Dunn RJ
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
A CTCA image of the LAD has been added to the Other diagnostic modalities in ACS page.
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.
The ECG in acute coronary syndromes page has been updated with an ECG demonstrating T inversion secondary to hyperventilation.
The ECG in acute coronary syndromes page has been updated with a short segment on non ACS causes of T wave inversion.
The ECG in acute coronary syndromes page has been updated with gastric volvulus added to the possible caused of ST elevation.
The Oesophageal causes of chest pain page has been updated with additional management to prevent symptoms.
A short segment outlining the ECG features of a first diagonal branch LAD occlusion has been added to the ECG in acute coronary syndromes page.
The segment on CTCA on the Other diagnostic modalities in ACS page has been revised and updated.
A small segment on epipericardial fat necrosis has been added to the Pericarditis page.
Additional information about the management of isolated subsegmental PE has been added to the Management of PE page. Kearon, C, Akl, EA, Ornelas, J, et al. Antithrombotic therapy for vte disease: Chest guideline. Chest 2016 .
Some additions have been made to the segment on Takotsubo cardiomyopathy in the MINOCA page.
The ECG in coronary syndromes and ECG and abnormal cardiac chambers pages have been updated with additional information about the significance of an inverted T wave in aVL
A short segment describing the Modified Goldman score has been added to the Risk stratification in suspected ACS page.
A short segment describing the Vancouver chest pain score has been added to the Risk stratification in suspected ACS page.
The Clinical assessment of ACS page has been updated with revised information regarding LRs for ACS from the following article. Fanaroff, AC, Rymer, JA, Goldstein, SA, et al. Does This Patient With Chest Pain Have Acute Coronary Syndrome?: The Rational Clinical Examination Systematic Review. JAMA 2015;314(18):1955-65. http://www.ncbi.nlm.nih.gov/pubmed/26547467.
Additional information about hsTnI has been added to the Troponins in ACS page.