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Archive for June 2011

CHADS and HASBLED scores

We are full of ‘scoring systems’ and ways of calculating risk. Here are two important ones. If you have a smart-phone, there will be some type of calculator on there for you to use. The important thing is to know that they exist. The CHADS2 score is a means of assessing who needs anticoagulation, in our AF patients.…

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I've got rhythm

Atrial Fibrillation is one of the most common ED presentations. Currently it affects about 1% of the population and is expected to increase by FIVE FOLD in the coming years as more of the population ages. When it causes symptoms, it can be debilitating for those with it. More importantly, it is associated with a…

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Troponins and renal failure

One of the common occurrences is that we have raised troponins in patients with renal impairment. This sets up all sorts of questions. Is it cardiac? Is it a renal phenomenon? We simply aren’t sure and the theories to explain the rise aren’t proven. We know that in patients with renal failure: -troponin T is raised in about…

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Dizziness and vertigo

A 67 year old patient comes to the emergency department with a complaint of dizziness. He says that the the room started spinning suddenly 3 days ago and although it is getting better, he still can’t stand at all and has been in bed with it for the last 3 days. His daughter has tried to get him up…

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