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Dynamic OMI ECG. Negative trops and negative angiogram does not rule out coronary ischemia or ACS.

Dr. Smith's ECG Blog

Compensatory enlargement was defined as being present when the total coronary arterial cross-sectional area at the stenotic site was greater than that at the proximal nonstenotic site. We documented that the majority of stenotic lesions had compensatory enlargement and thus exhibited remodeling. As was emphasized by Dr.

Coronary 123
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Elder Male with Syncope

EMS 12-Lead

There is increased LV cavity dimensions with an increase in transient ischemic dilation, suggesting Left Main, or 3-vessel coronary artery disease. 2. Coronary angiography reveals significant and severe CAD involving all three epicardial vessels. Strongly positive stress ECG Lexiscan administration. He was taken to the Cath Lab.

Coronary 290
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FOAM Eye-Catchers 8: New ACS rule out rule, Tamiflu Scandal, ACEP Seizure Policy & more

EMergucate

MACS Rule for early rule out/in of ACS! The exciting new Manchester Acute Coronary Syndrome Rule (MACS) is explained by … Continue reading →

ACS 100
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ECG Cases 40 – Approach to Spontaneous Coronary Artery Dissection (SCAD)

Emergency Medicine Cases

Jesse McLaren on when to consider Spontaneous Coronary Artery Dissection (SCAD), which patients are at risk for reocclusion, and the challenges of diagnosing SCAD in patients who have nonischemic ECGs despite silent occlusion, occlusions perfused by collaterals, or from non-occlusive MI on this ECG Cases.

Coronary 130
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High sensitivity cardiac troponins for ED chest pain evaluation (2022 ACC pathway)

ALiEM

Intermediate-risk patients may be further stratified based on recent stress testing or coronary angiogram findings plus a modified HEART or Emergency Department Assessment of Chest Pain (EDACS) score. The patient has no previous stress testing or coronary angiogram, and he is not low risk by HEART or EDACS scoring.

E-9-1-1 276
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SGEM#370: Listen to your Heart (Score)…MACE Incidence in Non-Low Risk Patients with known Coronary Artery Disease

The Skeptics' Guide to EM

Major adverse cardiac event rates in moderate-risk patients: Does prior coronary disease matter? Major adverse cardiac event rates in moderate-risk patients: Does prior coronary disease matter? He has no history of coronary artery disease. If we thought about ACS, we brought them in. AEM June 2022. AEM June 2022.

Coronary 100
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Clinical Conundrum: Should a Troponin Routinely be Ordered in Patients with SVT?

REBEL EM

What Your Gut Says: The patient has a tachydysrhythmia which may be the presentation of acute coronary syndrome (ACS) even though the patient has no ischemic symptoms. Essentially, we are using the troponin assay to find patients with ACO who may be benefited by coronary interventions or risk factor modification.

Coronary 143