Cardiology

The ECG in acute coronary syndromes page has been updated with new information regarding ECG changes associated with different culprit artery lesions in inferior infarction.

The Pericarditis page has been updated with information about the frequency of chest wall tenderness in pericarditis.

The Management of acute coronary syndromes page has been updated following the recent publication of the Australian Heart Foundation 2016 Guidelines on ACS. Chew, DP, Scott, IA, Cullen, L, et al. National Heart Foundation of Australia and Cardiac Society of Australia and New Zealand: Australian clinical guidelines for the management of acute coronary syndromes 2016. Med … Read more

The Risk stratification of ACS page has been updated following the recent publication of the Australian Heart Foundation 2016 Guidelines on ACS. Chew, DP, Scott, IA, Cullen, L, et al. National Heart Foundation of Australia and Cardiac Society of Australia and New Zealand: Australian clinical guidelines for the management of acute coronary syndromes 2016. Med … Read more

The Pericardial tamponade page has been updated including the diagnostic accuracy of pulsus paradoxicus.

The features of benign murmurs have been revised on the Cardiac murmur differentiation page.

The Aortic stenosis page has been updated with a revision of the clinical features of AS.

The features of peripheral ischaemia have been updated on the Peripheral ischaemia ischaemia.

The Cardiovascular examination page has been revised with additional information about the JVP including how 8cm (not 5cm) should be added to the height above the manubriosternal angle to estimate CVP.

The Non ACS causes of elevated troponins has been modified to include additional information about the almost universal finding of elevated hsTroponins following a 30km run in well trained individuals. Klinkenberg, LJ, Luyten, P, van der Linden, N, et al. Cardiac Troponin T and I Release After a 30-km Run. Am J Cardiol 2016 . … Read more

The Clinical assessment of suspected ACS page has been updated with additional information about the incidence of silent ischaemia. Incidence and Prognostic Significance of Silent Myocardial Infarction in the Atherosclerosis Risk in Communities (ARIC) Study. Circulation 2016;133(22):2141-8.

The Cardiovascular risk reduction page has been updated with the recommendation that fasting for lipid sampling is no longer required. Mora, S. Nonfasting for routine lipid testing: From evidence to action. JAMA Internal Medicine 2016.  

The Troponins in ACS page has been updated with some additional information about single value hsTnI to rule out ACS. The bottom line is that hsTnT is probably more sensitive than hsTnI for clinically significantly outcomes, so is currently preferred. Carlton, E, Greenslade, J, Cullen, L, et al. Evaluation of High-Sensitivity Cardiac Troponin I Levels … Read more

The Risk stratification in suspected ACS page has been updated, including information about the use of a hsTnI 1 hour rapid ACS diagnostic pathway. The proposed pathway appears to be not as useful as similar hsTnT pathways. Neumann, JT, Sörensen, NA, Schwemer, T, et al. Diagnosis of Myocardial Infarction Using a High-Sensitivity Troponin I 1-Hour … Read more

The Management of acute coronary syndromes page has been updated with additional information about the role of pre-PCI beta blockers. Roolvink, V, Ibanez, B, Ottervanger, JP, et al. Early Administration of intravenous Beta blockers in patients with ST-elevation myocardial infarction before primary PCI. Journal of the American College of Cardiology 2016.

The Other cardiac biomarkers page has been updated with additional information about the role of myoglobin in excluding ACS in low risk patients. Meek, R, Braitberg, G, Cullen, L, et al. Outcome at 30 days for low-risk chest pain patients assessed using an accelerated diagnostic pathway in the emergency department. Emerg Med Australas 2016.

The Risk stratification in suspected ACS page has been updated with additional information about the characterstics of patients with ACS who are < 40 years of age.

The ECG in acute coronary syndromes page has been updated with additional information about determining which artery is likely the source of the culprit lesion in inferior MI.