Reducing Door-to-Balloon Time Using EMS-Initiated App-Based Communication.

Background: Reducing door-to-balloon (D2B) time for ST-segment elevation myocardial infarction (STEMI) has been shown to improve outcomes. Delays still occur due to various factors such as time to laboratory activation and diagnostic clarification in equivocal cases. We propose that early communication through a mobile application (app) between emergency medical services (EMS) and in-hospital providers can reduce EMS-to-balloon time and provide coordinated care to impact D2B time.

DKA-induced Brugada phenocopy mimicking STEMI.

Case Presentation: A 47-year-old Caucasian woman with type 1 diabetes presented with epigastric pain and vomiting. She had not been adherent with her diet and insulin therapy for the past 3 weeks. She never had a personal or family history of arrhythmia-related symptoms, ventricular tachycardia or fibrillation (VT/VF) or premature sudden cardiac death (SCD).