Podcast #180: Aortic Dissection

a_dissectionRun Time:  4 minutes

Author: Jared Scott, MD

Educational Pearls:

  • Aortic dissection = separation between 2 layers of vessel wall (usually intima and media)
  • Aortic Aneurysm = cystic dilation of the aorta
  • Aortic dissection associated with severe HTN or connective tissue disorders (Marfan’s, Ehlers-Danlos, etc.)
  • AAA associated with HTN, DM, HLD, smoking (same risks for MI)
  • Aortic dissection starts proximal in chest and peels down
  • AAA confined to abdomen and can rupture. 90% mortality.

Link to Podcast: http://medicalminute.madewithopinion.com/aortic-dissection/

References: http://www.mayoclinic.org/diseases-conditions/aortic-dissection/basics/definition/con-20032930

Podcast #179: Concussions

b3a1b8b3-ea78-4c07-bbc8-8db303511de8Run Time: 1 minutes

Author: Aaron Lessen M.D.

Educational Pearls:

  • Patients with concussions are frequently seen in the ED, and generally are given good home health care precautions.
  • A new study for post concussion management looked at driving performance after a concussion.
  • The study showed that 48 hours after symptoms had resolved, patients who were diagnosed with a concussion did worse on a standard performance test than people without a concussion.

Link to Podcast: http://medicalminute.madewithopinion.com/concussions/

References: http://psycnet.apa.org/journals/neu/24/4/493/

http://emedicine.medscape.com/article/92095-overview

Podcast #178: Lupus Myocarditis

3c26d8f8-0b3c-4930-9051-44c6a0804477Run Time:  3 minutes

Author: Gretchen Hinson M.D.

Educational Pearls:

  • Case presentation: a 44 year-old male after a syncope was found to have a heart rate of 261 wide complex tachycardia and a SBP in the 80s for EMS in the field. The patient was given adenosine on arrival to the ED, but with no resolution of the tachycardia, but after electrocardioversion the patient’s heart rate converted to 100 but still in a wide complex tachycardia.
  • The missing piece of history for this patient is a diagnosis of lupus with previous pulmonary complications and systemic skin changes.
  • Lupus can also cause myocarditis and conduction abnormalities along with the more common skin changes and renal complications.

Link to Podcast: http://medicalminute.madewithopinion.com/lupus-myocarditis/

References: http://rheumatology.oxfordjournals.org/content/45/suppl_4/iv8.full

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