Abel Casso Dominguez

ADJUSTED ODDS OF INPATIENT MORTALITY FOR NON-ST ELEVATION MYOCARDIAL INFARCTION IS NOT AFFECTED BY DAY OF ADMISSION: A NATIONWIDE ANALYSIS

Background: Day and month of admission has been shown to be an important predictor in other cardiac related admissions. We aim to show the impact of admission day in patients hospitalized for non-ST elevation myocardial infarction (NSTEMI) in the United States. Methods: This was a retrospective

PATIENTS WITH NON ST-SEGMENT ELEVATION MYOCARDIAL INFARCTION UTILIZING MEDICARE/MEDICAID HAVE LOWER ADJUSTED ODDS OF IN-HOSPITAL MORTALITY: A NATIONWIDE ANALYSIS

Background: There have been no studies looking at the type of insurance utilized by patients in Non-ST-segment Elevation Myocardial infarction (NSTEMI). The aim of this study was to look at insurance as an independent risk factor in outcome of NSTEMI patients. Methods: This was a retrospective

Intermittent Brugada Syndrome Presenting with Syncope in an Adult Female

Background. Brugada syndrome accounts for 4–12% of all sudden deaths worldwide and at least 20% of sudden deaths in patients with structurally normal hearts. Case Report. A 48-year-old female presented to the emergency department after two witnessed syncopal episodes. While awaiting discharge had a third collapse followed by cardiac arrest with shockable rhythm. Initial electrocardiogram showed wide QRS complex with left axis deviation, ST-segment elevation of <1 mm in V1 and V2, and flattening of T waves in V1. The angiogram did not demonstrate obstructive coronary disease. The electrocardiogram obtained two days after these events showed a right bundle branch block with ST-segment elevation of >2 mm followed by a negative T wave with no isoelectric separation, suggestive of spontaneous intermittent Brugada type 1 pattern. Cardiac magnetic resonance imaging demonstrated neither structural heart disease nor abnormal myocardium. After placement of an implantable cardioverter defibrillator the patient was discharged. Why should an emergency physician be aware of this? Brugada syndrome is an infrequently encountered clinical entity which may have a fatal outcome. This syndrome primarily presents with syncope. It should be considered as a component of differential diagnosis in patients with family history of syncope and sudden cardiac death.