Archive for category: Cardiovascular

Game Changers in Emergency Medicine

03 Mar
March 3, 2014

Recently, I have been asked if there are any studies that have been performed over the past few years that should shape the way emergency medicine physicians should practice and can greatly improve patient care. So I asked some of my friends and colleagues if there are any studies that stick out in their minds. […]

High Sensitivity Troponin Testing

06 Feb
February 6, 2014

Troponin testing is an important component of the diagnostic workup and management of acute coronary syndromes (ACS). The increasing sensitivity of troponin assays has lowered the number of potentially missed ACS diagnoses, but this has also created a diagnostic challenge due to a decrease in the specificity of the test. From 1995 to 2007, the […]

Chest Pain: Can we do 2-hour rule outs?

26 Jan
January 26, 2014

Hospital admissions for chest pain often incur costly and resource-intensive workups for ACS. Is there a way to identify a low risk group who can be discharged home in a timely manner, without further workup, and without short-term adverse events from ACS?

Chest Pain: Coronary CT Angiography in the ED

26 Jan
January 26, 2014

It is well known that taking a good history and physical, getting a non-ischemic EKG, and serial cardiac biomarkers, results in a risk of death/AMI of <5% in 30 days. Patients, in whom you still suspect have CAD, should undergo provocative testing within the next 72 hours based on the AHA/ACC guidelines. Their guidelines deem […]

The HEART Score: A New ED Chest Pain Risk Stratification Score

10 Jan
January 10, 2014

Chest pain is a common presentation complaint to the emergency department (ED) and has a wide range of etiologies including urgent diagnoses (i.e. acute coronary syndrome (ACS), pulmonary embolism, aortic dissection) and non-urgent diagnoses (i.e. musculoskeletal pain, gastroesophageal reflux disease (GERD), pericarditis). The challenge in the ED is to not only to identify high risk […]

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