Tag Archives: cardiology

Troponin testing, “Answers”

Troponin is a structural protein found in striated muscle and is involved in calcium processing.  Although troponin can be found in many types of muscle, cardiac troponins are structurally different from the variety found in skeletal muscle. Therefore tests can … Continue reading

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Troponin testing, Questions

1. Do you ever send a single troponin in patients with chest pain? If so, when? 2. How do you manage patients with end stage renal disease (ESRD) and chest pain who have equivocal troponins? 3. Do you send a … Continue reading

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Cocaine Chest Pain, “Answers”

 1. What is the relationship between cocaine and Acute Coronary Syndrome/MI? Cocaine is the second most commonly abused drug in the United States, accounting for the most drug-related visits to the Emergency Department (Finkel, 2011). Chest pain is the most … Continue reading

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Acute Coronary Syndromes, “Answers,” IV/IV

4. How reassuring is a recent (< 1 year) negative stress test in managing a patient with chest pain? How about a recent “normal” cath (i.e., < 30% blockage, no intervention)? In a word (or two): not very. The problem … Continue reading

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Acute Coronary Syndromes, “Answers,” III/IV

3.  How do you risk stratify patients with chest pain?  Do you use any clinical decision rules? It’s a daily ED conundrum: how concerning is this patient’s chest pain? This most common, yet challenging, clinical quandary is not an insignificant one … Continue reading

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Acute Coronary Syndromes, “Answers” II/IV

2.  How do you identify and manage patients with unstable angina? Patients with unstable angina (UA) are  on the same ACS spectrum as NSTEMIs and STEMIs.  Unstable angina is defined as either angina at rest, new onset (< 2 months) … Continue reading

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Acute Coronary Syndromes, “Answers”

NB: For this topic, perhaps the most researched in all of modern medicine, we are going to break up the answers to avoid dyspepsia. Our apologies for the extra emails. 1.     What anti-coagulants and/or anti-platelet agents do you use in … Continue reading

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Acute-Onset Atrial Fibrillation: “Answers”

1. What is your approach to managing a patient with acute-onset (< 48 hours) atrial fibrillation (afib)?  Which patients do you cardiovert? Does your management algorithm differ for patients with acute-onset rapid afib? The management of acute-onset afib in stable … Continue reading

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August 2011: Acute Coronary Syndrome, Questions

1. What anti-coagulants and/or anti-platelet agents do you use in a patient with a STEMI?  In an NSTEMI? 2.  How do you identify and manage patients with unstable angina? 3.  How do you risk stratify patients with chest pain?  Do … Continue reading

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Acute-Onset Atrial Fibrillation: Questions

1. What is your approach to managing a patient with new-onset (e.g., within the last 24 hours) atrial fibrillation?  Which patients do you cardiovert? Does your management algorithm differ for patients with new-onset atrial fibrillation with rapid ventricular rate (RVR)? … Continue reading

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