The American journal of emergency medicine
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Cerebral infarction associated with myocardial hypertrabeculation is a rare condition that requires optimal management to reduce the risk of thromboembolism and stroke. As intravenous thrombolysis (IVT) is a standard treatment for acute ischemic stroke, it is important to investigate whether it is safe and effective in patients with this rare condition. ⋯ This case report provides evidence that IVT is safe and effective in the treatment of cerebral infarction associated with myocardial hypertrabeculation in adults.
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6.2 million Americans live with heart failure (HF) and are at risk for hospitalization due to hypertensive emergencies. Optimal treatment strategy for acute hypertensive heart failure remains unclear. Our study investigates what treatment modality is most effective in achieving guideline-directed blood pressure control. ⋯ Acute hypertensive heart failure was managed adequately with any treatment modality. Use of IV bolus therapy in these patients was associated with shorter ICU length of stay. Our results add to growing evidence that hypertensive emergencies may be less clinically significant than previously thought.
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Emergency Departments (EDs) frequently care for patients with life-limiting illnesses, with nearly 1 in 5 patients enrolled in hospice presenting to an ED during their hospice enrollment. This study investigates the reasons patients enrolled in hospice seek care in the ED, the interventions they receive, and their outcomes. ⋯ Patients enrolled in hospice most frequently presented to the ED for trauma. Most received laboratory studies and imaging. Nearly half of patients were admitted to the hospital and short-term mortality was high, particularly for patients enrolled in hospice for <30 days, enrolled with a hospice diagnosis of cancer, or admitted to the hospital. Understanding the care patients enrolled in hospice receive in the ED can help prevent avoidable visits and ensure care aligns with patients' goals.