Acute Coronary Syndromes

Acute Coronary Syndromes

JC: Cardiac arrest centres and bypass. St.Emlyn’s

The concept of cardiac arrest centres is not entirely new and is something we’ve been talking about in Virchester for some time. Indeed, there are several articles in the literature and a fairly reasonable patho-physiological argument for them1–3. We know…
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One high sensitivity troponin test to rule out acute myocardial infarction

This month I was honoured that a study I wrote with some terrific colleagues from Europe, Australia and the US has been published as the ‘Editor’s Choice’ in Academic Emergency Medicine. This was a secondary analysis from a large, multi-centre, international…
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Life and Learning from Rob Rogers on the other side of that ECG. St.Emlyn’s

Last week I was  wandering through Amsterdam when I came across a tweet which stopped me in my tracks. A real game changer, a shock, a wake up call and a surprise. Rob Rogers (aka @EM_Educator) tweeted a really interesting…
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Cardiology Case 05: Detective work

  It’s been a while since we shared a cardiology case but here’s a cracker for you. As usual, see our Caveats and Cautions. While these cases are based on our genuine experiences (often pooling several experiences), we always alter details…
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Getting your chest pain evaluation right: #UMECS16

Last week, while Iain was giving a keynote lecture in Austria, I was also heading for distant shores to speak about chest pain evaluation at a special conference set up by the legendary Amal Mattu: the University of Maryland Emergency…
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JC: High sensitivity Troponin I on presentation. Is it enough to rule out ACS? St.Emlyn’s

As you surely know we love thinking about Troponin at St.Emlyn’s. We have our own world expert in Rick Body and there is loads of stuff here on the site about the use (and abuse) of Troponin as a diagnostic…
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JC: Are typical chest pain symptoms predictive of outcome? St.Emlyn’s

We love a bit of meta-cognition here at St.Emlyn’s. As time passes and we all become a little longer in the tooth it becomes increasingly apparent that it’s not just ‘what’ we know it’s how we use it. In diagnostic…
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The MACS rule: a new user-friendly version

This blog post is based on a paper we’ve just had published in the Emergency Medicine Journal entitled: ‘The Manchester Acute Coronary Syndromes (MACS) decision rule: validation with a new automated assay for heart-type fatty acid binding protein’.  You can…
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Is severe chest pain more likely to be a heart attack?

    Have you ever heard this sort of conversation in your ED? Junior ED doc: Can I run my patient by you, please? Senior ED doc: Sure Junior: I  have a 40 year old man with chest pain.  I don’t think it’s…
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