Thank you so much for having me.

All right.

Thank you again.

So I will go ahead and get us started with the question.

We have a sixty-four-year-old male with a history of hypertension and dyslipidemia presenting to the emergency department with crescendo angina.

His ECG shows ST segment depression in leads V4 through V6, and high-sensitivity troponin levels are significantly elevated.

A diagnosis of non-ST elevation ACS is made, and the patient is scheduled for an early invasive strategy with percutaneous coronary intervention.

Dr. Shah, it is an honor to have you with us.

Thank you for having me.

All right, so to get us started with the question, we have a 64-year-old woman with an NSTEMI acute coronary syndrome taken to the cardiac catheterization lab.

She is P2Y12 inhibitor naive as she was unable to tolerate oral intake due to severe nausea and vomiting.

Coronary angiography reveals a high-grade thrombotic lesion in the mid-right coronary artery.

The interventionalist decides to initiate an intravenous P2Y12 inhibitor before proceeding with PCI.

Which of the following is the most appropriate management strategy? Option A, administer Kangler as a 30 mg per kg IV bolus, followed by a 4 mg per kg per minute infusion for at least 2 hours or the duration of PCI, whichever is longer.

Those patients did

It's a pleasure to join you.

All right, thank you again.

So for our question today, we have a 78-year-old man with a history of hypertension and controlled type 2 diabetes presents to a rural emergency department with 90 minutes of persistent crushing substernal chest pain.

His ECG reveals 3-millimeter ST segment elevation and leads V1 through V4.

The nearest PCI-capable center is approximately 140 minutes away by ground transport, and air transport is unavailable due to weather.

The patient refuses transfer to another facility for the duration of this admission.

The clinical team decides to proceed with fibrinolytic therapy using weight-based tenecteplase.

And so, you know, this is the time when if you need to go ahead and look at or maybe your pharmacist will remember some of these dosings.

Thank you for having me.

All right.

So for our question today, we have a 55-year-old woman is brought to the emergency department after an out-of-hospital cardiac arrest.

She had a witness collapse with an initial shockable rhythm.

Return of spontaneous circulation was achieved after 15 minutes of advanced cardiac life support.

Her post-resuscitation ECG shows diffuse ST-segment depression, but no ST-segment elevation, and she remains comatose.

Which of the following is the most appropriate next step in her management regarding coronary angiography? Option A, immediate emergency coronary angiography within two hours should be performed.

world, however, is a little

Grace, why don't you take it away?

All right.

Thanks so much for being here.

So we first up have a question.

There is a sixty-three-year-old woman who presented to the emergency room for chest pain.

She described having exertional chest pain for the past two months and had an episode of severe pain after dinner three days ago.

She went to bed and slept it off, but told her children today at a family gathering and was immediately brought to the ED by her daughter.