Cardiology/Vascular

Reassessment Case: Acute Pulmonary Edema in a Boarding Patient

Tina H Chen, MD1, David Fernandez, MD2, Amrita Vempati, MD3, Kelly Roszczynialski, MD, MS4, Stephanie Cohen, DO5, Charles Lei, MD6, Hillary Moss, MD7, Tiffany Moadel, MD8, Stephanie Stapleton, MD9 and Lars K Beattie, MD10

DOI: https://doi.org/10.21980/J8.52353 Issue 10:5[mrp_rating_result]
By the end of the case, the learner should will be able to:  1) demonstrate competency with the new ABEM Certifying Exam Reassessment case format, 2) demonstrate the ability to evaluate new information and integrate it into an existing care plan, 3) recognize signs and symptoms of pulmonary edema, 4) review possible etiologies of acute respiratory distress and the evaluation/work up to differentiate and diagnose those causes, and 5) manage pulmonary edema including implementing afterload reduction, positive pressure ventilation, and diuresis.
Current IssueCardiology/VascularCommunication

Ultrasound Case: Syncope in PE

Neil Wallace, MD1, Andrew Melendez, DO2, Lars K Beattie, MD3, Tina H Chen, MD4, David Fernandez, MD5, Amrita Vempati, MD6, Kelly Roszczynialski, MD, MS7, Stephanie Cohen, DO8 Stephanie Stapleton, MD9 and Tiffany Moadel, MD10

DOI: https://doi.org/10.21980/J8.52365Issue 10:5[mrp_rating_result]
By the end of the session, learners will be able to: 1) obtain and interpret the parasternal short-axis view of the heart to assess right ventricular size and function, 2) identify ultrasound findings suggestive of pulmonary embolism (PE) on cardiac short-axis view, including right ventricular dilation and septal bowing, 3) demonstrate appropriate probe selection and positioning to obtain optimal images of the heart and inferior vena cava (IVC), 4) evaluate the IVC using a subxiphoid or longitudinal view to assess distension and lack of respiratory collapse as supportive findings for elevated right heart pressures, 5) identify the anatomy of the neck vasculature, differentiate between the internal jugular vein and carotid artery, and select the appropriate puncture site, 6) describe ultrasound-guided central venous catheterization via the right internal jugular vein, using a sterile technique and real-time guidance
Current IssueCardiology/VascularProcedure & UltrasoundUltrasound

Clinical Decision-Making Case: Pulmonary Embolism

James H Lee, MD* and Linda Herman, MD*

DOI: https://doi.org/10.21980/J8.52339 Issue 10:5[mrp_rating_result]
By the end of the clinical decision-making case, the learner will: 1) gain familiarity with clinical decision-making (CDM) case format to be used in the new American Board of Emergency Medicine (ABEM) certification examination starting in 2026, 2) demonstrate the ability to obtain a focused history and physical examination and develop appropriate differential diagnoses for chest pain and dyspnea, 3) demonstrate understanding of clinical decisions rules to estimate the pre-test probability for pulmonary embolism and the application of rules to guide appropriate diagnostic testing, 4) recognize high clinical suspicion for pulmonary embolism and indication for empirical treatment, 5) recognize the unstable patient and provide appropriate hemodynamic and respiratory support, 6) understand indications for thrombolytic therapy or embolectomy in unstable pulmonary embolism, 7) demonstrate communication skills with patients and specialists across the health care spectrum, and 8) arrange appropriate disposition for the unstable patient with a pulmonary embolism.
Current IssueCardiology/Vascular

Prioritization: Run This Board: Septic Shock, Acute Coronary Syndrome, Small Bowel Obstruction, and Penetrating Chest Trauma

Colleen Donovan, MD1, Nicole Novotny, MD2, Charles Lei, MD3, Alaa Aldalati, MBBS4, Andrew Melendez, DO5, Neil Wallace, MD6, Tiffany Moadel, MD7, Stephanie Stapleton, MD8 and Shagun Berry, DO9

DOI: https://doi.org/10.21980/J8.52355 Issue 10:5[mrp_rating_result]
By the end of this case learners will be able to: 1) Become familiar with format of a prioritization case (a component of the ABEM Certifying Exam), 2) Practice their ability to prioritize multiple patients and provide stabilizing care, 3) Consider changes in status/patient acuity/new cases as presented, 4) Understand how to utilize team resources appropriately.
Current IssueAbdominal/GastroenterologyCardiology/VascularCertifying Exam CasesClinical Decision-MakingInfectious DiseaseNeurologyOb/GynPediatricsPrioritizationTrauma

Myopericarditis and Pulmonary Edema

Lubna Ahmad Saffarini, MBBS*^

DOI: https://doi.org/10.21980/J8.52187 Issue 10:4[mrp_rating_result]
At the end of this oral board session, learners will be able to: 1) Demonstrate the ability to evaluate and treat a somnolent and hypoxic patient, 2) Identify a critical airway situation and manage it with a holistic approach, 3) Interpret the history, physical examination, ECG, and chest x-ray findings and discuss the list of differential diagnoses, 4) Identify a state of cardiogenic shock induced by myopericarditis and treat it appropriately, 5) Assess the presence of pericardial effusion and cardiac tamponade utilizing bedside echocardiography.
Current IssueCardiology/VascularCertifying Exam Cases

The Silent Saboteur: Teaching the Clinical Implications of Occult Hypoxemia & Social Determinants of Health via a Pulmonary Embolism Case

Eugene Marrone, MD*, John Cafaro, MD* and Jared Klein, DO*

DOI: https://doi.org/10.21980/J8FD14 Issue 10:2[mrp_rating_result]
By the end of this oral board case, learners will be able to: 1) obtain appropriate history of present illness (HPI) and physical exam elements for the undifferentiated chest pain patient, 2) identify elements of history and physical exam that are compatible with pulmonary embolism, 3) formulate a differential diagnosis for chest pain and perform the appropriate work-up to narrow this differential diagnosis, 4) appropriately manage pulmonary embolism, 5) review and discuss the diversity, equity and inclusion (DEI) elements of the case, and 6) review and discuss the importance of social determinants of health (SDH) in disposition decisions and patient outcomes.
Cardiology/VascularCertifying Exam CasesSocial Determinants of Health

My Broken Heart

Kelly N Roszczynialski, MD, MS*, Alana E Harp, MD^, Cameron A Fisk, MD*,Kristen M Ng, MD, MEHP† and Ashley C Rider, MD, MEHP*

DOI: https://doi.org/10.21980/J85W7RIssue 10:2[mrp_rating_result]
By the end of this simulation session, learners will be able to: 1) assess the hemodynamics of an LVAD patient by using a Doppler to determine mean arterial pressure, 2) Manage an arrhythmia in an LVAD patient with a suction event by addressing preload, 3) Identify and treat the source of hypovolemia (a massive lower gastrointestinal hemorrhage), 4) Perform clear closed-loop communication with other team members.
Cardiology/VascularSimulation

Stabilization of Cardiogenic Shock for Critical Care Transport, a Simulation

Matthew Heffernan, MD*^, Jennifer Quinn, MSN*^, Craig Tschautscher, MD*^, Ryan Newberry, DO*^, Andrew Cathers, MD*^ and Brittney Bernardoni, MD*^

DOI: https://doi.org/10.21980/J82354 Issue 10:2[mrp_rating_result]
ABSTRACT: Audience: This simulation is designed for critical care transport providers but can be easily adapted for the inpatient setting. It is applicable to an interdisciplinary team including nurses, respiratory therapists, medical students, emergency medicine residents, and emergency medicine attendings. Introduction: Cardiogenic shock carries an incredibly high burden of morbidity and mortality.  Acute myocardial infarction accounts for 81% of cardiogenic
Cardiology/VascularEMSSimulation

Journal Court: A Novel Approach to Incorporate Medicolegal Education into an Emergency Medicine Journal Club

Kevin McGurk, MD*, Mary Jordan, MD* and Bradley Davis, DO*

DOI: https://doi.org/10.21980/J8093TIssue 10:1[mrp_rating_result]
By the end of this exercise, participants should:  1) identify the four necessary elements for a malpractice claim, 2) understand the basic structure of medical malpractice litigation, and 3) critically analyze medical literature representing diverging viewpoints or conclusions.
Cardiology/VascularMiscellaneous (stats, etc)Small Group Learning

Drowning Complicated by Hypothermia

Alexander Close, MD* and Jennifer Yee, DO*

DOI: https://doi.org/10.21980/J8QS7P Issue 10:1[mrp_rating_result]
At the conclusion of the simulation session, learners will be able to: 1) obtain a relevant focused history, including circumstances of drowning and/or cold exposure; 2) outline different clinical presentations of hypothermia, loosely correlated with core temperature readings; 3) discuss management of hypothermia, including passive external rewarming, active external rewarming, active internal rewarming, and extracorporeal blood rewarming; 4) discuss pathophysiology of drowning; 5) identify appropriate disposition of patients who present after drowning; and 6) identify appropriate disposition of hypothermic patients.
Cardiology/VascularSimulationWilderness