15 hours of chest pain. Too late for thrombolytics, right? Unstable Angina still exists.
The time window for therapy with thrombolytics is up to 12 hours after the onset of chest pain, based on many studies done in the thrombolytic…
Unstable angina still exists. Beware.
A middle aged male with h/o one stent 5 years prior presented with 7 hours of continuous vague chest pressure. During this, while he got…
It is Far too Early for a Requiem for Unstable Angina
Dr. Braunwald declared that high sensitivity troponins will make Unstable Angina a thing of the past. That very well may be true, but in…
Unstable Angina: Dr. Braunwald asks if it is time for a Requiem
In a recent commentary, Dr. Eugene Braunwald asked if it is time for a Requiem for Unstable Angina (ACS without a positive troponin, as…
Chest pain, normal ECG, and serial undetectable high sensitivity troponins. Should we do further testing?
Many authors state that if troponins are undetectable and ECG is normal, no further testing should be done. For example, in JACC:…
Dizziness in a 40-something with recent stent for inferior OMI
Dizziness is so unlikely to be OMI without an obvious ECG, that I am going to pretend that this patient presented with chest pain. The…
Dynamic OMI ECG. Negative trops and negative angiogram does not rule out coronary ischemia or ACS.
By Smith, peer-reviewed by Interventional Cardiologist Emre Aslanger Submitted by anonymous A 53 y.o. male presents to the ED at 6:45 AM with…
A 40-something with 2 hours of new active chest pain and new T-wave inversion
A 41-year-old male who presents to the emergency department with chest pain. Patient reports approximately 2 hours prior to arrival…
Our residents are getting really good at this.
I was asked to look at this ECG in a patient with 30 minutes of acute onset of nausea and vomiting and perhaps some chest discomfort: First ED…
Is this a STEMI? No, not by definition! Why not? Why is this Important?
A 40-something male presented with dyspnea and left arm numbness, and perhaps some chest tightness, for 1 1/2 hours. Here is his triage ECG:…