ALiEM
FEBRUARY 9, 2024
Encourage your ED to set up an algorithm that you can follow based on your laboratory’s assay. Low-risk patients do not routinely require stress testing in the ED. You (or someone in your department) needs to know which assay your ED has, and use the appropriate values for that assay. Otherwise, apply a simplified approach.
ACEP Now
NOVEMBER 7, 2024
1 It is important to pick up this diagnosis early, as emergency treatment with percutaneous coronary intervention (PCI) to restore blood from to the heart can be lifesaving. TCAD occurs as a result of rapid deceleration, which increases shear forces on the endothelium of the coronary artery.
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Dr. Smith's ECG Blog
SEPTEMBER 18, 2024
male presents to the ED at 6:45 AM with left sided chest dull pressure that woke him up from sleep at 3am. He arrived to the ED at around 6:45am, and stated the pain has persisted. Here is his ED ECG at triage: Obvious high lateral OMI that does not quite meet STEMI criteria. The pain radiated to both shoulders.
REBEL EM
JULY 5, 2023
Sepsis) De Winters T waves are the earliest sign of an anterior wall MI but will only be present in ~ 2% of LAD infarcts Patients with Wellens Syndrome on ECG should have a cardiac cath within 24 hours, not necessarily within the first 60 minutes of ED arrival.
Core EM
NOVEMBER 30, 2024
The Case An 88-year-old woman with a history of dementia, major depressive disorder, and hyperlipidemia presented to the ED via EMS after a near syncopal episode. The ED team emergently notified cardiology and loaded her with aspirin, ticagrelor, and heparin. High-sensitivity troponin peaked at 61 and BNP was normal.
Dr. Smith's ECG Blog
NOVEMBER 14, 2024
I found out that the interventionalist had just finished a case and came to the ED to see about the de-activated case. He saw the ECG and ordered an ED ECG." As per Dr. Smith — I also found it difficult to understand why the admitting ED physicians cancelled the cath lab activation. Kudos to the medics." "I
Dr. Smith's ECG Blog
NOVEMBER 15, 2023
[link] Case continued She arrived in the ED and here is the first ED ECG. Angiogram No obstructive epicardial coronary artery disease Cannot exclude non-ACS causes of troponin elevation including coronary vasospasm, stress cardiomyopathy, microvascular disease, etc. Detailed coronary artery evaluation not performed.
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