Cardiology

The Non ACS causes of elevated troponin page has been updated to include some new information about the prevalence of elevated Tn in the general ED population as well as the effect of renal failure on Tn levels.

The Troponins in ACS page has been updated with some additional information about the efficacy of a combined EDACS and single hsTroponin measurement. Pickering, JW, Flaws, D, Smith, SW, et al. A risk assessment score and initial high-sensitivity troponin combine to identify low-risk of acute myocardial infarction in the emergency department. Academic Emergency Medicine, 2017

The ECG in acute coronary syndromes page has been updated with additional information about ECG changes in RV infarction.

The Aortic dissection page has been extensively revised and updated

The Pericardial tamponade page has been updated including some additional information about causes of visible clot in the pericardium.

The ECG in acute coronary syndromes page has been updated with additional information about ECG patterns in circumflex artery occlusion.

The ECG in acute coronary syndromes page has been updated with additional information about how to differentiate subtle ST elevation due to ischaemia than that due to other causes.

Details of the interaction between prasugrel and fentanyl has been added to the Management of acute coronary syndromes page.

The Management of acute coronary syndromes page has been updated with information about the beneficial effects of NAC in patients undergoing PCI for STEMI.

The Assessment of heart failure page has been updated with the information that BNP outpatient monitoring does not appear to be superior to clinical monitoring in high risk patients. 

The Management of acute coronary syndromes page has been updated with some additional information about NAC and the removal of the section on non-thrombolytic therapy in MI. 

The ECG in acute coronary syndromes page has been updated with some additional information about patterns of regional ischaemia and reciprocal changes. 

Adenosine has long been considered contraindicated in transplanted hearts, but this is now being questioned in young patients. The Cardiac transplantation page has been updated to reflect this. Flyer, JN, Zuckerman, WA, Richmond, ME, et al. Prospective Study of Adenosine on Atrioventricular Nodal Conduction in Pediatric and Young Adult Patients After Heart Transplant. Circulation 2017 … Read more

The ECG in acute coronary syndromes page has been updated with additional information about the ECG findings in LV aneurysm.

The Management of acute coronary syndromes page has been updated with an expanded segment on the role (or lack of) of opioids in managing ACS.

The Management of suspected acute coronary syndromes page has been updated with additional information about indications for cardiac monitoring in the ED.

A segment on Coronary artery dissection has been added to the Coronary artery disease page.

Additional details about the accuracy and role of CCTA have been added to the Other diagnostic modalities in ACS page.