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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.

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SGEM#421: I Think I’d Have a Heart Attack – Maybe Not in a Rural Area?

The Skeptics' Guide to EM

Date: November 22, 2023 Reference: Stopyra et al. Date: November 22, 2023 Reference: Stopyra et al. A 12-lead electrocardiogram (ECG) demonstrates ST elevations in leads II, III, and aVF with ST depressions in leads I and aVL and the team begins transport to the nearest percutaneous coronary intervention (PCI) capable hospital.

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Case Report: Coronary Vasospasm-Induced Cardiac Arrest

ACEP Now

A 45-year-old male with a history of chronic obstructive pulmonary disease (COPD), asthma, amphetamine and tetrahydrocannabinol (THC) use, and coronary vasospasm presented to triage with chest pain. During assessment, the patient reported that a left heart catheterization six months prior indicated spasms but no coronary artery disease.

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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

Studies such as those by Moise et al 14 and Ellis et al 39 have shown that the relative risk of developing an acute myocardial infarction in the territory supplied by an artery with a 70%. years, with the interval as long as 12 or 18 years in some studies. Unfortunately, vascular remodeling is variable and inconsistent.

Coronary 123
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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

Date: June 30th, 2022 Reference: McGinnis et al. Major adverse cardiac event rates in moderate-risk patients: Does prior coronary disease matter? Date: June 30th, 2022 Reference: McGinnis et al. Major adverse cardiac event rates in moderate-risk patients: Does prior coronary disease matter? Reference: McGinnis et al.

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Normal angiogram one week prior. Must be myocarditis then?

Dr. Smith's ECG Blog

Why Was Cardiac Cath Negative for Coronary Disease? As noted by Dr. Nossen — this patient qualified as MINOCA ( M yocardial I nfarction with N on- O bstructive C oronary A rteries ) — since troponin was positive on his 2nd admission, yet there was no evidence of obstructive coronary disease on cath.

Coronary 121
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SGEM#234: Contrast Induced Nephropathy – A Unicorn?

The Skeptics' Guide to EM

[display_podcast] Date: October 17th , 2018 Reference #1: Aycock, Westafer et al. Ann Emerg Med 2018 (CRD42017056195) Reference #2: Weisbord SD, Gallagher M, Jneid H, et al; PRESERVE Trial Group. display_podcast] Date: October 17th , 2018 Reference #1: Aycock, Westafer et al. Reference: Aycock, Westafer et al.

Coronary 173