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Coronary calcification occurs almost exclusively in atherosclerosis. Several autopsy studies 5,6 and histopathologic studies 7 have shown a direct relationship between the extent of calcification and atherosclerotic disease. Sangiorgi et al 7 performed a histologic analysis of coronary artery segments.

Cardiac Arrest, An Issue of Emergency Medicine Clinics - E-Book - Volume 30-1 - eBook

The amount of calcium correlated well with the area of plaque:. Coronary artery calcium has also been associated with obstructive coronary artery disease in studies using intravascular ultrasonography and optical coherence tomography. First-generation CT scanners used for calcium scoring in the s were electron-beam systems in which a stationary x-ray tube generated an oscillating electron beam, which was reflected around the patient table.

These systems have been replaced by multidetector scanners, in which the x-ray tube and multiple rows of detectors are combined in a gantry that rotates at high speed around the patient. Coronary calcium is measured by noncontrast CT of the heart. Thus, there is no risk of contrast-induced nephropathy or allergic reactions. Images are acquired while the patient holds his or her breath for 3 to 5 seconds. Electrocardiographic gating is used to reduce motion artifact. The entire test takes 10 to 15 minutes. Figure 2.

Book Series: The Clinics: Internal Medicine

A screenshot from a standard calcium scoring program. The images show a small calcified plaque in the mid-left anterior descending artery left upper panel, colored yellow , left circumflex artery right upper panel, colored blue , and right coronary artery right lower panel, colored red.

The table in the left lower panel lists the results of the calcium score. The graph in the right lower panel shows the results of the individual patient relative to an age- and sex-matched patient population eg, the MESA trial. This patient has a score of The results fall into 4 categories, which correlate with the severity of coronary artery disease, ranging from no significant disease to severe disease Table 1. Feasibility study of advanced focused cardiac measurements within the emergency department. Crit Ultrasound J. Novel quality indicators for radiologists interpreting abdominopelvic CT images: Risk-adjusted outcomes among emergency department patients with right lower quadrant pain.

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Epub Mar 9. Epub Nov 2. Influence of study population definition on the effect of age on outcomes after blunt head trauma. Poor sleep is linked to impeded recovery from traumatic brain injury. J Neurotrauma. Korley FK. JAMA Cardiol.

Epub Mar A Qualitative Study. Circulation 2 PMID: Lozon MM , Bradin S. Pediatric Disaster Preparedness. Journal of Pediatrics Pediatrics Pediatricians' participation in quality improvement at the time of enrollment in MOC. Pediatrics 5 ee PMID: Pediatric Medication Safety in the Emergency Department. Common problems in the emergency department in a child with known heart disease. An evidence-based approach to evaluation and management of the febrile child in Indian emergency department. Epub Sep 6.

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Progressive myocardial injury is associated with mortality in the acute respiratory distress syndrome. J Crit Care. Medicaid expenditures among children with noncomplex chronic diseases. Discordance between age- and size-based criteria of child passenger restraint appropriateness. The influence of psychosocial stressors and socioeconomic status on sleep among caregivers of teenagers with asthma, the Puff City study. Pilot study of a randomized trial to evaluate a Web-based intervention targeting adolescents presenting to the emergency department with acute asthma. Mahajan, P. Pediatric Emergency Medicine. Diagnostic Decision-Making in the Emergency Department. The importance to develop global emergency medicine research network. Epub Jan Epub Jan 3. J Pediatric Infect Dis Soc. SHOCK 49 6 Emergency Department Stroke Care.

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Tsuchida, RE; Meurer, W. More questions than answers - ALS interventions for out of hospital cardiac arrest. The stroke navigator: meaningful use of the electronic health record to efficiently report inpatient stroke care quality.

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J Am Med Inform Assoc. Just Say No to Testing. An experimental study and finite element modeling of head and neck cooling for brain hypothermia. J Therm Biol. Epub Nov 4. Resuscitation Circulation. Circulation 22 ee PMID: Resuscitation PMID: Anesthesia and analgesia 2 PMID: Circulation 23 ee PMID: Resuscitation Resuscitation. Is initial rhythm in OHCA a predictor of preceding no flow time?

Implications for bystander response and ECPR candidacy evaluation. Health Educ Behav. Epub Dec 3. Epub Jun 5.

Skill and knowledge retention after training in cardiopulmonary ultrasound in Ghana: an impact assessment of bedside ultrasound training in a resource-limited setting. Journal of graduate medical education 10 1 PMID: Next Steps for the Future. Pomeranz ES. What Happens Next?

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Health Serv Res. Stroke 49 3 ee PMID: To treat or not to treat? Exploring factors influencing intravenous thrombolysis treatment decisions for minor stroke. Stroke 49 8 PMID: Impact of formal training on agreement of videofluoroscopic swallowing study interpretation across and within disciplines. McDermott, M; Sozener, C.