Causes of T wave inversion
The ECG in acute coronary syndromes page has been updated with a short segment on non ACS causes of T wave inversion.
Cardiology
ST elevation in gastric volvulus
The ECG in acute coronary syndromes page has been updated with gastric volvulus added to the possible caused of ST elevation.
Oesophageal reflux management
The Oesophageal causes of chest pain page has been updated with additional management to prevent symptoms.
Diagonal branch of LAD occlusion
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.
CTCA
The segment on CTCA on the Other diagnostic modalities in ACS page has been revised and updated.
Epipericardial fat necrosis
A small segment on epipericardial fat necrosis has been added to the Pericarditis page.
Subsegmental PE
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 .
Takostubo cardiomyopathy
Some additions have been made to the segment on Takotsubo cardiomyopathy in the MINOCA page.
T inversion in aVL
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
Modified Goldman score
A short segment describing the Modified Goldman score has been added to the Risk stratification in suspected ACS page.
Vancouver chest pain score
A short segment describing the Vancouver chest pain score has been added to the Risk stratification in suspected ACS page.
Clinical assessment of suspected ACS
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.
hsTnI
Additional information about hsTnI has been added to the Troponins in ACS page.
CXR in ACS
A short segment on the utility of routine CXR in patients with ACS has been added to the Management of acute coronary syndromes page.
hsTnT in stable IHD and type II diabetes
Some normal values of hsTnT in patients with stable IHD and type II diabetes have been added to the Non ACS causes of elevated troponin page.
ANZ Cardiac Society hsTroponin guidelines
Some additional information about the Australian and New Zealand Cardiac Society 2011 guidelines on hsTroponin has been added to the Troponins in ACS page. 2011 addendum to the National Heart Foundation of Australia/Cardiac Society of Australia and New Zealand guidelines for the management of acute coronary syndromes (ACS) 2006. Heart, Lung and Circulation 2011;20(8):487-502.
hsTnT in renal impairment
Some additional information about hsTnT in patients with renal impairment (90% with eGFR 30-60mL/min) has been added to the Troponins in ACS page, derived from the following reference. Twerenbold, R, Wildi, K, Jaeger, C, et al. Optimal Cutoff Levels of More Sensitive Cardiac Troponin Assays for the Early Diagnosis of Myocardial Infarction in Patients With … Read more
LBBB and lateral ST depression ECG
The ECG in acute coronary syndromes page has been updated with an image of an ECG with a LBBB and lateral ST depression due to MI.
D dimer in pregnancy
The PE in special populations page has been updated with particular reference to d dimer levels during pregnancy. Some relevant references are: Greer, IA. Pregnancy Complicated by Venous Thrombosis. New England Journal of Medicine 2015;373(6):540-47. http://www.nejm.org/doi/full/10.1056/NEJMcp1407434. Kline, JA, Williams, GW, Hernandez-Nino, J. D-dimer concentrations in normal pregnancy: new diagnostic thresholds are needed. Clin Chem 2005;51(5):825-9. … Read more
1 hour delta hsTnT strategies in ACS
The Risk stratification of suspected ACS page has been revised and updated with particular emphasis on the role of hs troponin only and 1 hour delta hsTnT strategies in ACS.