Emergency Medicine Reports – June 21, 2009
June 21, 2009
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The Missed MI: Understanding the Limits of Biomarkers and CT Angiography
I remember when the Goldman myocardial infarction (MI) algorithm came out, quickly followed by a seven-button hand-held "calculator." It promised to reduce all decision-making regarding ED chest pain patients to seven yes or no questions. But when you looked into the mathematics, if you answered no or negative to all of the questions, it indicated a 4% chance of acute cardiac ischemia. So, what would you do with this information? Could you tell the patient that there was only a 4% chance of a heart attack, so it was OK to go home? -
Emergency Medicine Reports - Full June 22, 2009 Issue in Streaming Audio/Downloadable MP3 Format