Welcome back to the IBCC podcast.

We're here on our second recording

and to talk about the ischemia evaluation in the ICU,

a topic near and dear to our hearts.

Obviously that's Josh Farkish,

your work course for this guys, and I'm Adam Thomas.

So this chapter is all about the approach

of the ischemia evaluation for the

non-cardiac ICU patient. And I think staff me, they get really frustrated when we just

reflexively throw troponins around and we don't know what to do with them. So we're going to cover

an approach here for how to work up what you think is a cardiac issue in the ICU. Before we get

started, it may seem during this podcast that I don't care about the heart,

and that's not true. So I do think that it's important for us to think carefully about our patients

and consider the possibility of ischemia and evaluate our patients' heart carefully. And for me,

for most ICU patients, I think it's a good idea to get an admission EKG. It's good to have it as a

baseline. And for patients with a cardiopulmonary problem, I think it's a good idea to get an admission EKG. It's good to have it as a baseline.

And for patients with a cardiopulmonary problem, I think it's a really good idea to take a look

at their heart with a bedside echo. I think those are good initial evaluations for a patient

coming into the ICU. And that can be useful for a lot of reasons. It can reveal an unexpected

acute disease process like tamponad, massive pulmonary embolism,

or it can reveal a chronic disease that will affect how your patient responds to acute illness.

For example, severe aortic stodosis or chronic pulmonary hypertension.

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