Acute Coronary Syndromes
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Computer-Interpreted ECGs Sometimes Miss Acute Coronary Occlusion
Emergency physicians can shield against risk by viewing ECGs of chest pain patients immediately to identify subtle signs of acute coronary occlusion.
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Stroke and a Wide QRS
The ECG in the figure is from an older man who presented with an acute stroke. He denied chest pain. Why is there QRS widening? What might be the clinical implications?
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Does One Negative Troponin Measurement Rule Out Acute Coronary Syndrome?
Using a common clinical chest pain algorithm plus a point-of-care troponin measurement for low-risk patients, researchers reported significantly lower healthcare costs. Also, this approach did not seem to result in more major adverse cardiovascular events.
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Does One Negative Troponin Measurement Rule Out Acute Coronary Syndrome?
Using a common clinical chest pain algorithm plus a point-of-care troponin measurement for low-risk patients, researchers reported significantly lower healthcare costs. Also, this approach did not seem to result in more major adverse cardiovascular events.
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Some Acute Chest Pain Patients Can Be Discharged Safely
Guideline authors recommend implementing high-sensitivity cardiac troponins and clinical decision pathways to safely discharge low-risk patients without additional testing. However, the decision pathway is not meant to replace the emergency physician's clinical judgment.
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Lack of EP Evaluation of Chest Pain Can Lead to Disaster
If an emergency physician never evaluates such a patient, leaving the care solely to a physician assistant or a nurse practitioner, this could lay the foundation for litigation.
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Limitation of Tidal Volume Is Cardioprotective Among Mechanically Ventilated Patients Undergoing Cardiac Surgery
In this experimental study, rising tidal volume increased right ventricular afterload.
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Appropriate Management of Thoracic Aortic Aneurysms
Among patients with arch and descending thoracic aorta aneurysms followed over a mean of 20 months, aneurysm-related mortality was predicted by the size and growth rate of the aneurysms, along with age and sex.
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Those Anterior T Waves
The ECG in the figure was obtained from a man in his 60s who was seen in the field for new chest pain. How might one interpret this tracing?
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Measure Stroke Risk with Asymptomatic Severe Carotid Artery Stenosis
A community-based, retrospective, observational study of patients with asymptomatic severe carotid artery stenoses showed the crude stroke risk over five years was about 5%. Patients whose stenoses progress to high grade or start at that severity were at the highest risk for stroke.