Clinical
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Combination Drug Therapy for Hypertension
A large regional database study from Italy demonstrated that initial combination therapy for newly diagnosed hypertension results in fewer major adverse cardiovascular events at one year compared to monotherapy.
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Safety and Efficacy of HEART Score Use in the ED
A prospective observational study of 30-day outcomes in patients with suspected acute coronary syndromes triaged in EDs before and after the implementation of the HEART score showed that there were fewer hospitalizations and a very low risk of death or myocardial infarction among low-risk patients who were discharged without further cardiac testing.
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An Update to the Management of Atrial Fibrillation
This focused update to the 2014 guidelines for the management of atrial fibrillation (AF) includes revisions to anticoagulation recommendations and the role of catheter ablation of AF in patients with heart failure.
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Volume-Outcome Relationship With Newer-Generation TAVR Devices?
This large-scale retrospective analysis of all balloon-expandable transcatheter aortic valve replacement valves revealed no apparent relationship between procedure volume and outcomes after an initial learning curve of 200 procedures.
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Welcome New Board Member
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Should Two-Dose Methotrexate Be the Standard of Care for Ectopic Pregnancy?
In this meta-analysis, the two-dose methotrexate treatment protocol was associated with higher odds of treatment success and a shorter treatment period compared to the single-dose protocol.
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Ripples From Original WHI Study Results Continue: Is This Appropriate?
Recommendations for menopausal hormone therapy were widely publicized and adopted following the original publication of the results of the Women’s Health Initiative and affected both initiation and continuation of estrogen therapy through at least 2013.
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Perimenopausal Depression
OB/GYNs strive to screen women for perinatal depression both in pregnancy and postpartum. Although depression frequently affects reproductive-age women, it is common in women throughout the lifespan. This article discusses depression in perimenopausal women.
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Brexanolone for Postpartum Depression: Promising, but Will It Deliver?
In two double-blind, randomized, placebo-controlled, Phase III trials of brexanolone, a new medicine for postpartum depression, researchers found a significant reduction in symptoms at 60 hours of infusion compared to placebo.
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Is There RBBB, Acute Ischemia, or Both?
The ECG in the figure was obtained from a 35-year-old man with a 20-year history of smoking. He presented to the ED with new-onset chest discomfort. He was hemodynamically stable at the time this tracing was obtained. How would one interpret his ECG? Is there right bundle branch block (RBBB)? Is there evidence of acute posterior ischemia or infarction?