Podcasts about troponins

The JournalFeed podcast for the week of Dec 11-15, 2023.These are summaries from just 2 of the 5 article we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.Tuesday Spoon Feed:This secondary analysis of the STOP CP cohort study found that, in isolation, using a 0/2 hour hs-cTnT rule-out protocol did not achieve a NPV ≥ 99% for 30-day cardiac death or MI (CDMI). When combined with a low risk History, ECG, Age, and Risk factor (HEAR) score, it did - but at the cost of significantly decreased efficacy (ruling out only 30.7% of patients).Thursday Spoon Feed:This systematic review and meta-analysis did not show significant improvement in measured patient outcomes for treatment of alcohol withdrawal syndrome with phenobarbital vs benzodiazepines.

Commentary by Dr. Bonnie Ky

In this episode of “Lab Medicine Rounds,” host Justin Kreuter, M.D., speaks with Allan Jaffe, M.D., a consultant in the Department of Laboratory Medicine and Pathology at Mayo Clinic, about cardiac troponins and checkpoint inhibitors. Dr. Jaffe is also the Wayne and Kathryn Preisel Professor of Cardiovascular Disease Research, professor of laboratory medicine and pathology, and professor of medicine in the Mayo Clinic College of Medicine and Science. Discussion includes:00:47 Introductory background on checkpoint inhibitors and cardiac troponins.15:12  Challenges with recognizing immune checkpoint inhibitor-associated myocarditis.19:28  Key takeaways for how laboratory professionals can support these patients.19:28 Considerations of questions that are top of mind when tackling these issues.

Paolo Bima, MD and Professor Christian E. Mueller MD, FESC discuss key takeaways from their study on prevalence of myocardial infarction in cancer patients and review the clinical implications of their findings. Moderated by JACC: CardioOncology Editor-in-Chief Bonnie Ky, MD, MSCE, FACC.

Get a free nursing lab values cheat sheet at NURSING.com/63labs   What is the Lab Name for Troponin I (cTNL) Lab Values? Troponin I   What is the Lab Abbreviation for Troponin I? cTNL   What is Troponin I in terms of Nursing Labs? Troponins are proteins that initiate contraction of muscle fibers. Troponin I (cTNL) is specific to heart muscle. Troponin levels stay elevated for a week after muscle damage before returning to normal.   What is the Normal Range for Troponin I? There is a wide range of normal values among varying institutions and texts with regard to Troponin I. It is essential to verify institutional norms. < 0.035 ng/mL   What are the Indications for Troponin I? Evaluating damage to heart muscle Diagnose a Myocardial Infarction (MI)   What would cause Increased Levels of Troponin I? Heart damage Myocardial Infarction (MI)   What would cause Decreased Levels of Troponin I? N/A

The First Principles of Acute Coronary Syndromes that can get you through your Internal Medicine placements: What are they? What are the ECG changes? How do you ask about the risk factors? === Other Links === Check out our new website 1pm.wiki for the Notion document, free Anki flashcards, and podcast episodes. Check out our Instagram: https://www.instagram.com/firstprinciplesofmedicine/ Recorded 6 September 2022 Co-hosts: JT Yeung, Jason D'Silva, Adian Izwan & Daniel Bontempo feat. Jayanth Cheyyur. Produced by Evangelyn Sim, JT Yeung & Adian Izwan. If you have any ideas or feedback, comment on this Notion document, or shoot us an email at hello@1pm.wiki *** We're really excited to be collaborating with Becky from Becky's notes, a UK based resource, to produce an infographic on ACS for our visual learners out there. Becky's notes brings together all the key topics medical students need to know in a readily available place, reviewed by specialists in the field. These visually striking notes are a refreshing change from all the boring textbooks. You can check her out on instagram at @beckysnotes01 and get her books at https://linktr.ee/Beckysnotes === Timestamps === (00:51) What is atherosclerosis? (01:56) Modifiable & non-modifiable risk factors (03:02) Troponins (06:15) Layers of the heart (08:36) What is ACS? (11:05) Taking a history of a suspected ACS (15:45) ACS differentials (17:09) Investigations (20:15) Management (22:53) PCI vs Thrombolysis (24:47) Long term management (27:01) Complications

We will conclude our month-long observance of American Heart Month on the Talk Ten Tuesdays weekly Internet radio broadcast with an upcoming guest appearance of Cardiologist Harry B. Peled, MD with St. Jude Medical Center in Fullerton, Calif.Last Tuesday, Dr. Mahesh Amin reported on the use of new protocols centered on high-sensitivity troponins for the diagnosis of type 2 myocardial infarction (MI). The response to his appearance was overwhelming; hence the continuation of this timely and critically important topic during the next broadcast.Our series on the plight of rural hospitals will also continue with Dr. James Kennedy, who will report on an unfolding tragedy facing America's rural populations as they seek care from facilities faced with drastically dwindling resources.The live broadcast will also feature these other segments:Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will report on the latest coding news.News Desk: Timothy Powell, CPA, will anchor the Talk Ten Tuesdays News Desk.TalkBack: Erica Remer, MD, founder and president of Erica Remer, MD, Inc. and Talk Ten Tuesdays co-host, will report on a subject that has caught her attention during her popular segment.

Last year, the Food and Drug Administration (FDA) issued its approval of using new protocols centered on high-sensitivity troponins for the diagnosis of type 2 myocardial infarction (MI).Reporting our lead story during the next edition of Talk Ten Tuesdays will be Dr. Mahesh Amin, CV Service Line Medical Director for BayCare Health Systems in Clearwater, Fla., a board-certified cardiologist.This story, along with a Feb. 28 report by Henry Peled, MD at St. Jude Medical Center in Fullerton, Calif., will conclude the monthlong observance of American Heart Month by ICD10monitor and Talk Ten Tuesdays. In previous February broadcasts, the focus has been on the topics of coding and clinical documentation integrity (CDI).This live broadcast will also feature these other segments:Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will report on the latest coding news.SDoH Report: Tiffany Ferguson, a subject-matter expert on the social determinants of health (SDoH), will report on the news that's happening at the intersection of coding and the SDoH.News Desk: Timothy Powell, CPA, will anchor the Talk Ten Tuesdays News Desk.TalkBack: Erica Remer, MD, founder and president of Erica Remer, MD, Inc. and Talk Ten Tuesdays co-host, will report on a subject that has caught her attention during her popular segment.

Podcast summary of articles from the May 2022 edition of the Journal of Emergency Medicine from the American Academy of Emergency Medicine.  Topics include High Sensitivity Troponins, Modified Shock Index in Dementia, Tramadol, Haloperidol vs Ziprasidone, Masking for COVID, and REBOA.  Guest speaker is Dr. Tyler Hughes.

Discussion with Forum members about the various accelerated troponin pathways e.g. 0-1hr, 0-2hr and how these might be implemented in practice and used with risk scores. https://www.facebook.com/groups/cardiologynurseforum 'A safe haven for Nurses and allied health professionals to network, discuss all things Cardiology, and share ECGs, cases and learning'.  

Troponins: remember if is elevated this is a emergency

Nurses remember that this test need to be repeated at 12 hrs. And also rotate the side of puncture ✍

High Sensitivity Troponins are coming

I visit with Robert Christenson PhD about the troponin assays and how they can be falsely positive from anti-body mediated interference. I present a case and we discuss the mechanisms which create the false positives (or negatives) with the assays, how manufacturers are trying to mitigate them and the emerging challenge of biotin supplements. References … Continue reading False Positive Troponins →

It's our tenth episode! Thanks for getting us this far. Today we discuss the new coronavirus outbreak, what to do with high sensitivity troponins, whether hydroxyethyl starch should be used in abdominal surgery (spoiler alert: it shouldn't) and the appropriate use of testosterone therapy.Novel Coronavirus in China High Sensitivity Troponins and the Fourth Universal Definition of MIHydroxyethyl Starch versus Saline in Major Abdominal SurgeryEfficacy and Safety of Testosterone Treatment in Men Music from https://filmmusic.io"Sneaky Snitch" by Kevin MacLeod (https://incompetech.com)License: CC BY (http://creativecommons.org/licenses/by/4.0/)

High sensitivity troponins are taking over the nation are you ready? Dr. Bryn Mumma is ready and in this heartbeat she shares what we need to know to be ready!  Are you using high sensitivity troponins? How is it going? Let’s continue the conversation on social media @empulsepodcast or at ucdavisem.com. Please subscribe and rate us on iTunes – it helps us reach more people!  Host: Dr. Julia Magaña, Assistant Professor of Pediatric Emergency Medicine at UC Davis Guest: Dr. Bryn Mumma (bemumma@ucdavis.edu [bemumma@ucdavis.edu], Associate Professor of Emergency Medicine at UC Davis Resources:  Twerenbold, R, Boeddinghaus J. Clinical Use of High-Sensitivity Cardia Troponin in with Suspected Myocardial Infarction.  JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY. VOL. 70, NO. 8, 2017  (http://www.onlinejacc.org/content/accj/70/8/996.full.pdf) Email Dr. Bryn Mumma to get our protocol (bemumma@ucdavis.edu) Boeddinghaus J, Twerenbold R, et al. Clinical Use of a New High-Sensitivity Cardiac Troponin I Assay in Patients with Suspected Myocardial Infarction.  Clin Chem. 2019 Sep 30.  (https://www.ncbi.nlm.nih.gov/pubmed/31570633) ***Registration is still open for UC Davis Emergency Medicine Update: Hot topics 2019! November 5-9 at the Kahala Hotel and Resort in Honolulu, Hawaii*** Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

Show Notes By Jacqueline Posada, MD, 4th-year resident in the department of psychiatry & behavioral sciences at George Washington University, Washington. In this episode, Lorenzo Norris, MD, host of the MDedge Psychcast, interviews Jonathan M. Meyer, MD, about prescribing clozapine and understanding barriers of use. Dr. Meyer is clinical professor of psychiatry, University of California, San Diego, and a psychopharmacology consultant with the California Department of State Hospitals. Overview of clozapine Clozapine is an effective medication for treatment-resistant schizophrenia and lethality/suicide. Clozapine is underused by clinicians for many reasons. Clinicians have less comfort with prescribing clozapine. Too few trainees are exposed during residency to prescribing clozapine. Using clozapine during training provides the knowledge and comfort necessary to prescribe it once out in practice. Fear of prescribing clozapine outweighs the benefits to patients who need it. Other barriers include monitoring burdens in confluence with systems issues. Indications for use Treatment-resistant schizophrenia is defined as an inadequate response to two antipsychotic trials, and treatment-resistant schizophrenia occurs in about 30% of patients with schizophrenia. People with treatment-resistant schizophrenia have a 5% chance of responding to other antipsychotic medications, while the response rate to clozapine is about 40%. In light of those statistics, getting patients with schizophrenia on clozapine should be a priority. Everyone benefits when a patient with treatment-resistant schizophrenia is started on clozapine. Clozapine treatment leads to decreased symptoms and suffering, improved quality of life, decreased suicidality and aggression, and lower hospitalization rates, which in turn, lead to decreased health care costs. Barriers to using clozapine Education is key to empowering physicians to start prescribing clozapine and overcoming the initial resistance to prescribing. SMI Adviser is a website sponsored by the American Psychiatric Association (APA) and the Substance Abuse and Mental Health Services Administration (SAMHSA) that provides access to education, data, and consultations for clinicians who treat serious mental illness. SAMHSA also has sponsored “centers of excellence” in New York state and the Netherlands that provide consultation and on-demand answers to questions about prescribing. The Clozapine Handbook, written by Dr. Meyer and Stephen M. Stahl, MD, PhD, is another centralized resource for prescribers. Dr. Meyer and Dr. Stahl wrote the handbook to educate and encourage clinicians to prescribe clozapine and improve patient outcomes.  Adverse events and monitoring Myocarditis: Rate of myocarditis ranges from 0.5% to 3% (most rates from Australia), an adverse event that happens primarily within the first 6 weeks of clozapine therapy. Symptoms suggesting myocarditis include fever and elevated troponin level more than twice the upper limit of normal. Clinicians can order a C-reactive protein test, which can help rule in myocarditis if troponins are elevated but not at twice the upper limit range. In the first 6 weeks of therapy, clinicians are encouraged to order a troponin test during the patients' weekly labs. Isolated fever does not mean myocarditis, because fever is a common side effect during titration, and clinicians can complete the fever work-up. Cigarette smoke can induce cytochrome P450 (CYP) enzyme, including CYP1A2. It is not necessary to have patients stop smoking when they start clozapine. Clinicians can adjust the clozapine dose based on response and clozapine level. Induction of CYP1A2 enzyme happens only when people smoke or burn the actual leaf of tobacco or marijuana. Vaping or e-cigarettes will not induce CYP1A2 and change clozapine levels. Threshold of response is 350 ng/mL, however levels that lead to response differ with each individual and will be influenced by smoking habits. Other common side effects include orthostasis, sedation, and sialorrhea. New technologies are available to reduce barriers of prescribing clozapine and to improve patient adherence to hematologic monitoring. Athelas is a company that manufactures a Food and Drug Administration–cleared point-of-care device to measure neutrophil count by way of a finger stick. Results are dispensed real time. Athelas also will take care of medication dispensing. A point-of-care device is in development for plasma clozapine levels with fingerstick, which will allow clinicians to make titration decisions in real time instead of 1 week after levels. The device already is available in Europe. Creating a system that allows for adherence Using case managers to improve clozapine adherence is cost effective when the amount saved from avoiding hospitalization is taken into account. Clozapine can lead to a functional recovery in terms of how a patient interacts with family, friends, and society at large. Clozapine has the ability to improve productivity leading to employment, which is another way the benefits of creating a system to improve clozapine adherence outweigh financial costs.   References Kane JM et al. Clinical guidance on the identification and management of treatment-resistant schizophrenia. J Clin Psychiatry. 2019 Mar 5;80(2): doi: 10.4088/JCP.18com12123. Suskind D et al. Clozapine response rates among people with treatment-resistant schizophrenia: Data from a systematic review and meta-analysis. Can J Psychiatry. 2017 Nov;62(11):772-7. doi: 10.1177/0706743717718167. Kelly DL et al. Addressing barriers to clozapine underutilization: A national effort. Psychiatr Serv. 2018 Feb 1;69(2):224-7. Bui HN et al. Evaluation of the performance of a point-of-care method for total and differential white blood cell count in clozapine users. Int J Lab Hematol. 2016 Dec;38(6):703-9.   Other resources SMI Adviser: Clozapine Center of Excellence, sponsored by the APA and SAMHSA. The Clozapine Handbook (Cambridge University Press, 2019). Clozapine and smoking cessation (NSW Health, Australia). Point of care neutrophil measurement. https://athelas.com/fda/. https://curesz.org/.   For more MDedge Podcasts, go to mdedge.com/podcasts   Email the show: podcasts@mdedge.com   Interact with us on Twitter: @MDedgePsych              

Solidify your knowledge on troponins and more! Quiz yourself on the 5 pearls we will be covering: What aspects of the history are concerning in a patient with a positive troponin? (4:00) What is the difference between the TIMI, GRACE, and HEART scores, and how should we use them in the evaluation of a patient with an elevated serum troponin? (8:42) How does the change in troponin over time help with diagnosis, and what should we consider in a patient with uptrending troponins but an unremarkable ECG? (14:48) What can a “negative but detectable” troponin tell you about any patient, not just those with suspected ACS? (21:31) Pearls Recap (25:26) Throwback – what are the first-line medications for alcohol use disorder? (28:36) For full transcript of the podcast, show notes and references: https://www.coreimpodcast.com/2019/01/04/5-pearls-on-troponins/ Tags: chest pain, cardiology, myocardial infarction, acute coronary syndrome

Commentary by Dr. Valentin Fuster

Join John Bielinski for live CME in 2019.  www.Emergency-Medicine-Institute.com Demystifying Emergency Medicine Conference April 1-4, 2019 Marriott Key West Beachside Master labs/CXR and EKGs Urgent Care Medicine Conference July 8-11, 2019 The Lakefront Anchorage  All aspects of urgent care medicine Critical Access Emergency Medicine Conference Oct 8-11, 2019 Yellowstone For critical access providers who are solo providers

Commentary by Dr. Valentin Fuster

Here is the follow-up to the mammoth ACS chapter. This one has some key factoids to put into your mind map / memory pallace / organic computer.   List Sgarbossa criteria for AMI in pre-existing LBBB What is Takotsubo cardiomyopathy and how does it present? Describe the kinetics of cardiac biomarkers (Troponins and CK) List DDx for ↑ Troponin What is the utility of CTA in the diagnosis of MI? What is the role of ED-based chest pain centers? List 3 phases of delay in the management of AMI; and describe the time-points in ED management of AMI. What are door-to-needle and door-to-balloon timelines by AHA recommendations? Describe the mechanism of action and indications/contraindications for Nitroglycerin Morphine BBlockers ACE-I Antiplatelet Therapies Anti-thrombins Describe eligibility criteria for Fibrinolytics List contraindications to Fibrinolytic therapy in MI What is the utility of Rescue PCI and Facilitated PCI? List 5 indications for Rescue PCI Describe factors assisting with decision to utilize PCI or thrombolytics In NSTEMI, who will benefit from an early invasive strategy of management? Wise Cracks:   What is the HEART Score? What is the management of ACS in the setting of recent cocaine use? How is STEMI diagnosed in the setting of LBBB? How is STEMI diagnosed in the setting of a ventricular pacemaker? When should you be getting a 15 lead ECG?

Here is the follow-up to the mammoth ACS chapter. This one has some key factoids to put into your mind map / memory pallace / organic computer.   List Sgarbossa criteria for AMI in pre-existing LBBB What is Takotsubo cardiomyopathy and how does it present? Describe the kinetics of cardiac biomarkers (Troponins and CK) List DDx for ↑ Troponin What is the utility of CTA in the diagnosis of MI? What is the role of ED-based chest pain centers? List 3 phases of delay in the management of AMI; and describe the time-points in ED management of AMI. What are door-to-needle and door-to-balloon timelines by AHA recommendations? Describe the mechanism of action and indications/contraindications for Nitroglycerin Morphine BBlockers ACE-I Antiplatelet Therapies Anti-thrombins Describe eligibility criteria for Fibrinolytics List contraindications to Fibrinolytic therapy in MI What is the utility of Rescue PCI and Facilitated PCI? List 5 indications for Rescue PCI Describe factors assisting with decision to utilize PCI or thrombolytics In NSTEMI, who will benefit from an early invasive strategy of management? Wise Cracks:   What is the HEART Score? What is the management of ACS in the setting of recent cocaine use? How is STEMI diagnosed in the setting of LBBB? How is STEMI diagnosed in the setting of a ventricular pacemaker? When should you be getting a 15 lead ECG?

Overweight and obese patients are routinely counselled about weight loss since it is thought to improve numerous outcomes. However, as many of us know, achieving stable weight loss is easier said than done! In patients with existing coronary disease, is the weight fluctuation that is often associated with weight loss attempts harmful? Fahad takes listeners ...The post A VISION of Stability: Effects of Body Weight Fluctuation on Coronary Outcomes and Post-Operative Troponins on Mortality appeared first on Healthy Debate.

Overweight and obese patients are routinely counselled about weight loss since it is thought to improve numerous outcomes. However, as many of us know, achieving stable weight loss is easier said than done! In patients with existing coronary disease, is the weight fluctuation that is often associated with weight loss attempts harmful? Fahad takes listeners ... The post A VISION of Stability: Effects of Body Weight Fluctuation on Coronary Outcomes and Post-Operative Troponins on Mortality appeared first on Healthy Debate.

This podcast is taken from a talk I gave at Grand Rounds at The Bristol Royal Infirmary on the Top 10 Papers in EM over the last 12 months. Many of these have been covered in previous podcasts, but running through them gives a good opportunity for further recap and reflection. Papers Covered; Chest wall thickness and decompression failure: A systematic review and meta-analysis comparing anatomic locations in needle thoracostomy. Laan DV1. Injury. 2015 Dec 13. pii: S0020-1383(15)00768-8. doi: 10.1016/j.injury.2015.11.045. [Epub ahead of print] (more in February'sPapers of the month) Platelet transfusion versus standard care after acute stroke due to spontaneous cerebral haemorrhage associated with antiplatelet therapy (PATCH): a randomised, open-label, phase 3 trial. Baharoglu MI. Lancet.2016 May 9. pii: S0140-6736(16)30392-0. doi: 10.1016/S0140-6736(16)30392-0. [Epub ahead of print] (more in July's Papers of the month) Causes of Elevated Cardiac Troponins in the Emergency Department and Their Associated Mortality. Meigher S. Acad Emerg Med. 2016 (more in our Troponins podcast) Propofol or Ketofol for Procedural Sedation and Analgesia in Emergency Medicine-The POKER Study: A Randomized Double-Blind Clinical Trial. Ferguson I, et al. Ann Emerg Med. 2016. (more in September's Paper's of the month) Prevalence of Pulmonary Embolism among Patients Hospitalized for Syncope. Prandoni P. N Engl J Med. 2016 (more in our podcast PE The Controversy) Association Between Tracheal Intubation During Adult In-Hospital Cardiac Arrest and Survival. Andersen LW. JAMA. 2017 (more in March's Papers of the month) Review article: Why is there still a debate regarding the safety and efficacy of intravenous thrombolysis in the management of presumed acute ischaemic stroke? A systematic review and meta-analysis. Donaldson L. Emerg Med Australas. 2016 Aug 25 (more in our Stroke Thrombolysis podcast) Prophylactic hydration to protect renal function from intravascular iodinated contrast material in patients at high risk of contrast-induced nephropathy (AMACING): a prospective, randomised, phase 3, controlled, open-label, non-inferiority trial. Nijssen EC. Lancet. 2017 (more in April's Papers podcast) Immediate total-body CT scanning versus conventional imaging and selective CT scanning in patients with severe trauma (REACT-2): a randomised controlled trial. Sierink JC. Lancet. 2016 Jun 28 (more in August's Papers podcast) Accuracy of point-of-care focused echocardiography in predicting outcome of resuscitation in cardiac arrest patients: A systematic review and meta-analysis. Tsou PY. Resuscitation. 2017  (more coming up in May's Papers podcast!) Enjoy and we'll be back with our papers of the month next week! Simon  

As the years tick by our healthcare systems work harder and harder to ensure that acute coronary syndromes are picked up as they present to our Emergency Departments, the evolution of high sensitivity troponins and their application have been key to this. The utility of a test however is dependant upon it's application to the appropriate patient. In a heavily burdened system it can at times seem sensible to front load tests and 'add on a troponin' before we are even sure the history is consistent with a possible acute coronary syndrome. But is this a safe approach for our patients and what are the potential consequences? In this podcast we run through a recent paper from the US on the topic. Whilst not the highest level of evidence and also looking at a system not entirely generalisable to the UK, it does highlight the aforementioned concerns and is a useful reminder to consider our approach to testing in patients with chest pain. We are certainly not berating the use of troponin, we just think the paper serves a great reminder that testing must be appropriately applied. Enjoy, and as ever we'd love to hear your feedback! References SIGN ACS Guidelines 2016 RCEMFOAMed SIGN ACS Guidelines Causes of Elevated Cardiac Troponins in the Emergency Department and Their Associated Mortality. Meigher S. Acad Emerg Med. 2016 Cardiac Troponin: The basics from St. Emlyn’s Rick Body via St Emlyns; One high sensitivity troponin test to rule out acute myocardial infarction  

Positive troponins (NRSNG=0.035… check your institutions ranges) What is a troponin? Troponins are proteins that initiate contraction of muscle fibers. Troponin I is specific to heart muscle. Get an EKG Do we need a third? Use your judgement. Is there… The post Critical Thinking in the ED (real life examples from the emergency room) appeared first on NURSING.com.

For those of you who weren't able to attend and for those of you who want to listen again to some of the great talks, this month we'll be bringing you some of the superb plenary sessions on the podcast.

In Part 1 of this Episode on Acute Coronary Syndromes Risk Stratification Dr. Eric Letovksy, Dr. Mark Mensour and Dr. Neil Fam discuss common pearls and pitfalls in assessing the patient who presents to the ED with chest pain. They review atypical presentations to look out for, what the literature says about the value of traditional and non-traditional cardiac risk factors, the diagnostic utility of recent cardiac testing, and which patients in the ED should have a cardiac work-up. Finally, in the ED work up of Acute Coronary Syndromes Risk Stratification, they highlight some valuable key points in ECG interpretation and how best to use and interpret cardiac biomarkers like troponin. Drs. Letovksy, Mensour & Fam address questions like: How useful are the traditional cardiac risk factors in predicting ACS in the ED? How does a negative recent treadmill stress test, nuclear stress test or angiogram effect the pre-test probability of ACS in the ED? What does recent evidence tell us about the assumption that patients presenting with chest pain and a presumed new LBBB will rule in for MI and require re-perfusion therapy? How can we diagnose MI in the patient with a ventricular pacemaker? What is the difference between Troponin I and Troponin T from a practical clinical perspective? Is one Troponin ever good enough to rule out MI in the patient with a normal ECG? Should we be using a 2hr delta troponin protocol? How will the new ultra-sensitive Troponins change our practice? and many more.....

In Part 1 of this Episode on Acute Coronary Syndromes Risk Stratification Dr. Eric Letovksy, Dr. Mark Mensour and Dr. Neil Fam discuss common pearls and pitfalls in assessing the patient who presents to the ED with chest pain. They review atypical presentations to look out for, what the literature says about the value of traditional and non-traditional cardiac risk factors, the diagnostic utility of recent cardiac testing, and which patients in the ED should have a cardiac work-up. Finally, in the ED work up of Acute Coronary Syndromes Risk Stratification, they highlight some valuable key points in ECG interpretation and how best to use and interpret cardiac biomarkers like troponin. Drs. Letovksy, Mensour & Fam address questions like: How useful are the traditional cardiac risk factors in predicting ACS in the ED? How does a negative recent treadmill stress test, nuclear stress test or angiogram effect the pre-test probability of ACS in the ED? What does recent evidence tell us about the assumption that patients presenting with chest pain and a presumed new LBBB will rule in for MI and require re-perfusion therapy? How can we diagnose MI in the patient with a ventricular pacemaker? What is the difference between Troponin I and Troponin T from a practical clinical perspective? Is one Troponin ever good enough to rule out MI in the patient with a normal ECG? Should we be using a 2hr delta troponin protocol? How will the new ultra-sensitive Troponins change our practice? and many more..... The post Episode 15 Part 1: Acute Coronary Syndromes Risk Stratification appeared first on Emergency Medicine Cases.