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.
Cardiology
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.
hsTnT risk stratification pathway
A hsTnT based risk stratification pathway for suspected ACS has been added to the Risk stratification of ACS page.
hs Troponins
The Troponins in ACS page has been extensively revised to reflect new understanding of the role of hsTnT in the evaluation of chest pain.
Single ‘rule out’ hsTnT
The Troponins in ACS page has been updated with additional information about the role of a single low level hsTnT in excluding ACS in ED patients with acute chest pain.
High sensitivity troponin and CVasc risk prediction
The Troponins in ACS page has been updated with a section on hsTnT as a predictor of CVasc risk.
hs TNT
Additional information about high sensitivity troponin has been added to the Troponins in ACS page.
Massive anterior STEMI ECG
An ECG demonstrating a massive anterior STEMI has been added to the The ECG in acute coronary syndromes page.
Supplemental O2 and STEMI
The Management of acute coronary syndromes page has been updated with a more definite statement against the use of routine supplemental O2 for the treatment of ACS following publication of a recent Australian RCT on the subject.
Age and gender effects on hsTNT
The Troponins in ACS page has been updated with additional information about the importance of age and gender related cut-off values when interpreting hs TNT and hs TNI values.
High sensitivity troponins
Additional information about high sensitivity troponins has been added to the Troponins in ACS page.
4 new ECGs added to gallery
4 new ECGs have been added to the ECG gallery, taking the total number past 90.
Proximal anteroseptal MI ECG
An ECG demonstrating a proximal anteroseptal MI has been added to the ECG in acute coronary syndromes page.
ACS treatment summary table
The ACS treatment summary table on the Management of acute coronary syndromes page has been slightly modified to include UFH for patients likely to go the cath lab within 24 hours of presentation.
Revised Jones criteria for rheumatic fever
The Rheumatic fever page has been updated with information about the latest AHA guidelines for the diagnosis of rheumatic fever.