EMS 12-Lead
APRIL 9, 2024
He denied any specific prodrome of gross palpitations, however did endorse feeling quite dizzy just before the event. Given no clinical prelude of anginal (or equivalent) descriptors, prior to the acute event, risk stratification of the ECG and Troponin was pursued via Echo and nuclear Myocardial Perfusion Imaging (MPI).
Dr. Smith's ECG Blog
SEPTEMBER 18, 2024
Furthermore, if this occurs at all, it is a rare event. It is not small but rather large plaques, which may not be producing significant stenosis, that undergo rupture with acute occlusive thrombosis, resulting in myocardial infarction and other ischemic events. These are typical findings at sites of plaque rupture.
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EM Didactic
JANUARY 27, 2019
Myth 1 Absence of Classic Chest Pain obviates the need for ACS work up The absence of chest pain in no way excludes the diagnosis of ACS. Around 33-50% of the patients with ACS present to the hospital without chest pain. Close to 20% of patients diagnosed with acute MI present with symptoms other than chest pain.
REBEL EM
SEPTEMBER 21, 2023
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. There are other reasons aside from ACO for troponin elevations: Type 1: MI due to a spontaneous coronary atherosclerotic event. Send the troponin just to make sure.
The Skeptics' Guide to EM
JULY 2, 2022
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? If we thought about ACS, we brought them in. Date: June 30th, 2022 Reference: McGinnis et al. AEM June 2022. AEM June 2022.
Pediatric EM Morsels
AUGUST 18, 2023
Myth #1: Musculoskeletal Adverse Events (MAE) This concern is likely the most common reason fluoroquinolones are rarely used in children. Musculoskeletal Adverse Events include: Articular cartilage damage causing arthralgias or arthritis , Tendonitis , and Tendon rupture. Which is a risk of 1 event for 62.5 Binz 2015).
Dr. Smith's ECG Blog
FEBRUARY 14, 2024
The faculty physician thought this is highly likely to be ACS. I do not think it is possible for a 2nd trop to remain undetectable in a patient then goes on to rule in for acute MI, unless there is a 2nd event. I know of no data on unstable angina/30-day adverse events/acute MI after 2 serial undetectable trops.
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