliac Artery Endofibrosis – Exercise-induced fibrosis of the iliac artery causing claudication in athletes. o   466: Subacute Sclerosing Panencephalitis (SSPE) – Progressive, fatal neurodegenerative disease from persistent measles infection. o   477: Postpolypectomy Electrocoagulation Syndrome – Transmural burn of the colon after polypectomy causing localized peritonitis without perforation. o   578: Brown-Séquard Syndrome – Hemisection of the spinal cord causing ipsilateral motor/proprioception loss and contralateral pain/temperature loss. o   697: Kounis Syndrome – Acute coronary syndrome triggered by allergic reaction causing coronary vasospasm or plaque rupture. o   973: Meningitis Retention Syndrome – Acute urinary retention due to sacral nerve dysfunction during meningitis. Segment 2- Individual Interviews Segment 3- Looking forward Segment 4- Trivia Podcast 38, what is significant about diphtheria and March 18th? o   On March 18th, the Iditarod is run in Alaska to commemorate a sled dog team, led by Balto, that ran from Nome to Anchorage and back to provide children in Nome with the diphtheria anti-toxin serum. Podcast 52: Syphilis the Great Imitator. The study of Syphilis or "Syphilology" evolved into the field of what? o   Dermatology Podcast 121:  The Poor Man's Methadone. What is the poor man's methadone? o   Imodium Podcast 136:  James Lind, conducted the first clinical trial in 1747 and proved that what cure what? Hint: think vitamins. o   Citrus fruits cure scurvy. Podcast #213: --- and Potatoes. What food has been shown to lower LDL? o   Oats Podcast #216: Roller Coasters and Kidney Stones. A study used a model of a kidney and ureter with different sized stones and put it on ------ roller coaster in Disney World. o   Thunder Mountain Podcast #261. ---- was introduced to treat ACE-inhibitor induced angioendema. but later, better-powered studies showed that it had no benefit compared to standard treatment. o   Icatibant Podcast #304: ---. ---- was a formal medical diagnosis, and one that dates back to 17th century when soldiers had longing for home and melancholy with a constellation of symptoms including lethargy, sadness, disturbed sleep, heart palpitations, GI complaints, and/or skin findings for which the only cure was to return home. o   Nostalgia Podcast # 351: Steakhouse Syndrome. What is steakhouse syndrome? o   Impacted food bolus 2/2 esophageal stricture Podcast # 362: Giant Hogweed. What can Giant Hogweed cause. o   Photosensitivity, severe blisters, and burns Podcast #398:  Who is gonna fail your antibiotic plan? What vital sign abnormality at triage had the highest odds ratio for treatment failure for the treatment of cellulitis with antibiotics. o   Tachypnea Podcast # 458: A Tylenol a Day Keeps the ---- Away? A recent study investigated the effect of scheduled IV acetaminophen on the incidence of ---- in post-CABG patients in the ICU o   Delerium Podcast 554: Sleeping Away Alzheimer's. What is the difference between white noise and pink noise? o   White noise is all the surrounding sound frequencies mixed together that your brain tunes down so you don't get distracted while you're sleeping o   Pink noise, or deep soothing noises, is the accentuated bass sounds like falling rain or waves crashing your brain keys into while sleeping. o   Pink noise during sleep has been shown to increase stage 4, creating more CSF washout of beta amyloid. Podcast 580:  Origin of PPE. Why were rubber gloves invented? o   The invention of surgical gloves are credited to surgeon William Halsted. He developed gloves because one of his assistants (and later wife), Carol Hampton, was having severe irritation due to a caustic pre-op disinfecting process. They developed the rubber glove for Hampton which garnered popularity, and by the early 20th century, half of surgeons were using rubber gloves. Podcast 587:  Puppies Preventing Burnout? Puppies lower stress, what activity in that study increased stress? o   Coloring, because they were denied a chance to play with a puppy Podcast 596: Weather Can be a Headache. What are the three weather events that can increase the frequency of headaches? o   High temp o   Low humidity o   High air pollution Podcast 612: Origin of Vaccines. Guess both diseases. The potential of vaccinations was first observed in the late 1600s when Jenner observed people who had cowpox never contracted ----. Years later, Louis Pasteur inoculated chickens with ---- after his assistant accidently created the first live attenuated vaccine by creating a weakened bacteria when he left the bacteria out while he went on vacation o   Smallpox, cholera Podcast 670: Operation Tat-Type. In 1951, Operation Tat-Type began tattooing adults with their ---- in an effort to prepare for ---- in the time of the Cold War and the Korean War o   Blood type, rapid transfusions Podcast 695: Einstein and Cellophane. Albert Einstein had ----- as a middle-aged man. Dr. Rudolph Nissen, founder of the Nissen fundoplication, performed exploratory surgery for this pain and found a ---- -          The only treatment for an AAA at that time was to----, causing a fibrotic response to prevent rupture -          Einstein died 7 years after this surgery, likely from his leaking abdominal aortic aneurysm o   chronic abdominal pain o   AAA o   wrap the vessel in cellophane Podcast 748: -----. Whale blubber, honey, home fermented foods, homemade wine (especially the wine made in prison), and improperly stored canned food can all contain the toxin o   Botulism Podcast 777: Grass, Weed, and Ancient Rome. Wine and wormwood and white hellborn were used in ancient rome to treat ----. o   Nausea, sea sickness Podcast 821: EKGs in Syncope. Travis suggests a mnemonic for remembering additional EKG findings to look for in syncope o   WOBBLER §  Wolff-Parkinson-White (WPW) §  Obstructed AV node §  Brugada syndrome §  Bifascicular block §  Left Ventricular Hypertrophy (LVH) §  Epsilon waves §  Repolarization abnormalities Podcast 890: Outdoor Cold Air for Croup A 2023 study, published in the Journal of Pediatrics, investigated whether a 30-minute exposure to outdoor cold air could improve mild to moderate croup symptoms before the onset of steroid effects. In what country was this study conducted. o   Switzerland Podcast 925: Pediatric Tongue Entrapment. Case study of a peds patient with his/her tongue stuck in a drinking cap. What was the substance that finally set it free? o   Table sugar Podcast 960: Frank's Sign - A Marker for Coronary Artery Disease. What is Frank's Sign? o   Bilateral earlobe crease Thank you to all that make the EMM awesome! Hosted and editted by Jeffrey Olson MS4 | Additional editting by Jorge Chalit, OMS4 Donate: https://emergencymedicalminute.org/donate/ Join our mailing list: http://eepurl.com/c9ouHf

Darshan H. Brahmbhatt, Podcast Editor of JACC: Advances, discusses a recently published original research paper on Clinical Decision-Making of Artificial Intelligence vs Medical Professionals in Patients With Syncope.

This episode covers syncope.Written notes can be found at https://zerotofinals.com/paediatrics/neurology/syncope/Questions can be found at https://members.zerotofinals.com/Books can be found at https://zerotofinals.com/books/The audio in the episode was expertly edited by Harry Watchman.

Nouveaux pilotes, un brin déjantés, à bord de la Libre Antenne sur RMC ! Jean-Christophe Drouet et Julien Cazarre prennent le relais. Après les grands matchs, quand la lumière reste allumée pour les vrais passionnés, place à la Libre Antenne : un espace à part, entre passion, humour et dérision, débats enflammés, franc-parler et second degré. Un rendez-vous nocturne à la Cazarre, où l'on parle foot bien sûr, mais aussi mauvaise foi, vannes, imitations et grands moments de radio imprévisibles !

2:19 - What is the RSV vaccine? 5:17 - Sports physicals and their importance 10:05 - Parenting Tip 11:43 - Syncope 19:15 - Trivia 19:49 - Conclusion

  Delighted to share a concise update on the latest NEJM review of Long QT Syndrome

The JournalFeed podcast for the week of Nov 9-14, 2025.These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.Thursday's Spoon Feed:After 48 hours of brain rest, moderate recreational screen time may support better psychological recovery post-concussion compared to restrictive or excessive use.Friday's Spoon Feed:Presyncope has a 30-day serious cardiac outcome risk that is identical to patients with true syncope—despite presyncope patients being admitted less often and considered lower risk.

Episode 187. Understand dizziness, including the definition and different types, such as vertigo, pre-syncope, and disequilibrium. We'll also discuss the causes of dizziness, from dehydration and bradycardia to vestibular migraines and anemia.Visit First Line's website and blog: ⁠https://www.firstlinepodcast.comEditing Service for Pre-Med and Medical Students (CV, personal statement, applications): https://www.firstlinepodcast.com/servicesFor a discount on your TrueLearn subscription use ⁠https://truelearn.referralrock.com/l/firstline/⁠ and code firstlineContent on First Line is for educational and informational purposes only, not as medical advice. Views expressed are my own and do not represent any organizations I am associated with.

In this week's episode, both of our storytellers learn the hard way that getting high doesn't always mean having a good time.Part 1: At his friend's bachelor party, Andrew McGill joins in on a mushroom trip that quickly spirals out of control.Part 2: In an attempt to calm his nerves about going on an Alaskan cruise, Will Clegg turns to marijuana. Andrew McGill is a storyteller born and raised in Brooklyn, NY when not on stage is a English teacher at a high school in Brooklyn. Will Clegg is a filmmaker, storyteller, and new dad living in Westfield, NJ. He's the co-creator and sometimes host of the long-running storytelling show “Awkward Teenage Years” as well as the writer and performer of two solo shows: “The Lonely Road” and “Syncope.”See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

In this episode, we review the high-yield topic ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Syncope ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠from the Cardiovascular section at ⁠⁠⁠⁠Medbullets.com⁠⁠⁠⁠⁠⁠Follow⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Medbullets⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ on social media:Facebook: www.facebook.com/medbulletsInstagram: www.instagram.com/medbulletsofficialTwitter: www.twitter.com/medbulletsLinkedin: https://www.linkedin.com/company/medbullets

A 17 yo male presents for follow up on a “fainting” episode that occurred during football practice at the end of a running exercise. He states, “I do not know what happened. We finished a set of running sprints and next thing I knew, I was on the ground.” He denies injury from the event and history of prior episodes. His physical examination reveals a crescendo-decrescendo systolic murmur heart best at the apex, increasing in intensity with position change from supine to standing position.  This most likely represents: A. Mitral regurgitation B. Physiologic murmur C. Hypertrophic cardiomyopathyD. Aortic stenosis Visit fhea.com to learn more!

    The king of berlin-school music returns with another stellar mix. Our friend, Erwin Boers, was nice enough to put together a follow up to his spring EM mix with this excellent summer update. Here what he says about this latest set: "For this summer update in the synth-cosmic-Berlin School-electronic-music scene, I faced the same problem as a few months ago with the spring update: a heterogeneous bunch of tracks in a wide variety of moods, rhythms and styles. This time, to produce a coherent mix, I figured telling the "story" of a journey into outer space - not very original I know... ;-) Starting with a couple of upbeat pieces, to depict hectic life on Earth, we then lift off slowly by means of a set of tracks focused on soloing, soundscapes, layered sequencing and space sounds. As we reach the edge of the solar system, several deep contemplative atmospheres invite us to consider the distance travelled and the long journey ahead....I'll leave the scenery of the places visited to the listener's imagination! In short, a pleasant floating audiotrip just under two hours, to be enjoyed day and night, lounging in the shade or stargazing on your back.  Special mention for a fantastic retro track by Xan Alexander in pure Berlin School style, a bit of electric guitar bombast by Otarion aka Rainer Klein and a pick from ex-Tangerine Dream member Peter Baumann's latest album "Nightfall"." Here are links to all the music used in this mix: 1. https://moonbooter.bandcamp.com/album/syncope-1 2. https://www.klangwelt.info 3. https://tim-stebbing.bandcamp.com/album/supraluminal 4. https://frankvanbogaert.bandcamp.com/album/sounds-from-higher-grounds 5. https://othersideaudio.bandcamp.com/album/the-pulse-of-life 6. https://othersideaudio.bandcamp.com/album/ouroboros-ii 7. https://totemtag.bandcamp.com/album/space-ascension 8. https://skoulamanongroove.bandcamp.com/album/live-at-dem 9. https://peterbaumann.bandcamp.com/album/nightfall 10. https://www.junodownload.com/products/afterlife-playing-place/7046968-02/ 11. https://beyondberlinongroove.bandcamp.com/album/meandering-tear 12. https://gertemmens.bandcamp.com/album/all-that-is-left-behind 13. https://dinrecords.bandcamp.com/album/transmissions-din92 14. https://otarionongroove.bandcamp.com/album/time-of-nations 15. https://tiratheartofdance.bandcamp.com/album/time-travel 16. https://galacticsoundstation.bandcamp.com/album/music-for-the-mental-health-of-astronauts-volume-1 17. https://andrewlozano.bandcamp.com/album/voyager 18. https://iluiteq.bandcamp.com/album/fade-remain 19. https://onionwave.bandcamp.com/album/summer-somewhere   Thanks Erwin! Cheers!   T R A C K L I S T : 00:00:00   Moonbooter - Syncope Part 1 (Syncope 1) 00:07:14   Klangwelt - Molecules (Second Nature) 00:12:29   Tim Stebbing - Sands Of Time (Supraluminal) 00:16:40   Frank Van Bogaert - Green Valley (Sounds From Higher Grounds) 00:21:07   Craig Padilla - Particles In Radiance (The Pulse Of Life) 00:29:24   Xan Alexander - Horn Of Monoceros I-II-III (Ouroboros II) 00:41:44   Totemtag - Tech Beta (Space Ascension) 00:50:00   Skoulaman - World Oceans (Live at DEM) 00:57:46   Peter Baumann - From A Far Land (Nightfall) 01:03:26   Afterlife - Il Piu Nell' Uno (Playing Place) 01:07:08   Beyond Berlin - Anthem (Meandering Tear) 01:16:44   Gert Emmens - Only Time Will Tell (All That Is Left Behind) 01:22:28   Ian Boddy & Erik Wøllo - Revolve (Transmissions) 01:29:54   Otarion - Time Of Silence (Time Of Nations) 01:35:28   TiRa feat. Missi Wainwright - Journey Beyond The Clock (Time Travel) 01:42:01   Hollan Holmes - The Eternal Light (Music for the Mental Health of Astronauts - Vol. 1) 01:47:26   Andrew Lozano - Atlas (Voyager) 01:51:05   ILUITEQ + Eraldo Bernocchi - Fade, In The Dusk (Fade, Remain) 01:56:20   unitrΔ_Δudio - The Final Glimpse Of The Sun (Summer Somewhere) 01:59:17   end

This episode covers: Cardiology This Week: A concise summary of recent studies Colchicine for secondary prevention An algorithmic approach to the workup of syncope Milestones: CIBIS II Host: Rick Grobbee Guests: Carlos Aguiar, Sanjit Jolly, Michele Brignole Want to watch that episode? Go to: https://esc365.escardio.org/event/1805 Disclaimer: ESC TV Today is supported by Bristol Myers Squibb and Novartis. This scientific content and opinions expressed in the programme have not been influenced in any way by its sponsors. This programme is intended for health care professionals only and is to be used for educational purposes. The European Society of Cardiology (ESC) does not aim to promote medicinal products nor devices. Any views or opinions expressed are the presenters' own and do not reflect the views of the ESC. Declarations of interests: Stephan Achenbach, Michele Brignole, Diederick Grobbee and Nicolle Kraenkel have declared to have no potential conflicts of interest to report. Carlos Aguiar has declared to have potential conflicts of interest to report: personal fees for consultancy and/or speaker fees from Abbott, AbbVie, Alnylam, Amgen, AstraZeneca, Bayer, BiAL, Boehringer-Ingelheim, Daiichi-Sankyo, Ferrer, Gilead, GSK, Lilly, Novartis, Pfizer, Sanofi, Servier, Takeda, Tecnimede. Davide Capodanno has declared to have potential conflicts of interest to report: Bristol Myers Squibb, Daiichi Sankyo, Sanofi Aventis, Novo Nordisk, Terumo. Sanjit Jolly has declared to have potential conflicts of interest to report: grant support from Boston Scientific, honorarium from Boston Scientific, Shockwave, Abiomed, SIS, and Teleflex.  Steffen Petersen has declared to have potential conflicts of interest to report: consultancy for Circle Cardiovascular Imaging Inc. Calgary, Alberta, Canada. Emma Svennberg has declared to have potential conflicts of interest to report: Abbott, Astra Zeneca, Bayer, Bristol-Myers, Squibb-Pfizer, Johnson & Johnson.

Host: Rick Grobbee Guest: Michele Brignole Want to watch that extended interview? Go to: https://esc365.escardio.org/event/1805?r  Disclaimer: ESC TV Today is supported by Bristol Myers Squibb and Novartis. This scientific content and opinions expressed in the programme have not been influenced in any way by its sponsors. This programme is intended for health care professionals only and is to be used for educational purposes. The European Society of Cardiology (ESC) does not aim to promote medicinal products nor devices. Any views or opinions expressed are the presenters' own and do not reflect the views of the ESC. Declarations of interests: Stephan Achenbach, Michele Brignole, Diederick Grobbee and Nicolle Kraenkel have declared to have no potential conflicts of interest to report. Carlos Aguiar has declared to have potential conflicts of interest to report: personal fees for consultancy and/or speaker fees from Abbott, AbbVie, Alnylam, Amgen, AstraZeneca, Bayer, BiAL, Boehringer-Ingelheim, Daiichi-Sankyo, Ferrer, Gilead, GSK, Lilly, Novartis, Pfizer, Sanofi, Servier, Takeda, Tecnimede. Davide Capodanno has declared to have potential conflicts of interest to report: Bristol Myers Squibb, Daiichi Sankyo, Sanofi Aventis, Novo Nordisk, Terumo. Steffen Petersen has declared to have potential conflicts of interest to report: consultancy for Circle Cardiovascular Imaging Inc. Calgary, Alberta, Canada. Emma Svennberg has declared to have potential conflicts of interest to report: Abbott, Astra Zeneca, Bayer, Bristol-Myers, Squibb-Pfizer, Johnson & Johnson.

Welcome to the Choosing Wisely Campaign series! This is the second episode of a 6-part series exploring the ABIM Foundation's Choosing Wisely Lists. This campaign aims to promote conversations between clinicians and patients to avoid unnecessary medical tests, treatments, and procedures. The first of our case-based episodes presents a school age child with syncope. After a clear discussion of the case and thoughtful consideration of an acute care differential, we use the AAP's Choosing Wisely cardiac list to create a resource-conscious care plan that is safe and patient-centered. In the coming episodes, we'll explore the pediatric lists and apply our knowledge to cases of common presentations seen in primary and acute care pediatrics.    Series Learning Objectives: Introduction to the Choosing Wisely Campaign: Understand the origins, historical precedent, and primary goals of the campaign. Case-Based Applications: Explore five common presentations in primary and acute care pediatrics, applying concepts from various Choosing Wisely lists to guide management and resource stewardship. Effective Communication: Learn strategies for engaging in tough conversations with parents and colleagues to create allies and ensure evidence-based practices are followed. Competencies: AACN Essentials: 1: 1.1 g, 1.2f 2: 2.1 de, 2.2g, 2.5 ij 6: 6.1 i 7: 7.2 ghk 9: 9.1ij, 9.2ij, 9.3ik NONPF NP Core Competencies: 1: NP1.1h, NP 1.2km 2: NP2.1jg, NP2.2kn, NP2.5 lo 6: NP6.1o 7: NP7.2m 9: NP9.1mn, NP9.2n, NP9.3p References: AAP Section on Cardiology and Cardiac Surgery. (2020). Five things physicians and patients should question. https://downloads.aap.org/AAP/PDF/Choosing%20Wisely/CWCardio.pdf Gilpin, K., & Goode, Z. (2024). Syncope. Pediatrics in review, 45(10), 606–608. https://doi.org/10.1542/pir.2023-006053

Syncope (SINK-a-pee) is a clinical word for fainting or passing out. Many people may faint or feel faint once or twice in their lives, and there are several minor triggers for it. But in some cases, it's a sign of a heart issue, such as an abnormal heart rhythm or heart valve issue.Electrophysiologist Dr. Manoj Duggal (MAHN-oage DOO-gle) will discuss what happens when a person experiences syncope, what may be causing it, and why it's important to identify the cause.

Syncope is a symptom, not a diagnosis. Often it's a symptom of a benign etiology but it can indicate a life-threatening condition. So how do we distinguish between the two? We dive into the complex topic of syncope with guest Matt Mendes. We discuss the importance of recognizing syncope, differentiating it from seizures, and identifying who are the high-risk patients and why. The episode covers the guiding principles syncope- a good history, physical exam findings, and the ECG. It also delves into common presentations, risk stratifying strategies, and real-world cases to equip EMS providers with the knowledge needed to manage syncope calls effectively.    00:00 Intro 01:07 Welcome to EMS Cast, host and guest introductions 04:51 Guiding Principles for Syncope Assessment 07:22 High-Risk Syncope Patients 09:14 Initial Approach to Syncope Patients 15:15 Syncope vs. Seizure 20:08 Physical Exam and EKG Importance 25:14 Identifying Arrhythmias in Syncope Patients 26:37 Understanding Wolf Parkinson White Disease 27:46 QT Prolongation and Its Implications 29:49 Left Ventricular Hypertrophy and Its Risks 31:28 Recognizing Brugada Pattern 32:02 Arrhythmogenic Right Ventricular Dysplasia 33:04 Bifascicular Block and Its Dangers 35:00 EKG Interpretation and Syncope Risk Stratification 39:53 Emergency Department Workups for Syncope 55:49 Case Studies and Memorable Syncope Calls   Resources The Resus Tailor EMS Cast Syncope Blog Post Other episodes you might like: Wide Complex Tachycardia Podcast announcements- WE'RE RENAMING THE SHOW TO, LOUD & CLEAR: EMS GUIDING PRINCIPLES Survey- Help us learn what content you want Gear We Like Good Stethoscope - https://amzn.to/3YJJrf2 Good Shears - https://amzn.to/40FROuF or https://amzn.to/3ChZ4Tn  Notepad for taking notes on calls - https://amzn.to/3Z1X21J Sunglasses - https://frontline-optics.com/discount/EMSCAST15 Books we recommend -  The Dichotomy of Leadership - https://amzn.to/4fiCAjN Extreme Ownership - https://amzn.to/3O1FWfa  Managing the Unexpected: Sustained Performance in a Complex World -        https://amzn.to/3V7BwYf Thinking Fast and Slow - https://amzn.to/4fiJG85 A Thousand Naked Strangers: A Paramedic's Wild Ride to the Edge and Back -  https://amzn.to/3YJJrf2 Guest/Cast/Crew information- Guest- Matt Mendes, EM doc, Resident didactics coordinator, former EMS Cast Co-Host Hosts- Ross Orpet, Will Berry  Catch up with us after the show Instagram- @emscast Twitter- @ems_cast Website- www.emspodcast.com  

Syncope Hydrocephalus Coma Final Step type Questions What key symptom differentiates syncope from seizure? What triad is seen in normal pressure hydrocephalus? At what Glasgow Coma Scale (GCS) score is intubation typically required? What is the first-line treatment for increased intracranial pressure in hydrocephalus? What pupil finding suggests opioid toxicity? What test is used to […] The post 126b: Syncope, Hydrocephalus, Coma PANCE Questions appeared first on Physician Assistant Exam Review.

Syncope, Hydrocephalus, and Coma Syncope Transient loss of consciousness due to global cerebral hypoperfusion, often with rapid onset, brief duration, and spontaneous recovery A key differential in cerebrovascular cases, distinct from stroke, TIA, and seizures Clinical Presentation Preceding Symptoms: Dizziness, lightheadedness, nausea, pallor, diaphoresis Triggers: Prolonged standing, vasovagal (emotional stress) Orthostatic hypotension (sudden positional changes) […] The post 126 Syncope, Coma & Master Class Tonight!  appeared first on Physician Assistant Exam Review.

Happy New Year!!! We hope you've had some time off over the festive period and now we're back to kick start the new year with three more great papers. Syncope is common presentation to the Emergency Department, accounting for 1% of presentations. Without a clear precipitant of the event it can be challenging to identify those patients who have a higher risk of associated morbidity and mortality, and furthermore those who would benefit from further investigation and observations. Our first paper looks at syncope risk-stratification tools and sheds some light on their utility. Acute exacerbations of COPD with acute type 2 respiratory failure and frequently treated with non-invasive ventilation (NIV), with high flow nasal oxygenation a treatment normally for patients in type 1 respiratory failure. However our second paper is a fantastic RCT looking at the the application of either NIV or high flow nasal oxygenation in those type 2 COPD exacerbations, are both options for our patients? Finally, since the advent of trauma networks in the UK, prehospital patients have been triaged to the most relevant centre based upon trauma triage tools. Our third paper looks at the performance of these tools and gives valuable insights for both those clinicians using the tools and those receiving trauma patients in both MTCs and other trauma units. Once again we'd love to hear any thoughts or feedback either on the website or via X @TheResusRoom! Simon & Rob

Join us as Monee and Meredith with the rest of the hospital medicine team reflect on the past year, discussing some favorite insights gained covering a range of topics, including diabetic foot infections, sepsis, sickle cell inpatient management, syncope, psychiatry for the hospitalist, and acute coronary syndrome.  No CME for this episode, but claim CME for past shows at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Show Segments Introduction Picks of the Year Diabetic Foot Infections  Sepsis Sickle Cell Inpatient Management  Psychiatry Primer Syncope  Acute Coronary Syndrome  Reflections from the Year  Credits Written, Produced, and hosted by: Meredith Trubitt  MD; Monee Amin MD Script Written: Caroline Coleman, MD, RJ Blackburn, MD Cover Art: Caroline Coleman, MD Reviewer: Rahul Ganatra MD Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Sponsor: Rosetta Stone Redeem your 50% off at rosettastone.com/curbsiders

خلاصه‌ی مباحث آبان‌ماه مقدمه‌ی آذرماه ۱۴۰۳: سنکوپ

keywords   medical emergencies, dental office, anesthesia, airway issues, syncope, laryngospasm, bronchospasm, patient safety, sedation, anesthesiology   summary   In this conversation, Dr. Serv Wahan and Dr. Peter Pfeiffer discuss critical medical emergencies that can occur in dental settings, focusing on anesthesia-related issues. They explore common emergencies such as syncope, the differences between laryngospasm and bronchospasm, and the protocols for managing these situations effectively. The discussion emphasizes the importance of preparedness in dental offices, including the necessity of monitoring equipment and understanding patient safety during sedation procedures.   takeaways Medical emergencies in dental offices are common and require preparedness. Syncope is the most frequent emergency, often caused by fainting. Proper monitoring equipment, like pulse oximeters, is essential in dental practices. Laryngospasm can occur during sedation and requires immediate attention. Understanding the difference between laryngospasm and bronchospasm is crucial for management. Efficient management of emergencies can reduce patient risks and improve outcomes. Anesthesiologists play a vital role in complex dental procedures. Training and experience in anesthesia can vary significantly among dental professionals. Patient safety protocols should be in place for all sedation procedures. Communication and teamwork are key in managing medical emergencies in dental settings. titles Navigating Medical Emergencies in Dental Practices The Role of Anesthesia in Dental Emergencies Sound Bites "I've seen dental students faint." "If you see someone pass out, lay them down." "Laryngospasm is a cough gone haywire." "Halcion has a little amnesia with it." Chapters   00:00 Introduction to Medical Emergencies in Dental Settings 04:23 Common Medical Emergencies: Syncope and Fainting 10:08 Understanding Airway Complications: Laryngospasm vs. Bronchospasm 16:12 Managing Laryngospasm: Techniques and Protocols

Podcast summary of articles from the August 2024 edition of the Journal of Emergency Medicine from the American Academy of Emergency Medicine.  Topics include sepsis, pediatrics, opioids, syncope, and a review of psychiatric patients boarding in the ED.  Guest speaker is Dr. Kinda Sweidan.

Cardioneural Ablation - A Promising Treatment Strategy for Refractory Vasovagal Syncope   Guest: Guru G. Kowlgi, M.B.B.S. Host: Anthony H. Kashou, M.D.    The learners will get an overview of how to diagnose and manage vasovagal syncope. In addition, they will gain an understanding of cardioneural ablation, which is a promising new catheter ablation treatment option for these patients.   Topics Discussed What is vasovagal syncope (VVS)? How do we diagnose vasovagal syncope? What are some treatment strategies for VVS (including a discussion on cardioneural ablation and the use of pacemakers)?   Connect with Mayo Clinic's Cardiovascular Continuing Medical Education online at https://cveducation.mayo.edu or on Twitter @MayoClinicCV and @MayoCVservices. LinkedIn: Mayo Clinic Cardiovascular Services Cardiovascular Education App: The Mayo Clinic Cardiovascular CME App is an innovative educational platform that features cardiology-focused continuing medical education wherever and whenever you need it. Use this app to access other free content and browse upcoming courses. Download it for free in Apple or Google stores today! No CME credit offered for this episode. Podcast episode transcript found here.

Episode description: Mukund presents a case of nausea, vomiting and syncope with many twists and turns to Valeria and Jas. Featuring: Mukund RaguramJasdeep BajwaValeria Roldan SchemasSyncopeNausea and vomiting thought trainImage negative abdominal pain Download CPSolvers App here RLRCPSOLVERS Click here to view the weekly episode recap email!

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HRS24: CNA for Vasovagal Syncope

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Have you ever fainted? Miranda sure has... like, a LOT of times, and in some pretty weird situations! Fortunately, Mel uncovers what causes these fainting spells, also known as vasovagal syncope episodes, and what to do about them. After that, Miranda shares about some of the most common childhood injuries and how we as parents can be better prepared when our youngsters bump, bruise, scrape, and otherwise hurt themselves! Prop your feet up, drink some water, and join us for a hilarious episode that will tickle (not bump) your funny bone! Spotlight:The Childress Institute for Pediatric Traumahttps://saveinjuredkids.org Sources:Mel-https://www.verywellhealth.com/vasovagal-cardioneurogenic-syncope-1746389 Miranda-https://www.healthpartners.com/blog/most-common-childhood-injuries/https://www.parents.com/health/injuries/first-aid/fast-first-aid-tips-for-6-common-accidents/ Hosted on Acast. See acast.com/privacy for more information.

Don't pass up on passing out! Stand up to syncope as Dr. Dan Dressler (Emory University) guides us to confidently manage cases! We review a framework for understanding different types of syncope, and strategies for determining which low-risk patients can be safely discharged, and appropriate next steps to work up those high-risk and in-between cases.  Claim CME for this episode at curbsiders.vcu health.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Show Segments Intro Picks of the Week Case 1: Tamara What is syncope? Categorizing Syncope Initial workup Risk scores Pulmonary embolism  Case 2: Travis Cardiac evaluation Take-home points Outro Credits Producer, Script and Show Notes: Emi Okamoto MD  Infographic and Cover Art: Caroline Coleman MD Hosts: Monee Amin MD and Meredith Trubitt MD Reviewer: Rahul Ganatra MD, MPH Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: Daniel D. Dressler, MD, MSc, MHM, FACP Sponsor: Freed You can try Freed for free right now by going to freed.ai. And listeners of Curbsiders can use code CURB50 for $50 off their first month. Sponsor: Pattern Request your disability insurance quotes with Pattern at patternlife.com/curbsiders. Sponsor: Pathway Download the Pathway app by visiting pathway.md

Commentary by Dr. Valentin Fuster

Syncope is a noun that refers to the temporary loss of consciousness caused by a fall in blood pressure.  Our word of the day comes almost directly from a Greek word that means ‘strike' or ‘cut off.' By the Late Middle English period, syncope had been adopted into English. Here's an example: Having a significant drop in blood pressure may not seem like a huge problem. But frankly, it would terrify me to experience the syncope that often comes with it. I can't imagine anything scarier than losing consciousness. 

Welcome back to February's papers of the month. Syncope is a really common presentation to the Emergency Department and it can be complicated to tease out those with a concerning precipitant from the others with a more benign cause. The first paper gives us some context to the management of these undifferentiated syncopes and provides a barometer for how stringently ESC guidance on the topic is followed. Next up we take a look a huge RCT of transfusion thresholds in patients presenting with a myocardial infarction. Should we be restrictive in our approach, saving a valuable resource, or is it validated to transfuse more liberally in terms of the patients outcome? Finally we take a look at a paper looking to tease out the predictors of post intubation hypotension in those getting a prehospital anaesthetic following trauma, with some interesting associations and factors to looks out for. Once again we'd love to hear any thoughts or feedback either on the website or via X @TheResusRoom! Simon & Rob

Lancet 1993;342:821-28.Background The Survival After Ventricular Enlargement (SAVE) trial demonstrated that administration of the angiotensin converting enzyme inhibitor (ACEi) captopril, following MI complicated by LV dysfunction (EF ≤40%) but without clinical heart failure significantly improved morbidity and mortality over 3.5 years of follow-up. Yet many post-MI patients at the time had clinical heart failure and this represented a vulnerable population of patients with significantly increased morbidity and mortality compared to those without clinical heart failure. The Acute Infarction Ramipril Efficacy (AIRE) trial sought to test the hypothesis that administration of Ramipril to patients with AMI complicated by acute congestive heart failure would reduce morbidity and mortality vs a placebo. Cardiology Trial's Substack is a reader-supported publication. To receive new posts and support our work, consider becoming a free or paid subscriber.Patients Eligible patients were 18 years of age or older with a definite AMI occurring 2 to 9 days prior to randomization with clinical evidence of congestive heart failure at any time after the index MI. While clinical evidence of heart failure was mandatory for study entry, it could be transient and not necessarily present at the time of randomization. Patients were excluded with NYHA IV heart failure (these patients would receive ACEi therapy regardless), heart failure of primary valvular or congenital etiology, or patients with any recognized contraindications to ACEi therapy were excluded.Baseline characteristics The average age of patients was 65 years and 74% were men. Approximately one quarter of patients had had a prior MI, 12% had diabetes, 30% had hypertension and smoking status was not listed. The ejection fraction of study participants was not systematically assessed as part of the study protocol. 62% had a Q wave MI and the predominant location was anterior. The mean time to randomization was 5 days. Approximately 60% of patients received thrombolysis. The average blood pressure and heart rate were not provided. At the time of randomization 22% of patients were receiving a beta blocker and 12% digoxin.Many more patients (52,019) were reviewed than ultimately enrolled (1,986). The main reasons for exclusion were no definitive MI (21,302) and no definite heart failure (16,989). The authors estimate that among eligible patients with a definitive MI and heart failure that approximately half were enrolled. Information on those enrolled versus not enrolled was not provided.Procedures Patients were initiated on Ramipril 2.5 mg twice daily or matching placebo for 2 days after which the dose was increased to 5 mg twice daily. If patients could not tolerate the 5 mg twice daily dose they were discharged on 2.5 mg twice daily. For patients who could not tolerate the 2.5 mg dose they were given 1.25 mg twice daily for 2 days with attempts to up-titrate to 2.5 mg and 5 mg at discharge. For patients that could not tolerate at least 2.5 mg twice daily at discharge they were NOT discharged on the 1.25 mg dose. These patients were withdrawn from study treatment but followed up at the prespecified visit intervals and were included in the intention-to-treat analysis.Outpatient visits were scheduled at 1 month and 3 months following discharge from the index hospitalization and every 3 months thereafter until study close. Monitoring of renal function and electrolytes was done at the discretion of study investigators based on their normal practice. During follow up patients could be started on any medication with exception of an ACEi.Endpoints The primary study endpoint was all-cause mortality. The secondary endpoint was time to first event including (death, progression to NYHA class 4 heart failure, reinfarction or stroke).The investigators estimated they would need a sample size of 2,000 patients to detect a 25% relative reduction in the risk of death with 80% power and 2-sided alpha of 5%. This was based on an estimated death rate of 20% at 15 months in the placebo group and 15% in the Ramipril group.Results 2,006 patients were recruited from 144 centers in 14 countries. However, 20 patients from 1 center were excluded from the final analysis due to inconsistencies in the data. According to investigators the exclusion of these patients did not meaningfully change the final results. The final analysis included 1,986 patients; 1004 in the Ramipril group and 982 in the placebo group.90% of study participants were discharged from the hospital on study drug. In the Ramipril group, 77% were on the 5 mg dose, 14% were on the 2.5 mg dose and 9% were on no therapy. In the placebo group, 86% were on the 5 mg dose, 7% on the 2.5 mg dose and 7% on no therapy.Patients were followed for an average of 15 months and only 1 was lost to follow-up. Compared to placebo, Ramipril significantly reduced all cause death by 27% (17% vs 23%; p = 0.002). Ramipril also significantly reduced the secondary composite endpoint of time to first validated event (including death, progression to severe heart failure, reinfarction or stroke) by 19% (28% vs 34%; p = 0.008). Differences in this composite endpoint were mainly driven by death and progression to severe heart failure.Examination of subgroups showed no evidence of treatment effect heterogeneity but again, similar to the SAVE trial, the size of the trial limits subgroup testing.Premature withdrawals from study drug, not including death, occurred in 352 patients in the Ramipril group compared to 318 in the placebo group. Intolerance to the drug was cited as a factor in 126 of the Ramipril withdrawals and 68 of the placebo withdrawals whereas progression to severe heart failure was cited in 58 Ramipril withdrawals and 92 placebo. Syncope was more common in Ramipril treated patients compared to placebo (2.4% vs 1.7%) and so was hypotension (4.2% vs 2.3%) but not renal failure (1.5% vs 1.2%).Conclusions In patients with AMI complicated by clinical congestive heart failure, Ramipril significantly reduced death over 1.3 years of follow-up with a number needed to treat of approximately 17 patients. Ramipril also significantly reduced a composite of events, which were mainly driven by death and progression to severe heart failure. Unlike the SAVE trial, which did not estimate a particular sample size for hypothesis testing, AIRE was specifically designed to test whether Ramipril would reduce death by 25% over 15 months and indeed, it did! Thus, results from AIRE not only support but add legitimacy to findings from SAVE.One perceived limitation of AIRE, particularly when viewed through a contemporary lens, is its lack of ejection fraction estimation. There should be no doubt that these were sick patients in whom, significant LV dysfunction would have been present in most. We base this claim on the observation that the death rate in AIRE at 1.3 years in the placebo group was nearly equal to SAVE at 3.5 years (23% vs 25%). This highlights that development of clinical heart failure (regardless of LV function) confers a worse prognosis than LV dysfunction without heart failure.In our opinion, the external validity of AIRE is high for a trial performed 30 years ago. The average start date for treatment was 5 days post MI complicated by clinical heart failure. This is longer than we would anticipate in contemporary practice by 2 or 3 days but not unreasonable, especially for post-MI patients with tenuous hemodynamics requiring intravenous diuretic therapy. Furthermore, the dose titration parameters and follow up schedule in AIRE can be approximated in clinical practice. Also, no obvious treatment effect heterogeneity was noted across important subgroups (e.g., age > vs < 65 years) but these analyses are limited due to the overall sample size. Finally, no strict limits were placed on blood pressure and heart rate at study entry.Thank you for reading Cardiology Trial's Substack. This post is public so feel free to share it. Get full access to Cardiology Trial's Substack at cardiologytrials.substack.com/subscribe

We review a general approach to syncope in children. Hosts: Brian Gilberti, MD Ellen Duncan, MD https://media.blubrry.com/coreem/content.blubrry.com/coreem/Syncope_in_Children.mp3 Download Leave a Comment Tags: Cardiology, Pediatrics Show Notes Initial Evaluation and Management: Similar initial workup for children and adults: checking glucose levels for hypoglycemia and conducting an EKG. The history and physical exam are crucial. Dextrose Administration in Children: Explanation of the ‘rule of 50s' for determining the appropriate dextrose solution and dosage for children. ECG Analysis: Importance of ECG in diagnosing dysrhythmias like long QT syndrome, Brugada syndrome, catecholamine polymorphic V tach, ARVD, ALCAPA, and Wolff-Parkinson-White syndrome. Younger children's dependency on heart rate for cardiac output and the risk of arrhythmias in kids with congenital heart disease. Condition Characteristic ECG Findings Congenital/Acquired Long QT Syndrome (LQTS) Prolonged QT interval Congenital/Acquired Wolff-Parkinson-White Syndrome (WPW) Short PR interval, Delta wave Congenital Brugada Syndrome ST elevation in V1-V3, Right bundle branch block Congenital Atrioventricular Block (AV Block) PR interval prolongation (1st degree), Missing QRS complexes (2nd & 3rd degree) Congenital/Acquired

CardioNerds meet with fellows from The Christ Hospital, Drs. Hanad Bashir, Hyunsoo Chung, and Dalia Aziz to discuss the following case that highlights angioleiomyoma: A 60-year-old woman with a past medical history significant for breast cancer (on tamoxifen) presented as a transfer to our facility for a clot-in-transit. She had initially presented to the outside hospital after progressive dyspnea on exertion and recent syncope. She was found on an echocardiogram to have a right atrial mass spanning into the right ventricle. CTA of the chest and abdomen/pelvis demonstrated extensive thrombus burden spanning from the IVC into the right ventricle. She was transferred to our facility for intervention. Endovascular attempts were unsuccessful, at which point she underwent surgical thrombectomy. Gross examination of the mass revealed a cylindrical shape, homogeneous tan color, rubbery soft tissue, measuring 25.5 cm in length and 2.3 cm in diameter. Histology confirmed the presence of angioleiomyoma. A second, smaller mass (5.2cm long and 4mm in diameter) was removed from under the tricuspid valve, with histology consistent with leiomyoma. Estrogen receptor and progesterone receptor staining were strongly positive, leading to the discontinuation of tamoxifen. Given the presence of uterine fibroids identified on the CT scan, there was concern about a uterine origin. A hysterectomy is planned for her in the near future. Expert commentary is provided by Dr. Wojciech Mazur. Episode audio was edited by student Dr. Adriana Mares. US Cardiology Review is now the official journal of CardioNerds! Submit your manuscript here. CardioNerds Case Reports PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Case Media - The Tall Tail Heart: Angioleiomyoma – The Christ Hospital Pearls - The Tall Tail Heart: Angioleiomyoma – The Christ Hospital Although evaluation of cardiac mass by echocardiography can provide information such as size, location, and morphology, adjunctive cross-sectional imaging may be used depending on the need for further temporal resolution (CT) or tissue characterization via cardiac MRI (CMR). If suspicious for elevated metabolic activity, there should be consideration of FDG-PET. Tamoxifen (a selective estrogen receptor modulator) is an agent used for breast cancer therapy. However, its use has been associated with endometrial hyperplasia, uterine fibroids, endometrial and uterine malignancy. Increased risk of malignancy has been seen more often in post-menopausal women and is dose and time-dependent. Clot in transient is a mobile thrombus, typically within the right heart structures. It is estimated to occur in 4-18% of patients with pulmonary embolism and is associated with elevated morbidity and mortality. Treatment includes surgical embolectomy, endovascular embolectomy, systemic thrombolysis, catheter-directed thrombolysis, or systemic anticoagulation. Angioleiomyoma is a rare benign pericystic tumor that most commonly affects the extremities. There are case reports of other affected sites, including the uterus. Invasion into the cardiac structures is exceedingly rare. The only established treatment for angioleiomyoma is surgical resection. Show Notes - The Tall Tail Heart: Angioleiomyoma – The Christ Hospital Syncope Syncope is a transient loss of consciousness secondary to reduced blood flow to the brain. Often, certain presentations are mislabeled as syncope, such as seizure disorders, posttraumatic loss of consciousness, and cataplexy. An organized diagnostic approach should be used to reduce hospital admissions and medical costs and increase diagnostic accuracy. Syncope can be divided into five general subgroups. 1) Neurally mediated reflex syncope (carotid sinus syndro...

Syncope (1:40), testosterone therapy and adverse effects (7:40), baricitinib for alopecia areata (9:30), intestinal parasites (13:10), antiarrhythmics in atrial fibrillation (19:20), and AFP Clinical Answers (21:40).

Did you know around 15 to 25% of children will have at least one syncopal episode before adulthood? Join medical students Sanya Dudani and Caleb Robertson, along with Pediatric Cardiologist Dr. John Plowden, as they discuss the evaluation and management of syncope in the pediatric patient.  Specifically, they will: Discuss the definition of syncope and its underlying pathophysiology Recall the incidence and risk factors of syncope in the pediatric population Describe the various etiologies and their distinguishing factors Understand the proper approach to taking a history for a pediatric patient with a chief complaint of syncope Recognize findings on the physical exam that help narrow the differential diagnosis Understand the appropriate lab tests and imaging needed Discuss when it's appropriate to refer patients to specialists Special thanks to Dr. Rebecca Yang and Dr. Melissa Lefebvre for peer reviewing this episode! CME Credit (requires free sign up): Link Coming Soon! References: Arthur W, Kaye GC  The pathophysiology of common causes of syncope  Postgraduate Medical Journal 2000;76:750-753. Cipolla MJ. The Cerebral Circulation. San Rafael (CA): Morgan & Claypool Life Sciences; 2009. Chapter 5, Control of Cerebral Blood Flow. Available from: https://www.ncbi.nlm.nih.gov/books/NBK53082/ Clark, BC, Hayman, JM, Berul, CI, Burns, KM, and Kaltman, JR. Selective use of the electrocardiogram in pediatric preparticipation athletic examinations among pediatric primary care providers. Ann Noninvasive Electrocardiol. 2017; 22:e12446. https://doi.org/10.1111/anec.12446] De, A. and Davidson Ward, S.L. (2014), Syncope at altitude: An enigmatic case. Pediatr Pulmonol., 49: E144-E146. https://doi.org/10.1002/ppul.23062 Gupta A, Menoch M, Levasseur K, Gonzalez IE. Screening Pediatric Patients in New-Onset Syncope (SPINS) Study. Clinical Pediatrics. 2020;59(2):127-133. doi:10.1177/0009922819885660 Hainsworth, R. Pathophysiology of syncope. Clin Auton Res 14 (Suppl 1), i18–i24 (2004). https://doi.org/10.1007/s10286-004-1004-2 Phillip A. Low, Paola Sandroni, Chapter 106 - Postural Tachycardia Syndrome (POTS), Editor(s): David Robertson, Italo Biaggioni, Geoffrey Burnstock, Phillip A. Low, Julian F.R. Paton, Primer on the Autonomic Nervous System (Third Edition), Academic Press, 2012, Pages 517-519, ISBN 9780123865250, https://doi.org/10.1016/B978-0-12-386525-0.00106-2 Zavala, Rennette MD∗; Metais, Benjamin MD†; Tuckfield, Lynnia BS‡; DelVecchio, Michael MD‡; Aronoff, Stephen MD, MBA‡. Pediatric Syncope: A Systematic Review. Pediatric Emergency Care: September 2020 - Volume 36 - Issue 9 - p 442-445 doi: 10.1097/PEC.0000000000002149 

QD245 - Patients Don't Read Textbooks   https://youtu.be/gK18TgDTGyg QD246 - Neighbor Consults   https://youtu.be/D3ffK3l_gbU QD247 - Habitually Noncompliant    https://youtu.be/Vpwue51878c QD248 - OA and Syncope   https://youtu.be/O4v03KL_gOg QD249 - Hemoptysis  https://youtu.be/WbRSPBsfec8

Welcome to my podcast. I am Doctor Warrick Bishop, and I want to help you to live as well as possible for as long as possible. I'm a practising cardiologist, best-selling author, keynote speaker, and the creator of The Healthy Heart Network. I have over 20 years as a specialist cardiologist and a private practice of over 10,000 patients. The episode discusses different causes of non-traumatic loss of consciousness or syncope, including cardiac, epileptic, and psychogenic reasons. Cardiac causes could be things like structural heart issues, arrhythmia, or orthostatic hypotension from standing up. Doctor Warrick highlights how an epileptic seizure may involve jerking at the onset of loss of consciousness unlike cardiac syncope. Taking a thorough history from witnesses is important to determine the likely cause. One interesting point was how tongue biting on the sides suggests epilepsy while biting the tip suggests falling during cardiac syncope. Distinguishing the etiology helps guide appropriate workup and management.

Can you die from passing out or syncope? Cardiologist explains this mysterious condition. https://dralo.net/links

Podcast summary of articles from the July 2023 edition of the Journal of Emergency Medicine from the American Academy of Emergency Medicine.  Topics include pediatric missed diagnoses, resistant urinary tract infections, syncope, tidal volume calculations, difficult IV access, and hyperglycemia.  Guest speaker is Dr. James O'Hora.

Claire Goldwitz is the Co-Founder and CEO of Square Fare, a tailored, individualized service that delivers the food you need and crave while fitting into your busy life. Designed to help professionals hit their health and fitness goals, SquareFare eliminates the guesswork and legwork by simply allowing users to reply "lunch" or "dinner" and have their food come to them. Prior to founding Square Fare, Claire has been a Senior Leader in various roles across the marketing industry.   As a young professional working in corporate roles, Claire enjoyed the hustle and drive that her work provided her with. However, keeping busy and working over eventually led Claire to neglect her nutrition and wellbeing. She soon hit a breaking point that changed the course of her health and career. Find out what Claire did with this moment today on the One Away Show.   Read the show notes on Arcbound's Podcast Page: https://arcbound.com/podcasts/    Find Arcbound here: Homepage: Arcbound.com Services/Work with Us: https://arcbound.com/work-with-us/ About: https://arcbound.com/about/ Founders Corner: https://arcbound.com/category/founders-corner/ Connect: https://arcbound.com/connect/  

Episode 102 of Ask Dr Jessica with Dr Michael Silka MD, electrophysiologist and pediatric cardiologist.  On this episode we discuss fainting! (also known as syncope).  We talk about reassuring signs of fainting (often known as vasovagal syncope) and how to distinguish it from times when losing consciousness may be more concerning (for example, how to know when it's cardiac (the heart)?  Dr. Silka is an innovator in the fields of pediatric cardiology and electrophysiology and has pioneered the development of guidelines for the use of implantable cardiac rhythm devices. He previously served in the role of chief of Cardiology and co-director of the Heart Institute from 2000 to 2014.Dr. Silka has published over 200 peer-reviewed articles and book chapters and served as lead investigator for multiple NIH-funded studies as well as multi-center collaborative research efforts.Dr. Silka has held posts in several national organizations committed to advancing the care of children, most notably as past president of the Pediatric Electrophysiology Society.   Dr Silka currently practices medicine at Children's Hospital of Los Angeles.Get matched with a therapist by using Better Help! Give it a try---invest in your mental health: https://betterhelp.com/askdrjessica for 10% off your first month of therapy. Thank you to Better Help for supporting the Ask Dr Jessica podcast.Dr Jessica Hochman is a board certified pediatrician, mom to three children, and she is very passionate about the health and well being of children. Most of her educational videos are targeted towards general pediatric topics and presented in an easy to understand manner. Do you have a future topic you'd like Dr Jessica Hochman to discuss? Email Dr Jessica Hochman askdrjessicamd@gmail.com. Dr Jessica Hochman is also on social media:Follow her on Instagram: @AskDrJessicaSubscribe to her YouTube channel! Ask Dr JessicaSubscribe to this podcast: Ask Dr JessicaSubscribe to her mailing list: www.askdrjessicamd.comThe information presented in Ask Dr Jessica is for general educational purposes only. She does not diagnose medical conditions or formulate treatment plans for specific individuals. If you have a concern about your child's health, be sure to call your child's health care provider.

This week we will discuss a debilitating neurological disorders of COVID-19 syndrome in survivors, the scope of SARS-CoV-2-induced dysautonomia (DNS) is yet to be understood, though the implications are enormous. Our guest today ended up with POTs (a form of dysautonomia) after receiving the first dose of the Pfizer vaccine.  Chelsea, a 21 yr old former nursing student was diagnosed after having so many symptoms she couldn't complete her studies.  Studies are just now surfacing that give credence to her claims it was the vaccine that made her ill.  Since the vaccine is very safe for the majority of individuals we would NEVER SUGGEST TO OPT OUT of the vaccine.  But knowledge is power, and researchers will find out more about this possible link thanks to stories like hers getting into the mainstream media.   Postural Orthostatic Tachycardia Syndrome or POTs is a debilitating condition  affecting the autonomic nervous system.    With neurocognitive impairments or “brain fog”; problems with body temperature regulation; gastroenterological symptoms like nausea, abdominal pain, diarrhea, or constipation; and dark red-blue discoloration of the legs being the most common symptoms. Some people with POTS also may have one or more associated conditions, including migraine, irritable bowel syndrome, and joint hypermobility syndrome.  Some people with POTs can have pre-syncope or syncope episodes where they feel like they might pass out or actually do pass out.  It's a serious condition that needs proper testing and follow up with a physician.