Archive

Tag: ACS

Retrospective Validation of High-Sensitivity Troponin with 5 Clinical Decision Instruments

Background: Chest pain is the second most common reason for presentation to the emergency department (ED) and accounts for nearly 6.5 million visits each year. [1] Management often requires the utilization of clinical gestalt, laboratory analysis, diagnostic imaging, and clinical prediction …

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Cardiovascular

ISAR-REACT 5 Trial: Ticagrelor vs Prasugrel in ACS

Background: In patients presenting to the ED with acute coronary syndrome (ACS), dual antiplatelet therapy is the current standard treatment.  This typically consists of aspirin and an adenosine diphosphate receptor antagonist.  It is fairly well understood that prasugrel and ticagrelor …

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Cardiovascular

Can Emergency Physicians Use Clinical Gestalt to Predict Acute Coronary Syndrome?

Background: Chest pain is a common chief complaint the Emergency Department, and the differential diagnosis includes life-threatening conditions from several organ systems including cardiac, pulmonary, and gastrointestinal, in addition to more benign etiologies. Historically, despite most patients not having acute …

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Cardiovascular

More Trials Showing Harm of Opioids in ACS…or do They?

Background: Typical medical treatment of ACS patients include dual antiplatelet therapy (DAPT) and revascularization with primary percutaneous coronary intervention (PPCI).  Nitroglycerin is first line therapy in the treatment of pain in ACS with morphine as a common adjunct. Morphine helps …

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Cardiovascular

The Death of MONA in ACS: Part III – Nitroglycerin

Background: Nitroglycerin is a first line agent in the treatment of ACS. The physiologic basis for it’s use rests on it’s ability to promote coronary vasodilation resulting in increased blood flow to the coronary arteries . Nitroglycerin, is typically given …

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Cardiovascular

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