No abstract

No abstract

The 2-point ultrasonographic live control of the GT position has a better sensitivity and a much higher specificity than the syringe test but similar to the xiphoid ultrasound control. However, our method allows to show the GT in the esophagus and to use the dynamic ultrasound fogging to reveal an intragastric position that was not obvious with the common techniques.

Our study demonstrates that public intervention programmes must stress the urgency of recognizing stroke symptoms and the importance of calling EMS through free telephone numbers. Further efforts are necessary to disseminate guidelines for healthcare providers concerning stroke recognition and the new therapeutic possibilities in order to increase the likelihood of acute stroke patients presenting to a stroke team early enough to be eligible for acute treatment. In addition, EMS dispatchers should receive further training about atypical stroke symptoms, and 'Face Arm Speech Test' tests must be included in the routine questionnaires used in emergency medical calls concerning elderly persons.

No abstract

Takotsubo cardiomyopathy consists of cardiomyopathy with transient apical ballooning and left ventricular systolic dysfunction in the absence of atheromatous disease of the coronary arteries, accompanied by ECG changes together with elevated cardiac enzymes appearing in a context of emotional or physical stress. A 51-year-old woman was referred to our emergency department for treatment after chest pain associated with acute dyspnoea during diving. On questioning, the patient confirmed that she had twice dived to 35 m without any missed decompression stops and informed us that she had experienced tightening of the chest followed by sudden dyspnoea during her second ascent in a setting of marked emotional stress since the previous evening. Her ECG showed inverted T-waves in DI, aVL, V1 and V2, whereas chest radiographs revealed bilateral infiltration of the lower half of the lung fields and a globular heart. Laboratory tests revealed: troponin Ic 7.49 μg/l, myoglobin 206 μg/l, creatine phosphokinase 341 IU/l and N-terminal prohormone brain natriuretic peptide 7919 ng/l. Echocardiography performed in the emergency department showed left ventricular hypokinesia in the medioapical segment with an appearance of apical ballooning, hyperkinesia of the basal portion and a left ventricular ejection fraction of 35%. Coronary angiography revealed healthy coronary arteries. In conclusion, diagnosis of takotsubo cardiomyopathy is based on the guidelines issued at a consensus conference of the Idiopathic Cardiomyopathy Research Committee. This case shows the possibility of this syndrome occurring while diving.

No abstract

No abstract